IDBI Bank Subscription Form – Pradhan Mantri Jeevanjyoti Bima Yojana (PMJJBY) from Download

Based on the provided document, here are the key points of the IDBI Bank Consent-cum-Declaration Form for the Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY), administered in partnership with the Life Insurance Corporation of India (LIC) (p. 1):

• Enrollment Intent: This form functions as a consent-cum-declaration document required for eligible savings bank account holders to officially join the PMJJBY scheme (pp. 1-2).
• Integrated Receipt: The second page includes a dedicated “Acknowledgement Slip-cum-Certificate of Insurance” that bank officials seal and sign to provide immediate proof of registration (p. 2).

• Identity Tracking: Captures vital personal metrics including the account holder’s name, savings account number, date of birth, physical address, mobile number, email ID, and Aadhaar number (p. 1).
• Nomination Field: Requires naming a beneficiary along with their address and relationship (p. 1). If the nominee is a minor, a separate legal adult guardian must be officially designated (pp. 1, 3).

• Mandatory Consent: By signing, the applicant gives explicit authorization to the bank to automatically debit the annual premium directly from their account (p. 1).
• Recurring Timeline: The premium auto-debit takes place annually between May 25th and June 1st to ensure continuous insurance coverage for the upcoming cycle (p. 1).
• Listed Premium: While this historical form template lists a premium of ₹330 plus applicable service taxes, please note that the current statutory annual premium set by the government is ₹436 (p. 1).

• Age Windows: The entry age is restricted to individuals between 18 and 50 years old (p. 2). However, the active insurance cover remains valid until the member reaches 55 years of age, provided the account stays funded (pp. 2-3).
• Fixed Benefit: The scheme provides a strict life cover benefit of ₹2,00,000 payable to the designated nominee in the event of the member’s death (pp. 1-2).
• Single Account Enforcement: An individual can only hold one PMJJBY policy nationwide (p. 1). If a customer mistakenly authorizes multiple banks to debit a premium, their total life cover remains capped at ₹2,00,000, and additional premiums may be forfeited (p. 1).
• Termination & Disqualification: The policy automatically terminates if the user hits age 55, closes their bank account, or maintains an insufficient balance to clear the annual premium (p. 3).
• No Maturity Payout: This is a pure term insurance policy; it carries no surrender value or maturity benefits if the insured survives the term (p. 3).

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