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Personal Accident Covers
Personal Accident Cover
Fill the form below to process the quotation
Info
Applicant
Applicant Limit
250,000
500,000
750,000
800,000
1,000,000
2,000,000
2,500,000
3,000,000
5,000,000
7,500,000
8,000,000
10,000,000
DOB of Applicant
- Date -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
- Month -
January
February
March
April
May
June
July
August
September
October
November
December
- Year -
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
Select who to include in the personal accident cover
Spouse
Child
Spouse Limit
----
250,000
500,000
750,000
800,000
1,000,000
2,000,000
2,500,000
3,000,000
5,000,000
7,500,000
8,000,000
10,000,000
DOB of Spouse
(Add this if you pick spouse limit)
- Date -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
- Month -
January
February
March
April
May
June
July
August
September
October
November
December
- Year -
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
Child Limit
----
50,000
75,000
100,000
150,000
200,000
Number of Children (0 - 18 years old)
When cover is to start?
First name
Middle name
Surname
Mobile Number
Email
Gender
- Select -
Male
Female
I agree with terms and condition including company
policies and terms
.