Get Sample Of Rupali Life Insurance Company Ltd Application Template


Rupali Life Insurance Company Ltd
Head Office: Raupali Life Tower, 50, Kakrail, Dhaka- 1000, PABX: 8392361-4
Fax: 88-02-8392370, Email: info@rupalife.com, Website: www.rupalilife.com
Reference Letter No: rle/audit/1699/2017 AD                                                                   Date: 23/10/2017 AD
To,
Senior vice president
Duplicate and claim department
Rupali Life Insurance Company Limited
Rupali Life Tower, 50, Kakrail
Dhaka- 1000.
Subject: Regrading the investigation of death claim of insurance receiver Shorgio Puspo Ranu Das, claim no- 1208/17, policy no- 101104230-9 and 0192600042-1.
Sir,
Th information those has been found are mentioned bellow as investigating the death claim physically of policy no- 101104230-9 and 0192600042-1 as per reference no- rle/ho/dabi/1208/2017 AD of insurance receiver Shorgio Puspo Rani Das.
Name of insurance receiver- Shorgio Puspo Rani Das
Claim no- 1208/2017 AD
Policy no- 101104230-9 and 0192600042-1
Insurance amount- 8,00,000/- and 2,16,000/-
Date of death- 22/05/2017 AD
Interview of nominee:
Insurance subscriber Shorgio Puspo Rani Das appointed nominee named Shorgio Puspo Rani Das of his son Kumar Das and Shojol Das, father- Pradip Kumar Das, Village- Court Vadun, Post Office- Pubail, Police Station- Gazipur Sadar, District- Gazipur. They informed their mother Puspo Rani Das has been fallen in ill as beome in caugh, cold and fever suddenly. In that situation they went went taking their mother Dr. Nirmal Kumar Sarkar in Gazipur Radiam Diagnostic Center dated 13/05/2017 AD and he prescribed examining somewhat. AS no improvement is made anyway of the body of Dr Nirmal Kumar Sarkar dated 17/05/2017 AD took to Uttara Crescent Hospital. Then she was in treatment at H.D in Uttara Crescent Hospital. Later as the health of Puspo Rani Das got diterioted she has been taken to life support in ICU. She passed away at around 3.55 AM at night stopping the heart activity becoming affected by heart disease on dated 22/05/2017 AD as was in treatment in ICU Mrs Puspo Rani Das. She was around 50 years old at the time of death. Puspo Rani Das left two sons and husband at the time of death.
Rupali Life- Safe Life


Page No- 2
Interviews from Grave Place Committee:
As no one one was presented of the grave committee therefore it was not possible to take written interviews from anyone else but as the participant in funeral activity the assistant teacher of high school Mr Chandra Mohon Mondol as was knew contacted through mobile that, Shorgio Puspo Rani Das got dead at night dated 22/05/2017 AD becoming affected in heart disease.

Interviews from neighbors:
Dipok Kumar Das, father- Late Dilip Kumar Das, Village- Court Vadun, Post Office- Pubail, Police Station- Gazipur Sadar, District- Gazipur.  She was in relation in anty with Mrs Rani Das. As she knew Shorgio Puspo Rani Das suddenly become affected in the illness in cold, fever as was 8 days at home got admitted in hospital. There she passed away at around 3.30 AM on dated 22/05/2017 AD.
Interviews from Neighbors/ Important People:
Badol Kera Piyard, father- Late Augustin Kera Piyard, and Md. Nazrul Islam, father- Late Abu Vuya, Village- Court Vadun, Post Office- Pubail, Polcie Station- Gazipur Sadar, District- Gazipur. They told Shorgio Puspo Rani Das was their neighbor. As far they know Mrs Puspo Rani Das was good person. She got dead on dated 22/05/2017 AD and they were invited in the funeral activity of Mrs Puspo Rani Das. She left two sons and husband at the time of death and she was 50 years old.
Interviews of City Corporation Councilor:
As went to 41 no ward in Councilor Parishod there has been found councilor and secretary. Both of them told Shorgio Puspo Rani Das is known to them and the mentioned death certificate is given from their Parishad. There mentioned that Shorgio Puspo Rani Das was present at the day of funeral activity. In their view Shorgio Puspo Rani Das passed away as becoming affected in heart disease on dated 22/05/2017 AD.
Interview of Doctor:
Manager Md. Tofazzol Hossen told as verifying the death certificate given by the Uttarar Crescent Hospital mentioned death certificate by their hospital and he himself attested that. Mrs Puspo Rani Das passed away at around 3.55 AM becoming affected by heart disease on dated 22/05/2017 AD.  


Page No- 3
This is certified in interview of mentioned above information and information provider people that Mrs Shorgio Puspo Rani Das passed away becoming affected in heart disease. At the time of death Shorgio Puspo Rani Das was around 50 years old. She left two sons and husband at the time of death. In invetigation the date of death, the present documents in file and as per description of family members insurance subscriber Puspo Rani Das got dead on dated 22/05/2017 AD.
Therefore, there is wishing the consideration to take next steps regarding the claim.
Sincerely,
Sd/ Illegible
28/10/2017 AD
Md. Abu Jafor
DAVP
Internal Control and Compliance












Page No- 4
Facing Sheet of Death Claim
(Monogram)                                                                                                                                Date: 15/11/2017 AD
1
Project
Ekok Insurance
2
Death claim no
Serial no- 83/17
3
Insurance letter no
101104230-9
4
Insurance receiver name
Puspo Rani Das
5
Insurance receiver profession
House wife
6
Age beginning (prove)
44 years
7
Age at the time of death
49 years (National Identity Card)
8
Insurance amount
8,00,000/- (Eight Lakhs)
9
Description pof lien
Not necessary
10
Amount of given installment
06 piece of premium (67,120X6)= 4,02,720/-
11
Cut off premium
Not necessary
12
Amount of total premium with cut off
Not necessary
13
Amount of given expected facility
Not necessary
14
Description of due debt
Not necessary
15
Support insurance
Not necessary
16
Table and Term
03/15
17
Premium giving system
Yearly
18
FPR issue date
24/11/2011 AD
19
Date of insurance starting
24/11/2011 AD
20
Date of risk receiving
24/11/2011 AD
21
Date of final premium receiving
24/11/2016 AD
22
Next given date
24/11/2017 AD
23
Expected date
23/12/2017 AD
24
Situation of death at the time of policy
On
25
Time of policy as is on ativated automatically
Not necessary
26
Number of installments given one time final
01 piece
27
Finnal PR and O/R date
04/12/2016 AD and 04/12/2016 AD
28
Date of death
22/05/2017 AD
29
Real reason of death
Heart attack
30
Related reason of the death
Not necessary
31
Duration of policy activated
05 years 05 months 28 days
32
Whether the form is submitted?
yes
33
Whether the claim investigated?
yes
34
Whether the post mortem report is submitted
Not necessary
35
Name of nominee
Prabir Kumar Das and Shojol Kumar Das, age- 35 and 30 years, relation- both of sons.
36
Guardian
Not necessary
Insurance amount taka= 800000/- eight lakhs taka only.
at the time the policy is on 05 years 05 months 28 days
There is seen as observed the received documents, insurance receiver last dated 22/05/2017 AD passed away. The reason of death is Heart attack. In that case the death claim is payable. Insurance receiver is son and nominee of policy. The claim can be given.    

Page No- 5
Principle account insurance amount taka= 800000/-
Bonus taka= 161600/-
Real given taka= 961600/=
As for death insurance claim taka= 961600/= (Nine Lakhs Sixty One Thousands Six Hundred Taka Only) there can be presented the file in death insurance claim committee for approval therefore is presented.
SVP (UW and claim dept)
Sd/ Illegible
15/01/2018 AD
Md. Abdullah
Senior Vice President
Claim Department
Rupali Life Insurance Co. Ltd
Head Office, Dhaka
(Seal)
Sd/ Illegible, 14/01/2018 AD
Mr Md. Shibbir Ahmed
CFO
MD Sir
The time policy was on about 05 years 05 months 28 days the reason of death is heart attack. There is presented in the claim committee for approval of taka 961600/= (Nine Lakhs Sixty One Thousands Six Hundred Taka Only) as for death insurance claim.
Sd/ Illegible
Mr Md. Golam Kibria
DMD
Page No- 6
Facing Sheet of Death Claim
(Monogram)                                                                                                                                Date: 10/12/2017 AD
1
Project
Islmai insurance
2
Death claim no
Serial no- 310/17
3
Insurance letter no
204400001-3
4
Insurance receiver name
Omar Faruk
5
Insurance receiver profession
Office T boy
6
Age beginning (prove)
29 years
7
Age at the time of death
39 years (National Identity Card)
8
Insurance amount
5,00,000/- (Five Lakhs)
9
Description of lien
Not necessary
10
Amount of given installment
10 piece of premium (40,750X10)= 4,07,500/-
11
Cut off premium
Not necessary
12
Amount of total premium with cut off
Not necessary
13
Amount of given expected facility
Not necessary
14
Description of due debt
Not necessary
15
Support insurance
Not necessary
16
Project and validity
11/15
17
Premium giving system
Yearly
18
FPR issue date
21/07/2008 AD
19
Date of insurance starting
30/06/2008 AD
20
Date of risk receiving
30/06/2008 AD
21
Date of final premium receiving
30/06/2017 AD
22
Next given date
30/06/2018 AD
23
Expected date
29/07/2018 AD
24
Situation of death at the time of policy
On
25
Time of policy as is on activated automatically
Not necessary
26
Number of installments given one time final
01 piece
27
Final PR and O/R date
28/09/2017 AD and 29/10/2017 AD
28
Date of death
10/10/2017 AD
29
Real reason of death
Heart attack
30
Related reason of the death
Not necessary
31
Duration of policy activated
09 years 03 months 10 days
32
Whether the form is submitted?
yes
33
Whether the claim investigated?

34
Whether the post mortem report is submitted
No
35
Name of nominee
Mst Kamrunnahar, Age- 31 years, relation- wife
36
Guardian
Not necessary

Principle insurance amount taka= 500000/- five lakhs taka only.
at the time the policy is on 09 years 03 months 10 days

There is seen as observed the received documents, insurance receiver last dated 10/10/2017 AD passed away. The reason of death is Heart attack. In that case the death claim is payable. Insurance receiver is wife  and nominee of policy Mst Kamrunnahar the claim can be given.    

Page No- 7
Principle account insurance amount taka= 500000/-
Additional Bonus taka= 136500/-
Real given taka= 2/=
As for death insurance claim taka= 636502/= (Six Lakhs Thirty Six Thousands Five Hundred Taka Only) there can be presented the file in death insurance claim committee for approval therefore is presented.
SVP (UW and claim dept)
Sd/ Illegible
10/01/2018 AD
Md. Abdullah
Senior Vice President
Claim Department
Rupali Life Insurance Co. Ltd
Head Office, Dhaka
(Seal)
Sd/ Illegible, 14/01/2018 AD
Mr Md. Shibbir Ahmed
CFO
MD Sir
The time policy was on about 09 years 03 months 10 days the reason of death is heart attack. There is presented in the claim committee for approval of taka 636502/= (Six Lakhs Thirty Six Thousands Five Hundred Two Taka Only) as for death insurance claim.
Sd/ Illegible
Mr Md. Golam Kibria
DMD

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