Counter Offer Review & Confirm Page
Basic Details
Plan A Details
Underwriting Comment:
I/ We have read and understood the terms and conditions of the Policy and confirm
to abide by the same. I/We hereby agree that the insurance coverage under the Policy
will commence only on realization of full premium, receipt of complete medical reports
(wherever applicable) and subject to medical underwriting approval by the Company.
Receipt of proposal form by the Company shall not be construed as acceptance of
proposal. Company in its sole discretion reserves the right to accept or reject
any proposal without assigning any reasons thereof. I/We hereby declare that I/We
will submit to medical examinations by the nominated doctors of the Company or undergo
diagnostic or other medical tests, as suggested by the Company for its medical underwriting.
I/We hereby agree that the Company reserves the right to enquire from any physicians,
nurse, hospital official or employee or any person, institution for all or any information
regarding the medical history of the proposed and that the Company shall have the
right to ask the proposed for the medical check-up. I/We, the undersigned hereby
declare that the above statements and particulars are true, accurate and complete
and I/We declare and agree that this declaration and the answers given above shall
be held to be promissory and shall be the basis of the contract between me/us and
the Insurer. I/We authorize the Company and their agents to exchange, share or part
with all the information relating to my/ our personal and financial details with
Government bodies / Regulatory Authorities/ Statutory bodies, or under court orders
as may be required and I/ we will not hold the Company and its agents liable for
use of this information. I/we agree that the Policy shall become voidable at the
option of the Insurer, in the event of any untrue or incorrect statement, misrepresentation,
non-description or nondisclosure in any material particular in the Proposal form/personal
statement, declaration and connected documents, or any material information has
been withheld by me/us or anyone acting on my/our behalf to obtain any benefit under
this policy. The information furnished by you in the proposal form has been recorded
for future reference. Henceforth, if it comes to our notice that you have purchased
another insurance policy(s) from us with the similar details as mentioned in the
previous policy, we shall initiate cancellation of the later issued policy(s). We
will process the refund of whole premium amount received for such policy(s). However,
we may deduct transaction fee from the premium amount to be refunded. I/We have
read and understood the terms and conditions of the realization of full premium
or on due reciept of the subsequent premiums (as agreed), on receipt of complete
medical reports (wherever applicable) and subject to medical underwriting approval
by the Company. Receipt of proposal form by the Company shall not be construed as
proposal . Company in its sole discretion reserves the right to accept or reject
any proposal without assigning any reason thereof.
