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Is the proposer NRI/Foreign National?*

Yes

PAN*

Name as per PAN*

Existing policy number

Date of Birth*

I do not have PAN

Form 60 Details

I have applied for PAN and it is not yet generated

Yes

Aadhaar Number

KYC details from CKYC

These details are fetched from Central Know Your Customer repository. If you find any mismatch in the KYC details please proceed with EKYC using your Aadhaar.

Personal Details

First Name

Middle Name

Last Name

Gender

Nationality

Mobile Number

Email Address

Permanent Address

Address Line 1

Address Line 2

Address Line 3

Address Line 4

Address Line 5

Pin Code

City

State

Communication Address

Address Line 1

Address Line 2

Address Line 3

Address Line 4

Address Line 5

Pin Code

City

State

KYC details from EKYC

These details are fetched from Electronic Know Your Customer repository, If you find any mismatch in the KYC details please proceed with entering details manually.

Personal Details

First Name

Middle Name

Last Name

Gender

Nationality

Mobile Number

E-mail Address

Permanent Address

Address Line 1

Address Line 2

Address Line 3

Address Line 4

Address Line 5

Pin Code

City

State

Communication Address

Address Line 1

Address Line 2

Address Line 3

Address Line 4

Address Line 5

Pin Code

City

State

Need Analysis

Personal Details

Existing Life Insurance Cover (in lakhs)

Education

Occupation

Nature of Duty

Company Name

Annual Income

Do you work in Defense/ Para-military Force/ Merchant Marine/ Oil & Natural gas/ Mining or any Industry where there is occupation hazard?

Yes

Household Benefits

Do you want to avail the Household family benefits ?

Yes

Details of the Family Member

First Name

Last Name

The Family Member Is My

PAN Policy Number (If Household member is an existing customer of BALIC)

PAN

Date of Birth

Mobile Number