Buy Insurance Step 7 – Tpllife

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Buy Insurance Step 7demo.deadhappy2022-12-02T06:17:32+00:00

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First Name

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Last Name

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Date

DD slash MM slash YYYY

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Age

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Gender

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Mobile Number

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Email

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Current Weight (kg)(Required)

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Current Height (cm)(Required)

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Occupation(Required)

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Monthly Income (PKR)(Required)

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Do you intake Tobacco or Nicotine in any form? Yes or no

Yes

No

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Do you intake Tobacco or Nicotine in any form? Yes or no

0-5 times

5 to 10 times

10 to 20 times

Can't specify

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Consume Alcohol Yes or no

Yes

No

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Consume Alcohol Yes or no

Social Drinking

Regular Drinking

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Select

Cancer

Hepatitis B

Hepatitis C

Diabetes

Coronary Artery Disease

Heart Attack

Heart Failure

Ischemic Heart Disease

Heart Valvular Disease

Cardiac Arrhythmia

Kidney Disease

High Blood Pressure

Thyroid Disorder

Liver Cirrhosis/Liver Failure

Stroke

Paralysis

Musculoskeletal Disorders

Chronic Obstructive Pulmonary Disease

Nervous Disorders (Depression, Psychiatric Disorder)

Bleeding Disorder

Anaemia

Deformity or Disability

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I don't want to contribute

I don't want to contribute

How much do you want to be insured for?
This will help us calculate your monthly price. You'll be able to amend this amount later.

Insurace amount

What is your desired term length?
This will help us calculate your monthly price. You'll be able to amend this amount later.

term length

Your annual premium

206 PKR

Do not like the price? Adjust your term length and sum assured to get a desired premium.

Ahmad, you got the nod!
Now it's your choice...

Life Insurance

PKR 50,000/year
we'll pay out PKR 560,000 if you die.

Who do you want to inform include in this Plan?

You can add beneficiaries or just people you want to include in your plans.

Name

DOB

MM slash DD slash YYYY

CNIC

Relationship to you

Code of Conduct | Privacy Policy

Great Job!

Words cannot express how grateful we are for your
willingness to volunteer

Thank you!

You now have the option to swiftly navigate to the Health Declaration
form or continue onward with Inshu Charity.