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name: |
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* |
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email: |
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* |
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contact no: |
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* |
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age |
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* |
male
female* |
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In event of hospitalization, which Type of Hospital /
Ward would you like to be admitted?*
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Do you need
or have coverage against all types of sickness / injuries?
yes
no* |
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If the sickness is more serious (critical illnesses like cancer, kidney
failure etc..)
Would you like to have extra coverage?
yes
no* |
|
If as a result of an accident, and, after treatment you are disabled (
loss of 1 leg) would you like to have extra coverage?
yes
no* |
|
For critical illnesses
like Cancer, kidney failure etc.
* |
|
When you are sick / injured and have made a claim, would you like to
remain insured?
yes
no* |
|
When you are under treatment and is unable to work, would you like the
plan to pay you a monthly income
yes
no* |
| |
|
*fields which are compulsary to fill
up |
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Alternatively, you may also contact us at
tel:
(65) 9109 5374 (65) 9040 9122 (65)
8188 8588 (65) 6456
6456fax: (65) 6458 6458email:
ask@financialhub-sg.com
Address:
1
Yishun Ave 9 #01-03 Nee Soon
East
Community Club Singapore 768893 |