I declare that to the best of my knowledge and believe that above statements are true and correct and that statements together with any forms, reports, or other information completed or supplied by me shall form the basis of contract. I am aware that giving full and correct information is my responsibility. If I do not provide complete and correct information, no claim would be payable in event of my permanent total disability or death.
I am aware that the insurer accepts the above declaration in good faith and if this declaration is proved to be wrong or if any material information regarding my health has been withheld, the insurer would not be liable to pay any of the claim amounts
. I am aware that, pre-existing conditions of ill health are exclusion and non-declaration of pre-existing health condition would invalidate the takaful cover.
I am aware that any congenital disease or congenital disability or psychiatric illness or nervous disorder is excluded for permanent total disability takaful cover.
I am aware that no claim would be payable in case of suicide or attempted suicide or self-inflicted injuries or injuries due to drugs and alcohol consumption.
I am aware that the takaful company is waving my medical examination by accepting this declaration as true that if anything in this declaration is found to be untrue, the insurer would not be liable to pay any of the takaful benefit.
I authorise any doctor, hospital, medical institutions, statutory authorities or Insurance/takaful companies to disclose information related to my physical or mental health and history including results of any tests to the Takaful Company and I agree that this authorization shall remain in force after my death.
