Claim For Permanent Disablement Benefit Deed Format

Claim For Permanent Disablement Benefit

Claim For Permanent Disablement Benefit Deed Format

I, ……………………………………………, s/w/d of ……………………… Insurance No.  ……………………having been declared as permanently disabled by

the Medical Board/Appeal Tribunal claim permanent disablement benefit accordingly for the period from ………… to ……………

The amount due may be paid to me by money order/in cash at local office.

Date …………                                         Signature or thumb impression

Present Address ………………

             ANOTHER FORM

I,  …………………………………   s/w/d of  ………………………………………

Insurance No. ……………… declare that,  because of sickness/temporary  disablement, I have not been at work since the date of last/first certificate sent to you.

I no longer claim to be sick/temporarily disabled ………… from ……… day of ……… 19…………  and I shall/did not take up any work for remuneration before that day, I claim benefit accordingly. I desire payment in cash at local office/by money order.

Signature or thumb impression

Date …………                                                   Local office ……………

Present Address …………………

Claim For Permanent Disablement Benefit Deed Format

Contact us for Company registration in India, NGO registration in India, ISO certification in India on +91-8540099000

Email us at : info@meerad.in