Personal Details
Risk Details
General Policy Details
* Allowed file formats (xlsx)
Please provide below information on any insurance claims you have reported in the last 3 years
I hereby warrant and declare the truth of all the above statements, that I am in good health and that I have not withheld any material information, and I hereby agree to give notice to the undermentioned company of any variation in my professional or occupation, health or pursuits I agree to accept a policy subject to the terms, exceptions and conditions prescribed by the company and that this Declaration shall be the basis of the contract between me and the company.
I/We consent to Bunna Insurance Company s.c; (i) Collecting, using, disclosing and/or processing my/our personal data; and (ii) Transferring my/our personal data to their reinsurers and affiliated companies for the purposes of insurance as permitted by law.
I/we do hereby confirm that I/we have authorized Bunna Insurance S.C. to share my/our credit information and to access my/our credit profile from Credit Reference Bureau (C.R.B)