Form14 - Claim for Permanent Disablement Benefit

Insured person has to apply in the given Form to claim for permanent disablement benefit.

Any person who makes a false statement or misrepresentation for the purpose of obtaining benefit, whether for self or another person, commits an offence punishable with imprisonment for a term that may extend up to six months or with a fine up to Rs. 2,000, or with both.

Form 14

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