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How do I fill this out?
To fill out this form, begin by providing personal details such as full name, address, and contact information. Follow with the necessary medical history and declarations regarding the life to be assured. Ensure that all answers are complete and accurate to avoid processing delays.

How to fill out the LIC Personal Statement Regarding Health for Minors?
1
Read through the form carefully before starting.
2
Fill in the proposer and life to be assured information.
3
Answer the health-related questions truthfully.
4
Review completed sections for accuracy.
5
Submit the form according to provided instructions.
Who needs the LIC Personal Statement Regarding Health for Minors?
1
Parents seeking life insurance for their children.
2
Guardians wanting to secure health statements for minors.
3
Insurance agents assisting clients with policy applications.
4
Financial advisors managing clients' insurance portfolios.
5
Legal representatives handling estate planning for minors.
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Edit the PDF on PrintFriendly by accessing our user-friendly PDF editor. You can click on any field to make changes or add new information seamlessly. Finally, download the updated document with your modifications to keep a copy.
1
Open the PDF document in our editor.
2
Click on the field you want to edit.
3
Type your corrections or updates directly.
4
After editing, review the document for accuracy.
5
Download the finalized version to your device.

What are the instructions for submitting this form?
To submit this form, email it as an attachment to the LIC office designated in your policy documents. Alternatively, you can fax it to the provided fax number or submit it via the online portal if available. Ensure that you keep a copy for your records and follow up with the insurance office as necessary.
What are the important dates for this form in 2024 and 2025?
For 2024, be sure to submit your application by the policy renewal dates set by LIC. In 2025, keep track of any changes to the health declaration policies that may affect new applications and renewals. Regularly check with LIC for updates on submission dates and requirements.

What is the purpose of this form?
This form serves to collect essential health information regarding minors looking to secure life insurance. It is designed to ensure the accuracy of data supplied, which aids in the underwriting process and assists LIC in making informed decisions on policy issuance. Proper completion of this form is critical for the approval of insurance coverage for young applicants.

Tell me about this form and its components and fields line-by-line.

- 1. Name of the Proposer: Full name of the individual submitting the application.
- 2. Address: Complete contact information including street, city, and postal code.
- 3. Email Address: Email for correspondence regarding the application.
- 4. Phone/Mobile No: Contact number for follow-ups.
- 5. Name of Life Assured: Full name of the minor for whom the insurance is being requested.
- 6. Health Questions: Medical history and current health status related to the life assured.
- 7. Declaration: Acknowledgment and confirmation that the provided information is accurate and complete.
What happens if I fail to submit this form?
Failure to submit this form may result in delays in processing the insurance application. It is vital to ensure that all information is provided accurately and fully to avoid complications.
- Delayed Processing: Incomplete forms may lead to significant delays in obtaining life insurance coverage.
- Rejection of Application: Incorrect or omitted information can cause the application to be rejected outright.
- Loss of Premiums: Any premiums paid may be forfeited if the application is deemed invalid.
How do I know when to use this form?

- 1. New Policy Application: To apply for a new life insurance policy for a minor.
- 2. Policy Revival: When reviving a previously lapsed policy for a child.
- 3. Health Disclosure: To disclose any pertinent health information required by the insurer.
Frequently Asked Questions
What is this form used for?
This form is utilized to provide health information for minors applying for life insurance with LIC.
How can I edit the PDF?
You can edit the PDF using our integrated PDF editor; simply click on the fields you want to update.
Do I need to sign the form?
Yes, signatures are required from both the proposer and the life assured for validation.
Can I save the PDF after editing?
Yes, you can download the edited PDF directly to your device.
Is there a deadline for submitting this form?
Please check with LIC for specific deadlines related to your application.
What if I make a mistake on the form?
You can easily edit the form again to correct any mistakes before final submission.
Who can fill out this application?
The proposer, generally a parent or guardian, should fill out this application on behalf of the minor.
Is this form applicable for all minors?
Yes, this form is necessary for all minors requiring life insurance coverage.
Where do I submit the completed form?
You may submit the form as directed in the submission instructions provided by LIC.
What happens after I submit the form?
After submission, LIC will process your application and notify you of any further requirements.
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