TERMS AND CONDITIONS

NOTE:

I hereby declare that, as of the date of this declaration, I am in good physical and mental health.

I declare that, as of the date of this declaration, I have not been diagnosed as suffering from, I am not under treatment for and I have not been advised to seek medical advice or treatment for any illness, ailment, disease or disability other than common ailments such as colds, flu, etc.

I declare that I have never suffered from or been diagnosed as suffering from or been treated for high blood pressure, chest pain, heart attack or other heart disease, diabetes or high levels of sugar in blood or urine, high cholesterol, stroke or paralysis, cancer or tumour or unnatural lump, asthma or any other respiratory disease, mental illness, disease of the nervous system, any disease of the liver, any disease of blood or the circulatory system, any digestive or bowel disorder, arthritis, musculoskeletal disorder or any joint disorder or deformity, any disease of the sensory organs, any disease of the kidney or reproductive organs, any disease of the thyroid or any other gland or any sexually transmitted diseases.

I declare that no application for Life or Health insurance on my life has ever been declined, postponed, rated up or accepted on special terms (such as the imposition of a special exclusion, a restriction of the policy term, or the replacement of the requested product with a different product).

I further declare that I have made all statements above in good faith and that they are true to the best of my knowledge and belief. I am fully aware that, in the event of insurance cover being provided, it is provided on the basis of this declaration and that, in the event of any misstatement of facts becoming evident after the issuance of such insurance contract (whether such misstatement be made wilfully or by negligence), the insurance company may exercise its right to cancel the contract and to declare it null and void from the date of commencement of cover (as if the insurance cover had never been issued).

I also understand, agree and confirm that these statements and this declaration are basis of the contract between the insurer and the policyholder. If any untrue statement are contained herein or there has been any non disclosure of any material fact, the policy to be issued by the insurer in the name of the policyholder may be treated as void as far as I am concerned.

I confirm that I have read and understood, the rules and any additional rules of the HDFC Life Group Credit Protect Plus Insurance Plan, the standard Policy provisions and any additional provisions that govern the policy to be issued by insurer in the name of the policyholder and on my life, and I agree and confirm that the same shall be binding on me.

I understand that HDFC SLIC has the right to reject a proposal without giving reasons thereto and client to give an undertaking thereof that he shall not raise any claims thereof. I understand the significance of the contract and the contract will be governed by the provisions of the Insurance Act 1938 and that the same will not commence until written acceptance of this application by Insurer issue on its normal terms and conditions is received.

I hereby declare that the content of the form and document has been fully explained to me and I have fully understood the significance of the proposed contract.

I/We do hereby declare that I/ we have received a loan of from HDFC Bank Limited (“Master Policyholder”). In order to secure the said loan I/ we have taken the above referenced policy from HDFC Standard Life Insurance Company Limited (“HDFC Life”). In consideration of receiving the said loan I hereby authorize HDFC Life to make payment of Outstanding Loan Balance amount to Master Policyholder by deducting from the claim proceeds payable on happening of the contingent event covered by the Group Life Insurance Scheme/ Policy referenced above. Request you to kindly take note of the above mentioned request and update your records accordingly.I understand, agree and confirm that these statements and this declaration are basis of the contract between the insurer and the policyholder. If any untrue statement are contained herein or there has been any non disclosure of any material fact, the policy to be issued by the insurer in the name of the policyholder may be treated as void as far as I am concerned.

I authorise the policyholder to disclose to the insurer such particulars as they may require including the details given above and any changes to the same pay the premium payable on my behalf /collected from me to the Insurer. I understand that any statutory levy or charges including any indirect tax may be charged to me either now or in future by the insurer and I agree to pay the same. I understand that HDFC SLIC has the right to reject a proposal without giving reasons thereto and client to give an undertaking thereof that he shall not raise any claims thereof.

I understand the significance of the contract and the contract will be governed by the provisions of the Insurance Act 1938 and that the same will not commence until written acceptance of this application by Insurer issue on its normal terms and conditions is received.

By buying online I am accepting , Insurance is the subject matter of the solicitation. HDFC Life Group Credit Protect Plus Insurance Plan (UIN 101N096V01) is a traditional non linked, non participatory group insurance product offered by HDFC Life. Life Insurance Coverage is available in this product. The life insurance product is underwritten by HDFC Standard Life Insurance Company Limited. For more details on risk factors, associated terms and conditions and exclusions please read sales brochure carefully or contact your Relationship Manager before concluding a sale.HDFCBank Ltd. Certified CorporateAgent IRDAI License No.: 933982.www.hdfcbank.com.ARN: MC/11/2015/7252.