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Insurance Checklist

The document contains a checklist of required information for medical, auto, home, life, group medical, and business insurance for two individuals, Vinay Vallabhdas Davda and Jagruti Vinay Davda. It includes personal details such as names, dates of birth, contact information, medical history, and insurance status. Additionally, it outlines the necessary documentation for government ID and insurance applications.

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Vinay Davda
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4 views3 pages

Insurance Checklist

The document contains a checklist of required information for medical, auto, home, life, group medical, and business insurance for two individuals, Vinay Vallabhdas Davda and Jagruti Vinay Davda. It includes personal details such as names, dates of birth, contact information, medical history, and insurance status. Additionally, it outlines the necessary documentation for government ID and insurance applications.

Uploaded by

Vinay Davda
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Cell: +971 52 515 6406

Email:[email protected]

Documents Checklist:
Medical Insurance:
 Full Name: Vinay Vallabhdas Davda
 Date of Birth: 05-04-1965
 Nationality: Indian
 Gender: Male
 Email: [email protected]
 Contact No.: 0504591821
 Height (Cm): 173
 Weight (Kg): 108
 Marital Status: Married
 Emirate of Visa Issuance: Dubai
 Salary (Below or Above AED 4000 or No salary): Abovr
 Type of Visa (Dependent/Employee/Investor): Employee
 If Dependent: Relationship with Sponsor
 If Dependent: Sponsor Salary above or below AED 4000?
 Preferred Clinic/Hospitals:
 Pre-existing Condition: Diabetes, BP, Cholesterol/Triglyceride
 Any Previous Insurance: Expired more than 6 months ago
 For Female: Are You Pregnant? Last Menstrual period date? Not
applicable

Medical Insurance:
 Full Name: Jagruti Vinay Davda
 Date of Birth: 03-11-1973
 Nationality: India
 Gender: Female
 Email: [email protected]
 Contact No.: 0504591821
 Height (Cm): 159
 Weight (Kg): 85
 Marital Status: Married
 Emirate of Visa Issuance: Dubai
 Salary (Below or Above AED 4000 or No salary): Not applicable
 Type of Visa (Dependent/Employee/Investor): Dependent
 If Dependent: Relationship with Sponsor Wife
 If Dependent: Sponsor Salary above or below AED 4000? Above
 Preferred Clinic/Hospitals:
 Pre-existing Condition: Nil
 Any Previous Insurance: Expired more than 6
 For Female: Are You Pregnant? Last Menstrual period date? Menopused

Auto Insurance:
 Licence:
 Mulkiya :
 Previous Insurance:
 Email:
 Contact No.:

Home Insurance:
 Ownership Proof:
 Passport or EID:
 Valuation Report:
 Previous Insurance:

Life Insurance:
 Full name:
 Birthdate:
 Smoker or Non-Smoker:
 Nationality:
 Pre-Existing Conditions:
 Family Members:
 Email:
 Contact No.:
Note: We request you for additional information for all members if
required for personal Insurance.

Group Medical Insurance &


Business/Commercial Insurance:
 Full name:
 Company Name:
 Trade Licence:
 Email:
 Contact No.:
 Census Form:
 Previous Insurance:

Note: We required details info. for group medical and Commercial


Insurance.

Government ID:
 Passport :
 Emirates ID :
 Visa Stamp:
 Trade Licence

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