Group Health Insurance

Name of Insured/Principal/Correspondence*
Address of Insured/Principal/Correspondence*
Location of work*
Email*
Mobile*
Bussiness of the insured(specify exact nature of work)*
Industry Type*
Renewal Policy*
Existing Insurer*
PED/Maternity Cover*
30 Days Waiting Period Waiver*
Addition-Deletion of Lives*
Co-Pay*
Corporate Floater*
OPD Per Live*
Physical Health Card*
Disease Sub Limit*
Baby cover first day*
Pre-Post Hospitlization*
Ambulance Cover*
Employees*
Please download file, input data and upload for premium*
Attachment*