Personal Accident Benefit Insurance

Customer details

Civil ID (Expiry Date)

PAB Details

Customer details

First Name
Last Name
Email
Mobile
Civil Id
Civil Id (Expiry Date)
Gender
Nationality
Date of Birth
Company CR Number
Company Registration Date
Company Expiry Date

PAB Details

Policy Start Date
Policy Year
No. of Adults (Age 18 to 65 Years)
No. of Children (Age below 18 Years)
No. of Servents (Age 18 to 70 Years)