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Udi, Bangalore - 560 004, www.metlife.co.in, Fax: +91-80-4150 6969 Declaration of Good Health Policy Number : Full Name of Policy Owner : Date Full Name of Life Insured: (If Different from Policy Owner) I wish to reinstate my above mentioned policy with MetLife India Insurance Co. Ltd. Signature of the Life Insured : Signature of the Policy Owner (If different from t.

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