Proposal form is meant to seek accurate information about the proposer and his/ her life. Proposal form for Optima Senior is easily accessible through the website of Apollo Munich. It requires the details like name, address, plan details, nominee details and about the life of the proposer. The form is to be filled by the proposer and the information provided should be authentic.
Information about any pre- existing illness if any and the lifestyle of the individual is to be provided by the policyholder. Along with the proposal form, the proposer need to attach certain crucial documents like ID proof, residence proof, age proof, renewal notice with claim details and photocopies of other documents like previous policies and endorsements. The form is to be duly filled and attached with all necessary documents (information regarding documents to be attached is clearly mentioned in the form).
This document is an insurance proposal form for an OptimaRestore health insurance plan. It requests information from the applicant such as personal details, plan details, details of individuals to be insured, nominee details, existing insurance policies, medical history, lifestyle details, and payment details. The document outlines general exclusions of the policy such as a 30-day waiting period for pre-existing diseases and exclusions for war-related events, criminal acts, suicide, and hazardous activities.
Proposal form is meant to seek accurate information about the proposer and his/ her life. Proposal form for Maxima is easily accessible through the website of Apollo Munich. It requires the details like name, address, plan details, nominee details and about the life of the proposer. The form is to be filled by the proposer according to the instructions provided in the form. Make sure that the information provided is genuine.
The form is to be closely studied by the proposer and must be filled with due attention. Along with the proposal form, the proposer need to attach certain crucial documents like ID proof, residence proof, age proof, renewal notice with claim details and photocopies of other documents like previous policies and endorsements. The form is to be duly filled and attached with all necessary documents (information regarding documents to be attached is clearly mentioned in the form).
Proposal form is meant to seek accurate information about the proposer and his/ her life. Apollo Munich website gives you ready access to the proposal form of Optima Plus- a unique top-up plan for people. The form is to be filled in by the proposer. The buyer needs to provide details like name, address, plan details, nominee details, occupation and income details and other medical and lifestyle information. Here, the insured need to make sure that information provided is genuine. It is important to claim all the committed benefits by the insurance company. With policy declaration and warranty information, it demystifies the understanding with clear details.
Along with the proposal form, the proposer need to attach certain crucial documents like ID proof, residence proof, age proof and income proof. Read all the related instructions about the documents to be attached.
This document is a proposal form for a family floater health insurance policy from Bajaj Allianz General Insurance Company. It collects personal and medical information about the proposer and family members to be insured. The proposer must provide full and accurate information in the proposal form which will form the basis of the insurance policy if issued.
This document contains a mock test for an English IC33 Chapter 12 exam. It consists of 29 multiple choice questions testing understanding of key concepts related to insurance policies, documents, and contracts. Key topics covered include policy documents, premium receipts, revival, non-forfeiture, and other standard policy provisions.
This document discusses various insurance documents needed at different stages of a life insurance policy. It explains that a proposal form is needed initially to apply for a policy and provide details. If approved, a policy document is issued which serves as the contract. Other documents include premium receipts, endorsements for any policy changes, proof of identity and age. Documents are also needed to make nominations, assign policies, or get duplicates if originals are lost. Renewal notices are sent as a courtesy to help policies stay active. Overall, documentation establishes the agreement and protects both insurer and insured.
This document describes several endowment insurance plans offered by an insurance provider. The plans include Jeevan Anand which provides life insurance coverage until death along with a sum assured and bonuses at the end of the premium term. Limited Payment Endowment with Profit allows limiting premium payments to a single payment or term shorter than the policy term. Jeevan Mitra provides a death benefit of double the basic sum assured along with accrued bonuses.
This document is an application for a deferred annuity from Farm Bureau Life Insurance Company. It collects information such as the proposed annuitant's name, date of birth, social security number, and contact details. It also requests details about the type of annuity and plan being applied for, including premium payment amounts and frequencies. The application is signed by the proposed annuitant, owner if different, and agent to certify that all statements are true.
This document is an insurance proposal form for an OptimaRestore health insurance plan. It requests information from the applicant such as personal details, plan details, details of individuals to be insured, nominee details, existing insurance policies, medical history, lifestyle details, and payment details. The document outlines general exclusions of the policy such as a 30-day waiting period for pre-existing diseases and exclusions for war-related events, criminal acts, suicide, and hazardous activities.
Proposal form is meant to seek accurate information about the proposer and his/ her life. Proposal form for Maxima is easily accessible through the website of Apollo Munich. It requires the details like name, address, plan details, nominee details and about the life of the proposer. The form is to be filled by the proposer according to the instructions provided in the form. Make sure that the information provided is genuine.
The form is to be closely studied by the proposer and must be filled with due attention. Along with the proposal form, the proposer need to attach certain crucial documents like ID proof, residence proof, age proof, renewal notice with claim details and photocopies of other documents like previous policies and endorsements. The form is to be duly filled and attached with all necessary documents (information regarding documents to be attached is clearly mentioned in the form).
Proposal form is meant to seek accurate information about the proposer and his/ her life. Apollo Munich website gives you ready access to the proposal form of Optima Plus- a unique top-up plan for people. The form is to be filled in by the proposer. The buyer needs to provide details like name, address, plan details, nominee details, occupation and income details and other medical and lifestyle information. Here, the insured need to make sure that information provided is genuine. It is important to claim all the committed benefits by the insurance company. With policy declaration and warranty information, it demystifies the understanding with clear details.
Along with the proposal form, the proposer need to attach certain crucial documents like ID proof, residence proof, age proof and income proof. Read all the related instructions about the documents to be attached.
This document is a proposal form for a family floater health insurance policy from Bajaj Allianz General Insurance Company. It collects personal and medical information about the proposer and family members to be insured. The proposer must provide full and accurate information in the proposal form which will form the basis of the insurance policy if issued.
This document contains a mock test for an English IC33 Chapter 12 exam. It consists of 29 multiple choice questions testing understanding of key concepts related to insurance policies, documents, and contracts. Key topics covered include policy documents, premium receipts, revival, non-forfeiture, and other standard policy provisions.
This document discusses various insurance documents needed at different stages of a life insurance policy. It explains that a proposal form is needed initially to apply for a policy and provide details. If approved, a policy document is issued which serves as the contract. Other documents include premium receipts, endorsements for any policy changes, proof of identity and age. Documents are also needed to make nominations, assign policies, or get duplicates if originals are lost. Renewal notices are sent as a courtesy to help policies stay active. Overall, documentation establishes the agreement and protects both insurer and insured.
This document describes several endowment insurance plans offered by an insurance provider. The plans include Jeevan Anand which provides life insurance coverage until death along with a sum assured and bonuses at the end of the premium term. Limited Payment Endowment with Profit allows limiting premium payments to a single payment or term shorter than the policy term. Jeevan Mitra provides a death benefit of double the basic sum assured along with accrued bonuses.
This document is an application for a deferred annuity from Farm Bureau Life Insurance Company. It collects information such as the proposed annuitant's name, date of birth, social security number, and contact details. It also requests details about the type of annuity and plan being applied for, including premium payment amounts and frequencies. The application is signed by the proposed annuitant, owner if different, and agent to certify that all statements are true.
This document contains a mock test with multiple choice questions about regulations for insurance agents in India. It covers topics like licensing requirements, training requirements, rules around offering rebates, types of agents and brokers, and the key acts that govern the insurance industry in India like the Insurance Act of 1938 and the IRDA Act of 1999.
The document is an internship report that outlines the personal accident insurance program of VRG Dongwha company. It includes:
1) Details of the personal accident insurance coverage including eligible individuals, geographic scope, benefits for injury or death, and insurance fee ranges.
2) Explanation of insurance benefits paid out depending on the insurance fee and type of insured event such as death or injury.
3) Description of the insurance payment procedure including notice period, documentation required, and payment terms.
4) Overview of personal income tax rates in Vietnam including taxable entities, tax periods, and partially progressive tax rate table.
Mr. Suresh took out a home loan but died after 2 years, leaving the loan unpaid. He should have taken out a term life insurance policy to secure repayment of the home loan in case of his death. Keyman insurance covers losses related to the period when a key employee is unable to work or has died, protecting the business. Creditors cannot seize assets that are part of the proceeds of a keyman insurance policy taken out on the life of a business owner like Mahesh.
This document contains a mock test with multiple choice questions about insurance concepts. It begins with 33 questions covering topics like the definition of insurance, the origins of the insurance business, the role of the Life Insurance Corporation in India, different types of insurance policies and contracts, and concepts like risk pooling, insurable interest, and proximate cause. It then continues with another 8 questions about level premiums, statutory reserves, types of insurance plans, and typical risks faced by individuals.
This document contains 50 multiple choice questions from an English exam paper on insurance topics. The questions cover topics like the Married Women's Property Act, types of annuities, health and life insurance concepts, and financial planning principles. The majority of the questions have a single correct answer selected from 4 answer choices labeled A, B, C or D.
The document is a 10 page mock bar exam containing multiple choice questions regarding civil law. Question I discusses whether a lease provision granting a lessee first right of refusal is an option contract or right of first refusal. Question II discusses the personal liability of an industrial partner for partnership debts. Question III addresses the validity of an articulo mortis marriage and legitime rights of the surviving spouse.
- Mortgage Redemption Plan is a decreasing term insurance plan designed to provide a death benefit that corresponds to the decreasing balance owed on a mortgage loan.
- Tax benefits are provided by the government to promote health insurance.
- An individual with an aggressive risk profile would likely follow a wealth accumulation investment style.
- Keyman insurance indemnifies fixed monetary sums specified in an insurance policy that are incurred due to the death or disability of important employees.
Perils are medical factors that influence the risk of dying, while hazards are lifestyle activities that influence risk. Perils refer to the risk that policyholders will die before a specified date, while hazards are factors that could influence that risk. Real needs are actual needs, while perceived needs are based on a client's thoughts and desires. If a person is concentrating more on health and retirement plans, they are likely in the pre-retirement stage of life.
This document contains 41 multiple choice questions prepared by Manish Suryawanshi related to insurance. The questions cover various insurance concepts including the stages of life when past savings are most appreciated, factors considered in insurance underwriting, types of risks that cannot be addressed by pensions, who provides public pensions, and conditions that can negatively affect insurability. The document also includes questions about complaint forums, traditional methods to determine insurance needs, types of retirement planning, and key terms like contingencies, key person insurance, phases of retirement planning, and objectives of mortgage redemption insurance.
This document contains a test paper with multiple choice questions and answers related to life insurance concepts. Some key topics covered include the main objective of life insurance (protection), clauses in insurance policies like the operative clause, roles of underwriters and agents, benefits provided by riders like accidental death benefits, requirements around premium payments, claim investigation timelines, the regulator IRDA, and the powers of the insurance ombudsman.
This document contains 27 multiple choice questions about life insurance concepts. It tests understanding of different types of insurance plans like term plans, endowment plans, and whole life plans. It also covers insurance principles like risk pooling, elements of insurance business, and objectives of different insurance products.
This document contains 50 multiple choice questions related to insurance. The questions cover various insurance concepts such as the different types of insurance policies, claim processes, insurance terminology, regulations, and more. The document was prepared by Manish Suryawanshi and contains his contact information at the top.
This document outlines the terms of an agreement between Western Carolina University and an independent contractor. It specifies:
1) The independent contractor's identifying information such as name, business address, tax ID number.
2) A description of the tasks to be performed by the contractor.
3) Details of payment including budget codes, total price, and payment schedule.
4) The agreement period and provisions for termination.
5) Clarification that the contractor is an independent entity, not a university employee.
The document contains 50 multiple choice questions from an insurance exam preparation document. The questions cover various insurance concepts including types of insurance policies, terms used, key features and benefits. The document is prepared by Manish Suryawanshi and contains his contact details. It has questions ranging from types of insurance, health insurance features, annuities, insurance regulations and more. The document is aimed to help students prepare for an insurance related certification exam.
In simple and uncomplicated policy wordings, the customer information sheet provide all policy details. Information regarding Optima Senior coverage is explained in uncomplictade language by Apollo Munich. It help the policyholder to get familiar with what he/ she is covered for, the benefits offered by the plan, exclusions, renewal benefits, information about renewal benefits, renewal conditions and the claim procedure. Conditions related to cashless access must also be studied in detail. With no hidden clause, it provide genuine information to make the process transparent and simple for the individual. As per the policy variant the benefits offered will differ, thus it require a close study.
The information must be read in accordance to the policy document and policy brochures to obtain a clear idea about the related terms and conditions.
This document outlines a project to help manage outsourcing projects more effectively. The project aims to decrease outsourcing project failures, improve efficiency for suppliers and contractors, and increase profitability. Specific objectives include creating supply chain and knowledge management systems, reducing costs, improving communication between partners, and regulating the outsourcing market. The project scope involves selecting organizations to help with events, producing a supplier directory, and documenting best practices. Risks include meeting deadlines, supplier issues, and changes to client requirements.
This document outlines a project to help manage outsourcing projects more effectively. The project aims to decrease outsourcing project failures, improve efficiency for suppliers and contractors, and increase profitability. Specific objectives include creating supply chain and knowledge management systems, reducing costs, improving communication between partners, and regulating the outsourcing market. The project scope involves selecting organizations to help with events, producing a supplier directory, and documenting best practices. Risks include meeting deadlines, supplier issues, and changes to client requirements.
This document outlines a project to help manage outsourcing projects more effectively. The project aims to decrease outsourcing project failures, improve efficiency for suppliers and contractors, and increase profitability. Specific objectives include creating supply chain and knowledge management systems, reducing costs, improving communication between partners, and regulating the outsourcing market. The project scope involves selecting organizations to help with events, producing a supplier directory, and documenting best practices. Risks include meeting deadlines, supplier issues, and changes to client requirements.
This document contains a mock test with multiple choice questions about regulations for insurance agents in India. It covers topics like licensing requirements, training requirements, rules around offering rebates, types of agents and brokers, and the key acts that govern the insurance industry in India like the Insurance Act of 1938 and the IRDA Act of 1999.
The document is an internship report that outlines the personal accident insurance program of VRG Dongwha company. It includes:
1) Details of the personal accident insurance coverage including eligible individuals, geographic scope, benefits for injury or death, and insurance fee ranges.
2) Explanation of insurance benefits paid out depending on the insurance fee and type of insured event such as death or injury.
3) Description of the insurance payment procedure including notice period, documentation required, and payment terms.
4) Overview of personal income tax rates in Vietnam including taxable entities, tax periods, and partially progressive tax rate table.
Mr. Suresh took out a home loan but died after 2 years, leaving the loan unpaid. He should have taken out a term life insurance policy to secure repayment of the home loan in case of his death. Keyman insurance covers losses related to the period when a key employee is unable to work or has died, protecting the business. Creditors cannot seize assets that are part of the proceeds of a keyman insurance policy taken out on the life of a business owner like Mahesh.
This document contains a mock test with multiple choice questions about insurance concepts. It begins with 33 questions covering topics like the definition of insurance, the origins of the insurance business, the role of the Life Insurance Corporation in India, different types of insurance policies and contracts, and concepts like risk pooling, insurable interest, and proximate cause. It then continues with another 8 questions about level premiums, statutory reserves, types of insurance plans, and typical risks faced by individuals.
This document contains 50 multiple choice questions from an English exam paper on insurance topics. The questions cover topics like the Married Women's Property Act, types of annuities, health and life insurance concepts, and financial planning principles. The majority of the questions have a single correct answer selected from 4 answer choices labeled A, B, C or D.
The document is a 10 page mock bar exam containing multiple choice questions regarding civil law. Question I discusses whether a lease provision granting a lessee first right of refusal is an option contract or right of first refusal. Question II discusses the personal liability of an industrial partner for partnership debts. Question III addresses the validity of an articulo mortis marriage and legitime rights of the surviving spouse.
- Mortgage Redemption Plan is a decreasing term insurance plan designed to provide a death benefit that corresponds to the decreasing balance owed on a mortgage loan.
- Tax benefits are provided by the government to promote health insurance.
- An individual with an aggressive risk profile would likely follow a wealth accumulation investment style.
- Keyman insurance indemnifies fixed monetary sums specified in an insurance policy that are incurred due to the death or disability of important employees.
Perils are medical factors that influence the risk of dying, while hazards are lifestyle activities that influence risk. Perils refer to the risk that policyholders will die before a specified date, while hazards are factors that could influence that risk. Real needs are actual needs, while perceived needs are based on a client's thoughts and desires. If a person is concentrating more on health and retirement plans, they are likely in the pre-retirement stage of life.
This document contains 41 multiple choice questions prepared by Manish Suryawanshi related to insurance. The questions cover various insurance concepts including the stages of life when past savings are most appreciated, factors considered in insurance underwriting, types of risks that cannot be addressed by pensions, who provides public pensions, and conditions that can negatively affect insurability. The document also includes questions about complaint forums, traditional methods to determine insurance needs, types of retirement planning, and key terms like contingencies, key person insurance, phases of retirement planning, and objectives of mortgage redemption insurance.
This document contains a test paper with multiple choice questions and answers related to life insurance concepts. Some key topics covered include the main objective of life insurance (protection), clauses in insurance policies like the operative clause, roles of underwriters and agents, benefits provided by riders like accidental death benefits, requirements around premium payments, claim investigation timelines, the regulator IRDA, and the powers of the insurance ombudsman.
This document contains 27 multiple choice questions about life insurance concepts. It tests understanding of different types of insurance plans like term plans, endowment plans, and whole life plans. It also covers insurance principles like risk pooling, elements of insurance business, and objectives of different insurance products.
This document contains 50 multiple choice questions related to insurance. The questions cover various insurance concepts such as the different types of insurance policies, claim processes, insurance terminology, regulations, and more. The document was prepared by Manish Suryawanshi and contains his contact information at the top.
This document outlines the terms of an agreement between Western Carolina University and an independent contractor. It specifies:
1) The independent contractor's identifying information such as name, business address, tax ID number.
2) A description of the tasks to be performed by the contractor.
3) Details of payment including budget codes, total price, and payment schedule.
4) The agreement period and provisions for termination.
5) Clarification that the contractor is an independent entity, not a university employee.
The document contains 50 multiple choice questions from an insurance exam preparation document. The questions cover various insurance concepts including types of insurance policies, terms used, key features and benefits. The document is prepared by Manish Suryawanshi and contains his contact details. It has questions ranging from types of insurance, health insurance features, annuities, insurance regulations and more. The document is aimed to help students prepare for an insurance related certification exam.
In simple and uncomplicated policy wordings, the customer information sheet provide all policy details. Information regarding Optima Senior coverage is explained in uncomplictade language by Apollo Munich. It help the policyholder to get familiar with what he/ she is covered for, the benefits offered by the plan, exclusions, renewal benefits, information about renewal benefits, renewal conditions and the claim procedure. Conditions related to cashless access must also be studied in detail. With no hidden clause, it provide genuine information to make the process transparent and simple for the individual. As per the policy variant the benefits offered will differ, thus it require a close study.
The information must be read in accordance to the policy document and policy brochures to obtain a clear idea about the related terms and conditions.
This document outlines a project to help manage outsourcing projects more effectively. The project aims to decrease outsourcing project failures, improve efficiency for suppliers and contractors, and increase profitability. Specific objectives include creating supply chain and knowledge management systems, reducing costs, improving communication between partners, and regulating the outsourcing market. The project scope involves selecting organizations to help with events, producing a supplier directory, and documenting best practices. Risks include meeting deadlines, supplier issues, and changes to client requirements.
This document outlines a project to help manage outsourcing projects more effectively. The project aims to decrease outsourcing project failures, improve efficiency for suppliers and contractors, and increase profitability. Specific objectives include creating supply chain and knowledge management systems, reducing costs, improving communication between partners, and regulating the outsourcing market. The project scope involves selecting organizations to help with events, producing a supplier directory, and documenting best practices. Risks include meeting deadlines, supplier issues, and changes to client requirements.
This document outlines a project to help manage outsourcing projects more effectively. The project aims to decrease outsourcing project failures, improve efficiency for suppliers and contractors, and increase profitability. Specific objectives include creating supply chain and knowledge management systems, reducing costs, improving communication between partners, and regulating the outsourcing market. The project scope involves selecting organizations to help with events, producing a supplier directory, and documenting best practices. Risks include meeting deadlines, supplier issues, and changes to client requirements.
This document outlines a project to help manage outsourcing projects more effectively. The project aims to decrease outsourcing project failures, improve efficiency for suppliers and contractors, and increase profitability. Specific objectives include creating supply chain and knowledge management systems, reducing costs, improving communication between partners, and regulating the outsourcing market. The project scope involves selecting organizations to help with events, producing a supplier directory, and documenting best practices. Risks include meeting deadlines, supplier issues, and changes to client requirements.
This document outlines the goals, objectives, scope, and budget for a project to develop a framework called MOOP (Management of Outsourcing Projects) to help manage outsourcing projects more effectively. The goals are to decrease outsourcing project failures, improve efficiency, and increase profitability. Objectives include creating supply chain and knowledge management systems to improve communication and flexibility. The framework will include an online platform, conference, and business plan. A budget is requested to implement the MOOP framework over 18 months.
This document summarizes the recipients of the City of Waterloo Urban Design Awards after a ten year period. It recognizes several projects that achieved the highest standard of design excellence and urban design objectives. These include the Perimeter Institute of Theoretical Physics, which won the William G. Dailey Award of Excellence for best overall design. The Seagram Lofts and Bauer Buildings & Lofts projects won the Reurbanization Award for best infill projects. Two other projects received an Award of Merit for their designs.
This document summarizes the results of an FDI Magazine ranking of major cities in North America and Latin America as "Cities of the Future." New York was ranked first overall and in North America, while Santiago, Chile was ranked first in Latin America. The top cities demonstrated strengths such as economic potential, infrastructure, human resources, quality of life, and business friendliness. US and Canadian cities dominated the top rankings in North America.
This document provides an overview of Gold Road Resources Limited's Yamarna Belt project in Western Australia. The Yamarna Belt is a newly discovered gold region that is highly prospective but remains largely underexplored. Gold Road has two existing gold resources at Central Bore and Attila and has made several additional high-grade gold discoveries in recent years. The company controls over 5,000 square kilometers of tenements along the Yamarna greenstone belt and shear zone, which is similar in nature to the major gold-producing Kalgoorlie region. Gold Road sees significant potential to define additional gold resources throughout its large land package.
Claim form for Optima Senior is easily available on the website of Apollo Munich. With this provision, the process has been uncomplicated.
The policyholder need to provide basic information like policy number, contact details, name of the insured and details regarding the illness for which the claim is to be filed. However, the insured need to be sure of the information provided. In case of any dishonest information provided, the benefits will be forfeited making the policy void. With a ready link to Claim Form, all customers can move ahead with the procedure. Proper reading of form is important before beginning to fill the form.
This document provides an overview of a PhD dissertation defense presentation on incorporating stakeholder participation and climatic variability into flood risk management. The presentation covers:
1) Investigating and incorporating climate change into flood risk management processes and assessing risk using conventional and fuzzy logic methods.
2) Evaluating how to enhance stakeholder participation in developing management processes.
3) Developing a decision support system for managers using hydrological and social data from the Kalu-Ganga river basin in Sri Lanka, including estimating climate variability and assessing flood hazard, vulnerability and risk.
In simple and uncomplicated policy wordings, the customer information sheet of Maxima provide all policy details. It help the policy buyer or the policyholder to get familiar with what he/ she is covered for, the benefits offered by the plan, exclusions, renewal benefits, information about renewal benefits, renewal conditions and the claim procedure. Conditions related to cashless access must also be studied in detail. With no hidden clause Apollo Munich help you understand the policy coverage with genuine information to make the process transparent and simple for the customers. As per the policy variant the benefits offered will differ, thus it require a close study.
The information must be read in accordance to the policy document and policy brochures to obtain a clear idea about the related terms and conditions.
Optima Restore claim form seek information like policy number, contact details, name of the insured and details regarding the illness for which the claim is to be filed. However, the insured need to be sure of the information provided. In case of any dishonest information provided, the benefits will be forfeited making the policy void. With a ready link to Claim Form at Apollo Munich website, all customers can move ahead with the procedure. Proper reading of form is important before beginning to fill the form.
Take a look at the check list of enclosures to be submitted with the claim form.
Este documento presenta una recopilación de artículos sobre la crisis del neoliberalismo y sus implicancias a nivel global y en América Latina. Los artículos analizan las causas estructurales de la crisis, sus efectos en la economía mundial y en las economías nacionales, y exploran posibles alternativas y proyectos en disputa en la región. El documento está dividido en cuatro partes que abordan estos temas desde diferentes perspectivas teóricas y empíricas.
In simple and uncomplicated policy wordings, the customer information sheet of Optima Restore provide all policy details. It help the policy buyer or the policyholder to get familiar with what he/ she is covered for, the benefits offered by the plan, exclusions, renewal benefits, information about renewal benefits, renewal conditions and the claim procedure. Conditions related to cashless access must also be studied in detail. With no hidden clause Apollo Munich help you understand the policy coverage with genuine information to make the process transparent and simple for the customers. As per the policy variant the benefits offered will differ, thus it require a close study.
The information must be read in accordance to the policy document and policy brochures to obtain a clear idea about the related terms and conditions.
Proposal form is meant to seek accurate information about the proposer and his/ her life. Easy Travel proposal form is easily accessible through the website of the company. It requires the details like name, address, contact details, plan details, nominee details and about the life of the proposer. The form is to be filled by the proposer and the information provided should be authentic. It help the insurer, Apollo Munich to provide customers required information.
Policy proposal form seek information about any pre- existing illness if any and the life style of the individual. Along with the proposal form, the proposer need to attach certain crucial documents like ID prooof, residence proof, age proof, renewal notice with claim details and photocopies of other documents like previous policies and endorsements. The form is to be duly filled and attached with all necessary documents (information regarding documents to be attached is clearly mentioned in the form).
Proposal form is meant to seek accurate information about the proposer and his/ her life. Easy Health proposal form is easily accessible through the website of the company. It requires the details like name, address, plan details, nominee details and about the life of the proposer. The form is to be filled by the proposer and the information provided should be authentic.
The form is to be closely studied by the proposer and must be filled with due attention. It seek information about any pre- existing illness if any and the life style of the individual. Along with the proposal form, the proposer need to attach certain crucial documents like ID prooof, residence proof, age proof, renewal notice with claim details and photocopies of other documents like previous policies and endorsements. The form is to be duly filled and attached with all necessary documents (information regarding documents to be attached is clearly mentioned in the form).
Health Insurance Proposal Form - HDFC ERGOSaurav Mishra
HDFC ERGO is one of the leading insurance companies in India which has brought to you a comprehensive health insurance plan at an cost-effective premium rate. Read the health Insurance proposal document for your reference.
Allianz have won several awards for providing quality health insurance products and exceptional claims services. Their Worldwide Care international medical insurance policy provides excellent cover and value for money. Brought to you by Pacific Prime Insurance Brokers. For more information, please visit: http://www.pacificprime.com/insurers/allianz/company-overview/
This document contains a health insurance claim form for Royal Sundaram Alliance Insurance Company. It requests information about the policyholder, patient, illness details, hospitalization details, other insurance policies, previous claims history, and authorization to obtain medical records. The attending physician section collects medical information about the patient's condition, treatment, and certification of the details provided.
This risk assumption letter from ICICI Lombard General Insurance Company provides the policy details for Ms. Mukta Mehta's international travel insurance. The policy number is 4129/107759001/00/000 and covers her travel from October 25, 2015 to January 22, 2016 for trips to Schengen countries. Key policy details like her name, address, passport number, nominee, and plan type are listed. The insured is asked to review the details and contact the company within 15 days if any discrepancies are found.
Travel Insurance Proposal Form - HDFC ERGOSaurav Mishra
HDFC ERGOis a leading health Insurance provider in India, here is Travel Insurance Proposal Form - HDFC ERGO. Have a look please or visit; http://www.hdfcergo.com/travel-insurance/travel-insurance.html
UltraCare plan individual application form for 1 January 2012. The document provides an application for an UltraCare health insurance plan. It requests personal details for the applicant and any dependents to be covered. It asks for coverage options including level of coverage, area of coverage, excess options, and payment details. It also requests contact information for the applicant's doctor. Credit card and direct debit payment authorizations are included.
Proposal form is the most important and basic document required for life insurance contract between the insured and insurance company. It includes the insured's basic information like address, age, name, education, occupation etc. It also includes the person's medical history.
This document provides information about making an insurance claim for residential property damage through CGU Insurance. It outlines the claims process, including that CGU will contact the claimant about the claim, may inspect damage before authorizing repairs, and may appoint a loss adjuster. It advises claimants not to authorize repairs themselves and to provide documentation like receipts or photos to support the claim. Disputes can be resolved through CGU or referred to the Financial Ombudsman Service. The second page is a claims report form for claimants to provide details of the damaged property, tenants, costs, and other relevant information to support their claim.
This document is an application form for a UTI-Unit Linked Insurance Plan (UTI-ULIP). It requests personal details of the applicant such as name, address, date of birth, PAN, bank account details. It also requests details of the nominee/guardian if applicant is a minor. The applicant needs to select the plan period (10 or 15 years), the type of insurance cover (declining term or fixed term) and the target investment amount. The applicant needs to provide health declaration, occupation and income details. The applicant needs to sign declaring that all information provided is true.
This document provides instructions for completing a guarantor information form required for a security guard or private investigator license application in Ontario, Canada. It explains that a guarantor must confirm the applicant's identity by viewing their original identification documents and signing the form. The guarantor must be at least 18 years old and have known the applicant for at least two years, or be one of the listed occupations if the two year requirement cannot be met. Acceptable identification documents include government issued photo IDs and documents proving eligibility to work in Canada. The guarantor must verify that the names on the two IDs presented by the applicant match and sign the three page guarantor information form.
This document is an annual confirmation form from the Social Security System of the Philippines. It collects information from pensioners to confirm their eligibility for continued pension benefits. The form collects identification information of the pensioner and their beneficiary. It asks questions about the pensioner's employment, marital, and dependent status. The pensioner must sign to certify the accuracy of the information. Bank managers or barangay chairmen can also certify the pensioner's identity. The form documents what verification materials were submitted and the actions taken and recommendations regarding the pensioner's benefits.
This document is a subscriber registration form for the National Pension System (NPS) in India. It collects personal details such as name, date of birth, address, identity details, bank account information, and pension fund selection. The form includes declarations by the subscriber to agree to the terms of NPS and confirm that the information provided is true. For government subscribers, it also requires employment details to be filled in and attested by the government department where the individual is employed.
This document contains a liability claim form that is used to report incidents or accidents that could result in claims being made against the policyholder. It requests details about the policy, those involved in the incident, witnesses, property damage, injuries, and other insurance coverage. The policyholder must complete all sections, provide documentation, and declare that the information is true for the claim to be assessed.
The form contains sections for policy details, client details, accident details, witnesses, damaged property details, injured persons details, and a declaration. It requests information to assess a claim for any demands or liability arising from an incident. Completing and returning the form allows the insurance company to process and administer the claim in accordance with the claimant's policy.
Pre- Authorization form is to be filled in case of hospitalization. It is basically a declaration by the patient to make claim for the expenses incurred during the hospitalization. Easy Health Pre- Authorization form will seek information about the patient or the insured person like name of the patient, contact details, age, policy number and card ID number, name of the hospital, nature of illness and other related details. All columns must be closely examined to provide genuine information to the insurer. The form must be duly filled and then must be attached with all the necessary documents to avail the service.
This document summarizes a registration form for a community exchange program that facilitates sharing of services among members. It requests basic contact information, references, skills, availability, and a signed waiver. Members agree to provide certain services, keep information confidential, and not hold the program liable for any injuries or damages from participation. Registration requires emergency contacts, driver's license if transporting others, and signed acceptance of terms.
This document is an 8-page proposal form for personal injury litigation insurance. It requests important information about the applicant, their legal representatives, their opponent, the details of the claim, estimated costs, funding arrangements, documents being provided in support of the application, and a declaration. The form notes that full information must be provided to enable an accurate quotation, and that any changes must be notified. It also contains a data protection notice regarding the use of any personal information collected.
Pre- Authorization form is to be filled in case of hospitalization. It is basically a declaration by the patient to make claim for the expenses incurred during the hospitalization. While seeking health insurance coverage under Optima Plus, the Pre- Authorization form must be filled to avail the policy support. Through this Apollo Munich seek information about the patient or the insured person like name of the patient, contact details, age, policy number and card ID number, name of the hospital, nature of illness and other related details. All columns must be closely examined to provide genuine information to the insurer. The form must be duly filled and attached with all the necessary documents absence of which can lead to complication.
Similar to Apollo Munich Optima Senior Proposal From (20)
Pre- Authorization form is to be filled in case of hospitalization. It is basically a declaration by the patient to make claim for the expenses incurred during the hospitalization. While seeking health insurance coverage under Optima Restore, the Pre- Authorization form must be filled to avail the policy support. Through this Apollo Munich seek information about the patient or the insured person like name of the patient, contact details, age, policy number and card ID number, name of the hospital, nature of illness and other related details. All columns must be closely examined to provide genuine information to the insurer. The form must be duly filled and then must be attached with all the necessary documents absence of which can lead to complication.
To assist insured people with uncomplicated health insurance services, Apollo Munich explains claim procedure in simple language and clear guidelines. Giving all information about the procedure for reimbursement for medical expenses, procedure to avail cashless facility and intimation details. Optima Restore offers unique coverage through easy to follow claim procedure. It is advised to be clear about the process of claim as it will affect the kind of services received. Optima Restore claim procedure form gives access to information about the steps to be followed.
To enjoy hassle free and uncomplicated claim process, it is advised to keep copies of documents submitted to the Third Party Administrator and also don’t forget to quote your policy number or member ID.
Claim intimation form seek information from the insured individual about self, illness he/ she is suffering from and kind of treatment against which the claim is filed. Apollo Munich explains the procedure to be followed while filing claim under Optima Restore coverage. The form is to be filled to intimate the insurer about the treatment to be availed and the related expenditure. It includes information about the policy holder, the diagnosis to be done, expected treatment expenses, address, date of birth and contact details. The claim settlement will depend on the information and documents provided by the insured. Also, the claimant must submit the claim intimation form as soon as possible, in order to allow the insurance company to work over it.
Complete submission of the required documents is extremely important. It will affect the kind of coverage offered by the insurer.
Optima Restore is the recently launched Unbelievable plan by Apollo Munich. The product is available in affordable sum insured options ranging from 3 lakhs to 15 lakhs. It is available for individual as well as family coverage. Optima Restore comes equipped with unique healthcare benefits like Restore benefit- that automatically reinstates entire sum insured if exhausted in the policy year and Multiplier benefit- that offers 50% no claim bonus going maximum up to 100%. Besides the basic coverage features, the policy weaves along another list of unique healthcare benefits. With no sub-limit, lifelong renewal and tax benefit, Optima Restore entitle the insured to family discount of 10% and an additional discount of 7.5% as per the policy terms.
Enjoy unique health insurance coverage with first of its kind plan- Optima Restore.
While undergoing any planned treatment the insured can inform his/ her respective insurer in advance. Like other plans of Apollo Munich, Optima Senior is also available with this provision. The insured can fill the claim intimation form and claim the coverage for better facilities. This form will seek information about self, the illness that the person is suffering from and the treatment against which the claim is filed. This will intimate the insurance company well in advance about the treatment insured will be going for thereby providing him/ her the right support.
The insured need to provide information about the diagnosis to be done, expected treatment expenses, address, date of birth and contact details. The claim settlement will depend on the information and documents provided by the insured. Also, the claimant must submit the claim intimation form as soon as possible, in order to allow the insurance company work over it. Complete submission of the required documents is extremely important.
Optima Senior is a plan exclusively designed for senior citizens by Apollo Munich Health Insurance. This wonderful plan is power packed with amazing benefits to guarantee best healthcare to people of age 61 years or above. With no additional loading, the plan ensures best coverage during retirement years. Optima Senior is available in cover options of 2 lakhs, 3 lakhs and 5 lakhs. It is possible to acquire lifelong coverage under this plan along with an access to e-opinion for listed critical illnesses. With an option of higher sum insured one can enjoy several benefits with comprehensive coverage.
Tax Benefit and discount offer makes the plan affordable for all income groups.
This document provides the prospectus for the OptimaSENIOR health insurance plan. It outlines the plan's suitability, schedule of benefits, salient features and benefits, exclusions, and waiting periods. Key details include:
- The plan covers medical expenses for inpatient treatment, pre-hospitalization, post-hospitalization care, day care procedures, and more.
- It has benefits like e-opinion and ambulance coverage up to specified limits.
- Several medical conditions and treatments have waiting periods of up to 36 months.
- Exclusions include cosmetic treatments, substance abuse, experimental treatments, and pre-existing conditions (among others).
- The basic sum insured ranges from Rs. 200,000
Claim intimation form seek information from the insured individual about self, illness he/ she is suffering from and kind of treatment against which the claim is filed. Apollo Munich explains the procedure to be followed while filing the claim. The form is to be filled to intimate the insurer about the treatment to be availed and the related expenditure. It includes information about the policyholder, the diagnosis to be done, expected treatment expenses, address, date of birth and contact details. The claim settlement will depend on the information and documents provided by the insured. Also, the claimant must submit the claim intimation form as soon as possible, in order to allow the insurance company work over it.
Complete submission of the required documents is extremely important. It will affect the kind of coverage offered by the insurer.
At times the policyholder need to get some changes in the details provided while buying the policy. Also the person might want to change the plan. To allow people do that, Apollo Munich provides the respective link on its website. The insured need to fill the Change Request Form in order to avail the provision. The individual need to provide the detail about the change. He/ she can opt from the categories of change in the plan, change in address, change in sum insured, member addition/ deletion and others. Thereafter, the form will seek further related information and details so as to exercise the required change. Along with these details, the individual need to provide name of witness, address and contact details.
In simple and uncomplicated policy wordings, this link provide all policy details about Optima Plus. It help policy buyers to get familiar with what he/ she is covered for, the benefits offered by the plan, exclusions, renewal benefits, claim procedure and other related terms of the policy. To help people understand all crucial features easily, Apollo Munich website provide link for policy wording form. The link will familiarize you with information about waiting period, schedule of benefits and similar other features that must be read well before making payment.
However, the information must be read in accordance to the policy document and policy brochures to obtain a clear idea about the related terms and conditions.
To assist insured people with uncomplicated health insurance services, claim procedure is explained in simple language by Apollo Munich. Giving all information about the procedure for reimbursement, this document help you get familiar with all the related terms and conditions. Obtain all claim procedure information about Optima Plus through link available on website. It explains the procedure to be followed in different circumstances. With the help of the information displayed, you can obtain information about the precautions to be exercised in terms of policy document for future references and claim purposes.
To enjoy hassle free and uncomplicated claim process, it is advised to keep copies of documents submitted to the Third Party Administrator and also don’t forget to quote your policy number or member ID.
Claim intimation form seek information from the insured individual about self, illness he/ she is suffering from and kind of treatment against which the claim is filed. Apollo Munich explains the procedure to be followed while filing claim under Optima Plus coverage. The form is to be filled to intimate the insurer about the treatment to be availed and the related expenditure. It includes information about the policyholder, the diagnosis to be done, expected treatment expenses, address, date of birth and contact details. The claim settlement will depend on the information and documents provided by the insured. Also, the claimant must submit the claim intimation form as soon as possible, in order to allow the insurance company work over it.
Complete submission of the required documents is extremely important. It will affect the kind of coverage offered by the insurer.
You can acquire the claim form for Optima Plus through Apollo Munich Health Insurance website. Here the buyer need to provide basic information like policy number, contact details, name of the policyholder, details of the insured, nature of disease or illness caused, nature of claim and list of enclosures to be attached with the form. The documents provided must be complete and genuine as per the claim. It is to be filled with due care and after proper understanding. Any dishonest information provided can affect the coverage offered by the plan.
With a ready link to Claim Form, all customers can move ahead with the procedure. Proper reading of form is important before beginning to fill the form.
To assist insured people with uncomplicated health insurance services, Apollo Munich explains claim procedure in simple language and clear guidelines. The form provides information in uncomplicated guidelines. The policyholder can read all about the claim procedure to be followed while seeking outpatient and inpatient benefits. The procedure for reimbursement of medical expenses incurred, procedure to avail cashless facility and intimation details must be understood before paying for any plan. It is advised to be clear about the process of claim as it will affect the kind of services offered.
To enjoy hassle free and uncomplicated claim process, it is advised to keep copies of documents submitted to the Third Party Administrator and also don’t forget to quote your policy number or member ID.
Claim intimation form seek information from the insured individual about self, illness he/ she is suffering from and kind of treatment against which the claim is filed. Apollo Munich explains the procedure to be followed while filing claim for coverage under Maxima health plan. The form is to be filled to intimate the insurer about the treatment to be availed and the related expenditure. It includes information about the policyholder, the diagnosis to be done, expected treatment expenses, address, date of birth and contact details. The claim settlement will depend on the information and documents provided by the insured. Also, the claimant must submit the claim intimation form as soon as possible, in order to allow the insurance company to work over it.
Complete submission of the required documents is extremely important. It will affect the kind of coverage offered by the insurer.
To claim insurance coverage under Maxima health plan, the insured need to fill the respective claim form. The form seek basic information like policy number, contact details, name of the insured and details regarding the illness for which the claim is to be filed. However, the insured need to be sure of the information provided. In case of any dishonest information provided, the benefits will be forfeited making the policy void. With a ready link to Claim Form at Apollo Munich website, all customers can move ahead with the procedure. Proper reading of form is important before beginning to fill the form.
Take a look at the check list of enclosures to be submitted with the claim form.
Maxima is a plan that takes care of your everyday health needs. It is an easy to buy plan that covers expenses incurred in the form of Doctors’ consultations, Pharmacy bills, Diagnostic tests, Dental treatment, Optical services and Annual health check-up. Maxima health plan by Apollo Munich offers comprehensive coverage while taking care of little illnesses too. Along with wide inpatient coverage, Maxima also offer benefits with unique outpatient coverage. With additional critical illness coverage and provision of lifelong renewal, the plan makes insurance coverage feasible at affordable premium rates. Get self as well as your family members insured under this easy to understand plan and enjoy a stress free health future.
Apollo Munich claim procedure is easy to understand with information provided in simple and uncomplicated wordings. Insure Health claim form is easily available on the website of the company. The form is to filled while filing the claim for insured illness.
The form seeks basic information like policy number, contact details, name of the insured and details regarding the illness for which the claim is to be filed. However, the insured need to be sure of the information provided. Details provided must be correct and complete to receive the listed benefits. In case of any dishonest information provided, the benefits will be forfeited making the policy void. With a ready link to Claim Form on the website, all customers can move ahead with the procedure.
1) This document outlines the benefits provided by an Individual Personal Accident Standard policy. The policy provides insurance coverage for accidental death, permanent total or partial disability, and other related costs like transportation of remains, education funds for dependents, etc. subject to specified terms and conditions.
2) The policy pays a percentage of the sum insured for permanent total or partial disabilities. It also provides a weekly benefit for temporary total disability, reimbursement of medical expenses, and other additional benefits like family transportation in case of certain claims.
3) The policy contains standard exclusions for pre-existing conditions, suicide, HIV/AIDS, war, pregnancy, congenital anomalies, non-allopathic treatments, and criminal acts.
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Apollo Munich Optima Senior Proposal From
1. OptimaSENIOR
Proposal Form 10th Floor, Building No. 10, Tower B, DLF City Phase II, DLF Cyber City, Gurgaon-122002
Application No. :
This proposal will be the basis of any insurance policy that We may issue. You must disclose all facts relevant to all persons proposed to be insured that may affect
Our decision to issue a policy or its price, terms, conditions and exclusions. Non-compliance may result in avoidance of the Policy. If there is insufficient space for You
to provide information, whether as requested or otherwise, please attach a separate sheet. If You are in any doubt, please seek advice of Your insurance advisor. We
are under no obligation to accept any proposal for insurance. If We accept a proposal for insurance, it shall be subject to the Policy terms and conditions and We shall
have no liability to make any payment under the Policy if premium is not received by Us in full and in time, or is not realised, or non-fulfillments of Pre Policy Checkup.
Please fill-up this form in CAPITAL LETTERS and attach a passport sized photograph for Yourself and each person proposed to be insured and write the name of the person above
the photograph.
1. Proposer Details
Proposer : (Mr./Ms./Mrs.)
First Name Middle Name Last Name
Address :
City/Town :
District : State :
Pin Code : Mobile :
Telephone : E Mail :
I want to opt for GO-GREEN and receive all my policy related document(s) and communications on the e-mail ID* provided in this proposal form. * I/We hereby authorize Apollo Munich Health
Insurance Company Limited to mail all service related communications to the email id as mentioned in the application form (applicable only if email id provided).
Nationality : Marital Status : Annual Income :
Profession : Salaried Self Employed Others Details
ID Proof Type : PAN Passport Driving License Voter’s Card Other Details
ID Proof No. :
2. Plan Details
Proposed Policy Period : From D D M M Y Y Y Y To D D M M Y Y Y Y
Proposed Policy duration: 1 Year 2 Year
3. Proposed insured(S) Details
Details of Person Proposed to be Insured
Insured 1 : Name : Mr./Ms./Mrs.
Height Relationship Date of Birth D D M M Y Y Y Y Occupation
Weight Gender Male Female Basic Sum Insured
Insured 2 : Name : Mr./Ms./Mrs.
Height Relationship Date of Birth D D M M Y Y Y Y Occupation
Weight Gender Male Female Basic Sum Insured
4. Please paste the photographs in sequence [Insured 1 and Insured 2] as specified in section 3 Details of the person proposed to be insured.
Insured 1 Insured 2
1
2. OptimaSENIOR
Proposal Form 10th Floor, Building No. 10, Tower B, DLF City Phase II, DLF Cyber City, Gurgaon-122002
5. Nominee Details
In the event of the death of an Insured Person any payment due under the Policy shall become payable to the nominee in accordance with the Policy terms and
conditions. The nominee must be an immediate relative of the Proposer. Nominee for any of the persons proposed to be insured shall be the Proposer.
Nominee Name Relationship Address of the Nominee
*If the Nominee is minor, Name and Address of Appointee and Relationship with Minor:
Appointee Name Relationship Address of Appointee
6. EXISTING/PREVIOUS INSURANCE DETAILS*
Is the proposer or the persons proposed, already insured under a plan with Apollo Munich Health Insurance Company Limited or any other insurance
company? Yes No
If yes, please indicate below the Policy/ Application number(s) (Please mention application number incase of pending proposal.)
Since when are you continuously insured: D D M M Y Y Y Y
Do you want Us to consider these details for continuity*? Yes No
Policy No./Application Insurer Period of Insurance Sum Insured Claims lodged during the
No. From To (Rs.) preceding 3 years
D D M M Y Y D D M M Y Y
D D M M Y Y D D M M Y Y
D D M M Y Y D D M M Y Y
D D M M Y Y D D M M Y Y
D D M M Y Y D D M M Y Y
D D M M Y Y D D M M Y Y
* Please note that continuity of benefits shall NOT be considered if the details are not provided.
7. medical and life style information
Medical History: Please answer the below mentioned questions Yes (Y) or No (N) ONLY:
Section A : Have any of the person proposed to be insured ever suffered from/ are currently suffering Insured Person 1 Insured Person 2
from any of the following :
i. Hypertension, Chest Pain, Ischemic heart disease or any other cardiac disorder Y /N Y /N
ii. Tuberculosis, Asthma, Bronchitis or any other lung/respiratory disorder Y /N Y /N
iii. Ulcer (stomach/duodenal), hepatitis, cirrhosis or any other Digestive or Liver/ Gallbladder disorder Y /N Y /N
iv. Renal failure, calculus or any other Kidney/Urinary tract or Prostate disorder Y /N Y /N
v. Dizziness, Stroke, Epilepsy, Paralysis or other brain/ nervous system disorder Y /N Y /N
vi. Diabetes, Thyroid disorder or any other endocrine disorder Y /N Y /N
vii. Tumor-benign or malignant, any ulcer/growth/cyst Y /N Y /N
viii. Arthritis, Spondylosis or any other disorder of the muscle/bone/joint Y /N Y /N
ix. Diseases of the Nose/Ear/Throat/Teeth/ Eye ( please mention Diopters ) Y /N Y /N
x. HIV/AIDS or sexually transmitted diseases or any immune system disorder Y /N Y /N
xi. Anaemia, Leukaemia or any other blood/lymphatic system disorder Y /N Y /N
xii. Psychiatric/Mental illnesses or Sleep disorder Y /N Y /N
xiii. DUB, Fibroid, Cyst/Fibroadenoma or any other Gynaecological/Breast disorder Y /N Y /N
Section B : Have any of the persons proposed to be insured:
xiv. Been addicted to alcohol, narcotics, habit forming drugs or been under detoxication therapy? Y /N Y /N
xv. Been under any regular medication (self/ prescribed)? Y /N Y /N
xvi. Undertaken any lab/blood tests, imaging tests viz. scans/MRI in the last 5 years other than routine health Y /N Y /N
check-up or pre-employment check-up?
xvii. Undertaken any surgery or a surgery been advised in the last 10 years or is a surgery still pending? Y /N Y /N
xviii. Suffered from any other disease/illness/accident/injury other than common cold or fever? Y /N Y /N
xix. Is any of the insured persons pregnant? If yes, please mention the expected date of delivery Y /N Y /N
xx. Any complaint of diabetes, hypertension or any complication during current or earlier pregnancy? Y /N Y /N
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3. OptimaSENIOR
Proposal Form 10th Floor, Building No. 10, Tower B, DLF City Phase II, DLF Cyber City, Gurgaon-122002
Section C : Name and details of Illness/ Medicine/Test/Surgery/ Diagnosis Date of last Treatment In/ Doctor/Hospital Name &
Diopter grade (for questions answered as Yes in Section A & B above) date consultation Outpatient Phone No.
Insured Person 1 :
Insured Person 2 :
Section D : Name, address, qualification and contact details of the family doctor, if any:
Name :
Qualification :
Address :
Pin Code : Mob. No. :
Phone No : Email ID :
Section E : Does any person proposed to be insured smoke or consume gutkha/ pan Pan
Alcohol Smoke Others
masala or alcohol. If yes, please indicate the name and quantity per week: Masala
Insured Person 1 :
Insured Person 2 :
Section F : In respect of any of the persons proposed to be insured: Insured Person Insured Person
1 2
Has any application for life, health, hospital daily cash or critical illness insurance ever been declined, postponed, loaded or been Y /N Y /N
made subject to any special conditions by any insurance company?
8. Payment Details
Instrument type : Cash Cheque Debit Card Credit Card Others
Name of the Premium
Instrument No. Bank Details Date Amount (in Rs.)
Payor
Please make a A/C Payee Cheque/DD/Pay Order in favour of ‘Apollo Munich Health Insurance Company Limited’ only.
Section 41 of Insurance Act 1938 (Prohibition of rebates):
1) No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take out or continue an insurance in respect of any kind
of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of premium shown on the policy, nor shall any
person taking out or renewing or continuing a policy accept any rebate, except such rebate as may be allowed in accordance with the prospectus or tables of the
insurers.
2) Any person making default in complying with the provisions of this section shall be punishable with fine which may extend to five hundred rupees.
additional information
(If there is insufficient space to provide additional relevant information, whether as requested or otherwise, please attach extra sheet duly signed.)
9. General exclusions
The following is an outline of the general exclusions under the policy. For more details on the exclusions and the waiting periods please refer to the policy wordings
before purchasing this policy.
Waiting Periods - 30 days waiting period in the first year and is not applicable in subsequent renewals. 2 years waiting period for the specified illnesses/ surgeries. 3
years waiting period for Pre-existing conditions.
Non medical - War or any act of war, invasion, act of foreign enemy, war like operations (whether war be declared or not or caused during service in the armed forces of
any country), civil war, public defence, rebellion, revolution, insurrection, military or usurped acts, nuclear weapons/materials, chemical and biological weapons, radiation
of any kind. Any Insured Person committing or attempting to commit a breach of law with criminal intent, or intentional self injury or attempted suicide while sane or
insane. Any Insured Person’s participation or involvement in naval, military or air force operation, racing, diving, aviation, scuba diving, parachuting, hang-gliding, rock
or mountain climbing.
Medical - Abuse or the consequences of the abuse of intoxicants or hallucinogenic substances such as intoxicating drugs and alcohol, including smoking cessation
programs and the treatment of nicotine addiction or any other substance abuse treatment or services, or supplies. Treatment of Obesity and any weight control program.
Plastic surgery or cosmetic surgery unless necessary as a part of medically necessary treatment certified by the attending Medical Practitioner for reconstruction
following an Accident, Cancer or Burns. Treatment for correction of eye due to refractive error. Circumcisions (unless necessitated by illness or injury and forming
part of treatment); Aesthetic or change-of-life treatments of any description such as sex transformation operations, treatments to do or undo changes in appearance
driven by cultural habits, fashion or the like or any procedures which improve physical appearance. Non allopathic treatment. Conditions for which Hospitalization is
not required. Experimental, investigational or unproven treatment devices and pharmacological regimens. Measures primarily for diagnostic and evaluation purposes
which are not consistent with or incidental to the diagnosis and treatment of Illness for which Hospitalization has been done. Convalescence, cure, rest cure, sanatorium
treatment, rehabilitation measures, private duty nursing, respite care, long-term nursing care or custodial care. Preventive care, vaccination including inoculation and
immunisations (except in case of post-bite treatment); any physical, psychiatric or psychological examinations or testing. Enteral feedings (infusion formulas via a tube
into the upper gastrointestinal tract) and other nutritional and electrolyte supplements unless certified to be required by the attending Medical Practitioner as a direct
consequence of an otherwise covered claim. Provision or fitting of hearing aids, spectacles or contact lenses including optometric therapy, any treatment and associated
expenses for alopecia, baldness, wigs, or toupees, medical supplies including elastic stockings, diabetic test strips, and similar products. Artificial limbs, crutches or
any other external appliance and/or device used for diagnosis or treatment (except when used intra-operatively). Psychiatric, mental disorders (including mental health
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4. OptimaSENIOR
Proposal Form 10th Floor, Building No. 10, Tower B, DLF City Phase II, DLF Cyber City, Gurgaon-122002
treatments), Parkinson and Alzheimer’s disease, general debility or exhaustion (“run-down condition”), sleep-apnoea. Congenital internal or external diseases, defects or
anomalies, genetic disorders. Stem cell implantation or surgery, or growth hormone therapy. Venereal disease, sexually transmitted disease or illness; “AIDS” (Acquired
Immune Deficiency Syndrome) and/or infection with HIV (Human Immunodeficiency Virus) including but not limited to conditions related to or arising out of HIV/AIDS
such as ARC (AIDS Related Complex), Lymphomas in brain, Kaposi’s sarcoma, tuberculosis. Pregnancy (including voluntary termination), miscarriage (except as a result
of an Accident or Illness), maternity or birth (including caesarean section) except in the case of ectopic pregnancy in relation to 1a) in-patient only. Sterility, treatment
whether to effect or to treat infertility, any fertility, sub-fertility or assisted conception procedure, surrogate or vicarious pregnancy, birth control, contraceptive supplies
or services including complications arising due to supplying services. Expenses for organ donor screening, or save as and to the extent provided for in 1f) Organ Donor,
the treatment of the donor (including surgery to remove organs from a donor in the case of transplant surgery). Treatment and supplies for analysis and adjustments
of spinal subluxation, diagnosis and treatment by manipulation of the skeletal structure; muscle stimulation by any means except treatment of fractures (excluding
hairline fractures) and dislocations of the mandible and extremities. Nasal concha resection. Items of personal comfort and convenience including but not limited to
television (wherever specifically charged for), charges for access to telephone and telephone calls (wherever specifically charged for), foodstuffs (except patient’s diet),
cosmetics, hygiene articles, body care products and bath additive, barber or beauty service, guest service as well as similar incidental services and supplies. vitamins
and tonics unless certified to be required by the attending Medical Practitioner as a direct consequence of an otherwise covered claim. Treatment rendered by a Medical
Practitioner which is outside his discipline or the discipline for which he is licensed. Referral-fees. Treatments rendered by a Medical Practitioner who is a member of
the insured’s family or stays with him, however proven material costs are eligible for reimbursement in accordance with the applicable cover. Any treatment or part of
a treatment that is not of a reasonable charge, not Medically Necessary; drugs or treatments which are not supported by a prescription. Charges related to a Hospital
stay not expressly mentioned as being covered, including but not limited to charges for admission, discharge, administration, registration, documentation and filing. Any
specific timebound or lifetime exclusion(s) applied by Us and specified in the Schedule and accepted by the insured, as per Our underwriting guidelines
10. Declaration & warranty on behalf of all persons proposed to be insured
I hereby declare and warrant on my behalf and on behalf of all persons proposed to be insured that the above statements are true and complete in all respects.
I agree that this proposal and the declarations shall be the basis of the contract between me and all persons to be insured and Apollo Munich Health Insurance
Company Limited.
I further consent and authorize Apollo Munich Health Insurance Company Limited. and/or any of their authorized representatives to seek medical information
from any hospital/consultant/insurer that I or any person proposed to be insured has attended or may attend in future concerning any disease or illness or injury
in respect to a particular claim.
I agree to Apollo Munich Health Insurance Company Limited taking appropriate measures to capture the voice log for all such telephonic transactions carried
out by me, in accordance with procedures/regulations.
I authorize Apollo Munich Health Insurance and associate partners to contact me via e-mail, phone or SMS.
Date :
Time : Signature of the Proposer :
Place :
Vernacular Declaration :
Certification in case the proposer has signed in vernacular (to be witnessed by someone other than agent/ employee of the company).
Name of the Proposer :
The content of this form and its particulars have been explained by me in vernacular to the proposer who has understood and confirmed the same :
Signature of the Proposer :
Signature of the witness :
Date : M
D D M Y Y Place : Name of the witness :
Insurance is the subject matter of solicitation
11. Agent’s declaration
I, (Full Name) in my capacity as an Insurance
Advisor/ Specified Person of the Corporate Agent/Authorised employee of the Broker/Relationship Officer, do hereby declare that I have explained all the contents
of this Proposal Form, including the nature of the questions contained in this Proposal Form to the Proposer including statement(s), information and response(s)
submitted by him/her in this Proposal Form to questions contained herein or any details sought herein will form the basis of the Contract of Insurance between
the Company and the Proposer, if this Proposal is accepted by the Company for issuance of the Policy. I have further explained that if any untrue statement(s)/
information/response(s) is/are contained in this Proposal Form/including addendum(s), affidavits, statements, submissions, furnished/to be furnished and further
more if there has been a non-disclosure of any material fact, the policy issued to his/her favour pursuant to this Proposal may be treated by the Company as null
and void and all premiums paid under the Policy may be forfeited to the company.
License No. (Advisor/Corporate Agent/Broker/Relationship Officer) :
Date : D D M M Y Y Place : Signature of Agent :
12. checklist
Please check the following documents are attached along with the proposal form
1. : Passport/ PAN Card/ Voter ID/ Driving License/ Letter from a recognized public authority
ID Proof
2. Proof of residence : Telephone Bill/ Bank Account Statement/ Letter from any recognized public authority/Electricity Bill/ Ration Card
AMHI/PR/H/0013/0036/062011/P
3. Age Proof : Proof of Age
4. Renewal Notice with claim details
5. Certification of previous insurer for previous claim details
6. Photocopies of all previous policies and endorsements
13. for office use only
Apollo Munich Health Office Code : Advisors Code & Name :
Branch Receipt Date : Channel Type :
Business Type : Urban/ Rural/ Social
E-mail : customerservice@apollomunichinsurance.com toll free : 1800-102-0333 www.apollomunichinsurance.com
5. OptimaSENIOR
Acknowledgement 10th Floor, Building No. 10, Tower B, DLF City Phase II, DLF Cyber City, Gurgaon-122002
Application No :
Date :
Name of Proposer :
We acknowledge with thanks the receipt of your application and amount by cash/cheque/Demand Draft/others
of amount of Rs. .
Signature of the receiver and official seal
Neither the submission to us of a completed proposal for insurance nor any payment for any policy sought obliges us to agree to issue a policy, which decision
is and always shall be in our sole and absolute discretion. If we accept a proposal for insurance, it shall be subject to the policy terms and conditions and we
shall have no liability to make any payment if premium is not received by us in full and in time, or is not realised, or non-fulfillments of Pre Policy Checkup. If
we do not accept the proposal, we will inform you and refund any payment received from you without interest within next 15 days.
INSURANCE IS THE SUBJECT MATTER OF SOLICITATION