UIN -130N034V01
BHARTI AXA LIFE INSURANCE COMPANY LIMITED
Registered Office: 4th & 6th floor Raheja Titanium, Off Western Express Highway,
Goregaon (W), Mumbai-400 063
Policy Document
Bharti AXA Life Group Term Cover
Name of Policyholder
Policy Number
Policy Effective Date <<Date>>
Mode of Premium Payment Single Premium
Place and Date of Issue Mumbai, India
<<Date>>
Bharti AXA Life
Group Term Cover, a yearly renewable group term life insurance policy
(”the Policy”) is issued by Bharti AXA Life Insurance Company Limited (“the Company”)
pursuant to the proposal of _____________________________ (”the Policyholder”) dated
MM\DD\YYYY and in consideration of payment of Premiums as set out in the Policy.
The Policy has been effected on the lives of the Life Insured based on the proposal form,
and the statements, information, data and evidence furnished by the Policyholder and
receipt of Coverage Premiums from the Policyholder.
The Company agrees to provide the Coverage/(s) and pay Benefit(s) in accordance with the
terms of the Policy.
The proposal together with the statements, information, data and evidence, already
furnished or to be furnished and leading to the effecting of the insurance hereunder, giving
all the variations in the particulars of the Lives Insured in so far as such variations have any
bearing on the insurance effected from time to time, shall be and are hereby declared to be
the basis of the Policy.
The terms printed on this and the following pages along with the Schedule as existing on the
date of issue of the Policy and as attached herewith and any endorsements placed on the
Policy form part of the Policy.
Authorised Signatory
Bharti AXA Life Insurance Company Limited
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I. DEFINITION
“Age” means the age at last birthday, in completed years attained by the Life Insured as on
the Issue Date of the Policy.
“Beneficiary/(ies)” means the Policyholder
“Benefits” means the Death Benefit.
“Coverage” means the life insurance affected in respect of each Life Insured under the
Policy.
“Coverage Premium” means the premium payable by the Policyholder to the Company to
effect the Coverage in respect of each Life Insured under the Policy.
“Coverage Term” means the period of Coverage for which the Life Insured is covered
under the Policy, commencing from the Issue date of the policy to the Termination Date of
Policy.
“Death Benefit” means the benefit payable on the death of the Life insured .
“Issue Date” means the date of issue of Policy.
“Life/(ves) Insured” means the individual/(s) who has/have been granted and is/are in
receipt of the proceeds of the loan from the Policyholder and whose Coverage is in effect
under the Policy and whose name appear in the list of life/(ves) insured available with the
Company as having been covered under the Policy.
“Policy” means the Bharti AXA Life Group Term Cover which is a Yearly renewable Group
term life insurance product issued to the Policyholder for securing the payment of the
Benefits to the Lives Insured.
“Policyholder” means ___________________, the holder of the Policy.
“Policy Effective Date” means the date of commencement of the Policy.
“Termination Date” means the date on which the Coverage of the Life Insured ceases
under the Policy for any reason whatsoever.
“The Company” means Bharti AXA Life Insurance Company Limited.
II. GENERAL PROVISIONS
(A) Non-participating Policy
The Policy is not entitled to participate in the distribution of surplus that may be declared by
the Company from time to time.
(B) Eligibility conditions
An individual shall be eligible to be covered under the Policy on the fulfillment of the
following conditions:
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1. She/he has an outstanding loan due to the Policyholder as on the date of admission
of Coverage under this Policy;
2. She/he has attained the age of 18 years but not exceeded 59 years;
3. She/he has opted for a Coverage of not more then Rs 2,000,000 as on the Issue
Date.
(C) Proof of age
The Coverage Premium in respect of a Life Insured is calculated based on the Age of the
Life Insured recorded in the list of Lives Insured. The Company may require proof of age as
per the standard age proofs prescribed by the Company in respect of Lives Insured. If the
Life Insured’s actual age is such that it would have made the Life Insured ineligible for the
Coverage, then the Company reserves the right, at its discretion, to take such action as it
deems fit, including termination of the Coverage and forfeiture of Coverage Premium
received in respect of such Life Insured.
(D) Disclosures - section 45 of the Insurance Act, 1938
The Policy has been issued and the Coverages herein have been granted on the
representation of the Policyholder that the Policyholder and to the best of the knowledge of
the Policyholder, Lives Insured have made and/or have caused to be made full disclosures
of all relevant facts and circumstances. Any concealment, non-disclosure, misrepresentation
or fraud shall render the Policy and the Coverages herein liable for termination and/ or
voidable at the option of the Company and also forfeiture of the Coverage Premium(s)
received, at the discretion of the Company.
No Policy or Coverage shall, after the expiry of two years from the date on which it was
effected, be called in question by the Company on the ground that a statement made in the
proposal for insurance or in any report of a medical officer, or referee, or friend of the
insured, or in any other document leading to the issue of the Policy or grant of Coverage/(s),
was inaccurate or false, unless the Company shows that such statement was on a material
matter or suppressed facts which it was material to disclose and that it was fraudulently
made by the Policyholder/Life Insured and that the Policyholder/Life Insured knew at the
time of making it that the statement was false or that the Policyholder/Life Insured
suppressed facts which were material to disclose.
(E) Commencement of Coverage
1. Coverage in respect of all eligible individuals to be insured will commence with effect
from the Issue Date subject to receipt of all the particulars of the proposed Life
Insured as per the prescribed format provided by the company and realization of the
premium cheque.
(F) Data and information
1. The Policyholder shall furnish to the Company all such data, information and evidence as
the Company may reasonably require in writing with regard to any matter with regard to
or affecting the Coverages effected or to be effected under the Policy and the Company
shall not be liable for any action taken in good faith upon any data, information or
evidence so furnished which shall be or shall prove to have been erroneous or
inaccurate.
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2. The Policyholder shall maintain the data, information, evidence pertaining to the list of
Life/(ves) Insured to calculate the Coverage Premiums and to ensure that the terms of
the Policy are fulfilled along with the data, information and evidence on the list of
Beneficiaries. Such data and information (in original or notarised photostat copies
thereof) available with the Policyholder as have a bearing on the Coverages hereunder
shall be open for inspection by the Company on prior written notice and during normal
working hours of the Policyholder.
3. The Policyholder shall indemnify for any loss, liability, damages that may arise to the
Company on account of delay in or not providing of information, providing incorrect/false
information to the Company at any stage including at the time of claim for the Benefit.
4. In the event the Company is required to honour a claim in respect of an individual who
does not meet eligibility condition - then the Policyholder shall indemnify the Company
for any and all costs, penalties, expenses, damages, fees (including any
lawyer’s/advocate’s/ attorney’s fees) in respect of such a claim.
5. The Parties hereby represent and warrant that till the Coverages are in force, neither of
them shall violate provisions of any applicable laws, nor do or cause to be done any act
which may be detrimental, prejudicial and /or in violation of the terms hereof. The Parties
further agree to indemnify and hold the other Party harmless from all losses, claims,
damages, costs, penalties, etc. of any kind to which it may be subjected due to any
breach or non-compliance of any of the terms of this Agreement.
(G) Place and currency
The Coverage/s effected hereunder shall be expressed in Indian Rupees. All moneys
payable to or by the Company under the Policy shall be made in India and in Indian Rupees.
(H) Free look option
If the Policyholder disagrees with any of the terms of the Policy, the Policyholder may, within
fifteen (15) days of the receipt of this Policy
by submitting a letter stating the reasons of
objection addressed to the Company enclosing the Policy, seek to cancel the Policy whereon
the Company shall refund to the Policyholder, the Coverage Premium including service tax
and cess after deduction of stamp duty incurred by the Company in issuing the Coverages.
(I) Grievance redressal procedure
1. In case you have any query or complaint/grievance, you may approach our
office at the following address:
Bharti AXA Life Insurance Company Ltd.
Unit No. 601 & 602, 6th Floor, Raheja Titanium
Off Western Express Highway,
Goregaon (E), Mumbai-400 063
Contact No: Toll Free no.: 1800 102 4444
Email ID: [email protected]
www.bharti-axalife.com
2. In case you are not satisfied with the decision of the above office, or have not
received any response within 10 days, you may contact the following official for
resolution:
UIN -130N034V01 Page 5 of 13 Bharti AXA Life Group Term Cover
Complaint Redressal Officer
Contact No: Toll Free no.: 1800 102 4444
Email ID: cro@bharti-axalife.com
3. In case you are not satisfied with the decision/resolution of the Company, you may
approach the Insurance Ombudsman at the address given below if your grievance
pertains to:
- Insurance claim that has been rejected or dispute of a claim on legal
construction of the policy
- Delay in settlement of claim
- Dispute with regard to premium
- Non-receipt of your insurance document
4. The complaint should be made in writing duly signed by the complainant or by his
legal heirs with full details of the complaint and the contact information of
complainant.
5. As per provision 13(3)of the Redressal of Public Grievances Rules 1998, the
complaint to the Ombudsman can be made
- only if the grievance has been rejected by the Grievance Redressal
Machinery of the Insurer
- within a period of one year from the date of rejection by the insurer
- if it is not simultaneously under any litigation.
A detailed list of all ombudsman is provided in Annexure I attached along with this Policy.
(J) Customer Service
All communication in relation to the Policy shall be addressed to any of the following:
Department: Customer Service
Registered Office: 6
th
floor, Unit no. 601 & 602, Raheja Titanium,
Off Western Express Highway,
Goregaon (E), Mumbai 400 063
Website: www.bharti-axalife.com
E-mail: service@bharti-axalife.com
Toll Free no.: 1800 425 1350 (MTNL, BSNL subscribers)
Toll Free no.: 1800 102 4444 (Airtel, TATA, BPL, Spice Telecom
- Punjab & Shyam Tel subscribers)
Phone: 020-4018 2300, 020-2614 1350
Fax: 022-40306347
III. COVERAGE PREMIUM
The Coverage Premium for the Coverage in respect of each Life Insured will be determined
by the Company on the basis of:
premium rates established by the Company and detailed in the Schedule I to the
Policy and
the list of Lives Insured consisting of such information as required by the Company.
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The Policyholder shall be solely responsible for remitting the Coverage Premium in respect
of each Life Insured while the Policy is in effect and shall ensure prompt remittance of the
Coverage Premiums in one lump sum to the Company alongwith a statement providing
additions and deletions to the list of Lives Insured in the format prescribed by the Company.
IV. BENEFITS
The Benefits payable under the Policy to the Beneficiary/ (ies) are as under:
Death Benefit: In the event of death of the Life Insured (proved to the satisfaction of the
Company), while the Coverage is in force, the Death Benefit, shall be payable to the
Policyholder. The Death Benefit is equal to the principal outstanding as on the date of death
and not exceeding the principal outstanding provided at date of admission of coverage under
the Policy. The loan schedule is calculated using the interest rate prevailing at the time the
loan is taken out. If there is a partial prepayment of the loan, the death benefit will be equal
to the loan outstanding. If the loan repayments are delayed or defaulted the death benefit will
be equal to the principal outstanding on the date of death had the loan repayment been
made on or before the due dates.
Incase life insured has multiple loans then the benefit payout will not exceed Rs 2,000,000.
On the payment of the Benefits under the Coverage, the Coverage provided to the Life
Insured under the Policy would terminate and all liability of the Company in respect of that
Life Insured would stand extinguished.
V. PROCEDURE FOR REGISTERING AND PAYMENT OF CLAIMS
1. On the death of the Life Insured, the Policyholder will give written notice and proof of
claim to the Company in respect of the Life Insured.
2. The Policyholder shall provide the following primary documents along with the written
notice for processing the claim:
Proof of membership and date of commencement of cover;
Loan account statement showing the outstanding loan as on date of death.
Last attending Doctor’s Certificate\Attending Physician’s Statement;
Copy of Death Certificate duly verified with the original Death Certificate with
signature of the authorized official of the Policyholder with name and employee
number;
Verification from the Policyholder signed off by an authorized official that the
deceased was a customer of the Policyholder;
Death Claim Form (to be submitted by the Policyholder);
The Company may also seek any other documentation that it may consider as material
and relevant to the claim
3. The Company reserves the right to call for any additional information and documents
required to satisfy itself as to the validity of the claim.
4. The Company shall draw a cheque or draft for payment of Death Benefit in favour of the
Policyholder.
5. A communication received via electronic mode in the format agreed upon between the
Company and Policyholder, confirming receipt of payment of Benefit/(s) shall be
construed as a good, valid, sufficient and conclusive discharge of all liabilities of the
Company in respect of any payment of Benefit/(s) to be made under the Policy.
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VI. EXCLUSIONS
The payment of Benefits is subject to the following exclusions:
Suicide - If a Life Insured, whether medically sane or insane, commits suicide within one
year of the Issue Date, the Coverage of the Life Insured shall terminate and no monies will
be payable to Policyholder.
VII. TERMINATION OF COVERAGE
The Coverage of a Life Insured under the Policy shall terminate on the Termination Date
which will be on the date of occurrence of the earliest of any of the following events:
Event 1 End of Polic
y
Term ie: One
y
ear from Issue Date
Event 2 Date of death of the Life Insured during the Policy Term
Event 3 Cancellation of Coverage by Policyholder by exercising the free look option
Event 4 Foreclosure of loan by the Life Insured
On the occurrence of the above events, the following shall be applicable as mentioned
against respective event numbers:
Event 1 The Company shall cease to pay the Benefits falling due after the policy term
under the Policy in respect of the Life Insured
Event 2 The Company shall pay the Death Benefit to the Beneficiary as per Section
IV or on admissibilit
y
of claims.
Event 3 The Company shall pay the amount to the Policyholder as per Section II (H)
(Free Look Option)
Event 4 No benefit shall be payable
VIII. SURRENDER OPTION
No surrender option is available to the policyholder.
IX. TERMINATION OF POLICY
The Policyholder shall not avail of a similar policy from any other life insurance company
from the Policy Effective Date till such time the Policy is terminated.
X. VARIATIONS TO THE POLICY
The Company reserves the right to vary from time to time the premium rates, terms and
conditions of the Policy including the Schedules, subject to the approval of the Insurance
Regulatory and Development Authority (‘IRDA’) and upon giving to the Policyholder 90 days’
prior notice in writing, of its intention to do so and any such variation will apply, only to
Coverages hereunder becoming effective on or after the date of expiry of such notice. Any
such alteration or amendment in the terms and conditions of the Policy shall be given effect
to by appropriate endorsements to the Policy signed by an authorised officer of the
Company.
If any of the parties to the Policy did not request the variation, the party not requesting the
amendment shall be entitled to object to it within a period of 90 days of the receipt of notice
of change. If the party not requesting the amendment does not object during this period, the
change will be considered effective on the date immediately subsequent to the completion of
the notice period of 90 days.
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Notwithstanding anything contained in the Policy, the provisions herein shall stand changed,
altered, amended, modified, discontinued or superseded to such extent and in such manner
as may be required with a short notice to comply with any change in the applicable law
(including any regulations made or directions / instructions or guidelines issued by the
Insurance Regulatory and Development Authority) or as may be necessary under a
judgement or order of a court of law.
XI. LEGAL PROVISIONS
Policyholder’s acts binding on Life Insured
The Policyholder will act for and on behalf of the Life Insured in any matter relating to the
Policy and Coverages.
Principal to principal relationship
Both the parties will act as independent service providers.
Loans
The Policyholder or the Life Insured will not be entitled to any loan under the Policy.
Governing Laws and jurisdiction
The Policy is subject to the applicable legislations prevailing in India. All disputes of any kind
whatsoever which may arise under or in connection with the Policy shall be subject to the
jurisdiction of the courts in Mumbai.
Taxation
1. The tax benefits under the Policy would be as per the prevailing provisions of the tax
laws from time to time and are subject to change.
2. In any case where the Company is liable to account to the revenue authorities for any
taxes or duties or cesses under the Policy, the Company shall deduct such sums from
the respective payment and the Company shall not be liable to the Life Insured or the
Policyholder for the sums so deducted.
UIN -130N034V01
Annexure I- List of Ombudsman
Office of the
Ombudsman
Name of the
Ombudsmen
Contact Details
Areas of
Jurisdiction
AHMEDABAD
Shri
Amitabh
Shri Amitabh,
Insurance Ombudsman,
Office of the Insurance
Ombudsman,
2nd Floor, Ambica House,
Nr. C.U. Shah College,
Ashram Road,
AHMEDABAD-380 014.
Tel.:- 079-27546840
Fax : 079-27546142
Email ins.omb@rediffmail.com
Gujarat , UT of
Dadra & Nagar
Haveli, Daman
and Diu
BHOPAL
Shri
N.A.Khan
Shri N.A. Khan,
Insurance Ombudsman,
Office of the Insurance
Ombudsman,
Janak Vihar Complex,
2
nd
Floor, 6, Malviya Nagar,
Opp. Airtel, Near New Market,
BHOPAL(M.P.)-462 023.
Tel.:- 0755-2569201
Fax : 0755-2769203
Email
bimalokpalbhopal@airtelmail.in
Madhya Pradesh
& Chhattisgarh
BHUBANESHWAR
Shri
S.K.Dhal
Shri S.K. Dhal,
Insurance Ombudsman,
Office of the Insurance
Ombudsman,
62, Forest Park,
BHUBANESHWAR-751 009.
Tel.:- 0674-2596455
Fax : 0674-2596429
Email [email protected]
Orissa
CHANDIGARH
Shri
K.M.Chadha
Insurance Ombudsman,
Office of the Insurance
Ombudsman,
S.C.O. No.101-103,
2nd Floor, Batra Building.
Sector 17-D,
CHANDIGARH-160 017.
Tel.:- 0172-2706468
Fax : 0172-2708274
Email [email protected]
Punjab ,
Haryana,
Himachal
Pradesh, Jammu
& Kashmir , UT
of Chandigarh
CHENNAI
Shri V.
Ramasaamy
Shri V. Ramasaamy,
Insurance Ombudsman,
Office of the Insurance
Ombudsman,
Fathima Akhtar Court,
4th Floor, 453 (old 312),
Anna Salai, Teynampet,
CHENNAI-600 018.
Tel.:- 044-24333668 /5284
Fax : 044-24333664
Email insombud@md4.vsnl.net.in
Tamil Nadu, UT–
Pondicherry
Town and
Karaikal (which
are part of UT of
Pondicherry)
UIN -130N034V01 Page 10 of 13 Bharti AXA Life Group Term
Cover
NEW DELHI
Insurance Ombudsman,
Office of the Insurance
Ombudsman,
2/2 A, Universal Insurance Bldg.,
Asaf Ali Road,
NEW DELHI-110 002.
Tel.:- 011-23239633
Fax : 011-23230858
Email [email protected]
Delhi &
Rajashthan
GUWAHATI
Shri Sarat
Chandra
Sarma
Shri Sarat Chandra Sarma,
Insurance Ombudsman,
Office of the Insurance
Ombudsman,
“
Jeevan Nivesh”, 5
th
Floor,
Near Panbazar Overbridge, S.S.
Road,
GUWAHATI-781 001 (ASSAM).
Tel.:- 0361-2132204/5
Fax : 0361-2732937
Email
ombudsmanghy@rediffmail.com
Assam ,
Meghalaya,
Manipur,
Mizoram,
Arunachal
Pradesh,
Nagaland and
Tripura
HYDERABAD
Shri K.
Chandrahas
Shri K Chandrahas
Insurance Ombudsman,
Office of the Insurance
Ombudsman,
6-2-46, 1
st
Floor, Moin Court,
A.C. Guards, Lakdi-Ka-Pool,
HYDERABAD-500 004.
Tel : 040-65504123
Fax: 040-23376599
Email [email protected]
Andhra Pradesh,
Karnataka and
UT of Yanam – a
part of the UT of
Pondicherry
ERNAKULAM
Shri James
Muricken
Shri James J. Muricken,
Insurance Ombudsman,
Office of the Insurance
Ombudsman,
2nd Floor, CC 27/2603, Pulinat
Bldg.,
Opp. Cochin Shipyard, M.G. Road,
ERNAKULAM-682 015.
Tel : 0484-2358759
Fax : 0484-2359336
Email iokochi@asianetindia.com
Kerala , UT of (a)
Lakshadweep ,
(b) Mahe – a
part of UT of
Pondicherry
KOLKATA
Insurance Ombudsman,
Office of the Insurance
Ombudsman,
North British Bldg.,
29, N.S. Road, 4
th
Floor,
KOLKATA-700 001.
Tel : 033-22134866
Fax : 033-22134868
Email [email protected]
West Bengal ,
Bihar ,
Jharkhand and
UT of Andeman
& Nicobar
Islands , Sikkim
UIN -130N034V01 Page 11 of 13 Bharti AXA Life Group Term
Cover
LUCKNOW
Shri
M.S.Pratap
Shri M.S. Pratap,
Insurance Ombudsman,
Office of the Insurance
Ombudsman,
Jeevan Bhawan, Phase-2,
6
th
Floor, Nawal Kishore Road,
Hazaratganj,
LUCKNOW-226 001.
Tel : 0522 -2231331
Fax : 0522-2231310
Email
Uttar Pradesh
and Uttaranchal
MUMBAI
Shri S.
Viswanathan
Shri S Viswanathan
Insurance Ombudsman,
Office of the Insurance
Ombudsman,
3rd Floor, Jeevan Seva Annexe,
S.V. Road, Santacruz(W),
MUMBAI-400 054.
Tel : 022-26106928
Fax : 022-26106052
Email
ombudsmanmumbai@gmail.com
Maharashtra ,
Goa
UIN -130N034V01 Page 12 of 13 Bharti AXA Life Group Term
Cover
UIN -130N034V01
Schedule I
Coverage Premium Rates exclusive of Service Tax for Individual Life: The Coverage Premium rate in
Rupees per ‘000 is Rs. :
The maximum Coverage per Life Insured under this product will not exceed Rs 2,000,000.
The Life Insured will be charged Service tax at the rate as per the prevailing tax laws in addition to the Coverage
Premium. The applicable service tax may vary from time to time as per prevailing tax laws.
