1. For authorization purpose, ₹ 1/- or ₹ 2/- will be charged to you by your Bank.
2. Your card information is safe.
3. Online SI is available for UPI/Netbanking/Debit Card/Credit Card.
4. International cards are not acceptable.
5. After SI is registered all future premiums will be debited automatically from the mode you select.
6. For deactivation of SI please contact our touch points.
7. I authorized the above mentioned card issuing bank / PG to debit my CC/DC/UPI/Net-banking Account as primary or secondary account, whichever is applicable, if my standing instruction is active and until I give a written request for cancellation.
8. I hereby authorize ICICI Prudential Life Insurance Company Ltd., to enable the standing instruction facility for my premium payments and in the instance of transaction dishonor, to re-debit my account with the mentioned bank to recover the premium payable.
9. In the future, if I opt out of ACH/ Direct Debit mode/Standing Instruction there may be an increase in premium amount.
10. I hereby understand, that I can choose to detach the ACH/Direct Debit Mandate/ Standing Instruction for my primary and/or secondary bank account(s). Unless specifically mentioned otherwise, the Company upon receipt of a detachment request, shall detach the ACH/Direct Debit Mandate/ Standing Instruction from both my primary and secondary accounts. I further understand that detachment of ACH/ Direct Debit mode/ Standing Instruction may result in increase in premium amount.
11. I hereby authorize to recover ₹ 150/- per transaction, if the payment is not honored on presentment of the premium as per the standing instructions given for primary or secondary account whichever is applicable.
12. I understand and agree that the submission of this form does not mean that the request will be processed. I understand that any payout under the policy shall be strictly in accordance with the policy terms and conditions. Also any payment shall be subject to realization of the last renewal premium payment.
13. I also understand and agree that the Company reserves the right to use any alternative payout option.