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Home Package

* Fields are mandatory
Salutation/Title*
**First Name***
Middle Name
Last Name*
Contact Number*
Email*
Construction Cost of Home (owned, Nil if rented)*		(Both For Fire & Burglary)
Value of Other Contents (incl. furniture)		(Both For Fire & Burglary)
Value of Jewellery		(Both For Fire & Burglary)
Value of Plate Glass*
Value of Domestic Appliances*
Value of Audio-Video Appliances*
Value of AC/Computers*
Personal Accident
Add On Cover		Earthquake Yes No Terrorism Yes No

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