STEP

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Health & Medical Declaration


  1. Are you currently receiving treatment or taking regular prescribed medication for any medical conditions (other than for common cold or flu) ?


  2. Have you ever been diagnosed with, consulted a medical practitioner or been given treatment for any of the following conditions:

    Heart attack, chest pain, high cholesterol, stroke, hypertension, diabetes, cancer, cyst, lump, tumour or abnormal growth, hepatitis, HIV infection or AIDS
    Any disease or disorder of the heart or vascular system, brain or nervous system, eyes, ears, throat, mouth or nose, thyroid, endocrine glands, lung or respiratory system, liver, pancreas, digestive system or gastrointestinal tract, gall bladder or biliary system, kidney or urinary system, breast, genital organs, muscle, bone, spine or joints, immune system, blood disorder, chronic skin disease, hereditary disease or congenital abnormality, mental health or psychiatric illness, physical impairment or deformity, drug or alcohol abuse?


  3. In the past 2 years, have you ever been hospitalised (except for giving birth), undergone any surgical operation, consulted a specialist or had an abnormal result from a medical investigation or diagnostic test or been advised to have any of these in the future ?


FILL IN YOUR DETAILS

SUMMARY

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Your Details
Name
Identification
Email
Contact No.
Protect Plan Summary
Package: Flexi Life Protection
Start Policy:
Expiry Policy:

Notes: Your insurance coverage is effective one (1) day after succesful payment on deduction on Flexi Credits. The insurance coverage is based on the package plan you have selected when completing the purchase.