aegon life premium shield rider policy contract · includes telephone-calling (ii) short messaging...

15
Dear <<Policy holder>>, <<Address of the Policyholder>> We thank you for including our rider in your financial planning. We are delighted to present your policy documents which represent your contract with Aegon Life Insurance Company. These are original and important documents. In case you are not satisfied with the terms and conditions of the rider, you can opt to cancel your rider within 15 days (30 days if purchased through Distance Marketing1) from the date of receipt of this policy. We will deduct proportionate risk premium charges, stamp duty paid and medical costs (if any) from the premium paid by you. (1Distance marketing: Distance marketing includes every activity of solicitation (including lead generation) and sale of insurance products through the following modes: (i) Voice mode, which includes telephone-calling (ii) Short Messaging service (SMS) (iii) Electronic mode which includes e- mail, internet and interactive television (DTH) (iv) Physical mode which includes direct postal mail and newspaper & magazine inserts and (v) Solicitation through any means of communication other than in person.) Warm regards, Sharad Mahamia Aegon Life Premium Shield Rider A Non-linked Non-Participating Rider UIN- [138B013V01] PART A Head - Operations

Upload: others

Post on 27-Jul-2020

2 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Aegon Life Premium Shield Rider Policy Contract · includes telephone-calling (ii) Short Messaging service (SMS) (iii) Electronic mode which includes e-mail, internet and interactive

Dear <<Policy holder>>,

<<Address of the Policyholder>>

We thank you for including our rider in your financial planning. We are delighted to present your

policy documents which represent your contract with Aegon Life Insurance Company. These are

original and important documents.

In case you are not satisfied with the terms and conditions of the rider, you can opt to cancel your

rider within 15 days (30 days if purchased through Distance Marketing1) from the date of receipt of

this policy. We will deduct proportionate risk premium charges, stamp duty paid and medical costs

(if any) from the premium paid by you.

(1Distance marketing: Distance marketing includes every activity of solicitation (including lead

generation) and sale of insurance products through the following modes: (i) Voice mode, which

includes telephone-calling (ii) Short Messaging service (SMS) (iii) Electronic mode which includes e-

mail, internet and interactive television (DTH) (iv) Physical mode which includes direct postal mail

and newspaper & magazine inserts and (v) Solicitation through any means of communication other

than in person.)

Warm regards,

Sharad Mahamia

Aegon Life Premium Shield RiderA Non-linked Non-Participating RiderUIN- [138B013V01]

PART A

Head - Operations

Page 2: Aegon Life Premium Shield Rider Policy Contract · includes telephone-calling (ii) Short Messaging service (SMS) (iii) Electronic mode which includes e-mail, internet and interactive

Aegon Life Premium Shield RiderA Non-linked Non-Participating RiderUIN- [138B013V01]

PART B

RIDER DEFINITIONS

The words and phrases defined below shall have the meanings assigned to them in this Policy unless the context otherwise requires. Words implying masculine include the feminine, and vice versa. Words in singular include the plural and vice versa. Age means age of the Life Assured/ Policyholder as on the last birthday unless specifically otherwise provided.

Accident is a sudden, unforeseen and involuntary event caused by external, visible and violent means, which causes Bodily Injury.

Annualized Premium means the Rider Premium amount payable in a year chosen by the Policyholder, excluding the taxes, underwriting extra premiums and loadings for modal premiums, if any.

Base Policy is the base plan on which this rider is purchased.

Company, We, Us, Our means Aegon Life Insurance Company Limited or its successors.

Date of Commencement of Rider is the start date of the Rider.

Date of Commencement of Risk is the date from which the insurance cover under the Rider commences.

Date of Maturity means the date on which the Rider terminates and is mentioned in the Policy Schedule.

Due Date means the date on which the Rider Premium is due and payable as per the Premium Payment Frequency opted by You.

Life Assured means the person to whom the insurance cover is granted by Us under the Base Policy. Medical practitioner means a person who holds a valid registration from the Medical Councilof any State or Medical Council of India or Council for Indian Medicine or for Homeopathy set upby the Government of India or a State Government and is thereby entitled to practice medicinewithin its jurisdiction; and is acting within its scope and jurisdiction of license.

This would mean a practitioner treating the life assured must be holding a degree equivalent toMD/MS or higher in the relevant field to certify the medical condition. The Medical practitionershould not be:

• the policyholder/life assured himself/herself; or• An authorised insurance intermediary (or related persons) involved with selling or

• Employed by or under contractual engagement with the insurance company; orservicing the insurance contract in question; or

• Related to the policyholder/life assured by blood or marriage.

Page 3: Aegon Life Premium Shield Rider Policy Contract · includes telephone-calling (ii) Short Messaging service (SMS) (iii) Electronic mode which includes e-mail, internet and interactive

Policyholder means the person to whom the insurance cover is granted by Us under this Rider.

Rider means the Aegon Life Premium Shield Rider more fully described in this document.

Rider Premium is the amount payable by You to avail the Benefits under this Rider. This amount may change depending upon the applicable taxes and Premium payment mode selected by You.

Rider Premium Payment Term means the period during which the Rider Premium is payable.

Rider Term is the period for which this Rider cover is granted as per the rules of the Company.

You,Y our means the Policyholder named in the Policy Schedule.

Page 4: Aegon Life Premium Shield Rider Policy Contract · includes telephone-calling (ii) Short Messaging service (SMS) (iii) Electronic mode which includes e-mail, internet and interactive

BENEFITS

This is an add-on benefit which is in addition to the benefits under the base Policy and this Rider is only granted along with the Policy and benefits shall be subject to continuation of the Policy along with this Rider.

There is no cash benefit payable under this Rider.

C.1 Benefit

Where Policyholder and Life Assured are different

In case of the death or occurrence of Permanent Disability of the Policyholder, either due to Accident or Sickness, as per Clause C.1.1, all future Instalment Premiums of the Base Plan to which this Rider is attached shall be waived and this Rider will be terminated.

Where Policyholder and Life Assured are same

In case of the Policyholder being Permanently Disabled, either due to Accident or Sickness, as per Clause C.1.1, all future Instalment Premiums of the Base Plan to which this Rider is attached (shall be waived and this Rider will be terminated.

The waiver of future Installment Premiums will be effective from the date of death or date of diagnosis of the Permanent Disability, whichever is applicable.

The Company will pay on Your behalf, the Installment Premium due under the Base Policy on the due date. This will be done until the Base Policy is in force.

C.1.1 Definition of Covered Disability Conditions under this Rider

The Policyholder shall be regarded as being Permanently Disabled only if he/she has been subjected, due to accident or sickness, to one (or more) of the impairments as mentioned below:

The following conditions need to be satisfied in order for this Benefit to be accrued:

• The Permanent Disability must be caused by bodily injury resulting from an accident or due to

Aegon Life Premium Shield RiderA Non-linked Non-Participating RiderUIN- [138B013V01]

PART C

S.No. Impairment1 Loss of or loss of use of both Limbs2 Loss of eyesight of both eye3 Loss of speech4 Loss of hearing in both ears5 Loss of or loss of use of any one limb

Page 5: Aegon Life Premium Shield Rider Policy Contract · includes telephone-calling (ii) Short Messaging service (SMS) (iii) Electronic mode which includes e-mail, internet and interactive

sickness, directly and independently of any other causes;

• It should be deemed as permanent and irrecoverable in the opinion of a Medical Practitioner appointed by the Company;

• Loss of use of limb(s), Loss of eyesight, Loss of speech and Loss of hearing in both ears must be persisted continuously for a period of at least 180 days.

Bodily Injury means accidental physical bodily harm excluding illness or disease solely and directly caused by external, violent and visible and evident means which is verified and certified by a Medical Practitioner.

Loss of limb shall mean physical severance of the arm at or above the wrist or physical severance of the leg at or above the ankle joint as the result of an accident or medically required amputation. This has to be confirmed by a Specialist Medical Practitioner of the relevant field.

Loss of use of limb shall mean impaired motor function leading to loss of voluntary movements precluding the use of muscle, joints, or tendon that normally control the movements.

Loss of eyesight means total, permanent and irreversible loss of all vision in both eyes as a result of illness or accident. The diagnosis must be clinically confirmed by a Specialist Medical Practitioner of the relevant field. The blindness must not be correctable by aides or surgical procedures.

Loss of Speech shall mean total and irreversible loss of the ability to speak as the result of physical injury or disease. The diagnosis must be confirmed by a Specialist Medical Practitioner of the relevant field. For the above definition Loss of speech due to psychiatric disorders is excluded.

Loss of Hearing in both ears is a definite diagnosis of a permanent and irreversible loss of hearing as a result of sickness or accidental injury. The diagnosis must be confirmed by a Specialist Medical Practitioner of the relevant field and supported by an audiometric and sound- testing threshold. The deafness must not be correctable by aides or surgical procedures

C.2 Maturity Benefit

The Rider does not provide any Maturity Benefit.

C.3 Surrender Benefit

The Rider does not provide any Surrender Benefit.

C.4 Payment of Rider Premium

The Rider Premium is payable as per the frequency of Premium payment under the base Policy to which it is attached. Any tax on Rider Annualised Premium will be levied and collected in addition to the Rider Annualised Premium.

To enjoy uninterrupted benefits under the Rider, You are required to make payment of the Rider Premium on or before the due date or within Grace Period.

If amount received towards payment of Rider Premium is less than the Rider Premium due and payable, the same will not be accepted. In such cases the Rider Premium due and payable on the due date will be treated as unpaid.

Advance Rider Premium will be accepted as per prevailing IRDAI guidelines.

C.5 Grace Period

Page 6: Aegon Life Premium Shield Rider Policy Contract · includes telephone-calling (ii) Short Messaging service (SMS) (iii) Electronic mode which includes e-mail, internet and interactive

Grace Period is 15 days for monthly frequency and 30 Days for all other premium payment frequencies, from the due date for payment of Rider Premium.

If the Grace Period as applicable falls on a holiday, then the Grace Period will end at the close of the business hours of the next working day.

The Rider will be in force during the Grace Period.

C.6 Discontinuance of Rider Premium

If the Rider Premium remains unpaid even after the expiry of Grace Period, the Rider will lapse with effect from the Due Date of the first unpaid Rider Premium. The lapsed rider may be reinstated as per the Terms and Conditions applicable to reinstatement of the base Policy to which it is attached and the reinstatement happens along with the base Policy. If the rider is not reinstated along with the base policy, then reinstatement of rider is not allowed at a later stage. However, a new rider can be added anytime during the policy term subject to Board approved underwriting guidelines.

C.7 Discontinuance of Rider

If you wish to discontinue this Rider, you can intimate the Company by sending an application in the specified form and this Rider shall stand terminated with effect from the immediately following Premium Due Date without any benefits.

C.8 Addition of Rider

You can anytime during the Premium Payment Term of the Base Plan, purchase this Rider by making an application for the same. The issuance of Rider will be subject to underwriting decisions and other conditions as may be applicable. If a Rider is purchased at any time other than that on Policy anniversary, proportionate premium will be payable from the inception of the Rider to the next Premium Due Date.

C.9 Premium reviewability

Rider Premium is guaranteed for the first 5 years of the Rider Premium Payment Term and for every 5 years thereafter. Reviews will be carried out to determine whether the Rider Annualised Premium will be changed at the end of the guaranteed period. Where a change is required, new premium rates after approval from IRDAI will be levied.

The Company would inform the Policyholder about the changes in Rider Premium at least 30 days in advance from the Policy Anniversary Date.

C.10 Rider Termination

This Rider will terminate immediately on the earliest of any of the following:

• On the Date of Maturity of this Rider,

• On payment of the Benefit under this Rider,

• If the Rider Premium is not paid within the Grace period and the Rider is not reinstated within the reinstatement period,

Page 7: Aegon Life Premium Shield Rider Policy Contract · includes telephone-calling (ii) Short Messaging service (SMS) (iii) Electronic mode which includes e-mail, internet and interactive

• On discontinuance of Rider Premium as under Clause C.6,

• The next Premium Due Date following the receipt of a request for discontinuance of this Rider under Clause C.7,

• The date on which the Base Policy is terminated.

C.11 Suicide Exclusion

� If death occurs due to suicide within 12 months from the Date of Commencement of Risk under the rider or from the date of revival of the rider, as applicable, the Claimant shall be entitled to 80% of the total Rider Premiums paid (excluding taxes) till the date of death or the surrender value as available on date of death whichever is higher, provided the rider is in force.

� The Rider terminates upon payment of such amount.

C.12 Exclusions

The benefit under the Rider shall not be payable in case of disability occurring directly or

indirectly as a result of any of the following:

• Intentional self-inflicted injury, or attempted suicide, while sane or insane.

• Pre-Existing Condition is defined as “Any condition, ailment or injury or related condition(s) for which you had signs or symptoms, and / or were diagnosed, and / or received medical advice / treatment within 48 months to prior to the first policy issued by the insurer”.

• Policyholder being under the influence of drugs, alcohol, narcotics or psychotropic substances unless taken in accordance with the lawful directions and prescription of a registered medical practitioner.

• Failure to follow medical advice/treatment prescribed by Medical practitioner.

• War, invasion, act of foreign enemy, hostilities (whether war be declared or not), armed or unarmed truce, civil war, mutiny, rebellion, terrorist act, revolution, insurrection, military or usurped power, riot or civil commotion, strikes.

• Taking part in any naval, military or air force operation during peace time.

• Participation by the Policyholder in any flying activity, except as a bona fide, fare-paying passenger of a recognized airline on regular routes and on a scheduled timetable.

• Participation by the Policyholder in a criminal or unlawful act with criminal intent.

• Engaging in or taking part in professional sport(s) or any adventurous pursuits or hobbies

Adventurous Pursuits or Hobbies includes any kind of racing (other than on foot or swimming); potholing, rock climbing (except on man-made walls), hunting, mountaineering or climbing requiring the use of ropes or guides, any underwater activities involving the use of underwater breathing apparatus including deep sea diving, sky diving, cliff diving, bungee jumping, paragliding, hand gliding and parachuting.

• Nuclear Contamination; the radio-active, explosive or hazardous nature of nuclear fuel materials or property contaminated by nuclear fuel materials or accident arising from such nature.

Page 8: Aegon Life Premium Shield Rider Policy Contract · includes telephone-calling (ii) Short Messaging service (SMS) (iii) Electronic mode which includes e-mail, internet and interactive

D.1 Free Look Cancellation

If Policyholder is not satisfied with any of the Terms and Conditions of the Rider, Policyholder may return the policy document of the Rider to the Company for cancellation within 15 days (30 days if purchased through Distance Marketing1) from the date Policyholder received the Policy.

(1Distance marketing: Distance marketing includes every activity of solicitation (including lead generation) and sale of insurance products through the following modes: (i) Voice mode, which includes telephone-calling (ii) Short Messaging service (SMS) (iii) Electronic mode which includes e-mail, internet and interactive television (DTH) (iv) Physical mode which includes direct postal mail and newspaper & magazine inserts and (v) Solicitation through any means of communication other than in person.)

On cancellation of the Rider during the free-look period, Company will return the Rider premium paid subject to the deduction of proportionate risk premium for the period of cover, Stamp duty paid and medical costs incurred (if any).

The rider will terminate on payment of this amount and all rights, benefits and interests under this rider will stand extinguished.

If base Policy is cancelled for the free look, the Rider is also considered free looked.

D.2 Reinstatement of the lapsed Rider

The lapsed rider may be reinstated (along with the base plan) as per the Terms and Conditions applicable to reinstatement of the base Policy to which it is attached and the reinstatement happens along with the base Policy.

If the rider is not reinstated along with the base policy, then reinstatement of rider is not allowed at a later stage. However, a new rider can be added anytime during the Policy Term subject to Board approved underwriting guidelines.

D.3 Surrender

The Rider does not provide any Surrender Benefit.

Not Applicable as this product is a non linked Rider.

Aegon Life Premium Shield RiderA Non-linked Non-Participating RiderUIN- [138B013V01]

PART D

Aegon Life Insurance Company LimitedAegon Life Premium Shield RiderA Non-linked Non-Participating RiderUIN- [138B013V01]

PART E

Page 9: Aegon Life Premium Shield Rider Policy Contract · includes telephone-calling (ii) Short Messaging service (SMS) (iii) Electronic mode which includes e-mail, internet and interactive

F.1 Assignment & Nomination

(i) Assignment (as per Section 38 of Insurance Act 1938 as amended from time to time)

The rider benefits cannot be assigned.

(ii) Nomination (as per Section 39 of Insurance Act 1938 as amended from time to time)

Not Applicable

F.2 Fraud or misrepresentation

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

(A simplified version of the provisions of Section 45 is enclosed in Annexure for reference)

F.3 Misstatement of Age or gender

As per the clause F.2, if the age or gender of the Policyholder has been misstated or incorrectly mentioned, then We may at Our sole discretion take the following action subject to the underwriting norms prevailing at the time of taking such action:

If at the correct age, the Policyholder was not insurable under this Rider according to our requirements, we reserve the right to refund the Rider Premium paid and terminate the Rider.

If at the correct age, the Policyholder was insurable, then we may revise the Rider Premium and/or applicable benefits payable under the Rider from the Date of Commencement of Risk by adjusting or deducting the differential Rider Premium that would have been payable.

F.4 Payment of Claim

We will require the following primary documents in support of a claim to enable processing of the claim intimation under the Rider.

In case of a Death of the Policyholder:

• Certificate of the Doctor / Medical Officer certifying the cause of death / Terminal Illness;

• In case of unnatural death - Post Mortem Report, First Information Report (FIR), Inquest Report and the Final Investigation Report of the Police;

• In case of disability on account of any illness – Complete hospital treatment papers, discharge summary and Attending Physician's statement will be required;

• Death Certificate issued by the local authority or the authority authorized to issue the

Aegon Life Premium Shield RiderA Non-linked Non-Participating RiderUIN- [138B013V01]

PART F

Page 10: Aegon Life Premium Shield Rider Policy Contract · includes telephone-calling (ii) Short Messaging service (SMS) (iii) Electronic mode which includes e-mail, internet and interactive

same under the Registration of Births and Deaths Act , 1969; and

• Claimant's statement in prescribed form

In case of Disability Claim:

• Certificate of the Attending Physician in prescribed form;

• Certificate from the Hospital in prescribed form;

• Complete hospital papers including diagnosis, treatment, hospitalisation and discharge summary duly attested by hospital authorities;

• Employer Certificate, if applicable in case of disability

• Claimant's statement in prescribed form.

We are entitled to ask for additional documents (including Policy document) or information for the processing of the claim. We may also seek professional/independent assistance for speedy disposal of the claim. You and/or the Nominee/legal heir/s shall have no objection for Us to obtain any details/information to form an opinion about the claim.

F.5 Electronic Transactions

You shall adhere to and comply with all such terms and conditions as, We may prescribe from time to time. Any transactions carried out by or through any electronic facilities or means established by or on behalf of Us, in respect of the Policy, shall constitute legally binding and valid transactions on You.

F.6 Taxation

The tax benefits and Benefits payable under the Rider would be as per the prevailing provisions of the tax laws in India. We reserve the right to recover statutory levies including Service Tax (plus applicable education cess) by way of adjustment to the Rider Premiums payable or make necessary recoveries from the benefits payable under the Policy.

F.7 Travel, Residence and Occupation

This Rider does not impose any restrictions as to travel, residence or occupation except for Exclusions mentioned under C.12

Page 11: Aegon Life Premium Shield Rider Policy Contract · includes telephone-calling (ii) Short Messaging service (SMS) (iii) Electronic mode which includes e-mail, internet and interactive

G.1 Notices

Any notice, direction or instruction given to Us under the Policy shall be in writing and delivered by hand, post, facsimile or from registered electronic mail to:

Customer Service Department

Aegon Life Insurance Company Limited,

Building No. 3, Third floor, Unit No. 1, NESCO IT Park, Western Express Highway, Goregaon (E),

Mumbai 400 063. Or such other address as may be informed by Us.

Toll free number: 1800 209 9090

E-mail: [email protected]

Any notice, direction or instruction to be given by Us under the Policy shall be in writing and delivered by hand, post, courier, facsimile or registered electronic mail at the updated address in the records of the Company.

You are requested to communicate any change in address immediately to enable us to serve you promptly.

G.2 Applicable Law

This Policy is subject to the provisions of the laws of India.

G.3 Currency and Payment

All payments to or by the Company will be in Indian rupees and shall be in accordance with the prevailing regulations and other relevant laws of India.

G.4 Consumer Grievance Cell:

You may reach us for any complaints/ grievances in any of the following manner:

Ÿ By calling the Toll Free Number 1800 209 9090 between 9.00 AM to 7.00 PM from Monday to Saturday or

Ÿ By writing an e-mail to [email protected] or

Ÿ By registering the grievance on the website of the Company at www.aegonlife.com or

In case of disagreement with the response of the Company or no- response within 15 days, the grievance can be escalated to Grievance Redressal Officer by an e-mail to [email protected] or written letter at:

Grievance Redressal Officer

Aegon Life Insurance Company Limited, Building No. 3, Third floor, Unit No. 1, NESCO IT Park, Western Express Highway, Goregaon (E),

Mumbai 400 063.

Aegon Life Premium Shield RiderA Non-linked Non-Participating RiderUIN- [138B013V01]

PART G

Page 12: Aegon Life Premium Shield Rider Policy Contract · includes telephone-calling (ii) Short Messaging service (SMS) (iii) Electronic mode which includes e-mail, internet and interactive

If you are not satisfied with the response or do not receive a response from us within 15 days, you may approach the Grievance Cell of the Insurance Regulatory and Development Authority of India (IRDAI) on the following contact details:

IRDAI Grievance Call Centre (IGCC) TOLL FREE NO: 155255

Email ID: [email protected]

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

9th floor, United India Towers, Basheer Bagh

Hyderabad – 500 029, Andhra Pradesh

Fax No: 91- 40 – 6678 9768

G.5 Insurance Ombudsman

In case You are not satisfied with the decision/ resolution or have not received any reply to Your complaints/ grievances within a period of 15 days, You may approach the Insurance Ombudsman, if your complaint pertains to:

i) Any partial or total repudiation of claim;

ii) Premium paid or payable in terms of the Policy;

iii) Delay in settlement of claim;

iv) Non-issue of Policy document to customers after receipt of Installment / Rider premiums

v) Any claim related dispute on the legal construction of the policies in so far as such disputes relate to claims.

The complaint should be made in writing duly signed by You, Nominee or by Your legal heirs with full details of the complaint and the contact information of complainant.

As per Rule 13(3) of the Redress of Public Grievances Rules 1998, the complaint to the insurance ombudsman can be made:

(a) If the complaint is not resolved to Your satisfaction by the Company.

(b) Within a period of one year from the date of rejection by the Company; and

(c) You have not initiated any other complaint/litigation.

The addresses of the Insurance Ombudsmen are given on the last page of this document. You are requested to visit the website of the Company for updated information on contact details of the Company and Insurance Ombudsmen.

Page 13: Aegon Life Premium Shield Rider Policy Contract · includes telephone-calling (ii) Short Messaging service (SMS) (iii) Electronic mode which includes e-mail, internet and interactive

Section 45 – Policy shall not be called in question on the ground of mis-statement after three years

Provisions regarding Policy not being called into question in terms of Section 45 of the Insurance Act, 1938, as amended from time to time are as follows:

1. No Policy of Life Insurance shall be called in question on any ground whatsoever after expiry of 3 yrs froma. the date of issuance of policy orb. the date of commencement of risk or c. the date of revival of policy ord. the date of rider to the policy

whichever is later.

2. On the ground of fraud, a policy of Life Insurance may be called in question within 3 years froma. the date of issuance of policy orb. the date of commencement of risk or c. the date of revival of policy ord. the date of rider to the policy whichever is later.

For this, the insurer should communicate in writing to the insured or legal representative or nominee or assignees of insured, as applicable, mentioning the ground and materials on which such decision is based.

3. Fraud means any of the following acts committed by insured or by his agent, with the intent to deceive the insurer or to induce the insurer to issue a life insurance policy:

a. The suggestion, as a fact of that which is not true and which the insured does not believe to be true;

b. The active concealment of a fact by the insured having knowledge or belief of the fact;c. Any other act fitted to deceive; andd. Any such act or omission as the law specifically declares to be fraudulent.

4. Mere silence is not fraud unless, depending on circumstances of the case, it is the duty of the insured or his agent keeping silence to speak or silence is in itself equivalent to speak.

5. No Insurer shall repudiate a life insurance Policy on the ground of Fraud, if the Insured / beneficiary can prove that the misstatement was true to the best of his knowledge and there was no deliberate intention to suppress the fact or that such mis-statement of or suppression of material fact are within the knowledge of the insurer. Onus of disproving is upon the policyholder, if alive, or beneficiaries.

6. Life insurance Policy can be called in question within 3 years on the ground that any statement of or suppression of a fact material to expectancy of life of the insured was incorrectly made in the proposal or other document basis which policy was issued or revived or rider issued. For this, the insurer should communicate in writing to the insured or legal representative or nominee or assignees of insured, as applicable, mentioning the ground and materials on which decision to repudiate the policy of life insurance is based.

7. In case repudiation is on ground of mis-statement and not on fraud, the premium collected on policy till the date of repudiation shall be paid to the insured or legal representative or nominee or assignees of insured, within a period of 90 days from the date of repudiation.

Page 14: Aegon Life Premium Shield Rider Policy Contract · includes telephone-calling (ii) Short Messaging service (SMS) (iii) Electronic mode which includes e-mail, internet and interactive

8. Fact shall not be considered material unless it has a direct bearing on the risk undertaken by the insurer. The onus is on insurer to show that if the insurer had been aware of the said fact, no life insurance policy would have been issued to the insured.

9. The insurer can call for proof of age at any time if he is entitled to do so and no policy shall be deemed to be called in question merely because the terms of the policy are adjusted on subsequent proof of age of life insured. So, this Section will not be applicable for questioning age or adjustment based on proof of age submitted subsequently.

[Disclaimer: This is not a comprehensive list as mentioned Insurance Act 1938 (as amended from time to time) but, only a simplified version prepared for general information. Policy Holders are advised to refer to the Act for complete and accurate details.]

Page 15: Aegon Life Premium Shield Rider Policy Contract · includes telephone-calling (ii) Short Messaging service (SMS) (iii) Electronic mode which includes e-mail, internet and interactive

Vist our website www.aegonlife.com for the updated ombudsman list.

OMBUDSMAN

Office of the Insurance Ombudsman,2nd Floor, Ambica House, Ashram Rd,AHMEDABAD-380 014.Tel.:- 079-27545441/27546840 Fax : 079-27546142Email: [email protected]

Office of the Insurance Ombudsman,62, Forest Park,BHUBANESHWAR-751 009.Tel.:- 0674-2596455/2596003 Fax : 0674-2596429Email: [email protected]

Office of the Insurance Ombudsman,Fathima Akhtar Court, 4th Floor, 453 (old 312), Anna Salai, Teynampet, CHENNAI-600 018.Tel.:- 044-24333668 /24335284 Fax : 044-24333664Email: [email protected]

Office of the Insurance Ombudsman,“Jeevan Nivesh”, 5th Floor, S.S. Road,GUWAHATI-781 001 .Tel.:- 0361-2132204/5 Fax : 0361-2732937Email: [email protected]

Office of the Insurance Ombudsman,2nd Floor, CC 27/2603, Pulinat Bldg., M.G. Road, ERNAKULAM-682 015.Tel : 0484-2358759/2359338 Fax : 0484-2359336Email: [email protected]

Office of the Insurance Ombudsman,3rd Floor, Jeevan Darshan, N.C. Kelkar Road, NarayanpetPUNE – 411030.Tel: 020-32341320Email: [email protected]

Office of the Insurance Ombudsman,2nd Floor, Janak Vihar Complex, 6, Malviya Nagar, BHOPAL-462 003.Tel.:- 0755-2769201/9202 Fax : 0755-2769203Email: [email protected]

Office of the Insurance Ombudsman,SCO No.101-103,2nd Floor, Batra Building, Sector 17-D,CHANDIGARH-160 017.Tel.:- 0172-2706468/2772101 Fax : 0172-2708274Email: [email protected]

Office of the Insurance Ombudsman,2/2 A, Universal Insurance Bldg.,Asaf Ali Road, NEW DELHI-110 002.Tel.:- 011-23234057/23232037 Fax : 011-23230858Email: [email protected]

Office of the Insurance Ombudsman,6-2-46, 1st Floor, Moin Court, A.C. Guards, Lakdi-Ka-Pool,HYDERABAD-500 004.Tel : 040-65504123/23312122 Fax: 040-23376599Email: [email protected]

Office of the Insurance Ombudsman,Hindustan Building. Annexe, 4th Floor, C.R.Avenue, KOLKATA - 700072Tel No: 033-22124339/22124346 Fax: 22124341Email: [email protected]

Office of the Insurance Ombudsman,Jeevan Bhawan, Phase-2,6th Floor, Nawal Kishore Road,Hazaratganj, LUCKNOW-226 001.Tel : 0522 -2231331/2231330 Fax : 0522-2231310Email: [email protected]

Office of the Insurance Ombudsman,Ground Floor, Jeevan Nidhi II, Bhawani Singh Road,JAIPUR – 302005.Tel: 0141-2740363Email: [email protected]

Office of the Insurance Ombudsman,24th Main Road, Jeevan Soudha Bldg.,JP Nagar, 1st Phase, Ground FloorBENGALURU – 560025.Tel No: 080-26652049/26652048Email: [email protected]

Office of the Insurance Ombudsman,1st Floor, Kalpana Arcade Building,Bazar Samiti Road, Bahadurpur,PATNA – 800006Tel No: 0612-2680952Email id : [email protected].

Office of the Insurance Ombudsman,4th Floor, Bhagwan Sahai Palace,Main Road, Naya Bans, Sector-15,NOIDA – 201301.Tel: 0120-2514250/51/53Email: [email protected]

Name of the Ombudsman / Office / Contact Details & Areas of Jurisdiction

Insurance Ombudsman Centres

Address & Contact Details of Ombudsmen Centres

For unattended grievances of the Policyholders with respect to their suggestions or complaints, Central Government has established offices of insurance ombudsmen who are empowered to receive and consider complaints regarding life insurance from any person who has any grievance against an insurer.

Office of The Governing Body of Insurance Council(Monitoring Body for Offices of Insurance Ombudsman)3rd Floor, Jeevan Seva Annexe, Santacruz (West), Mumbai – 400054. Tel no: 26106671/6889.Email id: [email protected] website: www.gbic.co.in

If you have a grievance, approach the grievance cell of Insurance Company first.If complaint is not resolved/ not satisfied/not responded for 30 days then You can approach The Office of the Insurance Ombudsman (Bimalokpal)Please visit our website for details to lodge complaint with Ombudsman.