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    Bajaj - Indemnity Bond

    Uploaded by

    Duksh Kohli
    This document is an indemnity bond between Bajaj Allianz Life Insurance Company and certain payees. It states that a life insurance policy was issued to the life assured and that the company has agreed to pay the policy value to the named payees without requiring a probate. In exchange, the payees agree to indemnify and hold the company harmless from any claims or actions related to payment of the policy value or possession of the original policy documents. The payees signed the indemnity bond to acknowledge their agreement to these terms.

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    © All Rights Reserved
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    Bajaj - Indemnity Bond

    Uploaded by

    Duksh Kohli
    90 views2 pages
    This document is an indemnity bond between Bajaj Allianz Life Insurance Company and certain payees. It states that a life insurance policy was issued to the life assured and that the company has agreed to pay the policy value to the named payees without requiring a probate. In exchange, the payees agree to indemnify and hold the company harmless from any claims or actions related to payment of the policy value or possession of the original policy documents. The payees signed the indemnity bond to acknowledge their agreement to these terms.

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    bajaj_indemnity bond

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    This document is an indemnity bond between Bajaj Allianz Life Insurance Company and certain payees. It states that a life insurance policy was issued to the life assured and that the company has agreed to pay the policy value to the named payees without requiring a probate. In exchange, the payees agree to indemnify and hold the company harmless from any claims or actions related to payment of the policy value or possession of the original policy documents. The payees signed the indemnity bond to acknowledge their agreement to these terms.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    90 views2 pages

    Bajaj - Indemnity Bond

    Uploaded by

    Duksh Kohli
    This document is an indemnity bond between Bajaj Allianz Life Insurance Company and certain payees. It states that a life insurance policy was issued to the life assured and that the company has agreed to pay the policy value to the named payees without requiring a probate. In exchange, the payees agree to indemnify and hold the company harmless from any claims or actions related to payment of the policy value or possession of the original policy documents. The payees signed the indemnity bond to acknowledge their agreement to these terms.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
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    of 2

    BAJAJ ALLIANZ LIFE INSURANCE COMPANY LTD.

    GE Plaza, Airport Road Yerawada, Pune 411006

    INDEMNITY BOND

    (To be stamped Rs.______________________(in words)______________________________________


    At the stamp office or collector 's office before execution or to be copied on a non-judicial stamped paper of equal value-to
    be executed before a magistrate or to be notarized)

    To all to whom these presents shall come _____________________________________________(Name of


    payee/s)________________(Place of residence of the payee/s). Whereas a policy of insurance Numbered
    ___________________(policy number) for Rs.__________________________________
    (in words) _________________________________________________________________________
    was granted on______________(date) by Bajaj Allianz Life Insurance Co Ltd (herein after called as the company) on the life
    of______________________________________________(Name of life assured) and whereas company has on the
    __________________________________________
    __________________________________________________________________________________
    (Name of payee/s) under taking to enter into with the company a covenant of the nature herein after appearing agreed to
    pay _______________________________________ (name of payee/s) the value of the policy viz. Rs
    __________________(in words) without requiring production of probate or letters of administration or succession certificate
    granted on the estate of _________________________________ (name of the policy holder) and .
    Now know by these presents that in pursuance of the said agreement and in consideration of the company having agreed to pay the
    value of the policy to ______________________________________________

    name of payee/s) the receipt whereof is hereby acknowledged)they,


    ________________________________________________________________(Name of the payee/s) do hereby for themselves,
    their heirs, executors or administrators, covenant with the company its successors and assign that
    __________________________________________(name of payee/s) their heirs executors or administrators will from time to
    time and at all times save and keep harmless and indemnified the company, its successors and assigns of and from all actions, suits
    , costs, claims and demands of whatever nature and kind whatsoever which may be instituted, preferred, claimed or made
    against the company its successors or assigns by any person or persons by reason of his or their possession of or right to the
    original __________________(policy number or assignment deed dated)by reason of anything in relation to the policy.
    In witness whereof the ________________________________________________________________
    _________________________________________________________________(Name of payee/s) have herein put hands
    at_________________________(place)_________________________(date)

    Signed and delivered by the________________________________________________(Name of payee/s)

    Signature of Payee/s

    I certify that the above signature/s is/are that of _______________________________________ (Name/s of the

    Payee/s) who had affixed the same after understanding the contents

    Sworn Before Me: ___________________

    PF016 Branch Address & Contact Numbers


    BAJAJ ALLIANZ LIFE INSURANCE COMPANY LTD.
    GE Plaza, Airport Road Yerawada, Pune 411006

    NOTE OF AUTHORITY

    I/We Class I legal heirs/joint nominees, names 1_____________________________, 2


    _____________________________, under policy no/s ______________________________________
    do hereby authorize Bajaj Allianz Life Insurance Co. Ltd. to pay claim amount under the policy/ies to
    Sri/Smt ___________________ on our behalf

    Signature of Declarant 1: ___________________


    Name:
    Date:

    Signature of Declarant 2: ___________________


    Name:
    Date:

    Signature of Declarant 3: ___________________


    Name:
    Date:

    Signature of Declarant 4: ___________________


    Name:
    Date:

    Signature of Witness:
    Name:
    Date:

    PF016 Branch Address & Contact Numbers

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