In modern financial planning and management, handling insurance policies with precision and care is paramount, especially when alterations or terminations are considered. The Surrender Request Form by PNB MetLife India Insurance Company Limited embodies a structured approach for policyholders aiming to partially withdraw, fully withdraw, or surrender their insurance policy. With a meticulous requirement for detailed personal and policy information, the form seeks to streamline the process while ensuring compliance and security. It encompasses the policy number, owner's name, contact information, and necessitates a slew of mandatory documents that affirm the policyholder's identity and intent. Notably, it emphasizes the need for original policy documents, KYC documents, bank account details for direct credit, along with clear instructions on how any changes in policy will be processed. This detailed procedure not only facilitates a more transparent interaction between the insurer and the insured but also safeguards against potential discrepancies or fraudulent activities. Moreover, the form touches upon the potential implications of partial withdrawals and the termination of policies, aligning with the overarching contractual agreements and terms. Understanding and navigating the intricacies of this form is crucial for policyholders to make informed decisions regarding their insurance investments.
| Question | Answer |
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| Form Name | Surrender Request Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | withdraw from metlife, metlife alico application form, metlife alico policy information, metlife insurance forms download pdf |
PNB MetLife India Insurance Company Limited
(Insurance Regulatory and Development Authority Life Insurance Registration No.117)
Registered Ofice: ‘Brigade Seshamahal’, 5 Vani Vilas Road, Basavanagudi,
Track your policy with ease. Log on to www.pnbmetlife.com, Generate our own user name/password by using your customer ID
Partial Withdrawal/ Full Withdrawal/ Surrender Request Form
Policy Number Name of the Policy Owner
Date (ddmmyyyy)
Contact number (Mandatory): |
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Email ID: |
(The Contact details mentioned above will be updated for future correspondence)
Is there a change in Address- Yes
No
Current mailing address of the Policy Owner (Mandatory) In case of a change in address, please raise a request for address change with valid proof.
MANDATORY Requirements to be submitted by the Policy Holder- (requests received without the speciied documents would be rejected):
□Original Policy Document/Certiicate of insurance (for Met Loan Assure) (for submission in case of Surrender/ Full Withdrawal and OSV & photocopy in case of Partial Withdrawal)
□Self attested Identity Proof & Address Proof Copy, as part of KYC requirement- in case of auto vested policy, the KYC and bank details of the new Policy
Owner would be required
□Bank Account Details along with original cancelled cheque / Self attested passbook copy / Self attested Bank statement authenticating Policy Owner account details for direct credit. In case if the cancelled cheque doesn’t carry the policy owner’s name and account number imprinted in it, passbook or bank statement bearing
□In case the request has been received from any one other than the customer, customer authorization letter and id proof of the person who submitted the request to be submitted
□No objection certiicate/Clearance certiicate from the bank to be submitted for Met Loan Assure.
I apply to, please tick (√) |
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□ Partial withdrawal (in Rs.) |
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from the Unit Account of my policy |
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Or in case of %, as per the table below |
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Fund Option |
%Withdrawal |
Preserver
Protector
Moderator
Balancer
Accelerator
Multiplier
Virtue
□Surrender/Full Withdrawal of my policy by withdrawing all the units/ full cash value of my policy.
Note:
1.If the requested partial withdrawal value is greater than the maximum eligible partial withdrawal value, the maximum eligible value will be paid.
2.In the event that a partial withdrawal results in the surrender value (being the fund value less applicable surrender penalty) of the policy falling below the threshold limit#, policy will be terminated and applicable surrender value will be paid. (#Pls refer ‘Auto Foreclosure clause’ as mentioned in Product T&C)
3.Amount payable on Surrender/ Full Withdrawal of the units is as per policy terms & conditions. The Surrender/ Full Withdrawal of the units’ results in termination of the contract and all rights/ title and interest under the policy shall stand extinguished.
Customer Service Toll free: |
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Mail us at indiaservice@pnbmetlife.co.in |
Version 3.2 |
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PNB MetLife India Insurance Company Limited
(Insurance Regulatory and Development Authority Life Insurance Registration No.117)
Registered Ofice: ‘Brigade Seshamahal’, 5 Vani Vilas Road, Basavanagudi,
Track your policy with ease. Log on to www.pnbmetlife.com, Generate our own user name/password by using your customer ID
Payment Details: Payout will be done through Direct Credit (Direct Transfer to your Bank Account)
Policyholder’s name as per the Bank Account
Bank Name:
Branch Name:
Bank Account Number:
Bank Account Type: □ Savings |
□ Current |
□ NRE* |
□ NRO |
Note- In case of NRE customer, please provide the Customer Declaration- Repatriation Request & bank certiicate for Repatriation
11 digit IFSC
IFSC Code*- (*You can get this code from your Bank) Note:
1.I understand that payout under the policy shall be strictly in accordance with the policy terms and conditions. Also, any payment shall be subject to the last payment realization.
2.If application for Unit Linked Product is received up to 15:00 hrs IST on a business/ working day, the same day`s unit value will be applicable. However, if the application is received after 15:00 hrs, then the next declared NAV will be applicable.
3.I hereby declare that the particulars given in this form are true, correct and complete in all aspects.
4.I take full responsibility of genuineness and correctness of the details illed herein.
5.I understand that in case of a mismatch in address or valid address proof not being submitted, My Surrender/Partial Withdrawal request will get rejected.
6.I understand that incase of any change in my contact details, I need to raise a request for the same. I also understand that my request for the Fund transfer to my New Business application would be affected only after proper updating of my contact details. I agree with PNB MetLife to reserve its right to make the payout to my registered account in case of any contradictory on insuficient details.
7.If the transaction is delayed or not effected at all for any reasons due to incomplete or incorrect information, I shall not hold PNB MetLife responsible in any manner whatsoever. Further, I understand that PNB MetLife shall not be held responsible for any
8.I also understand and agree that PNB MetLife reserves the right to use any alternative payout method (via cheque) incase the requisite information for Direct credit is not received or if the request is rejected by the bank.
9.I understand that for Fund Transfer request to New Business Application, in case PNB MetLife is not able to contact me at my registered mobile number, payout would be processed as per the Bank Proofs Submitted.
10.I also understand that PNB MetLife will be communicating through telephone calls, SMS, or emails for providing details of transactions, payment reminders, etc. and that these shall not be construed as unsolicited commercial calls/
Signature of Policy Owner/Assignor |
Signature of Assignee |
In case of the policy being conditionally assigned, request should |
In case of the policy being absolutely assigned, request should only be |
be signed both by the Assignee & Assignor |
signed by the Assignee |
To be illed by branch Services (Mandatory)
1.Please tick the appropriate - □ Partial Withdrawal □ Full Withdrawal/ Surrender
2. Request received from □ FA □ SM □ Sales personnel □ Speciied Person (SP) □ Customer □ Customer Representative
3.For All Surrender/Partial Withdrawal requests, Branch Services person to mandatorily OSV the policy document for processing the request
4.In case of thumb impression request to be witnessed by PNB MetLife employee
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Acknowledgement Slip |
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Received a request for |
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against Policy Number |
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Employee Code |
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Employee Name |
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Date and time stamp/seal of Branch
Customer Service Toll free: |
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Mail us at indiaservice@pnbmetlife.co.in |
Version 3.2 |
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