Disclaimer
Si Creva acts as a facilitator for the services, while the insurance services are provided by ICICI Lombard General Insurance Company Limited
Declaration
I am in good health and free from disease/ disability or symptoms thereof (relating to conditions other than to minor impairments such as colds or flu). I am not receiving any regular medical treatment and have not done so in the last 12 months. I have never had a heart condition, a stroke, paralysis, high blood pressure, cancer, diabetes, raised blood sugar, kidney failure, liver failure, mental illness, HIV infection or AIDS.
I understand that, if my declaration as above is shown to be false, my cover will terminate and no benefits will be payable.”
I hereby advise SI Creva Capital Services Private Limited to transfer the applicable premium for my health insurance policy to ICICI Lombard General Insurance Co. Ltd., as a part of loan disbursal.
I hereby assign the claim amount payable in the event of any total loss claim as covered under the policy issued by ICICI Lombard General Insurance Co. Ltd (“Insurer”) against the above mentioned product(s), to Si Creva Capital Services Private Limited (name of the assignee) and I further declare that this receipt shall be sufficient evidence/proof for discharge of claim to the Insurer.