LIC ALL IN ONE Policyholder Servicing Request Form –
Download
The uploaded form is a LIC policy servicing request form addressed to the Chief / Senior / Branch Manager of the concerned LIC Branch.
Details to be filled in
Branch Address – Enter the complete address of the LIC branch.
Date – Enter the date of submitting the request.
Name of the Life Assured – Enter the policyholder/life assured's name.
Policy Numbers – Up to 12 policy numbers can be mentioned.
Change Premium Payment Mode
Request change in premium payment mode, including ECS-related requirements where applicable.
Right-click to download this form
Services requested in the form
1. Register / Update Contact Details
Mobile number of the policyholder
Landline number with STD code
Email ID
PIN Code
Consent to receive SMS for policy servicing.
2. Change / Update Address
The new name and complete address can be recorded in LIC's books based on the enclosed proof of residence.
3. Register Bank Details for NEFT
Bank details can be registered for policy payments through NEFT. A cancelled cheque or bank passbook copy is to be enclosed.
4. Register PAN and Aadhaar
PAN Card and Aadhaar Card details can be registered with LIC, with attested copies enclosed.
5. Change Premium Payment Mode
Request change in premium payment mode, including ECS-related requirements where applicable.
6. Nomination / Assignment
Register nomination
Change nomination
Assignment
Re-assignment
Required forms and policy documents are to be enclosed.
7. Transfer of Policy Servicing Branch
Request transfer of policy records to another LIC branch for future servicing.
8. Premium Paid Certificate
Request a premium-paid certificate for the relevant financial year.
9. Duplicate Policy Bond
Request issuance of a duplicate policy bond.
10. Policy Alteration
Request alterations such as:
Change in plan/term/premium-paying term
Reduction in sum assured
Other specified alterations
11. Accident Benefit
Request grant of accident benefit, with the required documents and applicable fee.
12. Policy Revival
The form provides options for revival under:
Special Revival Scheme
SB-cum-Revival
Loan-cum-Revival
Instalment Revival
13. Loan / Surrender Quotation
Request quotations for loan, surrender or other requirements for submission to the concerned authority.
14. ULIP Fund Switch
Request switching of funds under a ULIP policy from one fund to another.
15. Other Request
Any other policy servicing requirement can be specified.
Submission
After selecting the required service and completing the relevant details, the policyholder should sign the form and attach the necessary supporting documents. The completed form can then be submitted to the concerned LIC servicing branch.
This form covers a wide range of LIC services, including mobile number change, email update, address change, bank/NEFT registration, PAN/Aadhaar update, nomination, branch transfer, premium certificate, duplicate policy bond, revival, loan, surrender and ULIP fund switching.

