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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   FK0M1  
     
   
 
*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

 


 
 
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