How to Fill and Submit the ICICI Prudential Life Insurance Payout Request Form

What is the ICICI Prudential Life Insurance Payout Request Form?

The payout request form is the official document you submit to ICICI Prudential Life Insurance when you wish to claim a death benefit, terminal illness, or any other payout under your policy. It captures personal details, policy information, beneficiary data, and the nature of the claim.

When Do You Need the Form?

Typical scenarios include:

• Death of the insured – to claim the sum assured.
• Terminal illness diagnosis – for accelerated benefits.
• Policy loan settlement – to close outstanding loans.

Where to Find the Form

The form is available in three convenient ways:

Step‑by‑Step Completion Guide

1. Personal & Policy Details

Provide your full name, policy number, and contact information. Double‑check the policy number to avoid processing delays.

2. Beneficiary Information

List all beneficiaries, their relationship to the insured, and share percentages. If beneficiaries have changed, include a signed affidavit.

3. Claim Type and Amount

Select the type of claim (e.g., death benefit, terminal illness) and specify the requested payout amount.

4. Supporting Documents Checklist

Attach the following (most are required):

• Original or certified copy of death certificate (for death claims).
• Medical certificate for terminal illness claims.
• Bank account details for direct transfer.
• Identity proof of the claimant.

5. Declaration & Signature

Read the declaration carefully, sign, and date the form. Some policies also require the beneficiary's signature.

6. Submission

Send the completed form and documents to:

ICICI Prudential Life Insurance, Claims Department, 5th Floor, Venkateshwara Complex, 5th Main, 3rd Cross, Jayanagar 4th Block, Bengaluru – 560011.

Alternatively, upload the scanned copy via the online claims portal.

Typical Processing Timeline

After receiving a complete claim, ICICI Prudential usually takes 15–30 business days to process, provided all documents are in order. The table below summarizes typical timelines for common claim types.

Common Pitfalls & How to Avoid Them

• Incomplete forms – always double‑check every field.
• Incorrect beneficiary details – verify names and share percentages.
• Missing documents – keep a checklist and submit originals or certified copies.

Frequently Asked Questions

What if I lose the original death certificate?

Submit a certified copy issued by the registrar office. Provide an affidavit stating the loss.

Can I change beneficiaries after filing the claim?

Changes are possible but require a signed affidavit and may delay processing.

Will the payout be tax‑free?

Under Section 10(10D) of the Income Tax Act, the death benefit paid under a life insurance policy is tax‑free, provided the sum assured does not exceed the policy's face value.