Date -: 





   

Plan:- 
 


                                                                                                                                                     
 
 

Life Insured:- 


 
                                                                                                                                                			   

Dear  

Thank you for choosing Bharti AXA Life as your preferred financial protection partner. We extend a warm welcome to you on behalf of the Bharti AXA
Life team.

Please find enclosed the Certificate of Insurance for your captioned policy. We request you to go through the same carefully as it details the features
and benefits of your policy.

Should you require any clarification, please do not hesitate to write to us at service@bharti-axalife.com. We will be glad to be of assistance.


Assuring you of our best services.


Regards,
Bharti AXA Life Insurance Company Limited


This is a computer generated letter and does not require a signature


Encl: Certificate of Insurance

1 of 6

Bharti AXA Life Group Term Insurance Plan – Single Life

This is to certify that the mentioned premium amount has been received on the Policy Date and adjusted towards premium on the Issue Date as mentioned above
Note :
        • Income Tax Benefits are as per Income Tax Act,1961 and are subject to conditions mentioned therein and amendments made thereto from time to time
        • GST shall be applicable as per prevailing tax laws. This is applicable on the total premium
        • GSTIN.: . SAC.: 
  

2 of 6

Bharti AXA Life Group Term Insurance Plan – Single Life

As a Life Insured under the Group Policy number issued to You will be entitled to the Benefits as per the Annexure attached. The Coverage under the product will be paid subject to the terms and conditions of the Policy.

Your Coverage is subject to fulfilment of the Conditions for Effective Date of Coverage and realization of Cheque/ Demand Draft

The maximum coverage allowed per life would be Rs.2,00,000/-

Note :

		• Income Tax Benefits may be available as per prevailing tax laws
		• GST shall be applicable as per prevailing tax laws.
		• GSTIN.: 27AACCB7227P1Z9. SAC.: 00997132
		• The Stamp Duty of Rs.  is paid for this policy vide Challan No. dated  (Letter of Authorisation No. dated )
		towards base sum assured.

3 of 6

Bharti AXA Life Group Term Insurance Plan – Single Life

SALIENT FEATURES OF THE TERMS AND CONDITIONS OF THE POLICY

DEFINITIONS:-

“Age” means the age at last birthday, in completed years attained by the Life Insured as on the Effective Date of Coverage.
“Appointee” means the person registered with us in the Nomination Schedule who is authorized to receive and hold in trust the benefits under this Policy on behalf of the
 Nominee/(s), if the Nominee/(s) is/are less than Age 18 on the date of payment.
“Benefits” means the Death Benefit.
“Beneficiary/(ies)/Nominee (s)” means the individual/(s) specified by the Life Insured to receive the Benefit in the event of the death of the Life Insured while the
Coverage is in force and whose name/(s) have been entered in the records kept by the Master Policyholder as being eligible for the Benefits under the Policy and
notified to the Company including any change of the specified Individual which the Life Insured intimates in writing to the Company.
“Certificate of Insurance” means the certificate issued to a Life Insured by the Company to confirm his coverage under the Policy. Coverage in respect of a Life
Insured shall commence from the Effective Date of Coverage mentioned therein and will be subject to terms & conditions of the Policy Document.
“Coverage” means the life insurance effected in respect of each of the Life/(ves) Insured under the Policy and as mentioned in the Certificate of Insurance.
“Coverage Term” means the period of Coverage for which the Life Insured is covered under the Policy, commencing from the Effective Date of Coverage to the
Termination Date of Coverage and shall be of a term as mentioned in the Policy Schedule attached herewith & as mentioned in the Certificate of Insurance.
“Death Benefit (Sum Assured)” means the benefit payable on the death of the Life insured as mentioned in the Certificate of Insurance provided the Coverage is in
force.
“Effective Date of Coverage” means the date of commencement of Coverage in respect of a Life Insured under the Policy and is subject to fulfilment of Conditions for
Effective Date of Coverage.
“Grace Period” means a period of 30 days to pay the unpaid premium due under the Policy and the benefits under the Policy will remain unaltered during this period. In
case of the death of the Life Insured during the Grace Period, the Death Benefit after deducting the unpaid due premium shall be payable and the Policy will be
terminated.
“Life Insured” shall mean a Member (as defined below) who is and continue to be Eligible Member and who in accordance with the provisions (eligibility conditions) of
this Policy Document, is participating in the insurance plan under this Policy Document.
“Member” means a natural person
 • who has opted for insurance under this Policy and for whom the premiums as herein specified have been paid to the Company, and
 • who is in good health and wherever required as per the understanding has duly completed and submitted the Declaration of Good Health (Evidence of Good Health),
   in the Company’s format to the Master Policyholder or has undergone medical examination, as required by the Company, and the Company has agreed to provide
   cover to him/her on the basis of results of medical examination and such other evaluation as the Company, may deem fit, and in respect of whom Member data is
   provided to the Company by the Master Policyholder as mentioned herein, and who falls within the age range indicated by the Company for this Policy Document
 • in respect of whom Member data is provided to the Insurer by the Master Policyholder as mentioned herein, and
 • who falls within the age range indicated by the Insurer for this Policy Document
“Master Policy/Policy” shall mean the contract of insurance entered into between Master Policyholder and the Company as evidenced by this Policy Document.
“Master Policyholder/You/Your” means Bharti Airtel Limited the holder of the Policy.
“Premium Due Date(s)” means the date(s) on which the premium becomes payable by the Master Policyholder/Life Insured dependant on the mode of
premium payment under the Policy.
“Termination Date of Coverage” means in respect of each Life Insured, the date on which the Coverage of the Life Insured ceases under the Policy for any reason
whatsoever.
“The Company/We/Our/Us” means Bharti AXA Life Insurance Company Limited.

ELIGIBILITY CONDITIONS:-

Individual/(s) shall be eligible to be covered under the Policy on the basis of the following conditions:
1. she/he has applied for sum assured which is within the minimum & maximum limits approved for the Master Policyholder.
2. she/he has applied for coverage term approved for the Master Policyholder,
3. she/he has attained the age of 18 years but not exceeded 54 years with maximum age at maturity limited to 60 years;
4. she/he has fulfilled the underwriting requirements as prescribed by the Company

BENEFITS PAYABLE:-

In case the Master Policyholder has collected due premiums from Life/(ves) Insured but failed to pay Insurer before expiry of the Grace Period, and in such an event if death
claim arises, the responsibility to pay the Death Benefit as per the Coverage Schedule rests with the Insurer.

CONDITIONS FOR EFFECTIVE DATE OF COVERAGE: Coverage in respect of all eligible individuals to be insured will commence with effect from the Effective Date of
Coverage subject to completion of all the following conditions and continuation of such conditions during the Coverage Term:

1. The proposed Life Insured should be a member of the group;
2. The Company has received all the particulars of the proposed Life Insured as per the prescribed format provided by the Company;
3. The Company has received the Coverage Premium in respect of the proposed Life Insured;
4. The Company has accepted the risk for the proposed Life Insured.

EXCLUSIONS: The payment of Benefits is subject to the following exclusions:
Suicide Exclusion: In case of death due to suicide within 12 months:
  • From the date of inception of the Policy, the Nominee(s) or Beneficiary(ies) of the Life Insured will be entitled to at least 80% of the Premiums paid, provided the
    Policy is in force or
  • From the date of Revival of the policy, the Nominee(s) or Beneficiary(ies) of the Life Insured shall be entitled to an amount which is higher of 80% of the Premiums
    paid till the date of death or the surrender value as available on the date of death.
This clause is not applicable in case of renewal of the policy.

CLAIMS PROCEDURE:-
a. On the death of the Life Insured, the Beneficiary(ies)/ Nominee(s) will give written notice and proof of death to the Company at its registered office/ at any of it
   branches in respect of the Life Insured.
b. In case of Lender Borrower, on death of the Life Insured, the Master Policyholder will give a written notice and poof of death to the Company at its registered office/ at
   any of its branches in respect of the Life Insured.
c. The Beneficiary(ies)/ Nominee(s) shall provide the following primary documents along with the written notice for processing the claim:

4 of 6

Bharti AXA Life Group Term Insurance Plan – Single Life

○ Certificate of Insurance
○ Copy of Death Certificate
○ Copies of medical reports, if any
○ Death Claim Form;(to be jointly signed by Nominee(s)/ Beneficiary(ies) and Master Policyholder and submitted by the Master Policyholder in case of lender borrower 
   groups)
○ Any other documentation that the Company may consider as material and relevant to the claim

d. The Company reserves the right to call for any additional information and documents required to satisfy itself as to the validity of the claim.
e. Claim Cheque for the death benefit amount would be drawn in Favour of “Nominee(s)/ ‘Beneficiary(ies)’ of the Life Insured. In case the nominee(s)/ beneficiary(ies) is
   a minor, claim proceeds will be paid to the appointee.
   

f. In case of Lender – Borrower Group : The Master Policyholder may submit to the Company, the specific authorizations received from its Life Insured authorizing the
   Company to make the payment of the claim proceeds to the extent of outstanding loan amount to the Master Policyholder and the balance, if any, to the nominee(s)/
   /beneficiary(ies). Where no such authorization is received by Us from the Life Insured, We will pay the entire Sum Assured directly to the nominee(s)/beneficiary(ies)
   of the Life Insured. The Master Policyholder shall submit a Credit Account Statement in respect of the Life Insured to whom or to whose nominee(s)/beneficiary(ies) the
   claim is payable. This option shall however be applicable only to the group insurance policies/schemes administered by the following regulated entities as group
   organizer/ Master Policyholder
   ○ RBI regulated Scheduled Banks (including Co-operative Banks);
   ○ NBFCs having Certificate of Registration from RBI;
   ○ National Housing Board (NHB)regulated Housing Finance Companies;
   ○ National Minority Development Finance Corporation (NMDFC) and its State channelizing agencies
   ○ Small Finance Banks regulated by RBI
   
g. Claim payment process for Regulated Entities - Claim cheque for the death benefit, to the extent available to settle the Outstanding Loan, would be drawn in favour of
   ‘”Name of the deceased Life Insured Master Policyholder Loan Ref No”. This amount will be applied towards settling the outstanding loan of the deceased Member.
   Cheque in respect of excess amount (excess of death benefit over the outstanding loan), if any, will be issued in favour of the ‘Beneficiary(ies)/ Nominee(s)’.
   
h. Claim payment process for other than Regulated Entities - The Death Benefit shall be payable by the Company to the nominee(s)/beneficiary(ies) of the Life Insured.

i. In respect of the claim cheques drawn in favour of Nominee(s)/ beneficiary(ies), Master Policy Holder shall be responsible for obtaining a discharge receipt from the
   Nominee(s) / beneficiary(ies) and shall forward the same to Bharti AXA Life Insurance Co. Ltd..
   
j. In respect of the Claim Cheque towards outstanding loan, an e-mail in the prescribed format from a specified e-mail id of Master Policy holder and clearance of the
   claim cheque will be considered as a valid discharge for the claim. Master Policy holder will be responsible for any liability arising thereafter on the said claim

FREE LOOK OPTION: If the premium is paid entirely or proportionally by the Insured Member, the Insured Member has the option to return the original Certificate of
Insurance along with a letter stating reasons for cancellation within 15 days of receipt of the Certificate of Insurance (“the free look period”). The Coverage will accordingly be
cancelled and an amount equal to the premium paid after deducting the stamp duty cost and medical costs, if any, incurred in issuance of the coverage will be refunded.

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:
		

·     You can opt to continue the Coverage, provided we receive premium
      for the unexpired period of Coverage from you within 30 days from
      termination of Policy by Policyholder.
·     You can opt to exit the Coverage and get an amount equal to the
      Premium for the unexpired Period of Coverage which will be refunded to
      Policyholder in the same proportion in which the premiums were
      received and the cover under the Policy will cease to exist.
	

DISCLOSURE: Section 45 of Insurance Act, 1938

Fraud, Misrepresentation and forfeiture would be dealt with in accordance with provisions of Section 45 of the Insurance Act 1938 as amended from time to time.

GRIEVANCE REDRESSAL PROCEDURE:

Step 1: Inform us about your grievance

In case you have any grievance, you may approach our Grievance Redressal Cell at any of the below-mentioned helplines:
   • Lodge your complaint online at www.bharti-axalife.com
   • Call us at our toll free no. 1800 102 4444
   • Email us at complaints.unit@bhartiaxa.com
   • Write to us at:
   
	  Registered Office:
	  Bharti AXA Life Insurance Company Ltd.							Grievance Redressal Cell
	  Unit No. 1904, 19th Floor, Parinee Crescenzo						Bharti AXA Life Insurance Company Ltd.
	  'G' Block, Bandra Kurla Complex, BKC Road,						Spectrum tower, 3rd Floor,
	  Behind MCA Ground, Bandra East,								  Malad link road, Malad (west),
	  Mumbai -400051, Maharashtra’									Mumbai 400064. Maharashtra’

5 of 6

Bharti AXA Life Group Term Insurance Plan – Single Life

	• Visit our nearest branch and meet our Grievance Officer who will assist you to redress your grievance/ lodge your complaint.
	
Step 2: Tell us if you are not satisfied
In case you are not satisfied with the decision provided or if you have not received any response post completion of 14 days, you may write to Head - Customer Service for
resolution at the above mentioned address or email at: head.customerservice@bhartiaxa.com:

You are requested to inform us about your concern (if any) within 8 weeks of receipt of resolution as stated above, failing which it will be construed that the complaint is
satisfactorily resolved.

If you are not satisfied with the response or do not receive a response from us within 14 days, you may approach the Grievance Cell of the Insurance Regulatory and
Development Authority (IRDA of India) of India on the following contact details:

IRDA of India Grievance Call Centre (IGCC) TOLL FREE NO: 155255 or 18004254732
Email ID: complaints@irda.gov.in

You can also register your complaint online at http://www.igms.irda.gov.in/
Address for communication for complaints by fax/paper:
Consumer Affairs Department
Insurance Regulatory and Development Authority of India
Sy no.115/1, Financial District,
Nanakramguda, Gachibowli, Hyderabad – 500032
Fax No: 91- 40 – 6678 9768.

Step 3: If you are not satisfied with the resolution provided by the Company
Where the redressal provided by the Company is not satisfactory despite the escalation above, the customer may represent the case to the Ombudsman for Redressal of the
grievance. For the complete list of Insurance Ombudsman please visit:
 • www.bharti-axalife.com
 • www.irdai.gov.in
 
 You can also refer to the complete list of Ombudsman centres given in the Master Policy available with the Master Policyholder.
 
 UIN for Bharti AXA Life Group Term Insurance: 
 
 

 

 

 
BEWARE OF SPURIOUS /FRAUD CALLS
 
IRDAI is not involved in activities like selling insurance policies, announcing bonus or investment of premiums. Public receiving such phone calls are requested to lodge a
police complaint.
 
 
 

6 of 6

Bharti AXA Life Group Term Insurance Plan – Single Life