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Star Health Senior Citizen Red Carpet Proposal Form
No.:
To
Coverage Required : From
Premium Rs.
Date
Payment details : Cash/Cheque/DD No
Photo
Name of Bank & Branch
Sales Manager
Code
Agent/MT
Code
Broker
Photo
Code
Nomination
In the event of the death of the insured Person, all the benefits that shall become payable under the policy will be paid to the person named as the ‘Nominee’
by the Insured Person and his/her receipt shall be sufficient discharge to the Company.
SI.No.
Relationship
Name of the Nominee
Name of the Insured...
Show details
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