BULLET POINTS WITH REGARD TO ASSIGNMENTS AND REASSIGNMENTS
CHECK POINTS:
Whether the policy is Inforce
Whether all the mandatory documents collected (pls refer below given grid)
Whether the form of assignment is completely filled in all respects and signed
Whether customer id of assignee is created
Whether the documents are verified by the ops incharge
Whether original policy bond is collected
Whether contact details (mobile number of the assignee) collected in case of third party assignment
Whether policyholder contact details are updated in SLIC
ASSIGNMENT REQUIREMENTS GRID
Close
REQUIREMENTS Institution Others
relative
Completely filled in Assignment form YES YES YES
Self attested ID proof of Policy holder / assignor YES YES YES
Self attested ID proof and address proof of Assignee YES YES YES
If the policyholder or the Assignee signed in vernacular – Declarant’s self attested ID proof YES YES YES
Type of assignment and consideration should be mentioned YES YES YES
Request on letter head expressing their intention to get the policy assigned in their favour and YES NO NO
mentioning the reasons therefor
Letter from the in-charge of the institution, authorizing any one to sign on behalf of the YES NO NO
institution
Self attested ID proof and address proof of the authorized person with the institution seal YES NO NO
Original Policy bond YES YES YES
REASSIGNMENT REQUIREMENT GRID
Close
REQUIREMENTS Institution Others
relative
Completely filled in reassignment form YES YES YES
Self attested ID proof of Policy holder YES YES YES
Self attested ID proof and address proof of Assignee (re-assignor) NO YES YES
No objection and No dues certificate YES NO YES
Original Policy bond YES YES YES
IMPORTANT INSTRUCTIONS FOR PROCESSING ASSIGNMENT (Read Carefully)
1. This form should be filled in by the Policyholder himself/herself in BLOCK LETTERS.
2. Please tick mark in appropriate box and write NA wherever not applicable.
3. Any cancellation/correction/alteration/overwriting must be authenticated by affixing signature
4. Self attested ID proof and address proof of the Assignee and the Declarant (wherever applicable) must be attached.
5. Self attested ID proof of the witness must be attached.
6. The Assignment shall automatically cancel the nominations made in the policy, except where the policy is being assigned in favour
of Shriram Life Insurance Company Limited, in which case the rights of nominee would get affected to the extent the Company’s
interest in the policy.
7. Shriram Life Insurance Company Limited expresses no opinions as to legality or validity of Assignment.
8. This assignment shall not be effectual against the Shriram Life Insurance Company Limited unless this assignment form is duly
completed and delivered, accompanied by the original policy bond to Shriram Life Insurance Company Limited.
9. Where the assignment is in favour of an Institution, such Institution should affix its stamp and should be countersigned by its
authorised signatory. And such authorised signatory must submit his/her self attested ID proof and Address proof.
10. Where the assignment is in favour of an Institution/Financial Institution/Bank, the policy shall be automatically assigned
absolutely, even if the request is for conditional assignment.
11. Where the Assignee is a minor, the legal/natural Guardian of the minor shall sign on behalf of the minor.
12. Relative for the purpose of this Assignment mean Grand Father, Grand Mother, Father, Mother, Brother, Sister, Spouse, Son and
Daughter.
13. Where the assignment is in favour of a relative or to third party/ies, other than Institution, the Assignor should submit the ID
proof and Address proof of the Assignee duly self attested by the Assignee, alongwith the notice of assignment.
14. Witness and Declarant should be a person competent to contract.
15. Witness and Declarant should be a different person.
16. Form should be filled in English language only.
17. In case the Assignment in favour of an Institution, the policy shall be automatically assigned absolutely, even if the request is for
Conditional Assignment.
18. In case the Assignment is in favour of a person other than Relative and Institution, Assignor shall mention the value of
Consideration received for Assignment of the Policy.
19. In case the signature is in vernacular, the Vernacular declaration must be filled and the person filling vernacular declaration must
submit his ID proof.
Version/SLIC/PS/A/092015 Page 1
FORM OF ASSIGNMENT
POLICY HOLDER DETAILS
Policy number: ___________________________ Date:_____________________
Name of the Policy holder: ___________________________________________________________________________________________
Address: __________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
Contact Number: ________________________________ E mail ID: ___________________________________________________________
PAN Number: ____________________________
DETAILS OF THE ASSIGNEE
Recent colour
photograph of the
Assignee
Name of the Assignee: Mr/Mrs/M/s _______________________________________Son/Daugther/of______________________________
Residing at _______________________________________________________________________________________________________
Contact No. ____________________________ Gender: Male / Female ___________________ Date of Birth: ______/______/_________
E mail id : ___________________________________________ PAN Number : _________________________________________________
Status of the Assignee: Bank / Financial Institution / Relative of the Assignor & for Others (Specify) ________________________________
_________________________________________________________________________________________________________________
If the Assignee is relative of the assignor please specify relation _________________________________ Occupation of the Assignee:
Salaried/Professional/Self employed/Student/House wife/Retired/_______
NOTICE OF ASSIGNMENT
I/We __________________________________________________ (Name of the Assignor), have read and understood the above instructions
herein above and subject to the above instructions, have assigned the policy to __________________ (Name of the Assignee*) mentioned
herein above. (*If the Assignee is minor, please provide Legal/Natural Guardian details)
Name of the Legal/Natural Guardian : ___________________________________________
Relationship with Assignee : ___________________________________________
Date of Birth of the Guardian : ____________________________________________
Address of the Guardian : ____________________________________________
Contact number of the Guardian :____________________________________________
FORM OF ASSIGNMENT
I, _____________________________________________ (Name of the Assignor) as the beneficial owner/s of the policy no.
______________________ issued by Shriram Life insurance Company Limited for Sum Assured of Rs. ________________ have Assigned the
said policy to _____________________________________________ (Name of the Assignee).
K Y C DOCUMENTS SUBMITTED
• Identity Proof : ___________________
• Address Proof : ______________________
• Income proof (if applicable) :_______________________
Version/SLIC/PS/A/092015 Page 2
TYPE OF ASSIGNMENT (Please tick whichever is applicable)
I/We hereby absolutely assign the policy to the Assignee mentioned herein above. I/We have Conditionally Assigned the policy to the
Assignee mentioned herein above, on the condition that the policy will revert to me in the event of __________________________________
CONSIDERATION (Please tick whichever is applicable)
I have received a sum of Rs. ________________ (Rupees ______________________________________) as consideration from Assignee for
the aforesaid assignment.
OR have assigned the policy out of love and affection and have not received any consideration from the Assignee.
DECLARATION
The submission of a duly filled and signed Assignment form along with the requisite documents will be treated as adequate notice of
assignment of the policy.
After the execution of Assignment (whether it is by an endorsement on the policy or by a deed of assignment), the Policy/deed of assignment
shall be sent to Shriram Life Insurance Company Limited, along with the Policy bond, at its offices for registration of Assignment.
In the event of the Assignment of the policy not being notified to the Company, as above, it will not be operative and will not confer upon
the Assignee or his legal representatives any rights as against the Company. Priority of claims after assignment will be governed strictly by
the order in which notices of assignments have been delivered to/received by the Company at its specified office.
Subject to the terms and conditions of the assignment, the Company shall, from the date of receipt of this notice, recognize the assignee
named in the notice as the only person entitled to the benefit under the policy.
Date:
Place: Signature of the Assignor Signature of the Assignee
VERNACULAR DECLARATION
i) If the application form is filled by a person other than the Policyholder or Assign or, OR / AND ii) Policyholder or Assignor has either
put thumb impression or signed in vernacular –
Declaration by Policyholder:
I hereby declare that the content and purpose of this form have been fully explained to me by ______________________________ (Name of
the person filling the form) in the language understood by me and I declare that whatever has been stated hereinabove has been recorded
by _____________________________ (Name of the person filling the form) as per information provided by me.
Thumb impression / Signature of the Policy holder
Declaration by person filling the form:
I ___________________________________________________ (name of the Declarant), residing at ______________________________,
____________________, ________________________________________ have explained the contents of this form to the Policyholder in
_________________ language and I have correctly recorded the answers provided to me. I further declare that the policyholder has signed
/ affixed his/her thumb impression in my presence.
Contact No of the Declarant ____________________ Signature of the Declarant
(A self attested copy of the photo identity proof of the Declarant is to be attached)
WITNESS DETAILS (Witness should be major and competent to contract)
The assignor has duly executed the endorsement on the policy, and the signature/thumb impression is of the assignor affixed on the date
and at the place herein above stated.
Name of the witness: ____________________________________________________
Address of the witness: __________________________________________________
Contact No. of the witness: ________________________ Signature of the witness: _____________________________________________
…………………………………………………………………………………………………………………………………………………………………………………………………………………….
ACKNOWLEDGEMENT SLIP
Received with thanks, a request for Assignment on _______________/ _____________ (Date and Time)
Policy number: ______________________ Signature of SLIC employee______________ Employee code: __________ Office seal
Version/SLIC/PS/A/092015 Page 3
