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Beneficiary Info

Last Name: First Name:
Joined Date: Relation:
Member ID: Main Member Name:
Email: Mobile Phone:
Bank A/C No: NIC No:
Policy Start Date: Policy End Date: 

Plan Limits




Plan SubLimits


Claims


Benefit Limit


 Limit for         


Wp Remarks


Waiting Period of: 
General Waiting Period Remarks
Kindly refer to the terms and conditions of your medical covers


Exclusion


Exclusions of: 
General Exclusions
Kindly refer to the terms and conditions of your medical covers

Alerts !