Personal Details
Risk Details
General Policy Details
Please provide below information on any insurance claims you have reported in the last 3 years
I/ We do hereby declare that the above answers and statements are true and that I/ We have withheld no material information regarding this proposal. I/ We agree that this declaration and the answers given above as well as any proposal or declaration or statement made in writing by me/ us or anyone acting on my/ our behalf shall form the basis of the contract between me/ us and the Company. I/ We further agree to accept indemnity subject to the conditions in and endorsed on the Company’s policy.
We hereby declare that the statements made by us in this Questionnaire and Proposal are, to the best of our knowledge and belief, complete and true, and we hereby agree that this Questionnaire and Proposal forms the basis and is part of any policy issued in connection with the above risk(s). It is agreed that the Insurers are liable in accordance with the terms of the policy only and that the Insured will not lodge any other claims of whatever nature. The Insurers undertake to deal with this information in strict confidence.
I/we do hereby confirm that I/we have authorized Bunna Insurance to share my/our credit information and to access my/our credit profile from Credit Reference Bureau (C.R.B)
Office Timing: Mon - Fri 8:00 AM - 5:00 PM Sat : 8:00 AM - 12:30 PM
