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Step 5

Life Insurance

Personal Information

Proposal Creation

Coverage Summary

Life Cover KD 2000/-
Accidental Death KD 4000/-
Accidental Disability KD 2000/-
Repatriation KD 500/-
Are you now in good health?
Have you ever suffered from any illness/disease?
Did you ever have any operation, accident or injury?
Did you take or are you taking treatment or medication for any disease or disorder
Do you take alcohol or any drugs?
Do you smoke cigarettes or tobacco? If yes, state quantity?

I declare that the statements and answers made in this form are true and complete to the best of my knowledge and belief and I agree that this statement together with any statement made to the Medical Examiner shall be the basis of the contract between me and the Company. If any untrue statement be contained therein, or if there be any material concealment, the contract of insurance shall be absolutely null and void and all moneys paid in respect thereof shall be forfeited to the Company. I fully understand that the Company will not be on the risk on my life until the issue of the formal letter of acceptance by the Company and the payment of the due premium by me.

I accept the terms of service.

Acceptance And Conversion

Account Statement

Step 5