Health & Data Declaration

This policy does not cover pre-existing medical conditions that are declared or undeclared.

In the event of a claim, in order to determine eligibility for benefit payments under the policy, I/ we authorise any medical care institution, physician, medical professional, pharmacy or insurers to furnish to Tata AIG General Insurance Company Ltd or its representative any and all medical information or records with respect to any injury or sickness suffered by the person whose death, injury, sickness or loss is the basic of a claim against the policy.

I/we understand that this authorization is valid during the pendency of the claim until all issues with regard thereto have been definitively resolved, either extra-judicially or judicially.

I/we have read the policy prospectus and am/are willing to accept the insurance coverage subject to all of the terms, conditions and exceptions described in the policy prospectus.

I/we hereby declare and warrant that all statements in this and the preceding two paragraphs are true and complete. If it is found that the answers or particulars stated in this proposal form and medical declaration are incorrect or untrue in any respect, I/we hereby acknowledge that the insurance company shall not incur liability for any insurance coverage.