PNB BANK PNB ORIENTAL ROYAL MEDICLAIM INSURANCE POLICY:PROPOSAL FORM DOWNLOAD

Based on the provided proposal form, here are the key points for the PNB Oriental Royal Mediclaim Insurance Policy (With Family Floater) (PNB_Orient… p. 1):

• Target Group: Exclusively for account holders and employees of Punjab National Bank (PNB) (PNB_Orient… p. 1).
• Maximum Size: A family floater can cover the proposer (account holder/employee), their spouse, and up to two dependent children (PNB_Orient… p. 1).
• Age Limits: Eligible individuals must be aged from 3 completed months up to 79 completed years (PNB_Orient… p. 1).
• Female Child Rule: Covered until she gets married, after which coverage ceases immediately (PNB_Orient… p. 1).
• Male Child Rule: Covered up to 26 years of age, provided he is a bonafide regular student and fully dependent on the proposer (PNB_Orient… p. 1).

• Form Layout: The proposal form must be completely filled out in BLOCK LETTERS (PNB_Orient… p. 1).
• Photographs: Applicants must submit two stamp-size photographs for each insured person along with two copies of the form (PNB_Orient… p. 1).
• Photo Labeling: The name and age of the respective insured person must be written on the back of their photograph (PNB_Orient… p. 1).
• Bank Details: Valid PNB account number, branch name, and city are mandatory fields to facilitate direct premium processing (PNB_Orient… pp. 2, 4).
• Proposer PAN: The Permanent Account Number (PAN) of the proposer must be supplied (listed as optional on the form layout) (PNB_Orient… p. 3).

• Health Status: Proposers must explicitly declare if all applicants are in good health and free from physical or mental diseases (PNB_Orient… p. 2).
• Premium Payment: The proposer must sign a specific authorization allowing PNB to directly debit the premium from their linked bank account (PNB_Orient… p. 4).
• Information Sharing: Authorizes the insurance company to collect health/medical information from past doctors, hospitals, or previous employers for underwriting and claim settlement (PNB_Orient… p. 4).
• Signatures Required: The form requires the signature of the proposer and a mandatory countersignature by the PNB Branch Manager, along with the branch code (PNB_Orient… p. 4).

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