Type of intermediary << Direct/ Bancassurance/ Broker/ Agent

Page 1 of 19

Welcome Letter

<< Date >>

<<Name>>

<<Designation>>

<<Address>>

Subject: Canara HSBC Oriental Bank of Commerce Life Sampoorna Kavach Plan - Master

Policy No. <<...>>

Dear Sir,

We thank you for choosing Canara HSBC Oriental Bank of Commerce Life Insurance Company Limited

as your preferred Insurance partner to provide Sampoorna Kavach Plan to your customers.

We are pleased to enclose your Policy Pack for our Sampoorna Kavach Plan bearing MASTER POLICY

NO. <<...>> issued on << Date>>.

Please find enclosed your Policy Pack comprising the following documents:

1. Policy Document

2. Master Policy Schedule

3. Stamp Endorsement

4. First Premium Receipt

5. Terms and Conditions

6. Details of members included (Annexure-I)

7. Complaint Redressal Procedure

8. Documents which are attached separately along with Master Policy document –

a. Copy of your Master Proposal Form

b. Copy of Signed Scheme Rules

It is the Company’s objective to provide financial protection for your customers supported by the

highest levels of customer service.

We request you to kindly go through the entire policy document to ensure that all details captured

herewith are correct. For any discrepancy found in the above mentioned documents please write to

us at grouphelpdesk@canarahsbclife.in or contact us on 1800-103-0003 or 1800-180-0003

(BSNL/MTNL).

Yours Truly

Canara HSBC Oriental Bank of Commerce Life Insurance Company Limited

Chief Operating Officer

Intermediary Details:

Type of intermediary

<< Direct/ Bancassurance/ Broker/ Agent/ Corporate Agent >>

Name

< from master proposal form >

Code/ branch code

<< _____ >>

Contact phone no.

<< _____________ >>

Policy Document Page 2 of 19

POLICY DOCUMENT

Plan Name: Canara HSBC Oriental Bank of Commerce Life Sampoorna Kavach Plan

Non-linked non-participating group micro insurance term plan UIN Number: 136N022V02

Name of Master Policy Holder:

Master Policy No.:

Canara HSBC Oriental Bank of Commerce Life Insurance Company Limited (the ‘Company’) having

received a Proposal and first premium from the Master Policyholder named above and the said Proposal

and Declaration together with statements, reports or other document leading to the issue of this

Master Policy having been accepted by the Company and the Master Policyholder as the basis of this

contract, do by this Master Policy agree in consideration of and subject to the due receipt of

subsequent premiums as set out in the Master Policy Schedule annexed hereto, and further subject

to the terms and conditions contained in this Master Policy or riders attached thereto and any

endorsements made thereon, that on proof to the satisfaction of the Company of the Benefits (as

hereinafter defined) and such other amounts having become payable upon the occurrence of one or

more events mentioned in this Master Policy, the Company shall pay the relevant benefits under this

Master Policy.

The date of commencement of risk under this Master Policy is as set out in the Schedule.

Chief Operating Officer

Canara HSBC Oriental Bank of Commerce Life Insurance Company Limited

Policy Document Page 3 of 19

Canara HSBC Oriental Bank of Commerce Life Sampoorna Kavach Plan

UIN – 136N022V02

MASTER POLICY SCHEDULE

MASTER POLICY DETAILS:

Master Policy No:

Proposal No.

Master Policy

Commencement Date:

Master Policyholder:

Address of Master

Policyholder:

Premium :

Premium periodicity:

Initial Total Sum

Assured:

Initial No. of Members

covered:

Scheme Name:

No frills account holders

or members of the SHG,

JLG, TFG & MCG having

savings account with

Canara Bank

Plan Type

Canara HSBC

Oriental Bank of

Commerce Life

Sampoorna Kavach

Plan

Benefit Type:

Rider coverage (if any)

Not Applicable

Annual Renewal Date

Annual Premium per

Member

Note: Risk on the life of insured member shall commence on date mentioned in the respective COI per member.

Chief Operating Officer

Canara HSBC Oriental Bank of Commerce Life Insurance Company Limited

Policy Document Page 4 of 19

Stamp Endorsement

Master Policyholders Details:

Name of Master

Policyholder

Master Policy No.

Plan

Canara HSBC Oriental Bank of

Commerce Life Sampoorna Kavach

Plan

Stamp Value (in `)

Policy Document Page 5 of 19

Premium Receipt

Date of Issue:

Master Policy No.:

Master Policyholder:

Address:

Receipt Number:

To: << Name of Master Policyholder,

This is to acknowledge receipt of premium against above referred Master Policy Number, as per detail

given below.

SUMMARY OF POLICY INFORMATION

Name of the Company

Address

Goods and Services Tax Identification

Number

{{GOODS AND SERVICES TAX IDENTIFICATION

NUMBER Of HO}}

HSN Code

Master Policyholder Current Address

Master Policyholder State/ Union Territory &

Code

Master Policyholder Goods and Services Tax

Identification Number

{{GOODS AND SERVICES TAX IDENTIFICATION

NUMBER}}

Plan

Canara HSBC Oriental Bank of Commerce Life

Sampoorna Kavach Plan

Basic Premium (Rs)

Total Premium Received (Rs)

No. of members covered

Should you need any further assistance, please call us on our Toll Free No.1800-103-0003 or

1800-180-0003 (BSNL/MTNL). You may also e-mail us at [email protected].

Yours Sincerely,

Chief Operating Officer

Canara HSBC Oriental Bank of Commerce Life Insurance Company Limited

Note: * Subject to Direct Credit / Realization of Demand Drafts

* Premium Rounded to next Rupee

Policy Document Page 6 of 19

IRDAI Regn No. 136

Micro Insurance Product

CANARA HSBC ORIENTAL BANK OF COMMERCE LIFE INSURANCE SAMPOORNA KAVACH

PLAN:

UIN: 136N022V02

1 - Year renewable Group Term Micro Insurance without return of premium, Plan.

Policy No.

Name and Address of

Master Policyholder:

Canara HSBC Oriental Bank of Commerce Life Insurance Company Limited (the

“Company”) is pleased to enter into this 1-year renewable Group Term Micro Insurance, without

return of premium, Plan with the Master Policyholder, as evidenced by this policy (“Policy”) and

agrees to pay the Benefits as stated herein, subject to the terms and conditions of this Policy. The

Policy is issued on the basis of the Proposal and Declaration from the Proposer and on the express

understanding that the said Proposal and Declaration and any statements made or referred to

therein shall be part and parcel of this Policy.

Policy Document Page 7 of 19

CONDITIONS APPLICABLE TO THIS POLICY

Canara HSBC Oriental Bank of Commerce Life Sampoorna Kavach Plan

(UIN – 136N022V02)

1. DEFINITIONS:

In this Policy, unless the context requires otherwise, the following words and expressions shall

have the meaning assigned to them respectively herein below:

“Accidental Death” shall means sudden death caused solely, directly and independently of

any other intervening causes from an Accident i.e. a traumatic event of violent, unexpected,

external and visible nature;

“Annual Renewal Date” shall mean the date mentioned in the Policy Schedule;

“Beneficiary” shall mean the spouse, children or dependents appointed by the Member to

receive the Benefits under this Master Policy in the event of death of the Member.

“Benefits” means the benefits enumerated in Section 2 of this Policy and payable in

accordance with the terms of this Policy;

“Company” means Canara HSBC Oriental Bank of Commerce Life Insurance Company Limited

or its successors and assigns;

"Eligible Member" means a person who satisfies the conditions of Eligibility provided for

in this Policy;

"Eligibility Criteria" means the criteria required to be satisfied by an Eligible Member as

specified under section 4 of this Policy;

“Frequency of Premium Payment” shall mean annual mode of payment of premium as

stated in the policy Schedule;

“Insurance Cover” means the arrangement in terms of this Policy, under which the

Company, subject to the terms of this Policy, undertakes to pay to the Beneficiary the

admissible Benefits in respect of an Insured Member on the happening of specified events in

this Policy;

“Insured Member” means an Eligible Member of the Master Policyholder who are admitted

by the Company and whose name appears in this Policy or subsequent document issued by

the Company informing the Insured Members who are provided with Insurance Cover in terms

of this Policy;

"Master Policyholder" means the group/organization/Institution named in the Policy

Schedule;

“Policy” means this Canara HSBC Oriental Bank of Commerce Life Insurance Sampoorna

Kavach Plan as may be amended from time to time;

“Policy Commencement Date” means the date specified as such in the Policy Schedule;

“Policy Contract” means the policy schedule, the policy terms & conditions, Annexures,

schedules, endorsements, applicable to this Policy shall together form the entire contract

evidenced by this Policy;

“Policy Schedule” means the Schedule termed as such and attached to this Policy;

“Policy Year” means a period of twelve consecutive calendar months starting from the Policy

Commencement Date and ending on the day immediately preceding the following anniversary

date and each consequent period of twelve consecutive months thereafter;

“Premium” means the Premium Amount specified in the Policy Schedule;

“Premium Due Date” shall mean the date on which Premium shall be due in

accordance with the Frequency of Premium payment as mentioned in the Schedule;

Policy Document Page 8 of 19

“Regulations” means the laws and regulations in effect from time to time and applicable to

this Policy, including without limitation the regulations and directions issued by the Regulatory

Authority;

“Regulatory Authority” means the Insurance Regulatory and Development Authority or

such other authority or authorities, as may be designated under the applicable laws and

regulations;

“Risk Commencement Date” means the date on which the Insurance Cover under this

Policy commences in respect of an Insured Member hereto;

“Schedule” shall mean the Schedule appended to this Policy and the same shall form part

and parcel of this Policy;

“Sum Assured” means in each case the amount specified as such against the name of each

Insured Member to this Policy;

1.1. Interpretation:

1.1.1 This Policy is divided into numbered clauses for ease of reference and reading. Except as

stated, these divisions and the corresponding clause headings do not limit the Policy or its

interpretation in any way. In this Policy, where the context permits, the singular shall include

the plural and vice versa and words denoting masculine gender shall include feminine gender

and vice versa.

1.1.2 The Policy comprises of the terms and conditions set forth in the Policy document, the Policy

Schedule and the Annexures/schedules referred to herein, which shall form an integral part of the

Policy.

2. Benefits Payable under the Policy.

2.1 Death Benefit.

Subject to the terms and conditions of this Policy and the Policy remaining in full force and

effect on the date of death of the Insured Member after Risk Commencement Date but before

the Insurance Cover ceases, the Company shall pay the Sum Assured to the Beneficiary.

2.2 Non-Participation in Profits.

This Policy does not confer any rights on the Insured Member to participate in the profits of

the Company.

2.3 Requirements for Death Benefit claims.

2.3.1 Within 90 days of a claim for Death Benefit of Insured Member arising under this Policy, the

claim needs to be intimated in writing, by either of the nominee / Appointee or Master

Policy Holder, along with the following documents to the Company to enable the Company

to process the claim:

(a) Original / attested copy of death certificate of the deceased member;

(b) Completed Death Claim Form duly filled by the Nominee / Appointee or the Master

Policyholder;

(d) Statement from Gram Panchayat/Village Authority regarding cause/ circumstances of

death;

(e) Medical records / Forms (if applicable);

(f) Certificate of Insurance;

(g) Any other document as required by the Company.

If We do not receive the notification of the death within 90 days, We may condone the delay

if We are satisfied that the delay was for reasons beyond the Claimant’s control and pay the

claim specified under the Policy to the Claimant.

Policy Document Page 9 of 19

2.3.2 Notwithstanding anything contained in Clause 2.3.1 above, depending upon the cause or

nature of the claim, the Company reserves the right to call for other and/or additional

documents or information.

2.3.3 Any claim intimation to Us must be made in writing and delivered to the address, which is

currently as follows:

Claims Unit

Canara HSBC Oriental Bank of Commerce Life Insurance Company Limited, 2nd Floor, Orchid

Business Park,

Sector-48, Sohna Road, Gurugram 122018, Haryana, India; Resolution Centre: 1800-103-

0003 / 1800-180-0003 (BSNL/MTNL)

Email id: claims.unit@canarahsbclife.in

Any change in the address or details above will be communicated by Us to You. For further

details on the process, please visit our claims section on our website www.canarahsbclife.com.

2.4 Payment of Benefits.

2.4.1 Payment of all the Benefits as shown in the Schedule shall be subject to receipt by the

Company of proof to its satisfaction;

2.4.1.1 of the Benefits having become payable as set out in this Policy; and

2.4.1.2 of the correctness of the age of the Insured Member as stated in the Member Enrollment Form.

2.5 Mode of payment of Benefits.

2.5.1 All Benefits and other sums under this Policy shall be payable in the manner and currency

allowed/permitted under the Regulations.

2.5.2 The Company shall pay the admissible Benefits and other sums payable under this Policy to

the Beneficiary through the Company’s National Operations Office in Gurgaon. A discharge or

receipt given by the beneficiary shall be a good, valid & sufficient discharge of the Company’s

liability in respect of payment of the Benefits under the Policy in respect of a deceased Insured

Member.

2.6 Exclusion:

2.6.1 Suicide Exclusion: If the Insured Member commits suicide for any reason, while sane or

insane, at any time within 12 months from the Risk Commencement Date or within 12 months

from the date of reinstatement of the lapsed cover then no Benefits shall be payable under

this Policy.

2.6.2 45 days Exclusion: During the first 45 days from the Risk Commencement Date in respect

of an Insured Member / date of reinstatement of the lapsed cover, the Company shall not be

liable to pay any Benefits except in the event of a death claim arising on account of an

Accidental Death as defined in Master Policy.

Note: In case the claim is not payable as per clause 2.6, the premium amount paid by the

respective deceased Insured Member shall be refunded.

3. Group Insurance

3.1 Basic Requirements.

3.1.1 This Canara HSBC Oriental Bank of Commerce Life Insurance Sampoorna Kavach Insurance

contract is effected by the Master Policyholder. The Master Policyholder shall hold this Policy

contract and all Benefits payable hereunder upon trust for the benefit of the Insured

Member(s) in accordance with this Policy.

3.1.2 This Master Policy is issued pursuant to a Proposal made to the Company by the Master

Policyholder along with such other documents as required by the Company.

3.1.2 The Insurance Cover for each Insured Member under this Policy shall come into effect on the

Risk Commencement Date stated against the name of the respective Insured Member

appearing in Annexure I and will be in force subject to receipt by the Company of all

Policy Document Page 10 of 19

Premiums payable on the Premium Due Date, from the Master Policyholder. The Master

Policyholder may renew the Policy annually and the Company has the right to vary the terms

of this Policy effective from the renewal date.

3.1.4 In case of death of an Insured Member during the Policy Year, while this Policy is in force,

subject to the terms of this Policy, the Sum Assured for such Insured Member shall become

payable and shall be paid to the Beneficiary.

4. Eligibility Criteria.

4.1 Master Policyholder's bona fide members, who satisfy the following eligibility criteria (the

"Eligibility Criteria") shall be entitled to become the Insured Member/s under this Policy, if.

Member of Self Help Group (SHG), Joint Liability Group (JLG), Tenant Farmer Group (TFG),

Micro Credit Group (MCG).

a) Aged at last birth date not less than 18 years and not more than 59 years, and

b) Has a bank account with the Master Policyholder, and

c) Any other criteria as laid down by the Company from time to time.

4.1.1 The Insurance Cover of an Insured Member shall cease on the earliest of the following

dates;

a) Date of death of the Insured Member ;or

b) Date on which the Insured Member attains the age of Sixty years; or

c) Date on which the Insured Member ceases to satisfy the Eligibility Criteria or;

d) Date of end of the insurance cover under this Master Policy.

e) Date of cover cancellation or surrender of the Insured Member’s Cover.

4.1.2 The Master Policy shall cease on the earliest of the following dates;

a) Date of lapse of the Master Policy or;

b) Date of termination of the Policy by the Master Policyholder or;

c) Freelook cancellation by the Master Policyholder or;

d) If all the Insured Member covered under the Master Policy have expired (either have

matured/surrendered/terminated).

4.2 Cessation of Eligibility.

The Master Policyholder shall promptly notify the Company in writing if an Eligible Member,

who has been enrolled as an Insured Member, ceases to be an Eligible Member.

5. Insured Members.

5.1 Particulars of Eligible Members, who have been insured under this Policy, are set forth in

Annexure-I . Such Insured Members shall be eligible for cover under this Policy from the Risk

Commencement Date as specified against the respective Insured Member in Annexure-

5.2 An Insured Member who ceases to be an Eligible Member or ceases to fulfill the Eligibility

Criteria after his/her enrolment as an Insured Member, shall cease to be an Insured Member,

on and from the date he ceases to be an Eligible Member or ceases to satisfy the Eligibility

Criteria.

6. Premium.

6.1 Payment of Premiums and Grace period.

6.1.1 This Master Policy is issued subject to the Master Policyholder making prompt and regular

payment of annual Premium on each Premium Due Date and it shall be the responsibility of

the Master Policyholder to ensure prompt and regular payment of the Premium.

6.1.2 The Company allows 30 days of grace period for payment of Premium which is due for payment

under this Policy and if the due Premium is not paid within such grace period, this member

cover shall lapse from the due date for payment of the first unpaid Premium. In such a case,

the Company shall have no obligation to pay any Benefits to the Insured Member whose

member cover has lapsed.

Policy Document Page 11 of 19

6.1.3 On the termination of the Master Policy by the Master Policyholder or the Insurance Cover in

respect of an Insured Member during the term of the Policy, the Master Policy or the Insurance

Cover shall be terminated respectively and no amount shall be refunded as consequences of

such termination.

7. Forfeiture Provisions.

In issuing this Master Policy, the Company has relied on the accuracy and completeness of

the information provided by the Proposer/Master Policyholder and the Insured Member/s and

any other declarations or statements made or as may be made hereafter, by the Master

Policyholder/ Insured Members. Subject to the provisions of the applicable Regulations

including Section 45 of the Insurance Act, 1938, in the event any such information, declaration

or statement is found to be false or incorrect or any material information is found to be

withheld or misrepresented, the Insurance Cover shall become null and void from

commencement, and the Company shall cease to be liable for any Benefits under this Policy.

In such a case, the Company shall also not pay any amounts received under this Policy.

8. Obligations of the Master Policyholder.

8.1 This Policy is issued on the condition that the Master Policyholder shall provide to the Company

correct, complete information of the Eligible Members as are necessary for the Company to

make its decision to provide Insurance Cover and provide such other or further information

as the Company require. All documents furnished to the Master Policyholder by any Insured

Member in connection with this Policy, and other records as may have a bearing on the

insurance under this Policy, shall be open for audit/inspection by the Company at all

reasonable times.

8.2 In the event of any change in the particulars of an Insured Member occurring during a Policy

Year, the Master Policyholder shall promptly notify such changes to the Company, in any case

within 15 days of occurrence of such change or on the Master Policyholder becoming aware of

the same, whichever is earlier.

8.3 In the event of an Insured Member ceasing to be an Eligible Member, the Master Policyholder

shall promptly notify the Company in writing of the same but in any case within 15 days of

that event.

8.4 It shall be the responsibility of the Master Policyholder to ensure that the personal information

provided about the Insured Member(s) to the Company is accurate and correct. The Master

Policyholder shall indemnify and keep indemnified the Company against any and all losses,

costs, expenses, actions, claims, proceedings suffered by the Company as a result of the

Master Policyholder’s failure to carry out and ensure the aforesaid.

8.5 The Master Policyholder acknowledges that the Company shall not be liable for any loss of

Benefit resulting from errors in or omissions from any information, data or evidence given to

the Company or if the Master Policyholder does not remit the Premiums on behalf of the

Insured Members as laid down under this Policy.

8.6 Where the Master Policyholder is acting on trust for the benefit of the Insured Members, or

otherwise, the Master Policyholder acknowledges that it shall take appropriate steps to ensure

that the Insured Member(s) are duly informed and reminded from time to time about the

Frequency of Premium Payment Premium Due Dates, consequences of nonpayment within the due

dates and such other information which is vital for the continuation of the Insurance Cover. The

Master Policyholder acknowledges that, while the Company will be liable to the Insured Member

under this Policy, the Master Policyholder agrees at all times whether during or after the term of

this Policy, to indemnify and keep the Company indemnified from and against any claims, losses,

damages incurred/suffered by the Company on account of the Master Policyholder failing to

perform/committing a breach of its obligations under this Policy

8.7 The Master Policyholder shall explain the contents of this Policy, including the details of the

schedules, Annexures, Certificate of Insurance, premium payments and due dates, Benefits

etc to the Insured Member(s).

Policy Document Page 12 of 19

9. Certificate of Insurance

The Company shall issue a Certificate of Insurance to the Insured Member evidencing the

Insurance Cover provided to the Insured Member in terms of this Policy. It is expressly agreed

the contract of insurance evidenced by this Policy is between the Master Policyholder and the

Company. It is expressly agreed that the Certificate of Insurance is issued in terms of the

Master Policy and it does not create, vest or evidence any independent right or interest in

favour of the Insured Member or his/her Beneficiary, in the Policy or the Benefits payable in

terms of the Policy.

10. Age Admission.

The age of the Insured Member has been admitted on the basis of the declaration made by

the Master Policyholder/Insured Member in the member proposal form and/or in any

statement or document based on which this Policy has been issued. If the age of the Insured

Member is found to be different from that declared, the Company may adjust the Premiums

and/or the Benefits under this Policy and/or recover the applicable balance amounts, if any,

as it deems fit. The Insurance Cover shall however become void from commencement, if the

age of the Insured Member at the Risk Commencement Date is found to be higher than the

maximum or lower than the minimum entry age that was permissible under this Policy at the

time of its issue and the amounts received under this Policy shall be liable to be forfeited, at

the option of the Company.

11. Assignment.

This Master Policy and the Benefits payable under this Policy shall not be assigned.

12. Surrender/Paid-Up value: There is no surrender or paid-up value applicable under the plan.

13 Miscellaneous.

13.1 Release and discharge.

On payment of the relevant Benefits payable under this Master Policy to the beneficiary the

Company shall be relieved and discharged from all its obligations under this Policy.

13.2 Limitation of Liability.

The maximum liability of the Company under this Policy shall not, in any circumstances,

exceed the aggregate amount of the relevant Benefits payable hereunder.

13.3 Review/ Revision: The Company reserves the right to review, revise, delete and/or alter

any of the terms and conditions of this Policy with the approval of the Regulatory Authority.

13.4 Loan: No loan is admissible under this Policy.

13.5 Grievance Redressal / Communication of information

For the process on lodging a grievance, refer to the Annexure on Grievance Redressal

Procedure.

13.6 Taxes, duties and levies and disclosure of information

13.6.1 This Master Policy and the Benefits payable under this Master Policy shall be subject to the

Regulations, including taxation laws in effect from time to time. All taxes, duties, levies or

imposts including without limitation any sale, use, value added, service or other taxes

(collectively “Taxes”) as may be imposed now or in future by any authority (collectively “Taxes”)

on the Premiums and other sums payable to the Company or the Company’s obligations under

the Policy or the Benefits payable under the Policy or in any way relating to this Policy, shall be

borne and paid by the Master Policyholder or the Insured Member as the case may be. The

Premium and other sums payable under or in relation to the Policy do not include the Taxes. If,

however, the applicable law imposes such Taxes on the Company, then the Company shall have

the right to recover the same from the Master Policyholder or the Insured Member.

13.6.2 The persons receiving the Benefits shall be solely liable for complying with all the applicable

provisions of the Regulations, including taxation laws, and payment of all applicable Taxes.

Except as otherwise required by law, the Company shall not be responsible for any Tax liability

arising in relation to this Policy or the Benefits payable in terms of this Policy. In any case

Policy Document Page 13 of 19

where the Company is obliged to account to the revenue authorities for any Taxes applicable

to this Policy or the Benefits payable under this Policy, the Company shall be entitled to deduct

such Taxes from any sum payable under this Policy, and deposit the amount so deducted with

the appropriate governmental or Regulatory Authority.

13.6.3 In any case where the Company is obliged to disclose to the revenue or other Regulatory

Authority any information concerning the Policy, including information concerning the

Premium and the Benefits under this Policy, the Company shall be entitled to disclose the

required information to the appropriate governmental or Regulatory Authority.

13.7 Notice by the Company under the Policy.

Any notice required to be issued in terms of this Policy may be issued, either by issuing

individual notice/s to the Master Policyholder, including by electronic mail and/or facsimile, or

by issuing a general notice, including by publishing such notices in newspapers and/or on the

Company’s website.

13.8 Entire Contract.

This Policy comprises the terms and conditions set forth in this Policy document, the Policy

Schedule, the Annexures to the Policy, and the endorsements, if any, made on or applicable

to this Policy, which shall form an integral part and the entire contract, evidenced by this

Policy. The liability of the Company is at all times subject to the terms and conditions of this

Policy and the endorsements made from time to time.

13.9 Governing Law and Jurisdiction

13.9.1 This Policy shall be governed by and interpreted in accordance with the laws of India. All

actions, suits and proceedings under this Policy shall be subject to the exclusive jurisdiction

of the courts of law within whose territorial jurisdiction the registered office of the Company

is situated.

13.9.2 No action in law or equity shall be brought against the Company to enforce any claim under

this Policy, unless the Master Policyholder has filed with the Company a claim together with

all the required documents, in accordance with the requirements of this Policy and complied

with the requirements of the Company, at least 60 days prior to the institution of such action.

Master Policyholder’s attention is invited to Section 45 of the Insurance Act, 1938, which is

reproduced below for reference.

14.0 Free Look Period

You will have a period of 15 (fifteen) days from the receipt of the Master Policy document to

review the terms of the Master Policy and satisfy Yourself about the terms. During this period,

you may cancel the Master Policy by giving us written notice stating the reasons for your

objection and We will refund the Contribution received after deducting the pro-rata mortality

charges along with stamp duty paid on the Master Policy.

15.0 We will send you the policy document in accordance with the applicable laws. We will send the

communication or notices to you either in physical or electronic mode (including sms) at your

registered address/email id or registered mobile number provided by you in proposal form or

otherwise notified to us. Any change in the registered address/email or registered mobile

number of Policyholder or Claimant must be notified to Us immediately.

Policy not to be called in question on ground of mis-statement after two years.

No policy of life insurance effected before the commencement of this Act shall, after the expiry of two

years from the date of commencement of this Act and no policy of life insurance effected after the

coming into force of this Act shall, after the expiry of two years from the date on which it was effected,

be called in question by an insurer on the ground that a statement made in the proposal for insurance

or in any report of a medical officer, or referee, or friend of the insured, or in any other document

leading to the issue of the policy, was inaccurate or false, unless the insurer shows that such statement

was on a material matter or suppressed facts which it was material to disclose and that it was

Policy Document Page 14 of 19

fraudulently made by the policy-holder and that the policy-holder knew at the time of making it that

the statement was false or that it suppressed facts which it was material to disclose:

PROVIDED that nothing in this section shall prevent the insurer from calling for proof of age at any

time if he is entitled to do so, and no policy shall be deemed to be called in question merely because

the terms of the policy are adjusted on subsequent proof that the age of the life insured was incorrectly

stated in the proposal.

Insurance is the subject matter of solicitation. Product UIN: 136N022V02

Registered Office: ‘Canara HSBC Oriental bank of Commerce Life Insurance Company Limited’,

Unit No. 208, 2nd Floor, Kanchenjunga Building, 18 Barakhamba Road,New Delhi - 110001, India

Corporate Office: ‘Canara HSBC Oriental bank of Commerce Life Insurance Company Limited’,

Orchid Business Park, 2

Floor, Sohna Road, Sector-48, Gurgaon, Haryana - 122018

Policy Document Page 15 of 19

Annexure - I

List of Members included in the Canara HSBC Oriental Bank of Commerce Life

Sampoorna Kavach Plan

(UIN – 136N022V02)

Master Policy No

Sum Assured for each Member

Premium for each Member

Sr.

No.

Member No.

Application No

Member Name

Age

Risk

Commencement

Date

Policy Document Page 16 of 19

GRIEVANCE REDRESSAL PROCEDURE

1. In case You wish to register a complaint with Us, You may visit our website, approach our

resolution centre or may write to Us at the following address. We will respond to You within two

weeks from the date of our receiving Your complaint. Kindly note that in case We do not receive

a revert from You within eight weeks from the date of Your receipt of our response, We will treat

Your complaint as closed. Complaint Redressal Unit: Canara HSBC Oriental Bank of Commerce

Life Insurance Company Limited; 2nd Floor, Orchid Business Park, Sector-48, Sohna Road,

Gurugram 122018, Haryana, India Toll Free: 1800-103-0003 / 1800-180-0003 (BSNL/MTNL)

Email: [email protected]

2. If You do not receive a satisfactory response from Us within the above timelines, You may write

to our Grievance Redressal Officer at:

Grievance Redressal Officer: Canara HSBC Oriental Bank of Commerce Life Insurance

Company Limited; 2nd Floor, Orchid Business Park, Sector-48, Sohna Road, Gurugram 122018,

Haryana, India Toll Free: 1800-103-0003 / 1800-180-0003 (BSNL/MTNL) Email:

[email protected]

3. If You are not satisfied with Our response or do not receive a response from Us within 15 days,

You may approach the Grievance Cell of the Authority at:

Insurance Regulatory and Development Authority of India; Grievance Call Centre

(IGCC) Toll Free No:155255 Email ID: [email protected].

Website Address for registering the complaint online: http://www.igms.irda.gov.in Consumer

Affairs Department Insurance Regulatory and Development Authority of India ;

9th floor, United India Towers, Basheerbagh; Hyderabad – 500 029, Telangana; Fax No: 91- 40

– 6678 9768

4. In case You are not satisfied with the resolution or there is no response within a period of 1

month, You/complainant may approach the Insurance Ombudsman for Your State at the address

mentioned below or on Authority's website www.irda.gov.in. if the grievance pertains to the

matters as mentioned below or an appropriate judicial/quasi-judicial authority having jurisdiction

over the matter for redressal of Your grievance. You may also refer to the GBIC website at

http://www.gbic.co.in/ombudsman.html for updated list of Ombudsman. The Ombudsman may

receive complaints:.

a) under Rule 13 of Insurance Ombudsman Rules, 2017 ("Rules");

b) for any partial or total repudiation of claim by Us;

c) for any dispute in regard to Premium paid or payable;

d) for any dispute on the legal construction of the Policy in so far as such dispute relate to

claim;

e) for delay in settlement of claim;

f) for non-issue of any insurance document after receipt of Premium;

g) misrepresentation of policy terms and conditions;

h) policy servicing related grievances against Company and their agents and intermediaries;

i) issuance of policy which is not in conformity with the proposal form submitted by proposer;

and

j) any other matter resulting from the violation of provisions of Insurance Act, 1938 or

regulations, circulars, guidelines or instructions issued by Authority from time to time or

terms and conditions of the policy in so far as they relate to issues mentioned above.

Policy Document Page 17 of 19

LIST OF INSURANCE OMBUDSMAN*

1. Ahmedabad: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak

Marg, Relief Road, Ahmedabad – 380 001. Tel.: 079 - 25501201/02/05/06

Email: [email protected] Jurisdiction: Gujarat, Dadra & Nagar Haveli,

Daman and Diu

2. Bengaluru: Office of the Insurance Ombudsman, Jeevan Soudha Building, Ground Floor,

19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 025. Tel.: 080 - 26652049 /

26652048 Email: [email protected] Jurisdiction: Karnataka.

3. Bhopal: Office of the Insurance Ombudsman, Janak Vihar Complex,2

Floor, 6, Malviya

Nagar, Opp. Airtel Office, Near New Market, Bhopal (M.P.)-462 003. Tel.: 0755-2769201 /

2769202 Fax : 0755-2769203 Email: b[email protected] Jurisdiction: Madhya

Pradesh & Chhattisgarh.

4. Bhubaneshwar: Office of the Insurance Ombudsman, 62, Forest Park, Bhubaneshwar-751

009. Tel.: 0674-2596461/2596455 Fax: 0674-2596429 Email:

[email protected] Jurisdiction: Odisha

5. Chandigarh: Office of the Insurance Ombudsman, S.C.O. No.101, 102,103, 2nd Floor, Batra

Building, Sector 17-D, Chandigarh-160 017. Tel.: 0172- 2706196/2706468 Fax : 0172-

2708274 Email: [email protected] Jurisdiction: Punjab, Haryana, Himachal

Pradesh, Jammu & Kashmir, Chandigarh.

6. Chennai: Office of the Insurance Ombudsman, Fathima Akhtar Court, 4th Floor, 453, Anna

Salai, Teynampet, Chennai-600 018. Tel.: 044-24333668/24335284 Fax : 044-24333664

Email: [email protected] Jurisdiction: Tamil Nadu, Pondicherry Town and

Karaikal (which are part of Pondicherry)

7. New Delhi: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf

Ali Road, New Delhi-110002. Tel.: 011-23239633 / 23237532Fax : 011-23230858 Email:

[email protected] Jurisdiction: Delhi

8. Guwahati: Office of the Insurance Ombudsman, “Jeevan Nivesh”, 5

Floor, Near Panbazar

Overbridge, S.S. Road, Guwahati-781 001(Assam). Tel.: 0361-2132204/2132205 Fax: 0361-

2732937 Email: [email protected] Jurisdiction: Assam, Meghalaya, Manipur,

Mizoram, Arunachal Pradesh, Nagaland and Tripura

9. Hyderabad: Office of the Insurance Ombudsman, 6-2-46, 1st floor, "Moin Court", Lane Opp.

Saleem Function Palace, A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004. Tel.: 040 -

65504123 / 23312122 Fax: 040 - 23376599 Email: [email protected]

Jurisdiction: Andhra Pradesh, Telangana, Yanam and part of Territory of Pondicherry

10. Jaipur: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh

Marg, Jaipur - 302 005. Tel.: 0141 - 2740363 Email: bimalokpal.jaipur@ecoi.co.in .

Jurisdiction: Rajasthan

11. Ernakulam: Office of the Insurance Ombudsman, 2nd Floor, , CC 27/2603,,Pulinat Bldg.,

M.G. Road, Ernakulam-682 015. Tel: 0484-2358759/2359338 Fax: 0484-2359336

Email: [email protected] Jurisdiction: Kerala, Lakshadweep, Mahe – a part

of Pondicherry

12. Kolkata: Office of the Insurance Ombudsman, 4th Floor, Hindusthan Bldg. Annexe, 4, C.R.

Avenue, Kolkata – 700 072. Tel: 033 22124339/22124340 Fax: 033 22124341 Email:

[email protected] Jurisdiction: West Bengal, Sikkim, Andaman & Nicobar

Islands

13. Lucknow: Office of the Insurance Ombudsman, Jeevan Bhawan, Phase-2, 6

Floor, Nawal

Kishore Road, Hazaratganj, Lucknow-226 001. Tel: 0522 -2231330/2231331 Fax: 0522-

2231310 Email: [email protected] Jurisdiction: Districts of Uttar Pradesh:

Laitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra,

Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur,

Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi,

Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh,

Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar.

14. Mumbai: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S.V. Road,

Santacruz(W), Mumbai-400 054. Tel: 022-26106552/26106960 Fax: 022-26106052 Email:

[email protected] Jurisdiction: Goa, Mumbai Metropolitan Region excluding

Navi Mumbai & Thane

Policy Document Page 18 of 19

15. Pune: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195

to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030. Tel.:020 – 41312555; Email:

[email protected] Jurisdiction: Maharashtra, Area of Navi Mumbai and Thane

excluding Mumbai Metropolitan Region.

16. Noida: Insurance Ombudsman, Bhagwan Sahai Palace, 4th Floor, Main Road, Naya Bans,

Sector 15, G.B. Nagar, Noida. 201 301 Tel.: 0120-2514250/52/53 Email:

[email protected] Jurisdiction: State of Uttaranchal and the following Districts of

Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kanooj,

Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah,

Farrukhabad, Firozbad, Gautambodhanagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur,

Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur

17. Patna: Office of the Insurance Ombudsman, 1st Floor,Kalpana Arcade Building, Bazar Samiti

Road, Bahadurpur, Patna 800 006. Tel.: 0612-2680952 Email: [email protected]

Jurisdiction: Bihar, Jharkhand

*For updated list of Ombudsman please refer to the GBIC website at

http://www.gbic.co.in/ombudsman.html

Policy Document Page 19 of 19

Below are the lists of documents which are attached separately along with Master

policy document -

1. Copy of your Master Proposal Form

2. Copy of Scheme Rules