CSB Integration Page - Edelweiss Life

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Group Life protection plan offering "Suraksha Kavach" for CSB Bank customers

EdelweissCsbIntegrationWeb

EdelweissCsbIntegrationWeb

Section A - CSB Bank Details

CSB Bank Account / Reference Number Required

Please enter 18 digit number.

CSB Bank Employee ID Required

CSB Bank Employee Name Required

Section B - Proposer Details

Client Name Required

DOB Required

Gender

Male Female

Occupation

Salaried Non-Salaried

Mobile Number(Registered with Bank) Required

Email ID(Registered with Bank) Required

Customer ID Required

Branch Code Required

Branch Name Required

Pin Code Required

Neo Application No.

Nominee Name Required

Relation Required

Section C - Risk Cover Details

Risk Cover Opted *

5lac

3lac

Premium to be Paid

Rs.2355/-

Rs.1413/-

Section D - Mandatory Health Declarations

a) Have you been currently taking any medication or undergoing medical treatment, hospitalized in the last 5 years, have suffered, or are suffering from diabetes, heart disease, cancer, or any major medical illness, which require regular follow up or treatment?

Yes No

b) Have you been advised to undergo any surgery, medical investigation, or treatment for any condition (including Covid 19)?

Yes No

c) Have you been currently diagnosed with Covid -19 or asked to undergo testing for Covid- 19 or have you come into close contact with someone who has tested positive for Covid-19?

Yes No

Section E - I agree to the terms & conditions

Asset Publisher

Application Submitted, please enter OTP to proceed

Terms and Conditions

1. CSB Bank under its Suraksha Kavach Campaign is the holder of the Life Insurance Master Policy issued by Edelweiss Life Insurance Company Ltd for Edelweiss Life - Group Life Protection Plan and you will be a member of this group policy.
2. Your age should be between 18-55 years at the time of purchase of this cover. You are not eligible to buy this cover if your age is below 18 years or above 55 years.
3. You are not involved in any hazardous or high-risk occupation.
4. You cannot purchase more than 1 cover under this scheme through CSB Bank, and the maximum Sum Assured payable at the time of claim will be restricted as per the Sum Assured purchased by you.
5. You will receive the Certificate of Insurance directly on your registered mobile no.
6. You may return the Certificate of Insurance to us within 15 days of receipt of the Certificate of Insurance if you disagree with any of the terms and conditions by giving us written reasons for your objection. We will refund the Premium received after deducting stamp duty charges, proportionate risk premium for the period of cover and medical expenses (if any).
After payment of the Free Look Amount, the Insurance Cover shall stand cancelled, and no benefits shall be payable with respect to Insurance Cover under this Certificate of Insurance.
7. For any further queries, you should reach out to Edelweiss Life Insurance Company at [email protected] or call on 1800 2121212
8. All other terms and conditions including those mentioned in the Certificate of Insurance will be applicable. The Policy wordings for this product can be downloaded from insurer company website.
Other Terms and Conditions:
1. I am aware that CSB Bank is the holder of the Life Insurance Master Policy issued by Edelweiss Life Insurance Company Ltd for Edelweiss Life - Group Life Protection Plan (Affinity Group) and I will be a member of this group policy.
2. I declare that the Company has disclosed and explained all the information related to this product and riders to me and I declare that I have understood the same.
3. I declare that the statements in this proposal are true, and I have disclosed all information which might be material to Edelweiss Life while issuing the policy contract.
4. I understand that any misstatement or suppression or non-disclosure of material information submitted or where the Company is not notified of any change as mentioned above, the Company reserves the right to repudiate the claim or declare the policy void in accordance with Section 45 of the Insurance Act.
5. I understand that Edelweiss Life reserves the right of seeking more information and/or to call for any additional documents for processing my application and Life Cover issuance will be subjected to acceptance of risk by Edelweiss Life.
6. I agree that I will inform Edelweiss Life if between the date of this proposal and the date of the issuance of the policy/certificate of insurance there is any change in my health condition, occupation, or financial position.
7. I agree that the Insurance protection shall only be provided effective from the date of acceptance of risk by Edelweiss Life.
8. I understand that benefits under this policy shall terminate, immediately if I fail to satisfy any of the eligibility criteria or cease to be a member of the Group for whatsoever reason or cessation of relationship with CSB Bank or if the due premium is not paid within the revival period.
9. I declare that the premiums paid have not been generated from the proceeds of any criminal activities/offences and I shall abide by and conform to the Prevention of Money Laundering Act 2002 or any other applicable laws.
10. I have disclosed my personal information to Edelweiss Life and I hereby provide consent to the Company to share the same with the Company's authorised service providers for carrying out the issuance process for the proposal and servicing of the policy such as underwriting, renewal, revival, claim management, in accordance with the rules and regulations applicable from time to time.
11. I understand that Edelweiss Life reserves the right to accept, decline or offer alternate terms on this application for life insurance.

12. I hereby consent to receiving information related to this proposal and resulting policy, through SMS/Email as updated by me from time to time.