1
Fill out the basic information
2
Health Statement Declaration
3
Confirmation
Step 1: Fill out the basic information
Basic Information
Step 2: Health Statement Declaration
Health Statement Declaration
Step 3: Confirmation
CareMore – Refundable Critical Illness Insurance Plan
Please confirm the information below:
Benefit Option
Policy Term
20 years
Date of Birth
Sex
Male
Smoker
Residence
Sum Insured
Payment Frequency
Premium Payment Term
Q1. Height & Weight
Height
cm
Weight
kg
Q2. Have you ever had cancer or carcinoma-in situ, heart disease, stroke or mini-stroke, diabetes, Hepatitis C, HIV or AIDS?
Q3. In the last 5 years have you had any condition affecting your arteries, brain, blood, lungs, kidney, liver or pancreas?
Q4a. Have you had a tumour, lump, nodule, polyp or cyst, OR in the last 5 years have you undergone investigations to screen cancer which showed abnormal results?
Q6a. Have any of your parents, brothers or sisters suffered from cancer before age 50?
