Tata aia policy servicing payout request form

The Authorization form along with the clear & self attested Credit Card copy should reach any of our branch offices at least 15 working days prior to the next premium due date. Kindly pay the premium amount by cash / cheque / online, if due during this period.

All Visa, MasterCard & American Express (AMEX) Credit Cards issued in India are accepted.

The form can also be handed over to your advisor or couriered / posted to the address mentioned in the form.

• Duly filled and signed ECS & Direct Debit Form(Download this form in other Language)
• Bank attestation or original personalized cancelled cheque. In case a non-personalized cancelled cheque is provided, please ensure a clear photocopy of Bank Passbook/Bank Statement reflecting a/c number & a/c holder's name is given along with the cancelled cheque.
• List of Valid MICR's for ECS

The form and cancelled cheque should reach any of our branch offices at least 30 working days prior to the next premium due date. Kindly pay the premium amount by cash / cheque / online, if due during this period.

The form can also be handed over to your advisor or couriered / posted to the address mentioned in the form.

• Duly filled and signed Standing Instruction form.(Download this form in other Language)
• Bank attestation

HSBC SI should be stamped and attested by HSBC Bank.

To change the current premium payment mode of policy, RFC should accompany the SI form.

Account number should be 12 digits.

All you need to do is fill the HSBC SI form and have it stamped and attested by HSBC and submit it at any of our branch offices The form can also be handed over to your advisor or couriered / posted to the address mentioned in the form. Please note that an unattested form will be Rejected

The Standing Instruction form should reach any of our branch offices at least 15 working days prior to the next premium due date. Kindly pay the premium amount by cash / cheque / online, if due during this period.

• Duly filled and signed Standing Instruction form.(Download this form in other Language)
• Bank attestation
• Original Personalized Cancelled cheque. In case a non-personalized cancelled cheque is provided, please ensure a clear self-attested photocopy of Bank Passbook/Bank Statement reflecting a/c number & a/c holder's name is given along with the cancelled cheque.
• Bank Attestation should have the SS number, signature and sign of the authorized SBI official.

A/c number should be 11 digits. Form should be either attested by SBI or original cancelled cheque should be provided.

Premium amount should be correctly mentioned on the SI form.

To change in current premium payment mode of policy, RFC should accompany the SI form.

The Standing Instruction form along with the cancelled cheque should reach any of our branch offices at least 15 working days prior to the next premium due date. Kindly pay the premium amount by cash / cheque / online, if due during this period.

The form can also be handed over to your advisor or couriered / posted to the address mentioned in the form.

• Completed and signed NACH form
• Cancelled Cheque copy with account details or Recently updated Passbook

• ONE FORM PER POLICY NUMBER IS USED. (Forms with multiple policy numbers are liable to be rejected)
• Form received / collected is filled and signed in original (and not a partial/full photocopy of the filled form). Partial and full photocopies will be rejected by HO. Stamp (Branch Received, Bank or any other) is NOT affixed anywhere on the first page or perforated area of the Form. Form is filled in BLOCK (Capital) letters. OVERWRITING/WHITENER USAGE is NOT PRESENT ANYWHERE on the form. ( Forms with smallest OVERWRITING/WHITENER USAGE will be rejected at HO as it is not acceptable by Banks) The POLICYHOLDER's and ACCOUNT HOLDER's Signature(s) are present in their respective columns (even if both are the same person)
• ONLY ONE PREMIUM AMOUNT is MENTIONED on the FORM. (Amount should be including service tax and 50% more than the Annual premium of the policy.
• For Walk In customers / agents, if the due date lies within the next 30 days, please collect the due premium in Cash/cheque (Such a form should be rejected over the counter by Branch and if it is received by courier at Branch, it will be rejected by HO for the same reason.)
• End Date of Debit (Only to be entered in CRM while creating SR and not on form) = End of PPT + 1 year as ‘End date’ of debit. (For e.g. - End date of PPT is 30/06/2026, End Date = 30/06/2027)
• For Walk In customers / agents, if the Accountholder on the form is different from the existing payor in the Policy (as per CRM / OLAS), the KYC (& AML if required) documents of the Accountholder are collected along with the form.
• The Account holder's name, Account Number, and Account Type and MICR /ISFC filled on the NACH form match EXACTLY with the Cheque/ Bank Statement / Passbook provided.