01

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02

Personal Details

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Health,Lifestyle & Additional Details

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Product Features

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Please enter Life Assured Date of Birth

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Smoker* If you consume Tobacco, please choose Yes.


Select your preferred Life Cover Payout option:

Lumpsum

Choose this option if you want the whole claim amount to be paid as a lumpsum

Increasing Monthly Income

Choose this option if you want the whole claim amount to be paid as monthly income, increasing @10% p.a. (simple interest)

Lumpsum + Increasing Monthly Income

Choose this option if you want the whole claim amount to be paid as a combination of lumpsum and monthly income, increasing @10% p.a. (simple interest)


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Please read the sales brochure carefully for details on risk factors, terms and conditions of the product before filling this proposal form. Insurance is the subject matter of the solicitation.

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