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
Only PDF, Excel & Word Files accepted
Type of cover required (Please tick if opting) Death onlyPermanent Total & Partial disabilityTemporary Total disability (Weekly benefits) Medical Expenses per head in hospital required Repatriation Expenses required Proposed Period of Insurance:
I/We certify that the above information is true to the best of my /our knowledge and belief.