Registration form for Associate Member

Sainik Ardhyasainik Seva Sangathan (SASS)

GROUP MEDICLAIM INSURANCE POLICY PROPOSAL

GROUP MEDICLAIM POLICY FOR (2026–27)

TO SERVE BEYOND SERVICE

Policy Document

Please review the complete policy document below

Download PDF

I have read and agree with the above policy document and conditions

Registration form for Associate Member

Details of Primary Member (PM)

Personal No. / Service No. (of Primary Member or Related Service Member) (Parent only)

Rank Category (of Primary Member)

Service (of Primary Member)

Other Service

Rank (of Primary Member as applicable)

Equivalent Rank (as per BSF / CAPF)

Details of Associate Member (AM)

Salutation

Name (as per Associate Member's ID linking them to Service member)

Name (as per Associate Member's Aadhaar card)

Gender

Relation to Service/Primary Member (as applicable)

PAN Number Format: ABCDE1234F (5 letters, 4 numbers, 1 letter)

Marital Status

Address

Pin code

State / Union Territories

City

Date of Birth

Enter Email OTP

Mobile No. (with Country code)

Enter Mobile OTP

Do you wish to opt for Mediclaim policy?

I select the following risk cover amount as a family floater plan?

I wish to subscribe for my family

Nominee Details (as per Nominee's Aadhaar as applicable)

Name

Relationship

Date of Birth

Mobile no.

Nominee Address

I agree to all membership conditions of SASS, SASS Bye Laws and AOP.

I agree to all the conditions of the Mediclaim plan opted by me.

All the details shared above are true and correct.

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GROUP MEDICLAIM POLICY FOR (2026–27)

Policy Document

Registration form for Associate Member

Details of Primary Member (PM)

Details of Associate Member (AM)

Nominee Details (as per Nominee's Aadhaar as applicable)

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