Service Request Form Module

Policy No

Policy holder / Walk-in Name

Policy Status

Type of Query Request

Category --Select-- Policy Servicing

Sub-Category --Select-- ACCOUNT STATEMENT ACCUMULATION CHANGE ADDITION / DELETION OF RIDERS ADDITION / DELETION OF SYSTEMATIC PARTIAL WITHDRAWAL ADDRESS CHANGE ALTERATION IN POLICY NOT EFFECTED ALTERATION OF SYSTEMATIC PARTIAL WITHDRAWAL REQUEST ANNUITY COE UPDATION ANNUITY PAYMENTS ASSIGNED POLICY SURRENDER ENQUIRY ASSIGNMENT CANCELLATION FROM INCEPTION CHANAGE OF TERM CHANGE OF OCCUPATION CHANGE OF PACKAGE CHEQUE DEPOSITED IN BANK CHEQUE DISPATCH QUERY CHEQUE HANDED OVER TO CUSTOMER CHEQUE SEND TO CUSTOMER CLEARANCE_ACCOUNT CONDITIONAL ASSIGNMENT CONVERSION TO SPTC CONVERT E - POLICY TO PHYSICAL POLICY CONVERT PHYSICAL BALIC POLICY TO E-POLICY COPY OF POLICY BOND CP CORRECTION DIRECT CREDIT DIRECT CREDIT DE-ACTIVATION DISCONTINUE PAYOUT DISCONTINUE REVERSAL DOB CORRECTION DOCKET RETRIEVAL DUPLICATE RECEIPT DUPLICATE POLICY BOND DUPLICATE POLICY BOND NOT RECEIVED E- MANDATE CAMPAIGN EMAIL-MOBILE REGISTRATION ENDORSEMENT LETTER ENDORSEMENT NOT RECEIVED-ADDRESS ENDORSEMENT NOT RECEIVED-ASSIGNMENT ENDORSEMENT NOT RECEIVED-NOMINATION FATCA FORM FATCA FORM-DOCUMENTS NOT IN ORDER FCF SERVICING FLEXI FREQUENCY CHANGE FLEXI PART/FULL WITHDRAWAL FLEXI_ACCUMULATION FREE LOOK CANCELLATION FREQUENCY CHANGE FUND SUMMARY STATEMENT FUND VALUE COMPLAINT FUND VALUE ENQUIRY FURTHER ASSIGNMENT FUTURE ANNUITY OPTIONS GMI FREQUENCY CHANGE GST STATEMENT HHID - LA VISIT HHID - SERVICE CALL HHID BRANCH VISIT HHID HOME VISIT INCORRECT ACCOUNT/PREMIUM STATEMENT INCREASE / DECREASE OF SA ISSUANCE MISTAKES IT CERTIFICATES LAPSE INTIMATION NOT RECEIVED LOAN POLICY BOND DISPATCH AND CREDIT CONFIRMATION LOAN QUOTATION MARK STOP PAYMENT OTHER THAN UL FORECLOSURE AND UL SURRENDER MATURITY - PENSION MATURITY CLAIMS MATURITY CROSS SALES NAME CORRECTION NB_BANK DETAILS CORRECTION NOMINATION CHANGE NON-RECEIPT OF PREMIUM RECEIPT NOTICE OF ASSIGNMENT/NOMINATION NOT ACKNOWLEDGED O-PIN PAN UPDATION PARTIAL WITHDRAWAL FOR INVEST PLUS PH SIGNATURE SCAN COPY PHYSICAL POLICY DOCKET POLICY BENEFIT OPTION NOT EFFECTED POLICY BOND NOT RECEIVED POLICY CONVERSION OPTION NOT EFFECTED POLICY DETAILS SUMMARY POLICY DOCKET SCAN COPY POLICY LOAN NOT PROCESSED POLICY LOANS POST PAYOUT CROSS-SELL PREMIUM HOLIDAY NOT EFFECTED PREMIUM INCREASE PREMIUM NOT ADJUSTED/WRONGLY ADJUSTED PREMIUM PAYMENT POSITION STATEMENT NOT RECEIVED PREMIUM REDUCTION PROPOSAL REJECTION PROPOSAL STATUS PS RELETED IT ISSUE RE-ISSUE OF EMO CASES REASSIGNMENT REMOVE POLICY FROM BLACKLIST RENEWAL HOME VISIT RENEWAL PREMIUM PAYMENT REQUEST FOR DUPLICATE POLICY IS NOT ACKNOWLEDGED RETRIEVAL OF ARCHIVED POLICY DOCUMENT REVIVAL REVIVAL DENIED REVIVAL NOT DONE REVIVAL REQUIREMENT NOT ACCEPTABLE REVIVAL REQUIREMENT NOT INFORMED SB-REVIVAL SERVICE TAX RELATED ISSUES SIGNATURE STALE CHEQUE REISSUANCE STATEMENT OF ACCOUNT NOT RECEIVED STOP REISSUE MINOR MAJOR CASES STOP REISSUE _PAYEE NAME CHANGE CASES SURRENDER - TRADITIONAL POLICIES SURRENDER VALUE ENQUIRY SURRENDER VALUE SMS SURRENDER_ REVERSAL_TRADITIONAL SURVIVAL BENEFIT NOT RECEIVED Sunita.Shaikh@bajajallianz.co.in TECHENICAL MODULE _F TRADITIONAL SURRENDER CROSS SALES UL FORECLOSURE UL FUND SWITCH UL PARTIAL WITHDRAWAL UL PARTIAL WITHDRAWAL - CROSS SELL UL SURRENDER UL SURRENDER CROSS SALES UL TOP-UP WRONG ENCASHMENT CHEQUE WRONG NEFT

Select Form Type --Select-- Urdu Telgu Tamil Surrender Withdrawal Form Standard Instruction Form Sindhi Signature Form Shantali Settlement of Maturity Benefit Sanskrit SHCIL-EI account Creation Form Reduction_Decrease in Regular Premium Receipt of Loan Reassignment Form Punjabi Policy Servicing Request Form Odia Nomination Form Nepali NSDL-EI account Creation Form Maturity Discharge Form Marathi Manipuri Malyalam Maithili Konkani Kashmiri Kannada KARVY-EI account Creation Form Hindi HEALTH CLAIM FORM(FCF-CF) Gujrathi Good Health Declaration English Electronic Payment Mandate Form ECS and ADI Forms Dogri Direct_Credit_Activation_Form Direct Credit Activation Form Declaration of Maiden Name DEATH CLAIM Consent Letter Certificate of Existence CLAIM RIDER OTHERS CLAIM RIDER CI CIRL-EI account Creation Form CAMS-EI account Creation Form Bodo Bengali Assignment Assami Appointment of Appointee Form Application for Top Up Application for Online Pin Application for Loan Annuity Form

Mode of Query Walkin

Select Request Given By --Select-- Policy Holder

IC Code SM Code Emp Code

Name

Whether the printing of this is for ? Branch Use Others

Reason --Select-- Form lost by customer Customer travelled to another city Excessive overwriting on the form by customer Wrong signature done by customer Form Mutilated