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You are in Business Solutions > For Employees

1. Employer Details

Name *

Address *

Phone

Fax

E-mail *

Nature of Business and Territories of Operation

2. Employee Details

Total No. of Employees *

No. of Employees to be Insured *

General categories of employees and their numbers :

Category	No. of Employees	Average Age
Office Staff
Technical Staff
Field Staff
Labourers
Machine Operators
Other (please specify)

3. Scheme Details

Type of benefits required (per category)

Category	Essential/Preferred/Premier
Office Staff
	Critical Illnes Cover Required
Technical Staff
	Critical Illnes Cover Required
Field Staff
	Critical Illnes Cover Required
Labourers
	Critical Illnes Cover Required
Machine Operators
	Critical Illnes Cover Required
Other (please specify)
	Critical Illnes Cover Required

Amount of benefits required (per benefit) :
The entered amount must be in Sri Lankan Rupees and rounded off to the nearest 1000

Category	Basic DeathCover Rs.	Critical IllnessCover Rs.	Hospital CashCover Rs.
Office Staff
Technical Staff
Field Staff
Labourers
Machine Operators
Other (please specify)

Comments

Verification Code

*Required Information

Contact us to discuss your exact requirements :

Telephone : (+94) 11 2310227 or (+94) 11 2310000 (ext. 3227)
Fax : (+94) 11 2305458
Email : info@eagle.com.lk