{"id":339,"title":"Claim Intimation Form - Superannuation Plan","purpose":"claim","insurer":{"slug":"indiafirst-life-insurance","name":"IndiaFirst Life Insurance Company Limited"},"source_pdf":"https://www.indiafirstlife.com/content/dam/ifliwebsite/in/en/download-center/claims/claim-intimation-form-superannuation-individual.pdf","sha256":"2b0db4d31977d350e87c559e6899b2e07063b7fff7d654a6916eb76182fba58a","pages":2,"collected":"2026-10-17","instructions":{"about":"This form is used to intimate a claim under the Superannuation Plan by the master policy holder or trustee on behalf of the employee or member.","notes":["All fields are mandatory.","Use original or copy of death certificate as applicable.","Provide cancelled cheque and copy of bank passbook and account statement for bank details.","Mode of payment selected will be used for all payouts.","For assistance contact 022 39418700 or email claims.support@indiafirstlife.com."],"title":"Claim Intimation Form - Superannuation Plan","submit":{"to":"Claim Department IndiaFirst Life Insurance Company Ltd., 12th and 13th Floor, North [C] Wing, Tower 4, Nesco IT Park, Nesco Center, Western Express Highway, Goregaon (East), Mumbai – 400063.","how":"post","address":"12th and 13th Floor, North [C] Wing, Tower 4, Nesco IT Park, Nesco Center, Western Express Highway, Goregaon (East), Mumbai – 400063"},"purpose":"claim","sections":[{"title":"Common Details","fields":[{"help":"","type":"text","label":"Scheme Type:","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Name of the Master Policy Holder:","options":[],"required":true,"pdf_field":""},{"help":"","type":"text","label":"Master Policy No:","options":[],"required":true,"pdf_field":""},{"help":"Enter the employee's name exactly as in the data sent to the insurer","type":"text","label":"Name of the Employee (As in the data sent to us) Mr./Mrs./Ms.","options":[],"required":true,"pdf_field":""},{"help":"Enter the employee code or member ID","type":"text","label":"Emp. Code/ Member Id.","options":[],"required":true,"pdf_field":""},{"help":"Use DD/MM/YYYY format","type":"date","label":"Date of Birth:","options":[],"required":true,"pdf_field":""},{"help":"Use DD/MM/YYYY format","type":"date","label":"Date of Joining Service:","options":[],"required":true,"pdf_field":""},{"help":"Use DD/MM/YYYY format","type":"date","label":"Date of Exit:","options":[],"required":true,"pdf_field":""},{"help":"Select the reason for exit","type":"choice","label":"Mode of Exit:","options":["Retirement","Resignation","Death","Other"],"required":true,"pdf_field":""}],"filled_by":""},{"title":"Benefits","fields":[{"help":"Enter the name of the approved superannuation fund to transfer the fund","type":"text","label":"1. Transfer of the fund to the new employers Superannuation fund* Name of the Superannuation fund to which fund is to be transferred","options":[],"required":null,"pdf_field":""},{"help":"Enter the percentage of commutation","type":"number","label":"2. Purchase of annuity with commutation Commutation %","options":[],"required":null,"pdf_field":""},{"help":"Enter income tax percentage to be deducted if exit other than death before normal retirement date","type":"number","label":"Tax* %","options":[],"required":null,"pdf_field":""},{"help":"Enter the insurer name","type":"text","label":"Insurer from whom the annuity to be purchased :","options":[],"required":null,"pdf_field":""},{"help":"Select the type of annuity","type":"choice","label":"Type of Annuity","options":["Life Annuity without ROC","Life Annuity with ROC"],"required":null,"pdf_field":""},{"help":"Enter tax percentage to be deducted","type":"number","label":"Tax to be deducted %","options":[],"required":null,"pdf_field":""},{"help":"Enter insurer name","type":"text","label":"3. Purchase of annuity without commutation Insurer from whom the annuity to be purchased :","options":[],"required":null,"pdf_field":""},{"help":"Select the type of annuity","type":"choice","label":"Type of Annuity","options":["Life Annuity without ROC","Life Annuity with ROC"],"required":null,"pdf_field":""},{"help":"Check if you want to return 100% contribution to the trust","type":"checkbox","label":"4. Return 100% Contribution to the Trust","options":["Select if applicable"],"required":null,"pdf_field":""}],"filled_by":""},{"title":"Mode of Payment","fields":[{"help":"Enter bank name","type":"text","label":"Bank name","options":[],"required":true,"pdf_field":""},{"help":"Enter bank account number","type":"text","label":"Account number","options":[],"required":true,"pdf_field":""},{"help":"Enter bank branch","type":"text","label":"Branch","options":[],"required":true,"pdf_field":""},{"help":"Enter type of bank account","type":"text","label":"Type of account","options":[],"required":true,"pdf_field":""},{"help":"Enter IFSC code","type":"text","label":"IFSC code","options":[],"required":true,"pdf_field":""},{"help":"Enter MICR code","type":"text","label":"MICR code","options":[],"required":true,"pdf_field":""},{"help":"Attach cancelled cheque and copy of bank passbook and account statement","type":"attachment","label":"It is mandatory to provide a cancelled cheque and copy of bank pass book & A/C statement.","options":[],"required":true,"pdf_field":""}],"filled_by":""},{"title":"Declaration and Signature","fields":[{"help":"Authorized signatory must sign here","type":"signature","label":"Authorized Signatory / Signature of Trustees","options":[],"required":true,"pdf_field":""},{"help":"Affix seal of the trust","type":"text","label":"Seal of Trust","options":[],"required":null,"pdf_field":""}],"filled_by":""}],"deadlines":[],"applies_to":"Superannuation Plan claims","attachments":["Death Certificate issued by Municipality/ Nagar Parishad Gram Panchayat (Original/ Copy Attached by Trustee/ Employer)","Cancelled cheque","Copy of bank pass book","A/C statement"],"declarations":["The company shall be discharged of all liabilities upon receipt of claim amount by the payee.","The claimant declares that the information provided is true to the best of their knowledge.","The claimant takes sole responsibility for correctness of bank account details and will not hold the company responsible for any incorrect transactions."],"dropped_labels":2},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"address","value":"IndiaFirst Life Insurance Company Ltd., 12th and 13th Floor, North [C] wing, Tower 4, Nesco IT Park, Nesco Center, Western Express Highway, Goregaon (East), Mumbai – 400063","label":"Claims documents submission address","level":null,"hours":null,"applies_to":"life","source_url":"https://www.indiafirstlife.com/claims/claims-overview","quote":"ntative will reach out to you soon to guide you through our life insurance plans that fit your life goals\nHome\nClaims - IndiaFirst Life Insurance\nClaims Overview\nLife Insurance Claim Process\nAt IndiaFirst Life, we stand firmly with our customers in their hour of grief. We provide a streamlined claim registration and settlement process, ensuring a worry-free future for our customers. With a focus on efficiency","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"claims.support@indiafirstlife.com","label":"Claims support email","level":null,"hours":null,"applies_to":"life","source_url":"https://www.indiafirstlife.com/claims/claims-overview","quote":"rstlife.com/claims/claims-overview/register-claim-online\n\"\nEmail:\nShare soft copies of all the mandatory documents at '\nclaims.support@indiafirstlife.com\n'\nCall:\nContact us at 1800-209-8700 for assistance. Our representative will guide you through the claim process registr","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800-209-8700","label":"Claims assistance phone","level":null,"hours":null,"applies_to":"life","source_url":"https://www.indiafirstlife.com/claims/claims-overview","quote":"\"\nEmail:\nShare soft copies of all the mandatory documents at '\nclaims.support@indiafirstlife.com\n'\nCall:\nContact us at 1800-209-8700 for assistance. Our representative will guide you through the claim process registration.\nVisit Us:\nDrop soft/hard copi","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"url","value":"https://www.indiafirstlife.com/claims/claims-overview/register-claim-online","label":"Register your claim online","level":null,"hours":null,"applies_to":"life","source_url":"https://www.indiafirstlife.com/claims/claims-overview","quote":"Claim Process\nClaim Documents\nFAQs for Claim\nStep 1. Claim Registration\nAnswer\nOnline:\nRegister your claim online at \"\nhttps://www.indiafirstlife.com/claims/claims-overview/register-claim-online\n\"\nEmail:\nShare soft copies of all the mandatory documents at '\nclaims.support@indiafirstlife.com\n'\nCall:\nContact us at","fetched_at":"2026-10-20"}],"how_to_use":"Ask the user for each field in order, in plain words; never invent an answer. Labels are as printed. If fillable_pdf is true, pdf_fields gives the PDF's own field names so the file can be filled directly. The printed form decides if anything differs.","url":"https://indiainsurances.com/forms/indiafirst-life-insurance/339-claim-intimation-form-superannuation-plan"}