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Promotion By Great Eastern and Mothercare

Declaration

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1.           I/We am aware that I/we can seek advice from a qualified adviser before applying for this insurance coverage. Should I/we choose not to, I/we take sole responsibility to ensure that this product is appropriate to my/our financial needs and insurance objectives.

2.           I/We declare that the information I/we have given to the Company in this proposal and any document are true and complete and I am/we are fully responsible for the truth of the information given in these documents. If I/we have withheld any information or given false information in this proposal, and the Company issues the policy, I/we agree the Company reserves the right to terminate or void the policy. I/We agree that all information given in relation to this proposal together with any documents I/we provide or I/we will provide in relation to myself/ourselves under this policy will form the basis of the contract of insurance. I/we agree that I/we will be legally bound by the information given upon submission of my/our proposal.

3.            I/We acknowledge that I/we are physically in Singapore for the application of the policy.

4.           I/We understand that my/our proposal will be subject to the acceptance by the Company, and that I and/or my family member will not be insured under any of the insurance plan(s) for which I and/or my family member have applied for, until the Company advises the Policyholder the terms and conditions on providing the insurance cover to myself and/or my family member. The Company reserves the right to decline to provide the insurance cover or impose special terms and conditions to the insurance cover. I/We also understand that if I/we do not satisfy the eligibility criteria to apply for the insurance plan, I/we will not receive the coverage under the plan even if I/we receive the certificate of insurance from the Company.

5.           I/We understand that I/we cannot be covered by more than GREAT Value Protect policy issued by the Company, and that if I/we are covered under more than one such policy, the Company will consider I/we to be covered only under the policy with the highest benefits and my/our coverage under such other policies will be cancelled. I/We further understand that where the benefits of the policies are identical, I/we will be insured only under the policy first issued and my/our coverage under such other policies will be cancelled. The Company will not refund any duplicated premium paid.

6.           I/We understand that my/our insurance cover under the policy will only be valid if I/we observe all the terms and conditions of the Policy and all subsequent written notices given by the Company to me/us.

7.           I/We agree that this proposal and all subsequent written statements given by me/us to the Company shall be my/our representations given to the Company. For the avoidance of doubt, any omission of facts by me/us shall be deemed as misrepresentations to the Company.

8.           I agree that my/our insurance cover (if valid) will begin on the Effective Date to be set out in the Certificate of Insurance for the policy.

9.           I/We have read and understood the Product Summary (available on the registration site) and have specifically taken note of the following information:

            i. Benefits, limitations and risks of the policy;

            ii. Conditions under which benefits will be payable;

            iii. Conditions under which the policy will terminate;

            iv. Exclusions where benefits will not be payable;

            v.  Free-look provision.

10.         I am/We are aware that a copy of "Your Guide to Health Insurance" can be downloaded on www.greateasternlife.com or www.lia.org.sg.

11.         I/We confirm that I am/we are not an undischarged bankrupt, and that no bankruptcy application (including any statutory demands) or order has been made against me/us within the last 12 months.

12.         I agree that the Policy will be issued as a Singapore policy and that the policy will be entered into the register of Singapore policies, and understand that all payments under the policy will be payable in Singapore dollars.

 13.         I/We authorise and agree to the following:

(a)    Any medical source, insurance office, reinsurer or organisation can release my/our relevant information to the Company and vice versa, regardless of whether the Company accepts this proposal;

(b)   The Company or any of its approved medical examiners or laboratories can carry out the necessary medical assessments and tests to assess the life assured’s health in relation to any claims I/we make under it; and

(c)    The Company can use or reveal as it reasonably considers appropriate, any information the Company has collected or hold (whether provided in this proposal or otherwise) to allow the Company, its related companies or independent third parties, within or outside Singapore, to deal with any matters relating to this proposal or policy or any other policies that I/we currently have with the Company.

A copy of this authorisation shall have the same effect as the original.

14.          I/We agree that I/We will update the Company promptly of any change or addition to the information provided herein about me/us, the life assured, the beneficiary named in this proposal or of the policy and any other relevant persons (if any, and collectively with the life assured and the beneficiary, the “Relevant Persons”) and as and when the Company may reasonably require. I/We further agree, or represent to the Company that each Relevant Person has agreed when information about him/ her is provided to the Company, that the Company may disclose such information for the purpose of its compliance with any applicable rules, laws and regulations, codes of practice or guidelines or to assist in law enforcement and investigations by relevant authorities.

15.          I/We agree that no insurer shall be deemed to provide cover and no insurer shall be liable to pay any claim or provide any benefit hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit may, in the insurer’s opinion, expose that insurer to the risk of or result in any breach or violation of, or non-compliance with, any sanction, prohibition, restriction or regulations imposed by any state or transnational organisation including but not limited to the United States of America, the United Nations, the European Union, the United Kingdom, the Republic of Singapore and any state or country where the insurer or its related entity carries on business (“Sanctions”). If the insured life, policyholder, beneficial owner of the policy (if applicable), beneficiary, payee or affiliate of any of the foregoing (collectively the “Insured”) is designated or listed as a person subject to Sanctions (“Restricted Party”) or has any involvement whatsoever with any Restricted Party, whether directly or indirectly, or has been charged, or convicted or has had judgment taken against them under any local or foreign law or regulations implementing any Sanctions, the insurer shall be entitled, in its sole discretion and without incurring any liability whatsoever, to exercise any one or more of the following rights and/or remedies against the Insured, namely (i) cancel, terminate, void and/or nullify any policy contract, transaction or business; (ii) withhold and/or suspend any payment, transfer and/or receipt of any money, refund or benefit; (iii) decline and/or refuse any transaction or request; and/or (iv) take or refrain from taking any step or action necessary to eliminate, reduce or minimise the risk of any breach or violation of any Sanctions or exposure to any Sanctions. The Insured shall indemnify the insurer and hold the insurer harmless from and against any and all losses, damages, costs and/or expenses suffered and/or incurred by the insurer, including but not limited to legal costs and attorney’s fees.

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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