Tenet Insurance Company Ltd - Quotations, Personal Accident

Applicant should be 21 years and above.

Applicant and all insured persons should be Singaporeans, Singapore Permanent Residents, Work Permit or Employment Pass Holders, Dependent Pass Holders, Student Pass Holders, or Long Term Social Visit Pass Holders and residing in Singapore.

You are require to enter Master / Visa credit card information upon submission of Personal Accident Insurance proposal.

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Applicant's Particulars

Will the spouse be insured?	Yes No *
Name
NRIC	Please enter NRIC for Singaporean (e.g. S1234567S)
Occupation Class	*
Date Of Birth (dd/mm/yyyy)	*
Nationality	*
If Employment Pass Holders/Others, pls specify Nationality
Retiree / unemployed / housewife / full-time student above 21 years old

Applicant Coverage

Sum Insured For Death	*

Sum Insured For Permanent Disablement
Scale 1	*
Scale 2	*

Sum Insured For Temporary Total Disablement
Basic Weekly Salary

Sum Insured For Medical Expense

Period of Insurance
From:	*
To:	*

Terms and Conditions

All persons to be insured do not participate in hazardous activities such as mountaineering, underwater activities and racing etc.

All persons to be insured are not involved in the following occupations : industrial workers using machinery, pilots, air crew, any occupation involving aviation activities, full-time National Servicemen/military personnel, police force personnel, construction/unskilled workers, ship crew or workers on board vessel, oil and gas rig workers, offshore workers, stevedores, shipbreakers, electrician, welders, professional sports teams, occupation involving work height and/or works underground and/or travel beyond normal speed on land and/or handling of hazardous chemical/electricity, woodworking related, professional divers and jockeys and the like.

I agree to the above Yes / No

* mandatory