Servicing Related Forms

General Requisition Form for

 • Alterations

• Surrender Value Quotation

• Policy Loan Quotation

• Revival Quotation

• Change of Mode/ Quotation

• Change of Address

• Discounted Claim

• Certificate of Premium Payment

Claims Discharge Voucher for

• Survival Benefit

• Maturity Value

• Discounted Value

Policy Loan Application Form

Change of Nomination Forms

Transfer of Policy: Form for Assignment/ Re-Assignment of a Policy

Loss of Policy - for issue of a "special policy" or duplicate policy in place of the lost policy.

Health Declaration for Revival of a Lapsed Policy.

Complaint Lodgment Form

Form for Bank Details for Direct Credit of Policy Payments 

New Business Related Forms

Proposal Forms for Insurance on Own Life (Form 300)


• To be used where the proposer is above 18 years last birthday, and is having independent income.

• To be also used for Smart Life 2 where Term Rider opted (and medicial exmaination report is need)

Proposal Forms for Insurance on Another Life (Form 340) – where the age of the life proposed is above 10 years of age, but below 18years

Proposal Forms for Insurance on Another Life (Form 360) – where the age of the life proposed is less than 10 years

Proposal Forms for Insurance on Another Life (Form 340) – For Key man Insurance Policies


• Where a company is insuring its key empolyee or manager or director.

Proposal Form for Smart Life 2 Plan (Form 300BN)

• To be used only in respect of 'without term rider' cases. Can also be used where only the 'accidental death rider' is opted

Agents’ Confidential Report- must accompany every proposal submitted to LICI 

Health Declaration in respect of a New Proposal 

Medical Examination Form 

Product Brochure Downloads

• The Money Tree Range

• Riders Range - Arm Your Policies with Extra Security Features

• The Target Range

• The Wealth Builder Range

• The Aspire Range 

• Important Information to Our Policyholders and Prospective Policyholders - Part 1, Part 2

 • Gold Life Single Premium Bond

• What Makes LICI Policies A Better Choice

You may send the completed forms by post or fax to our office. For postal address and fax numbers, please click here.

 You will be directed to the relevant web page within this site.


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