Singapore Insurance
Applicant's Declaration in the Insurance Proposal Form
The following is the standard declaration section in an insurance proposal form in Great Eastern Life. It is for your reference. You can read it at home before buying insurance.
1. I / We declare that the information given in this proposal and any
supplementary questionnaire(s) / form(s) and / or option form furnished
to the Company or the Medical Examiner of the Company are true and that
no material fact(s), that is, fact(s) likely to influence the assessment
and acceptance of this proposal have been withheld and to the best of my
/ our knowledge and belief the information given herein are true and complete
and if the assurance proposed here is not on my life but on the life of
another, the statements made in this proposal together with any supplementary
questionnaire and / or option form and any document(s) submitted in connection
with this
proposal shall form the basis of the proposed contract of assurance and
of the interim assurance should any be granted.
2. I / We understand and agree that I / we am / are solely and fully responsible
for the truth of the statements that I / we have made in the proposal form.
I / we also understand and agree unconditionally that once I / we have signed
this form, I / we shall be legally bound by the statements made herein.
3. I / We agree that any misrepresentation or concealment of facts which
are likely to influence the assessment and acceptance of this proposal shall
render the policy, if issued, null and void and benefits may be lost.
4. I / We agree to inform the Company if there is any change in the state
of my / our health between the date of this proposal and issuance of the
my / our policy. On receiving this information, the Company is entitled
to accept or reject my / our proposal.
5. I / We hereby declare that I / we have disclosed all the information
in this proposal form, which I / we had already disclosed in the proposal
forms for all my / our current policies with the Company.
6. I / We understand and agree that payment of premium before acceptance
of this proposal by the Company does not commit the Company to issue the
policy I / we have applied for and that the said policy shall not take effect
until this proposal has been fully accepted and the full initial premium
paid during my / our life and good health.
7. I / We understand and agree that if my / our proposal is for an Investment
Linked Policy, the number of units to be credited to the policy in respect
of the full initial premium shall be determined in accordance with the Company's
usual rules by reference to the Offer Price established on the Valuation
Date immediately following the approval of the policy and payment of the
full initial premium to the Company.
8. I / We agree that should I / we decide not to take up the proposal under
the standard or revised terms offered by the Company or if the proposal
is officially accepted by the Company and I / we decide to terminate the
policy within 14 days from the date of receipt of the policy documents,
then the amount refundable to me shall be the premium(s) paid less any adjustment
to reflect the change in market value of the underlying assets (if applicable),
less any cost(s) incurred by the Company in assessing the risk under the
policy, subject to a maximum refund of the premium(s) paid.
9. I / We agree and authorise any medical source, insurance office, organisation
or the Life Insurance Association's Medical Register to release to the Company,
and the Company to release to any medical source, insurance office, or the
Life Insurance Association's Medical Register any relevant information concerning
me / us at any time, irrespective of whether the proposal is accepted by
the Company.
10. I / We confirm that I / we am / are not an undischarged bankrupt, that
no Statutory Demand has been served on me / us and no bankruptcy order has
been made against me / us.
11. I / We have been given a copy of Your Guide to Life Insurance, Product
Summary and Benefit Illustration, the contents of which have been explained
to me / us to my / our satisfaction.
12. For Health Insurance riders attached
I/We have been given a copy of Your Guide to Health Insurance, Product Summary
and Benefit Illustration, the contents of which have
been explained to me/us to my/our satisfaction.
13. For Accident riders attached
I/We are aware that the benefits of the Accident riders attached will only
be payable upon an accident occurring.
14. For foreigners
I / We agree that the policy is issued as a Singapore policy expressed in
Singapore dollars and all payments under the policy, whether to or by your
Company will be payable in Singapore dollars in Singapore. I / We also agree
that the policy will be entered in the register of Singapore policies.
15. For proposer who is a minor
I agree that no cash benefits such as cash loan, cash surrender value or
survival benefits may be taken before attaining age twenty one.
16. For CPFIS-SA proposals
I hereby irrevocably authorise Central Provident Fund Board to:
a. Debit my CPF Special Account the sum of monies specified by the Company
or the amount determined by the Board for the purchase / placement of the
above product including any related fees, expenses and charges under the
CPF Investment Scheme - Special Account (CPFIS-SA).
b. Credit my CPF Special Account with any income or any proceeds from the
liquidation of the above product under the CPFIS-SA that are received from
the Company.
c. Disclose any particulars or information whatsoever relating to or in
connection with my investment with the Company to facilitate any transactions
that cannot be settled due to data discrepancies, insufficient funds of
any other reasons that the Board deems fit.
I understand that the above transactions shall be made, subject to the provisions
of the Central Provident Fund Act and the Central Provident Fund (Investment
Scheme) Regulations as may be amended from time to time and also to all
such terms and conditions may be imposed by the Board from time to time.
I hereby agree to indemnify the Board and shall keep the Board indemnified
against all actions, proceedings, liabilities, claims, damages, expenses
or legal costs whatsoever arising out of or in connection with the Board
accepting and acting upon this authorisation.
17. For US$ Plan
a. I am aware that the Singapore dollar return on this policy will depend
on prevailing exchange rates which may be highly volatile.
b. I request the Company to issue a policy on the basis of my proposal as
a Singapore policy expressed in US dollars. I agree that the policy will
be entered in the register of Singapore policies. I also agree that all
my payments under the policy, whether to or by the Company, will be payable
in US dollars in Singapore.
