kotak life insurance assignment form

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Assignment Form New 120813.cdr - Kotak Life Insurance

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INSTRUCTIONSASSIGNMENT FORM1. Please fill this form in BLOCK LETTERS using black or blue ink. The term Assignor stands for the current owner of the policy and the term Assignee stands for the personin whose favour the policy is being assigned.2. Only absolute assignment is permited by the company. Conditional / Partial assignment is not permissible.3. A third party major, other than the Assignor and the Assignee, must witness the signatures(s) and /or thumb impressions4. The assignment of a policy shall automatically cancel any nomination made in the policy, except where the policy is assigned to the insurer, in which case the Nominee'sright shall be affected to the extent of the insurer's5. In case of Re-assignment, please ensure a fresh nomination is registered by the assignee6. This assignment form must be sent to “<strong>Kotak</strong> <strong>Life</strong> <strong>Insurance</strong>”, The Policy Servicing Department, 7th Floor, <strong>Kotak</strong> Infiniti, Building No 21, Infinity Park,Off Western Express Highway, Goregaon Mulund Link Rd, Malad (E), Mumbai- 400097, India7. This form shall be accompanied by the original policy document in respect of which the assignment is made8. This assignment shall not be effective against the Company unless it is duly completed and delivered to <strong>Kotak</strong> Mahindra Old Mutual <strong>Life</strong> <strong>Insurance</strong> LimitedGENERAL INFORMATIONPolicy No Premium (p.a) Rs. Sum Assured (Rs.)PARTICULARS OF THE ASSIGNORTitle(Mr./Ms./Mrs.) Surname First name Middle nameRecent passport sizephoto of the assignee(for individuals only)ORCompany NameCorrespondence Address :- Office ResidenceCity/VillageStateTelephone Numbers (With STD Codes)Residence /OfficeE mailMobilePin CodeSignature of the Assignor :(In case of Bank/FI/Company, please affix companystamp counter signed by authorized signatory)I, Mr./Ms. ___________________________________________, on behalf of ___________________________________________________________ / as the beneficial owner of the above named policydo hereby absolutely and irrevocably transfer and assign the rights and benefits of the said policy to the Assignee named below and I hereby give you notice of the same. I declare that the Assignee's receipt of thebenefits under the policy shall be a valid and sufficient discharge of <strong>Kotak</strong> Mahindra Old Mutual <strong>Life</strong> <strong>Insurance</strong> Ltd. I understand that, by virtue of the assignment, the assignee has the right to give fund switchrequest in the policy.CONSIDERATION (if any)Please select the applicable options* <strong>Assignment</strong> out of love and affection <strong>Assignment</strong> to blood relative/spouse <strong>Assignment</strong> to others* <strong>Assignment</strong> for a valuable consideration of Rs. _____________ (consideration amount is mandatory) Purpose of the <strong>Assignment</strong>-___________________(e.g. loan, other financial obligation)Declaration from Bank/Financial Institution (FI) and Assignor (when Sum Assured is greater than Loan Amount):Incase of claim, <strong>Kotak</strong> Mahindra Old Mutual <strong>Life</strong> <strong>Insurance</strong> Ltd. shall pay the outstanding loan amount first to the Bank/FI and the balance amount may be paid to the legal heir by the Bank/FI itself.1] A loan statement giving the outstanding loan as at the time of death and amount payable to them.2] A letter stating that the balance amount shall be payable to the Nominee OR Legal Heir.Signature/Stamp ofauthorised signatory of Bank/FISignature of the AssignorPARTICULARS OF THE ASSIGNEEClient ID (If Existing Customer)Title(Mr./Ms./Mrs.)Surname First name Middle nameCorrespondence Address :- Office ResidenceStateTelephone Numbers (With STD Codes)Residence / OfficeCity/VillageMobilePin CodeE mailDate of Birth of Assignee(Only For Individuals)DDMMYYYYDo your bit for green world & switch to e-communication. Kindly mark if you would like to receive your communication through electronic mode.Relationship to Assignor ______________________________________Signature of the Assignee :(In case of Bank/FI/Company, please affix companystamp counter signed by authorized signatory)

DETAILS OF THE ASSIGNEE (The below details are mandatory except in case of assignment to Bank /FI)Occupation Salaried Agriculturist Housewife Retired/Pensioner Student Business Owner Self Employed Others (please specify)If assignee isPolitically exposed person*Company having only close family shareholdingTrustCharitable organisationNon Govt. organisationFirm having any sleeping partnerIdentity Proof Passport PAN CardVoter's identity CardOthers (please specify)Address Proof Telephone Bill Ration CardElectricity billOthers (please specify)Income Proof(For Premium >= 1 lac.)Future premiums will be paid by<strong>Form</strong> 16ITRAssigneeDated this ____________________- day of ________________, 20 ________________.Bank StatementAssignorOthers (please specify)* Politically exposed persons are the people who hold prominent public positions viz, ministers of Central or State Govt, Senior politicians, Senior Govt., judicial or military officials, senior executives of govt.companies, important political party officials, and immediate family members of above person.PARTICULARS OF WITNESSTitle(Mr./Ms./Mrs.) Surname First name Middle nameAddress :StateTelephone Numbers (With STD Codes)City/VillageResidence Office Signature of the Witness :(In case of Bank/FI/Company, please affix companyMobileE mailstamp counter signed by authorized signatory)Pin CodePARTICULARS OF NOMINEE: (The below details are mandatory incase of assignment to the life insured)Client IDNOMINEEAPPOINTEEPercentage Share(%)TitleFULL NAMESurnameSurnameFirst NameMiddle NameFirst NameMiddle NameDate of BirthD D M M Y Y Y YD D M M Y Y Y YRelationshipTo the AsigneeTo the NomineeGenderMaleFemaleMaleFemaleADDRESSOfficeResidenceOfficeResidenceCityCityStatePinStatePinTelephone Number(with STD Codes)E-mail IDDECLARATION BY THE PERSON FILLING IN THE FORM (Applicable only where form is filled in by a scribe or signed in vernacular languages)I, _____________________________________________________ having known the policy holder for a period of _________________________________ do declare that I have explained thenature of the questions contained in this form.Signature of ScribeAddress of ScribeCityDate D D M M Y Y Y YStateDECLARATION BY THE ASSIGNEEPinPlaceI hereby declare that I understand and agree to all the conditions and information given above.Date D D M M Y Y Y Y PlaceSignature of Assignee<strong>Kotak</strong> Mahindra Old Mutual <strong>Life</strong> <strong>Insurance</strong> Ltd.Regn. No. 107, CIN: U66030MH2000PLC128503, Regd. Office: <strong>Kotak</strong> Mahindra Old Mutual <strong>Life</strong> <strong>Insurance</strong> Ltd., 4th Floor, Vinay Bhavya Complex, 159-A, C.S.T. Road, Kalina,Santacruz (E), Mumbai - 400 098http://insurance.kotak.com/ • <strong>Insurance</strong> is the subject matter of the solicitation.FO/PS/<strong>Assignment</strong> <strong>Form</strong>/002ACKNOWLEDGEMENTBranch Name and codeWe acknowledge the receipt of your request for ______________________________ for policy number _________________________________Name of Operations Executive<strong>Kotak</strong> Mahindra Old Mutual <strong>Life</strong> <strong>Insurance</strong> Ltd.Regn. No. 107, CIN: U66030MH2000PLC128503, Regd. Office: <strong>Kotak</strong> Mahindra Old Mutual <strong>Life</strong> <strong>Insurance</strong> Ltd., 4th Floor, Vinay Bhavya Complex, 159-A, C.S.T. Road, Kalina,Santacruz (E), Mumbai - 400 098http://insurance.kotak.com/ • <strong>Insurance</strong> is the subject matter of the solicitation.FO/PS/<strong>Assignment</strong> <strong>Form</strong>/002

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• Know your account balance
• Activate / Deactivate Passbook
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• Report fraud / Raise Dispute
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• See All Other Loans
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• See All Insurance
• Life Insurance
• Term Insurance
• Health Insurance
• Kotak Group Accident Protect
• Car Insurance
• Two Wheeler Insurance
• See All Government Schemes
• National Pension Scheme (NPS)
• NPS Calculator
• Pradhan Mantri Jeevan Jyoti Bima Yojana
• Pradhan Mantri Suraksha Bima Yojana
• Atal Pension Yojana
• RBI - Floating Rate Savings Bond, 2020 (T)
• Sovereign Gold Bond Scheme
• See All Money Transfer / Forex
• Money Transfer (NEFT/RTGS/IMPS)
• Pay your contact
• Send money abroad
• Foreign Currency Cash Services
• Buy Forex Card
• See All Bill Payments & Recharges
• Utility payments
• Mobile / Landline postpaid bill payment
• Credit Card bill payment
• Recharge FASTag
• Mobile prepaid recharge
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• Income Tax Payment
• Goods & Services Tax (GST)
• Customs Duty Payment
• Bulk Tax Payment Solutions
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• Raise a service request
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• See All Working Capital
• Channel Finance
• Dealer Finance
• Agri SME Business
• Credit Card Receivables
• Transportation, Logistics, Warehouse
• Infrastructure Finance
• Submit e-financials
• Loan Against Property
• Commercial Vehicle
• Construction Equipment
• Agri Project
• Farm Equipment
• See All Payment Solutions
• Bharat QR Solution
• Point of sale Machine(POS)
• Bulk Upload Facility
• Kotak.biz App
• See All Money Transfer
• Fund Transfer (NEFT, RTGS & IMPS)
• See All Bill payments/Recharges
• Utility Payments
• Mobile/Landline Postpaid Bill Payments
• Credit Card Bill Payments
• Mobile Prepaid Recharge
• See All Loan/Card Payment
• Loan EMI Payment
• Bulk Upload Solutions
• See All Domestic
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• Digital Payments
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• Digital Collections
• Allpay Payment Gateway
• See All Trade & Supply Chain Finance
• Import Finance
• Export Finance
• Domestic Trade & Supply Chain Finance
• See All Trade Service
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• Others Trade Services
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• See All Current Account
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• See All NRI Home Loan
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• See All Credit Cards
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• See All Mutual Funds
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• See All Portfolio Investment Schemes
• See All Demat Account
• See All Tech@Kotak
• See All Kotak811 Events
• Accounts & Deposits --> -->
• Cards & Prepaid Services --> -->
• Loans --> -->
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How to make an assignment or transfer of a life insurance policy?

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Laura D. Adams

Insurance & Finance Analyst

Laura Adams is one of the nation’s leading finance, insurance, and small business authorities. As an award-winning author, spokesperson, and host of the top-rated Money Girl podcast since 2008, millions of readers and listeners benefit from her practical advice. Her mission is to empower consumers to live healthy and rich lives by planning for the future and making smart money decisions. She rec...

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Daniel Walker

Licensed Insurance Agent

Daniel Walker graduated with a BS in Administrative Management in 2005 and has run his family’s insurance agency, FCI Agency, for over 15 years (BBB A+). He is licensed as an insurance agent to write property and casualty insurance, including home, life, auto, umbrella, and dwelling fire insurance. He’s also been featured on sites like Reviews.com and Safeco. To ensure our content is accura...

UPDATED: Nov 3, 2014

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Kimberling Kimberling Insurance Moscow Summary

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Member info

Full information About Member, contact

Malakut Insurance Brokers LLC

Tel: +74959331373 FAX: +7 4959331370 Email: [email protected] Web: www.malakut.com

HQ Address: 12, Malaya Sukharevskaya Sq., Moscow, 127051, Russia

International Practice Group Address: 12, Malaya Sukharevskaya Sq., Moscow, 127051, Russia

Legal form ofthe company (plc etc. ): LLC

Registration number of the regulatory authority: 4004

Business area / specialization:

Corporate P&C

Personal lines and EB

Aviation and Space

Marine and Energy

Trade Credit

Reinsurance

Company Representatives

Tatiana Razuvaeva

+7 495 933 1373 +7 916 473 7884 +7 495 933 13 70 [email protected]

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GMA.LIFE: Quality treatment of policyholders in Russia

Ready-made solution for insurance companies in critical diseases

Company Global Medical Assistance specializes in organizing a qualified, quick and effective medical care in Russia for cancer and other critical diseases.

GMA.LIFE takes care of all cases when insured events occur

We cooperate with the leading federal centers and clinical complexes in Russia on oncology, cardiology, eye surgery and neurosurgery. GMA.LIFE patients receive assistance from the best certified and graduate doctors. This guarantees the diagnosis accuracy, a serious reduction in the treatment time and the selection of effective, personalized methods for fighting the disease.

Global Medical Assistance offers service filling to insurance companies for insurance of critical diseases, and also reduction of expenses due to use of means of both compulsory and voluntary medical insurance.