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Aby's Mother's Day Special

Active Care

Activate your complimentary Active Care plan!
Simply fill up the form below

Statement pursuant to Section 25(5) of the Insurance Act (Cap 142) (or any subsequent amendments thereof), you are to disclose in this proposal form, fully and faithfully, all the facts you know, or ought to know, which may affect the insurance cover you are applying for. Otherwise, you may receive nothing from the policy.

 

Please complete all the mandatory fields. Forms with incomplete details will not be processed.

As per your NRIC/FIN/Passport.
As per your ID.
Please enter a valid 8 digit mobile number e.g. 91234567.
Please enter a valid email address to receive your policy documents.

By providing the information set out above, I/ we agree and consent to GE and its related corporations (collectively, the "Companies"), as well as their respective representatives, agents, the Companies’ authorised service providers and relevant third parties (the Companies and all the other foregoing parties, collectively, "Great Eastern Persons"), collecting, using and/or disclosing my/ our personal data, for purposes reasonably required by the Companies to evaluate my/ our proposal and to provide the products or services which I am/ we are applying for (including any policy renewals and policy upgrades, substitutions or replacements) and such other purposes as described in Great Eastern’s Privacy Statement (collectively, the "Purposes") which is accessible from Great Eastern Singapore’s website and which I/ we confirm I/ we have read and understood. 
 
Where personal data of any person is disclosed by me/ us, I/ we confirm and represent that I/ we have obtained the consent of the individual concerned, unless such consent is not required under relevant laws: 
(i) to collect such personal data; (ii) to the disclosure of such personal data to the Great Eastern Persons; and (iii) for the Great Eastern Persons’ collection, use and/or disclosure of such personal data; for the Purposes.
Please read the following and indicate your consent before check out. 
 
We* want to ensure that you fully enjoy our services and products as we update you on relevant news, promotions and advice. We will keep in touch with you through post, digital platforms (including social media), and email.  
Your privacy is of utmost importance to us and you can withdraw your consent via Great Eastern’s website at any time.  
* We/us refers to Great Eastern, our related corporations, respective representatives and agents. For more details, please refer to the Privacy and Security Policy on Great Eastern’s website.
By activating Active Care, I agree to the Terms & Conditions and Important Notes.
Please enter the characters you see above.
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Great Eastern Holdings Ltd | Great Eastern Life Assurance Co Ltd | Great Eastern General Insurance Ltd
Great Eastern Holdings Ltd | Great Eastern Life Assurance Co Ltd | Great Eastern General Insurance Ltd