Section 4 : Additional cover ( will be covered with extra premium )
Do you wish to obtain additional cover?
Section 5 : Claims history ( The last three years)
No of persons
Section 6 : Personal Medical History ( In case of covering Pre-Existing and chronic disease )
Section 8 : Data related to sex and age (Determine the total no. in each category)
Main Application Male
Main Application Female
Note: The Minimum Number To Be Medically Insured As Corporate Insurance Are 30 Persons.