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UNDERWRITING CHARTS

( UPDATED up to: 12.07.2016 )

NON - MEDICAL (SPECIAL)


AGE S.U.C PLANS ALLOWED CONDITIONS
18-35 20 Lacs T.No. 814,815,816,817,818, 1) Standard Age Proof only.
820,821,827,830,831,833, 2) Minimum 1 year service completed.
36-45 15 Lacs 3) Male Major with literate & Female Major with SSLC pass
835,836, 838 & PWB and
issued from time to time. 4) Govt & Quasi Govt Offices, Reputed commercial
46-50 5 Lacs For T.No. 815,820,821,830 SUC firms, Industrial undertakings, Pvt schools, State
is 1.25 times of BSA corporations and state owned Industrial undertakings etc.

NON - MEDICAL GENERAL for PROFESSIONALS


(Self Employed & Employed if there is no NMS)

AGE S.U.C Plans Allowed CONDITIONS

18-35 15 Lacs T.No. 1) Std. Age Proof only.


814,815,816,817,818,820,821, 2) Income Proof: Copies of ITRs with
minimum Income of Rs. 1.5 Lacs p.a
827,830,831, 833,835,836, 838 & PWB 3) Chartered Accountants, Cost Accountants,
36-45 10 Lacs and issued from time to time.. Engineers, Computer Consultants, Doctors,
Lawyers, Architects, Management Consultants,
For T.No. 815,820,821,830, Teachers, LIC Agents etc.
46-50 5 Lacs
SUC is 1.25 times of BSA

NON-MEDICAL (GENERAL) OTHERS


(for Major Males & Literate Females)

STD. AGE NSAP - NSAP -


AGE PROOFS including ESIS card, All other PLANS ALLOWED CONDITIONS
PAN,DL & Aadhar Muslim MC, Proofs
Card with full DOB SR w/o SC
S.UC S.U.C T.No. 1) Age NBD as on date of Proposal.
814,815,816,817,818 2) Female Cat. III subject to their
5 3 2 ,820,821,827, 830, allowable overall limit
18-35
Lacs Lacs Lacs 831,833, 835,
3) NSAP Max. term 25 years.
4) NSAP Max. maturity age 65 years.
836,838 and issued 5) Self-employed Female Cat. III
from time to with education up to 8th std. can be
3 2 1.50 given total Insurance not exceeding
36-45 time..
Lacs Lacs Lacs For T.No. 2 Lac TRSA.
6) Max age at entry & maturity age
815,820,821,830, will be restricted to 50 & 65 years
2 1.25 1.25 SUC respectively.
46-50
Lacs Lacs Lacs is 1.25 times of BSA

(Please refer for details CO Cir. Ref: 1993/4 dtd. 21.2.2005 & 2091/4 dtd. 6.11.2006 & U&R/3/2007 dtd.15.1.2008, U&R
18/2008 dated 28.6.2008 & U&R/81/2012 dated 31.12.2012 & U&R/104/2014 dated 10.3.2014,
U&R/138/2016 dated 25.06.2016)
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INSURANCE TO 'MAJOR STUDENTS'
NON-MEDICAL (Age 18 to 25 Years)

AGE SA PLANS ALLOWED CONDITIONS


1) Students with minimum qualification of 10+2 or equivalent & who
Up T.No. 814,815,816, are pursuing graduation/PG/professional courses.
18
817,818,820,821, 2) Declaration from Student & Parent that they are regularly attending
to
to 827,830,831,833, College.
3) Copy of Passing /Appearing certificate of the just completed
835,836, 838 academic year.
25 15 and issued from time to
time..
4) No (matching) parent insurance is required for SA up to 5 lacs &
up to 10 lacs if PWB is opted.
Lacs
For T.No. 815,820, 5) Max 10 times Average Income of Proposer sub to parent's equal
821,830 SUC is 1.25 time insurance.
of BSA 6) Recent photograph must be insisted upon.
7) All Family members should be adequately insured, not on any
particular child.

(Pl. refer CO Cir. Ref: Actl. 2090/4 dtd. 1.1.2006 & 2091/4 dtd. 6.11.2006 & U&R/3/2007 dtd.15.1.2008, U&R/47/18.3.10,
U&R/84/2013 dated 8.3.2013 and U&R/104/2014 dated 10.3.2014, U&R/138/2016 dated 25.06.2016)

INSURANCE ON 'MINOR LIVES' (RISK PLANS)


AGE GROUP (LBD)
S.A Below 5 years 5 to 9 years 10 to 17 years RESTRICTIONS
Up No medical, only No Medical, only
1) T-814, 820, 821, 832, 834, 835 & 836 etc
to * No Medical. Height , Weight & ACR Height , Weight &
issued from time to time to std. & sub-std.
* Copy of latest SC, if required. Copy of latest ACR required.
8 lacs School Certificate. Lives up to cl. III due to over weight.
Copy of latest School
attending school 2) Cl. IV sent to CUS.
Certificate.
3) Other plans for std lives only.
* No Medical. * No medical. Juvenile FMR, 4) LA should have good physique.
8 to 25 * Immunization * Only Height , Copy of latest 5) Cl. 10(a) & Cl. 76 if SA up to 1 Cr. to be
lacs record Weight & ACR
* Copy of latest SC, if required.
S.C required. imposed.
attending school * Copy of latest SC. 6) No (matching) parent insurance is
required for SA up to 5 lacs &
25 *Juvenile FMR * Juvenile FMR. Juvenile FMR up to 10 lacs if PWB is opted.
to * Immunization * Copy of latest copy of latest 7) Family History-Parent Insurance & Socio
49.99 record. School Certificate S.C required. -economic status should satisfactory.
Lacs * Copy of latest S.C if is required 8) SA above Rs. 1 Cr sent to CUS along with
attending.
MM/SDM's special Recommendations.
* Juvenile FMR. * Juvenile FMR, ECG, Juvenile FMR,
9) Recent photograph of child is must.
50 Lacs * Immunization Haemogram, Serum ECG,
& record. creatinine, RUA, Elisa Haemogram, SBT- 10) Child must be attending school/college &
latest progress report is instead upon.
Above * Copy of latest S.C if test for HIV, Hbs Ag * 13, RUA & copy 11) Std age proof of the child is must.
attending. Copy of latest S.C of latest S.C
required required. 12) Std age proof of the proposer is must, if
PWB is opted.
Plans T.No. 814,817,827,832, T.No. 814,816,817,820,821,
Allowed 834,835,836 and issued from time to time.. 827,832,834,835,836,838 and issued from time to time..

(Pl. refer for details CO Circular ref: Actl/2090/4 dated 1.11.2006 and Actl/2104/4 dated 6.3.2007, U&R/25/2008 dated 4.12.2008,
U&R/84/2013 dated 8.3.2013, U&R/116/2015 dated 4.3.2015, U&R/124/2015 dated 15.5.2015, U&R/126/2015 dated 14.8.2015,
U&R/131/2016 dated 2.1.2016, U&R/138/2016 dated 25.06.2016)
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NON-MEDICAL SCHEME
EXCLUSIVE FOR 'SINGLE PREMIUM' PLANS
Non-Mediclal (Spl), Non-
Medical (Gen) to Employed NON-MEDICAL
& Self employed (GENERAL)
Professionals, Major TO CONDITIONS
RESTRICTIONS
Students and NRIs to whom
OTHERS.
AGE NM(Spl) is applicable
STD. AGE NSAP: NSAP
PROOFS including ESIS card, All
PAN,DL & Aadhar Card Muslim other
with full DOB MC, SR Proofs
w/o SC
18-35 15 1.50 1.50 1) All plans where 1) Limits based on SUC (TAS - Single
Lacs Lacs Lacs in Single Premium premium) under all single premium proposals
mode is applicable under Non-medical scheme in the last One full
10
36-50 and which are year on the basis of DOC should be clubbed for
Lacs 75000 75000 allowed under underwriting purpose.
existing Non- 2) The Proponent should be Std lives & should
Medical (Spl) & not attract any EMR.
No-Medical (Gen) 3) MHR limit should be on the basis of first year
scheme can be risk cover (death cover).
allowed. 4) Allowed to all Male and Female Cat I,II &III.
3
51-60 2) Pure term For Single ladies and Widows under Cat III age
Lacs assurance plans / up to 50 years only allowed.
TRB & CIRBs are 5) SUC under T.No. 186 not to be clubbed.
not allowed. 6) Pure term assurance plans not allowed.
(Please refer co cir U&R/44/2009 dated 24.12.2009, U&R/53/2010 dated 10.12.2010, U&R/86/2013 dated 16.3.2013 &
U&R/102/2014 dated 11.2.2014, U&R/138/2016 dated 25.06.2016)

STAND - ALONE NON-MEDICAL LIMIT UNDER


LIC'S NEW BIMA BACHAT -T.NO. 816
Non-Mediclal (Spl), Non-
Medical (Gen) to Employed NON-MEDICAL
& Self employed (GENERAL)
Professionals, Major TO
Students and NRIs to whom CONDITIONS
OTHERS.
AGE NM(Spl) is applicable
STD. AGE NSAP: NSAP
PROOFS including ESIS card, All other
PAN,DL & Aadhar Card with Muslim MC, Proofs
full DOB SR w/o SC

20 1.50 1.50 1) The above Non-Medical limits are stand alone applicable for
18-35 Lacs Lacs Lacs New Bima Bachat T.No. 816 only.
2) Limits based on SUC (TAS - Single premium) under the
10 New Bima Bachat only, taken in the last one full year under
36-50 Lacs 75000 75000 Non-Medical only.
3) The Proponent should be Std lives & should not attract any
EMR.
3 4) MHR is based on SUC as usual.
51-60
Lacs 5) Allowed to all Male and Female Cat I,II &III. For Single
ladies and Widows under Cat III age up to 50 years only
allowed.
(Please refer co cir Ref: U&R/4/2008 dated 15.1.2008, U&R/97/2014 dated 7.1.2014, U&R/CIP/13-14/461 dated 26.3.2014
U&R/108/2014 dated 6.6.2014 , U&R/138/2016 dated 25.06.2016)
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INSURANCE ON ' FEMALE - LIVES '
CATEG- ELIGIBILITY QUALIFI- AGE CONDITIONS INCOME MAX. S.A
ORY CATION PROOF PROOF

CAT .I i. Women with earned i. Min. 1 yr. Service Annual Premi. Age Multiples
Married income by virtue of ii. SSS addendum i. Up to Rs.1 lac up to 35 – 25 times
Single employment in Govt. or SSLC iii. Co. established at only MHR. 36 to 45 – 20 times
& Quasi Govt. or reputed STD ii. Above Rs.1 lac 46 to 55 – 12 times
Passed least
Widow Commercial Institutions ITR for 3 yrs. ( 2 56 & above – 10 times
even if NMS is not there.
3 yrs. & evidence of yrs. If recently)
employment.
ii. Doctors, Lawyers, CAs, SSLC + Practicing the profession
DO Engineers, Management Professional STD or employed where DO DO
Consultants, Teachers, degree NMS is not there
LIC Agents etc.
iii. Self employed women HSC + STD IT returns for last
DO filing IT returns. Professional or Self -Employed 3 yrs. ( 2 yrs. If DO
qualification NSAP started newly)

iv. Women with i. Taking active part in day-


DO unearned income Technically STD to-day business To be referred DO
Qualified ii. Recommended by
filing IT returns. to C.U.S
MM/SDM
CAT. II i. Women with unearned Good STD i. Income excluding IT returns for As stated above subject
Married income having personal education capital gains, one time last 3 years or
Single properties/ investments. to maximum S.A of Rs.
income. CA certificate
& ii. Filing IT returns.
ii. Adequate insurance with PAN
1.50 Crs
WIDOWS
on others.
CAT. IIIA.WITH OWN Max. age at entry 50 Spl. MHR by DO 1) 2 Lacs or 7 times
INCOME: i.e Self 1) Illiterate yrs. High risk plans , or Club member of average annual income
Married Employed , but no ITR or ALL Agents of DM & whichever is less.
or TRB & CIR not
Women Employed but not above /CLIA/ 2. SA 5 lacs under T.No. 186
studied up to allowed. T.No. 186 Max
Female. Cat.I or unearned 8th std. ABM(s) Sr./ BM stand alone.
income but no ITR.
age at entry 66 yrs. for SA above 1 lac
25 Lacs. Under Medical & 1) 5 Lacs or 7 times of avg.
th
2) 9 std. Husband's Matching annual income whichever is
insurance for SA above 5 less (with matching
DO DO Or STD
Lacs. Recent photograph &
above up DO insurance max. 25 Lacs).
Bank passbook /statement
2) SA 5 lacs under T.No. 186
to under of own account. T.No. 186
Max age at entry 66 years. stand alone.
Graduate.

Rs. 50 lacs SA Under 1) 7 Lacs or 7 times of avg.


3) Graduate Medical & Husband's annual income whichever is
& Matching insurance for SA less (with matching
DO DO DO DO
above 5 lacs. Recent
above. Insurance max. 50 Lacs
photograph & Bank
passbook/statement of own
2) SA 5 lacs under T.No.
account. T.No. 186 Max age 186(Stand alone).
at entry 66 years.
STD or Husband's matching ins. Husband's
1) Non- NSAP sound social status. income Max.SA: -25 lacs.
(if NSAP- Medical must. Max. age sufficient to
B. WITHOUT graduate
any Joint life: - 2 lacs.
DO INCOME at entry is 50 years. Cl. cover ins. On
other T – 186 : - 5 lacs.
Rrestrict
4(b) for age between 18 self, wife and
to 30 yrs. T.No. 186 Max children. (stand alone).
ions
apply) age at entry 66 yrs. Medical must.
2) Graduate Max. SA : - 50 lacs
DO DO with passport STD DO DO Joint life: - 15 lacs
/DL Cr Card T – 186 : - 5 lacs.
Medi-claim (stand alone).
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INSURANCE ON ' FEMALE - LIVES '(Continued)
CAT-III
WITH OWN Max. age at entry 50 Spl. MHR in 1) 2 Lacs or 7 times of
INCOME:- 1) Illiterate yrs. high risk plans, F.No. 3251 average annual income
Single Age 25 to 50 yrs. Self TRB/CIR not allowed.
women employed but no ITR. or
Recent photo & Bank
by competent whichever is less.
studied up ALL authority.
employed but not passbook/ statement of
to 8th std. 2) SA 5 lacs under T.No.
female Cat-I or own account. T.No. 186
Unearned income but Max age at entry 66
186 stand alone.
no ITR. years.
2) 9th std. 1) 5 Lacs or 7 times of
DO DO Or STD DO DO
above up to average annual income
under- whichever is less.
graduate.

3)Graduate
2) SA 5 lacs under
DO DO & STD DO DO T.No. 186 stand alone.
above
DO WITHOUT NA NA NA NA
INCOME:-
i) Widows Without NA NA NA NA Insurance not allowed
Income.

ii) Received Only single premium Proof of lump 1) Max : SA Rs. 10 Lacs
compensation from No policies. - sum income
employer, death claim ALL Deferred annuity (w/o
restriction and Spl. MHR 2) No limit for annuity
of Husband's policy or life cover) and from Dos/
other lump sum immediate annuity w/o ABM(s) /BM
without life cover.
income. any limit.
CAT. III

High risk plans , Proof of 1.) Max. SA : 3 Lacs.


WIDOWS
iii) Getting Family TRB & CIR not receiving (2 lacs at BO & further 1 lac
Pension. DO DO Pension. Spl. at DO on merit)
allowed. MHR from 2.) Immediate annuity no
T.No. 186 Max age DO/ CLIA/ limit.
at entry 66 years. ABM(s) / BM 3.) SA 5 lacs under T.No. 186
stand alone.
iv)WITH OWN Max. age at entry is Spl. MHR for
INCOME: 49 yrs. Having minor Widows by 1) Max. SA : 3 Lacs.
Authorised DO / ( 2 Lacs at BO & further 1
i.e. Self employed or major children.
CLIA BM / ABM Lac at DO on merit)
but no ITR or STD High risk plans & (s). If she has
Literate TRB ,CIR not 2) Immediate annuity - no
employed but not major earning
limit.
female cat. I or allowed. children, details
T.No. 186 Max age at of insurance held 3) SA 5 lacs under T.No. 186
unearned income but by them is to be stand alone.
no ITR. entry 66 yrs.
called for.
CAT. IV Copy of Matching insurance of Parent's income. 1) Non risk plans 2.5 Crs.
At par with Male passing parents for SA more than MHR by DM &
FEMALE
certificate of 5/10 lacs. above Agents/
STUDENTS
CHILDREN
Children major just STD Declaration from LA and DO /CLIA/ BM / 2) Risk plans- 1 Crore.
(MAJOR) Students not aged completed Proposer regarding ABM (s) in Sub. to parent's insurance.
above 25 years. academic yr studentship. F.No. 294.
3) Risk plans > 1 Crore &
FEMALE Age 0-5 -M.C - Juvenile FMR for
STUDENTS medical case - DO
non risk plans above 1.50
CHILDREN At par with Male Crores referred to CUS
(MINOR) Children. Age 5-9 - S.C - DO - DO with MM / SDM's
recommendations.
Age 10 - 17 - S.C -DO - DO
Please refer for details CO cir. Ref: Actl/1994/4 dated 1.3.2005 , U&R/24/2008 dated 4.12.2008, U&R/84/2013 dated
8.3.2013, U&R/86/2013 dated 16.3.2013 and U&R/104/2014 dated 10.3.2014))
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INSURANCE ON ' PREGNANT WOMEN '


CONDITIONS:

* Proposals are to be submitted within 24 weeks ( SIX MONTHS ) of pregnancy.


• Women falling under Cat. I & II only allowed.
• Proposal under Medical only including all Special Reports as per Special Report chart
• except Chest X-Ray and CTMT.
• Reports like attending Gynecologist in F.No. 3341, Last check up, Sonography etc. if opined by DMR/ZMR.
• Proposals from pregnant Ladies who had a normal full time confinement and normal delivery without any past
history of abnormal delivery or abortion (miscarriage) due to septic will be accepted on same terms as for a
women not pregnant.
• Proposals with the past history of Complications or Caesar ion section will be accepted with a single extra of Rs.
2 per thousand.
• Maximum S.A Rs. 1 Crore ( subject to other conditions as per Insurance on Female Lives)
• Pure Term Assurance and other Plans having highest term insurance element will be allowed.
• Special MHR in F. No. 3251 in all case irrespective any of SA or SUC is required from Competent Authority.
• No change in the Financial Underwriting guidelines as per Cir. Ref: 1994/4 dated 1.3.2005.
(Please refer for details CO Cir. Ref: Actl. 2088/4 dated 30.10.2006 )

UNDERWRITING OF
LIC'S JEEVAN AROGYA (T.NO. 904)
NON-MEDICAL (Spl) and NON- NON-MEDICAL(Gen) to Others
MEDICAL(Gen) to Professionals.
AGE SUC AGE SUC
18-45 5 Lacs 18-35 5 Lacs
46-50 4 Lacs 36-50 2 Lacs
CONDITIONS:
1) S.A for MSB under plans 901, 902, 903 & 904 for 2 full years will be clubbed.
(TRB Sum Assured should not be added for SUC)
2) Age proof: Standard and NSAP-2016 (revised) only allowed.
3) Female all categories allowed (TRB not allowed to Female Cat III)
4) Housewives (w/o Income) can be the P.I and allowed equal to Spouse's health insurance cover,
but not exceeding Rs. 5 Lacs.
5) Pregnant Female can be offered cover up to 24 weeks of pregnancy with
latest Gynec consultation & investigation reports.
6) Widows (with no proof of income) can be considered as Principal insured up to Rs. 2 Lacs.
7) Maximum Health Insurance including Tab 901, 902 , 903 & 904 to one life either as Principal Insured or as Beneficiary
should not exceed Rs. 10 Lacs.
8) Avocation risks are to be excluded.
9( NRIs allowed residing in countries excluding countries falling under group I&II without any residence extra. But Term
Rider Benefits are not allowed to groups III to VII (Benefits are payable only if the hospitalization
and treatments are taken in India.
10) TRBs max up to 25 Lacs including all policies.
11) Accident Benefits max up to 50 Lacs including all Policies.
12) KYC & AML norms are to be complied with.
13) Financial Underwriting- Proof of Income not to be insisted.
14) Passport size Photos, measurements, Identification marks and other details of all lives are required.

Please refer co cir. U&R/63/2011 dated 31.05.2011 & U&R/91/2013 dated 14.11.2013 )
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SPECIAL REPORT - CHART ( for 'JEEVAN AROGY'. (T.No. 904)
S.U.C AGE AT ENTRY (LBD)
Up to 35 Yrs 36 to 45 Yrs 46 to 50 Yrs 51 to 55 Yrs >55 Yrs
Upto FMR, FBS, RUA, ECG,
2 Lacs NIL NIL NIL FMR, FBS, RUA S.CREATININE
Up to 4 FMR, FBS, FMR, FBS, RUA FMR, FBS, RUA, ECG, FMR, FBS, RUA, ECG, LIPIDOGRAM,
Lacs NIL S,CREATININE S-CREATININE, LFTs, HBSAG,
RUA HAEMOGRAM, HBA1C

Up to 5 FMR, FBS, FMR, RUA, ECG, FMR, FBS, RUA, ECG, FMR, FBS, RUA, ECG,
Lacs NIL RUA, ECG, LIPIDOGRAM,
S.CREATININE LIPIDOGRAM,
S. S.CREATININE, LFTs,
HBSAG, HAEMOGRAM, S-CREATININE, LFTs, HBSAG,
CREATININE
HBA1C HAEMOGRAM, HBA1C, CTMT
Above FMR, FBS, FMR, FBS, FMR, FBS, RUA, ECG, FMR, FBS, RUA, ECG, FMR, FBS, RUA, ECG,
5 Lacs RUA, ECG, RUA, ECG, LIPIDOGRAM, S- LIPIDOGRAM,
LIPIDOGRAM, S-CREATININE,
S. S- CREATININE, LFTs, S,CREATININE, LFTs,
HBSAG, HAEMOGRAM, HBSAG, HAEMOGRAM, LFTs, HBSAG, HAEMOGRAM,
CREATININE CREATININE
HBA1C,CTMT HBA1C, CTMT HBA1C, CTMT
(Please refer co cir. U&R/63/2011 dated 31.05.2011 & U&R/91/2013 dated 14.11.2013)
STANDARD & NON-STANDARD AGE PROOFS-2016.
STANDARD AGE PROOFS NON-STANDARD AGE PROOFS
1) Municipal Certificate 1) ESIS Card
2) Certificate of Baptism or extract from Bible 2) Marriage Certificate in case of Muslims
3) School/College Certificate with DOB.
3) Service record extract where age not verified at entry into service or only year
4) S.R Extract-evidence of age submitted at
entry into the service with full DOB. of birth is mentioned
5) Identity Card issued by Defense Dept. 4) Horoscope, other than maintained by Hindu family in an Bahi or family
6) ID card by Govt/Quasi-Govt/Reputed horoscope book.
commercial./ndustrial undertkgs with full DOB 5) Election (Voter) identity card, if date of issue of the card is available
7) Marriage Certificate issued by Roman Cath. 6) Village Panchayat certificate
8) Domicile Certificate with DOB.
7) Elder's declaration Form No. 3261
9) Passport.
10) Horoscope by Hindu family in a Bahi or 8) Self declaration (Stamped) Form No. 5220
family horoscope to be satisfactory by M(NB) 9) Self declaration (Unstamped) Form No. 5096
11) PAN issued by IT dept 10) Ration card issued originally, clearly mentioned the date of issue.
12) Driving license issued by RTO 11) Aadhar card issued by UIDAI with only year of birth.
13) Aadhar card issued UIDAI with full DOB 12) Any other proof not classified as standard as above
CONDITIONS CONDITIONS
1) Class 1 extra min. 1.5%0 will be charged
2) Plans involving higher term assurance element, term rider will not be granted
3) Maximum age entry 50 years (nbd)
Applicable as per individual Plans 4) Maximum policy term 25 yrs.
5) Maximum maturity Age 65 yrs.
issued from time to time 6) The DOB may be taken in the NSAP as follows.
i). If the DOB is stated in the NSAP then the same may be taken as it is.
ii). If the month of birth alone is stated in the NSAP, then 15th of the month stated may be
taken as the date of birth
iii). If the year of birth alone is stated in the NSAP, then 1st July of the year stated may be
taken as the date of birth.
7) Form No. 3260 has to be obtained wherever Non-standard age proof is submitted
SUM TO BE ALLOWED FOR NON STANDARD AGE PROOFS-for NON-MEDICAL GENERAL COVER
1. ESIS Card Any other Non
AGE 2. Marriage certificate in case of Muslims standard age proofs
3. Service record where age is not verified at the time of entry into service or where
only year of birth is mentioned
Up to 35 Years 3 Lacs 2 Lacs
36 to 45 Years 2 Lacs 1.50 Lacs
46 to 50 Years 1.25 Lacs 1.25 Lacs
(Plans allowed as per the Underwriting circulars of the plans issued from time to time)
-8-

SUM TO BE ALLOWED FOR NON STANDARD AGE PROOFS


for MEDICAL COVER
1) ESIS Card
2) Marriage certificate in case of
Type of Age proof Muslims Any other Non standard age proofs
3) Service record where age is not
verified at the time of entry into
service or where only year of birth
is mentioned
Maximum SA allowed No Upper limit 2 Lacs

(Please refer for details CO Cir. Ref: Actl/2091/4 dated 6.11.2006, U&R/138/2016 dated 25.06.2016)

KYC & AML GUIDE LINES


ANTI MONEY
LAUNDERING ACT. KNOW YOUR CUSTOMERS ( KYC ) NORMS.
2002.

Cash beyond Rs. WHEN ANUUAL PREMIUM EXCEEDS Rs. 10,000


50,000/- per (including previous policies)
transaction can be * Proof of Identity
accepted Sub to * Proof of Residence
production of PAN * Recent Photograph are MUST.
or Form No 60 or 61 WHEN ANNUAL PREMIUM IS Rs. 1,00,000 & ABOVE
of IT rules duly including previous policies) Income Proofs like:
verified by Std. Income proofs:- IT Returns , F.No 16 A, Employer's Certificate, Audited
Br-in-charge or Company A/cs, Audited Firm A/cs & partnership deed.
Authorised person. Non-Std Income Proofs:- C.A Certificate, Agriculture Income Certificate,
Agricultural – land details & Income Assessments from Tahasildar, Bank Cash-Flows
statements, Pass Book with PAN etc are MUST.

(Pl. refer for details CO Cir. Mktg / ZD/18/2006 dated 1.8.2006) (Pl. refer for details CO. Cir. Ref: U &R dated 11.12.2007)
Pl ref: CO/F&A/cc/A-23A/EDA/2DB/925 dated 12.10.2009, CO/F&A/cc/A-23A/EDA/2DB/927/ dated 15.1.2010,
IRDA cir. IRDA/F&I/CIR/AML231/10/2011/ dated 5.10.2011, CO/DEIA/2DB/ dated 17.10.2011)

UNDERWRITING GUIDELINES FOR


MODIFIED LIC's PWB RIDER
1) SUC will be calculated as per the existing rules on the life of the Proposer.
2) Actual Sum Assured for PWB will be the future Outstanding premiums under the basic plan.
3) Standard Age proof only allowed.
4) Male and Female lives falling under cat. I & II only allowed. Married Woman with Own Income only
allowed under cat. III.
5) NMS and NMG - Professional allowed.
6) Matching Insurance not required up to SA 10 Lacs, if PWB is opted for & is allowed.
7) NRI & FNIOs under Residence group VII only allowed.
8) All other underwriting rules relating to Insurance on Minor lives & PWB remain unchanged.
(Please refer Co cir. U&R/130/2016 dated 02.01.2016)
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SPECIAL REPORT - CHART ( for Life Plans) w. e. f. 17. 01. 2008.
S. U.C AGE AT ENTRY (LBD)
UP TO 35 Yrs 36 TO 45 Yrs 46 TO 55 Yrs 56 Yrs & Above
UP to 2,00,000 NIL NIL NIL Rest ECG, FBS
2,00,001 to NIL NIL Rest ECG, FBS. Rest ECG, Lipidogram , FBS, RUA, Hb%.
5,00,000
5,00,001 to NIL NIL Rest ECG, Lipidogram Rest ECG, Lipidogram ,FBS RUA, Hb%.
10,00,000 FBS, RUA, Hb%.
10,00,001 to NIL Lipidogram, FBS, RUA Rest ECG, SBT-13, RUA Rest ECG, Haemogram, SBT-13 , RUA,
15,00,000 Elisa for HIV, Hb%. Hb%. CTMT.
15,00,001 to FBS, Lipidogram Rest ECG, SBT-13, Rest ECG, Haemogram, Rest ECG, Haemogram, SBT-13, RUA,
35,00,000 Elisa for HIV, Hb%. RUA Hb%. SBT-13, RUA, CTMT. CTMT, HbAlc.
35,00,001 Rest ECG, SBT- Rest ECG, Rest ECG, Haemogram, Rest ECG, Haemogram, SBT-13 , RUA,
to 13, RUA Hb%. Haemogram, SBT-13, SBT-13 RUA, CTMT, CTMT, HbAlc Chest X Ray.
50,00,000 RUA, CTMT. HbAlc.
50,00,001 Rest ECG, Rest ECG, Rest ECG, Haemogram, Rest ECG, Haemogram, SBT-13, RUA,
& Haemogram, Haemogram, SBT-13, SBT-13 RUA, CTMT, CTMT, HbAlc, Chest X-Ray.
Above SBT-13, RUA. RUA, CTMT, HbAlc. HbAlc , Chest X-Ray.
NOTE:- If HbAlc is not available PGBS (after giving 75 gm of Glucose) is compulsory. If HIV test by Elisa method is
available, then HIV test by Tridot method will be accepted upto SUC Rs. 24.99 Lacs only)
(Please refer for details CO. Cir ref: U&R/4/2008 dated 15.1.2008)
VALIDITY PERIOD OF VARIOUS REPORTS
(Medical & Special Reports)
SL EVIDENCE OF HEALTH VALIDITY PERIOD FOR VALIDITY PERIOD FOR SUB-STD
STD LIVES LIVES

1 Declaration of Good Health (DGH) 3 Months for Male and 3 Months for Male and Female(All
Female(All Categories) Categories)
2 Full Medical Report (FMR) 12 Months 6 Months

3 Proposal Form 6 Months 6 Months

4 Special Medical Reports 12 Months 6 Months

5 HIV Test 6 Months 6 Months


NO FULL MEDICAL REPORT (FMR) FOR SUBSEQUENT PROPOSALS (PP) Provided
* Original FMR is valid as per our rules (As above)
• Actual S.A for fresh proposal is up to 5 Lacs.
• Doctor should have sufficient limit including SA for subsequent Proposal.
(Pl. refer CO Cir.ref: Actl/1992/4 dated 21.2.2005 and U&R /51/2010 dated 3.11.2010)
FINANCIAL UNDERWRITING
AGE MULTIPLE
Up to 35 Years 25 Times
36 to 45 Years 20 Times
46 to 55 Years 12 Times
56 & Above 10 Times
The above multiples are applicable to Male and Female cat-I & II lives only
Minor & Non-Earning Major 10 Times of Proposer's average annual income (Sub to max SA
children up to Age 25 Years applicable)
(Please ref: co cir U&R/47/2010 dated 18.03.2010, U&R/85/2013 dated 8.3.2013)
-10-

INSURANCE ON “PHYSICALLY HANDICAPPED” LIVES

CONDITIONS:-
i. Proposer should be a Major life and gainfully employed ( with Income)
ii. Minor proposer – No risk plans, suggest Non Risk plans.
iii. Special MHR from DO/ABM(S)/BM along with additional requirements.

GROUP RISK CLASIFICATION Underwriting ADDITIONAL


AUTHORITY REQUIREMENT

I B.O FMR/D.Q
Accident, With loss of ONE limb (including eye,ear-Non-Progressive)
non -
progressive
With loss of one more than One Limb (including with loss of both DO /ZUS FMR/D.Q, D.S & CNS
eye,ears) CUS

D.O FMR/D.Q, D.S & CNS


II Can walk without aid, no history of epilepsy, no mental retardation
Cerebral - (with 2 or less limbs involved)
Palsy

History of epilepsy, mental retardation, wheel chair dependent( 2 or CUS FMR/D.Q, D.S & CNS
less limbs)
Slight to moderate paralysis, localized, little or no functional D.O FMR/D.Q, DS &
disability, moderate to severe paralysis, dependence on CNS
III crutches/calipers for locomotion
POLIO

Severe paralysis, complete dependence on wheel chair, any ZUS/CUS FMR/D.Q, D.S & CNS
complications like Abnormal Renal functions, urinalysis or
respiratory impairment
IV Muscular Dystrophy CUS FMR/D.Q, D.S & CNS
Muscular.
With loss of one limb (including ear / eye – non progressive) B.O FMR/D.Q
V
Congenital Loss of one eye with congenital blindness , including blindness due to B.O FMR/D.Q
– present small pox and chicken pox, but not following any systemic disease
since Birth like diabetes, hypertension, cancer etc.
cause
unknown With loss of more than one limb (including ear/eye progressive/ non DO /ZUS FMR/D.Q, & CNS +
progressive with congenital blindness due to small pox, chicken pox CUS Full size Photograph
but not due to any diseases , loss of both ears- Deaf & Dump due to
Otoscelerosis and Dwarf
VI With loss of one or more limbs due diseases like, Diabetes, FMR/D.Q other
Diseases Peripheral vascular diseases, Stroke, Paralysis, CVA ZUS/CUS requirements
(cerebrovascular accident) TIA (transient is chemic attack), Any depending of diseases.
known diagnosis / infections and Nervous disorders,

D.Q = Deformity Questionnaire, D.S = Discharge summary, CNS = CNS Questionnaire.

(Please refer for details CO Cir ref:Actl/2089/4 dated 31.10.2006 and revised DMR guidelines/U&R/125/2015
dated 7.7.2015)
-11-
Underwriting of LIC'S 'JEEVAN RAKSHAK' T.NO. 827 ( Standalone)
Age Max Standalone SA Max Standalone SA Max Standalone SA
Std & NSAP-I NSAP-II NSAP-III
Up to 35 years Rs. 2 Lacs Rs. 2 Lacs Rs. 2 Lacs
36 to 45 years Rs. 2 Lacs Rs. 2 Lacs Rs. 1.50 Lacs
46 to 55 years Rs. 2 Lacs Rs. 1.25 Lacs Rs. 1.25 Lacs
RESTRICTIONS
1) This plan is allowed for Standard Lives under Non-Medical Max SA 2 Lacs only.
2) Actual SA is the Basic SA under this Plan
3) This Plan is treated as STANDALONE
4) This plan is allowed to major male lives, all categories of Female lives, major students & minor lives w/o
insisting on matching insurance.
5) Not allowed to pregnant ladies and widows & single women without Income
6) Not allowed under Mail Order Business and Foreign Nationals of Indian Origin
(Please refer for details co cir ref:U&R/110/2014 dated 19.8.2014)
Underwriting Guidelines for
LIC's e-Term - T No. 825
Age Non-Medical Limit ( Life Time-Limit)
18 (LBD) to 35 years ( NBD) Rs. 40 Lacs
36 (NBD) to 45 years (NBD) Rs. 30 Lacs
Conditions:
1) The plan is allowed to male & female lives, with own income proof and PAN card. Self attested copy of
ITRs/F.No16,Salary slips and other Std/non-Std Income proofs etc. for at-least 3 years are compulsory.
2) Minimum educational qualification 10+2 or equivalent.
3) Female category -I only allowed and pregnant woman not allowed.
4) Not allowed to non-earning major students.
5) This plan is allowed to only non-smoker only.
6) Non-medical is allowed to NMS & NMG (Professional only).
7) The non-medical limit mentioned above is an exclusive Life Time limit under this plan.
8) SUC under this plan is to be taken as the total of actual sum assured under all concurrent proposals &
policies taken during the last two full years (DOC) under e-term plan from LIC only.
9) Only standard age proof is allowed.
10) No ACR/MHR up to SUC Rs. 1 Cr, for above 1 Cr SUC special MHR is required.
11) This plan is not allowed to NRIs /FNIOs, KMI/Partnership Insurance/Employer Employee cover.

Financial underwriting of e-Term – T. No. 825


Age group Revised multiples of average individual income for last 3 years
Up to 35 years 25
36 to 45 years 20
46 to 55 years 12
56 to 60 years 10
(Please refer for details co cir ref: U&R/106/2014 dated 15.5.2014, U&R/128/2015 dated 1.10.2015)
-12-
De-Centralisation of the
'MEDICAL - UNDERWRITING' to the Branches
1. ABORTION ( Irrespective of type):

Risk classification Rating Additional Requirements


Waiting period 3 Months after surgery
Period since Abortion > 3 years and subsequent full
time confinement (delivery) and/or family planning Standard - BO FMR – found satisfactory
operation
2. APPENDICITIS:
Risk classification Rating Additional Requirements
Waiting period 3 Months after surgery
Period since operation > 3 months Standard - BO FMR – found satisfactory
3. CIRCUMCISION:
Risk classification Rating Additional Requirements
Waiting period 3 Months after surgery
Not associated with any other impairment /disease/
complication. Period since Operation > 3 months & Standard - BO FMR – found satisfactory
< 1 year
Not associated with any other
impairment/disease/complication. Period since Standard - BO Accept without FMR
operation > 1 year
4. FRACTURE OF LIMBS DUE TO ACCIDENT:
Risk classification Rating Additional Requirements
Fracture > 1 year ( If there is no deformity, no FMR found satisfactory with remark No
deformity, No residual defect, & also
residual defect, & also movement normal/near Standard - BO movement normal/near normal. Deformity
normal) Q need not be insisted upon.

5. HERNIA:
Risk classification Rating Additional Requirements
Waiting period 3 Months after surgery
Period since operation > 1 year, Standard - BO FMR found satisfactory with remark
No recurrence No recurrence. Hernia Q need not be
called for.

6. HYDROCELE:
Risk classification Rating Additional Requirements
Waiting period 3 Months after surgery
Period since operation > 3 years Standard - BO If FMR found satisfactory
-13-
7. LOWER SEGMENT CAESAREAN SECTION (LSCS)
Risk classification Rating Additional Requirements
Waiting period 3 Months after surgery
LSCS with Tubectomy (without any other associated If FMR found satisfactory, and
impairments/ disease/complication): Period since Standard - BO Scar Healthy
operation > 3 months
LSCS without Tubectomy (without any other If FMR found satisfactory, and
associated impairments disease/complication): Period Standard - BO Scar Healthy
since operation > 1 year
8. POST NORMAL DELIVERY (Full time confinement):
Risk classification Rating Additional Requirements
Period since date of delivery < 3 months Postpone
Period since date of delivery ( not associated with any As per existing guidelines
other impairment/disease/complication) > 3 months Standard - BO given for medical and non-
and with resumption of menstruation whichever is medical proposals, amended
later. from time to time.
9. PNEUMONIA, PNEUMONITIS:
Risk classification Rating Additional Requirements
Not associated with any other impairment/disease / Standard - BO FMR found satisfactory
complication, 6 months after full recovery
10. TONSILLECTOMY:
Risk classification Rating Additional Requirements
Tonsillectomy (removal of Tonsils) –
Waiting period 3 months after surgery
Tonsillectomy ( Removal of Tonsils > 3 months < 1 Standard - BO FMR found satisfactory
year
Period since Operation > 1 year Standard - BO Accept without FMR
11. TUBECTOMY:
Risk classification Rating Additional Requirements
Waiting period 3 Months after surgery
Period since Operation > 3 months < 1 year Standard - BO FMR found satisfactory
Period since Operation > 1 year Standard - BO Accept without FMR

( Please refer for details co cir ref: U&R/125/2015 dated 7.7.2015)


-14-
MHR LIMITS FOR VARIOUS AUTHORITIES
SL AUTHORITY MHR LIMT SL AUTHORITY MHR LIMT
1 DISTNGD & BM'S CLUB 10 Lacs 6 CLIA (CM'S/ CORPORATE 1 Crore
CLUB/ DEV OFFICER
2 DM'S CLUB 20 Lacs 7 SBAs 1.50 Crores
3 ZM'S CLUB/ FSEs 30 Lacs 8 ABM(SALES) 2 Crores
4 CM'S CLUB/ RETIRED 50 Lacs 9 BM/SB/CM I/C 5 Crores
EMPLOYEES/CLIA(DM'S CLUB)
5 CLIA (ZM'S CLUB 75 Lacs 10 MANAGER (SALES) Up to 10 Crores
11 MARKETING MANAGER 10 Crores &
Above
• MHR is necessary for all NM(Gen) cases.
• MHR is generally not necessary for SA up to 1 Lacs (sss cases).
• For SUC in excess of 25 Lacs MHR should be in Form No. 3251 with Annexure A&B.
• MHR required in case of Female category III as per co cir Actl/1994/4/1.3.2005.
• Form No 3260 will be submitted by DO/CLIA in case of non-std age proofs.
(Please refer co cir Actl/1865/4/203.2003, Actl/1994/4/1.3.2005, U&R/19/2008/1.7.2008, U&R/85/2013 dated 8.3.2013)

'FINANCIAL POWERS' AT VARIOUS OFFICES.


BRANCH/ DIVISIONAL OFFICE ZONAL OFFICE CENTRAL
Authority SSO OFFICE
Non- Medical Non- Medical Medical Medical
Medical Medical
Std Sub-Std Std Sub-Std Std Sub- Std Std Sub-Std

HGA 3 3 1.50 4 4 2 10 10 - -
Lacs Lacs Lac Lacs Lacs Lac Lacs Lacs

AAO 7 7 3.50 10 10 5 25 25 50 50
Lacs Lacs Lacs Lacs Lacs Lacs Lacs Lacs Lacs Lacs

AO 10 10 5 15 15 7.5 40 40 75 75
Lacs Lacs Lacs Lacs Lacs Lacs Lacs Lacs Lacs Lacs

BM/SBM/M(Adm) ADM ADM


(At BO) 15 15 10 20 30 15 50 50 100 100
ADM/M(NB) Lacs Lacs Lacs Lacs Lacs Lacs Lacs Lacs Lacs Lacs

( At DO)
DM DM
35 Lac 20 Lac
CM/BMC/SDM/ 20 20 15 20 40 25 75 75 200 200
DM I/c Secy/DM Lacs Lacs Lacs Lacs Lacs Lacs Lacs Lacs Lacs Lacs

SDM/RM(Actl)/SDM - - - - - - 100 Lacs 100 Lacs 300 300


Lacs Lacs

ZM I/c - - - - - - 150 100 Lacs > 300 > 300


CHIEF/DIRECTOR Lacs Lacs Lacs

(Please ref co cir U&R/39/2009/29.9.2009 & U&R/105/2014 dated 10.3.2014)


( COMPILED BY: SRI. Y. M. MURAL. MANAGER (Customer Zone), HUBLI, DHARWAD DIVISION
Mobile No. 99021-46223 )
This is strictly for private circulation only. For detailed version, please refer relevant circulars/guidelines issued by the
Corporation which shall be final & abiding for any interpretation.
Any suggestions for an improvement may be mail to Ym.Mural@licindia.com

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