Care Insurance

1800-102-4499

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Basic Details

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Add-Ons

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Note: To proceed with Aadhaar/PAN-based KYC, the provided mobile number should match with the number registered with your Aadhaar or PAN records. If your current number does not match, OTP will not be triggered for KYC verification.

Terms & Conditions

I hereby grant explicit consent to Care Health Insurance Company for the retrieval and downloading of my CKYC record from the Central KYC Records Registry. I understand that this information is essential for the purpose of ensuring accurate and updated records for insurance services. I acknowledge that Care Health Insurance Company will handle my CKYC information in compliance with all applicable data protection laws and regulations. This consent is valid until revoked in writing by me. I have read and understood the terms and conditions regarding the usage of my CKYC information and voluntarily provide my consent.

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Proposer Details

Proposer is a person who submit the request and pays for the insurance coverage.

Proposer Details

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Permanent Address

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Bank Details

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Nominee Details

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Nominee 1

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Permanent Address

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Communication Address

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Bank Details

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*Please provide the details of the Appointee as the Nominee is below 18.

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Permanent Address

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Communication Address

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Insured Details

Individual whose Health is secured by an insurance policy.

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Health Details

Please enter the correct health details to avoid hassles in future claim filing.

  • Personal habit of smoking/alcohol/gutkha/tobacco/paan?

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  • Has any of your parents, brothers or sisters been diagnosed of heart ailment, cancer, Hereditary disease prior to age 60 or any hereditary or chronic disorder?

    Enter valid valid Month Year
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  • Have you ever suffered or investigated for any of the following :

    1. Unusual bleeding or discharge of any kind from anybody opening?

    2. Weight loss more than 5Kg in the last 3 months?

    3. Any other disease/health adversity/injury/condition/treatment not mentioned above?

    4. Any persistent headache, epileptic fits, sudden vision loss or hearing loss?

    5. Any change in usual bowel or bladder habits?

    6. Persistent indigestion or difficulty or obstruction in swallowing for a continuous period of 15 days?

    7. Recurrent cough, hoarseness of voice for 15 days?

    8. Any growth, cyst, tumor, lump, skin lesion, sarcoma, cancer, in any part of the body?

  • Have you in the last 5 years suffered or investigated for any of the following :

  • Does any insured member(s) use gutka, pan masala, consume Alcohol, smoke cigarettes, bidi or any other tobacco product or any recreational drugs?

  • Have you ever suffered from or been treated for any form of symptoms of (a) Cancer (b) Heart disease or heart attack (c) Stroke (d) Chest and/or heart surgery, or have been advised medically to undergo chest and/or heart surgery in the future (e) Kidney disease (f) Liver disease including hepatitis (g) Kidney and/or liver failure (h) Paralysis or paraplegia (1) Major organ transplantation, or have been advised to undergo a major organ transplantation (such as for example heart, lung, liver or kidney etc) in the future, (j) Any neurological or nervous disorders (k) HIV infections, AIDS or venereal diseases (k) Disorder of the bones, spine or muscle Cancer, tumor, polyp or cyst

  • Are you or anyone of your family member (1st blood relationship) suffering from any of the following conditions: - Down's syndrome / Turner's syndrome /Sickle Cell Anemia / Thalassemia Major / G6P Deficiency

    Has any of your parents, brothers or sisters been diagnosed of heart ailment, cancer, Hereditary disease prior to age 60 or any hereditary or chronic disorder?

    • Care Supreme Value One

    Summary

    Pincode110078
    Members3
    Sum Insured₹5
    Tenure

    Selected Add-Ons

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    Care Supreme Value One

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      Terms & Conditions of Premium Quote Generation

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