In the complex and structured world of insurance claims and policies, the LIC 3815 form plays a crucial role, especially in situations where a policy document has been misplaced or lost. This form is a key instrument used by the Life Insurance Corporation of India, established by the Life Insurance Corporation Act of 1956, to facilitate the process of claiming the insurance amount on a lost policy. The document outlines the undertaking by all parties involved – the payees, the surety, and the Life Insurance Corporation itself – to enter into an agreement rendering the corporation liable to pay the designated amount to the beneficiary or payees, provided they agree to indemnify and hold the corporation harmless against all possible claims, actions, or demands that might arise due to the loss of the original policy document. This form, to be executed before the stamp office or collector’s office, captures comprehensive details including the names and residences of the payees and surety, policy number, insurance amount, and the terms under which all parties agree to proceed with the claim. The process not only requires the signatures of the involved parties but also witnesses to the transaction, highlighting the legal and formal nature of the agreement to protect the interests of all parties involved. Further provisions are made for cases where the bond is signed in a vernacular language or by illiterate persons, ensuring inclusivity and comprehensibility in addressing the claim process of lost insurance policies.
| Question | Answer |
|---|---|
| Form Name | LIC Form 3815 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | lic form 3815, lic lost policy form 3815, lic 3815 form pdf hindi, lic 3815 form |
F. No. 3815(Rev)
(To be stamped Rs.At the stamp office or Collector’s Office BEFORE EXECUTION or to be copied out on a
To all to whom these present shall come ____________________________________
________________________________________________________________________ of
(Name of all Payees & Surety)
____________________________________________________________________________
(Name of all residence of Payee/s)
inhabitiants send Greetings
where a Policy of Insurance Numbered ___________________ for Rs. ____________________
was granted on _________________by the Life Insurance Corporation of India, established by the
Life Insurance Corporation Act 31 of 1956 (hereinafter referred to as the Corporation ) on the life
of ___________________________________________________________________________
(Name of Policyholder)
and WHAREAS _____________________________________________________ which was in
(Policy No. or Assignment Deed Dated)
Possession of ____________________________________________ has been lost or misplaced
(Name of Policyholder)
and whareas the said Corporation has on the said_____________________________________
_____________________________________________________________________________
(Name of all Payees & Surety)
undertaking to enter into the said Corporation a covenant of the nature hereinafter appearing agreed to pay to the said _________________________________________________________________
(Name or Name of Payee/s)
__________________________________________________________ the value of the said Policy
viz. Rs. ________________________ now know ye and these presents witness that in pursuance of
the said agreement and in consideration of the said Corporation having agreed to pay the value of the said Policy to the said_______________________________________________________________
(Name or Name of Payee/s)
(the receipt whereof is hereby acknowledged) they the said_________________________________
(Name or Name of Payee/s & Surety)
their hairs, executors or adminstrators will from time to time and at all times save and keep harmless and indemnified the said Corporation its succossers and assignees of and from all actions, suits, costs claims and demands of whatever nature and kindsover which may be instituted, preffered claimed or made against the said Corporation, its successor or assignees by any persons or person by reason of his, her, their possession of or right to the said original
_____________ ___________________________________________________________________
[Pol. No. or Assignment Deed Dated]
by reason of anything in relation to the premises.
In witness whereof the said
(Names of Payee/s & Surety)
have hereunto put their hands at _____________this _______________day of _____________20___
Signed and delivered by the said _______________________________________________________
(Names of Payee/s & Surety)
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In the presence of : |
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1) Full Signature of witness |
______________________ |
1) |
______________________ |
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Signature |
Designation : ________________________ |
2) |
______________________ |
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Signature |
Address : _____________________________
._____________________________
2)Full Signature of witness _________________ Signature of Surity __________________
Designation : __________________
Designation : __________________
Address: ______________________
Adrress : _________________________
N o t e : If this Bond is signed in Vernacular one of the attesting witnesses should be requested to certify that the contants of this Bond were explained to the party in varnacular before execution.
Illitrate Persons must affix their thumb impression which should be attested by Megistrate S.E.M. A Gazetted officer, a Block Development Officer or Class 1 Officer of the Corporation Provided
He is fully satisfied about the identify of the claimant