1) In last five years, apart from minor ailments like cough/cold etc, have you received any treatment under doctor’s consultation and/or undergone any major surgery and/or been hospitalized and/or undergone major investigations like CT/MRI scan, Angiogram, Endoscopy, Biopsy etc ?If yes, please provide full details in the space below

2) Do you suffer from or have ever suffered from:
Raised Blood sugar, Diabetes mellitus, high blood pressure, Disease of heart, lung, kidney, Liver, thyroid, brain/nervous system, bone/joint/spine, Genitourinary tract, any part of the body or blood disorder, digestive disorder, Gynaecological disorder, Psychiatric disorder, HIV/AIDS and/or cancer/tumor of any part of the body ? If yes, please provide full details in the space below

3) Do you consume more than 10 cigarettes / bidi's per day or equivalent tobacco?

4) Has your proposal for life insurance, critical illness or health insurance, ever been denied, declined, rejected, postponed or accepted with extra premium, due to health or lifestyle reason?If yes, please provide full details in the space below.

5) For Female lives only
Are you currently pregnant and/ or have suffered from any pregnancy related complications in the past or have suffered with any ailment related to cervix, breast or uterus?

6) Covid Questions:
a.In the last 3 months, have you or any of your family members tested positive or been advised to self-isolate for COVID-19 (excluding mandatory government orders to remain at home), or had a persistent cough, fever or been in contact with an individual suspected or confirmed to have COVID-19?