Call 800 - Nature (628873) | We're Always Here For You!

Group Personal Accident Proposal Form

    LIST OF EMPLOYEES
    Please ATTACH a list of all Employees to be Insured in the format below:

    No: | Full Name | Age | Designation | Annual Salary | Sum Insured

    Upload 1

    Death onlyPermanent Total & Partial disabilityTemporary Total disability (Weekly benefits)Medical Expenses per head in hospital required

    Repatriation Expenses required