| Application Number | Name of the Policy Holder | Father / Husband | Nominee |
| 011284XX016XXX000101 | Anjinamma madiga | narasimhamurthy madiga | dineshkumar |
| 011284XX016XXX000102 | Aswarthamma buddanna gari | kollappa buddanna gari | ramesh |
| 011284XX016XXX000103 | gangadevi anjinappa | shantharaju anjinappa | shantharaju |
| 011284XX016XXX000104 | Baby madiga | raghavendra madiga | yashwanthi |
| 011284XX016XXX000105 | Aswathamma chalakur | naga bhushanam chalakur | mallikarjuna |
| 011284XX016XXX000106 | ashwarthamma lalarao | akkulappa lalarao | kadirappa |
| 011284XX016XXX000401 | madiga Akkamma | aswarthappa madiga | aswarthappa |
| 011284XX016XXX000402 | s Lakshmi | shivakumar s | subashkumar |
| 011284XX016XXX000404 | b.n Parvathamma | aswarthappa b.n | nataraj |
| 011284XX016XXX000405 | enumula Nagamma | sudakar enumula | sudakar |
| 011284XX016XXX000407 | burappa gari Rathnamma | murali burappa gari | kartik |
| 011284XX016XXX000408 | kumara gari Prameela | kumar kumara gari | kumar |
| 011284XX016XXX000409 | parigi Lakshminarasamma | anandu parigi | naresh |