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Buy Insurance Step 12
demo.deadhappy
2023-01-26T12:00:11+00:00
Step
1
of
3
- Declaration Acceptance
33%
Medical Declaration
1- I am presently in good health and have never been prescribed any blood thinner medications or undergone any surgery, I have never suffered from any of these listed" diseases/conditions.
2- No proposal on my life has ever been postponed, declined, rated, cancelled or pending decision from any insurer for any reason.
3- I am not involved in any legal, religious, political activities and never had any involvement in any civil or criminal litigation or police case. I further declare that I am not involved in any of the dangerous/ hazardous activities, including but not limited to, motor racing, aviation, mountaineering, paragliding, skydiving, parachuting etc.
Do you accept all of these terms?
Do you accept all of these terms?
I accept
I decline
that the above declarations given by myself are correct to the best of my knowledge and belief. I declare that these declarations shall be the basis of the insurance contract between TPL Life Insurance Limited and myself. If the statements contained herein are untrue, the said insurance contract shall be treated as null and void. I am not a member/close associate of any domestic and foreign PEP (Politically Exposed Person). I understand that I have an option to review and correct the information already provided at any time before paying premium. I also authorize TPL Life to transmit and share my personal, financial and health related information in connection with this Proposal for Insurance with the Central Depository Company of Pakistan Limited (CDC) allowing it to maintain Centralized Information Sharing Solutions for the Insurance Industry (CISSII).
Download the
Terms & Conditions
|
Health Declaration
Hi Muhammad Ahmad
This section is specifically for you
Please fill out the form this is important for your security so that your policy is not misused
Father's name
Mother's name
CNIC
Address
Date
MM slash DD slash YYYY
Religion
Nationality
Source of Income
Self-Employed
Employee
Business
CNIC Issuance Date
CNIC Expiry Date
Let's just do a quick review and be sure
1- I am presently in good health and have never been prescribed any blood thinner medications or undergone any surgery, I have never suffered from any of these listed" diseases/conditions.
2- No proposal on my life has ever been postponed, declined, rated, cancelled or pending decision from any insurer for any reason.
3- I am not involved in any legal, religious, political activities and never had any involvement in any civil or criminal litigation or police case. I further declare that I am not involved in any of the dangerous/ hazardous activities, including but not limited to, motor racing, aviation, mountaineering, paragliding, skydiving, parachuting etc.
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