I hereby give my consent to become a member of ‘Pradhan Mantri Jeevan Jyoti Bima Yojana’ of Life Insurance Corporation of India which will be administered by your Bank under Master Policy No. 900100165.
I hereby authorize you to debit my Savings Bank Account with your Branch with Rs.436/- (Rupees Three Hundred Thirty Only) plus Service Tax if applicable towards premium of life cover under PMJJBY.
I further authorize you to deduct in future after 20th May and not later than on 1st of June every year until further instructions, an amount of Rs.436/- (Rupees three hundred thirty only) and Service Tax if applicable, or any amount as decided from time to time, which may be intimated immediately if and when revised, towards renewal of coverage under the scheme.
I have not authorized any other bank to debit premium in respect of this scheme.
I am aware that my life cover shall be restricted to Rs. 2,00,000/- only in the event of my death.
I am aware that the insurance cover will commence after the premium amount being debited from my account. No cover would be granted prior to premium receipt.
I have read and understood the Scheme rules and I hereby give my consent to become a member of the Scheme.
I am aware that the risk will not be covered during the first 30 days from the date of enrollment into the scheme (lien period) and in case of death (other than due to accident) during lien period, no claim would be admissible.
I authorize the Bank to convey my personal details, given below, as required, regarding my admission into the group insurance scheme to Life Insurance Corporation of India.