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Santa Monica

                                               Employee Benefits Schemes

                                               Enrollment Form

             Group Health Insurance | Group Personal Accident | Group Term Assurance

                                                               

 
1 Start 2 Submission Preview 3 Complete
+91 (to contact in emergencies)
Leave blank in case any or both parents are expired and hence not to be added to the scheme.
Copyright © 2012 BimaGenie™ Insurance Broking Pvt. Ltd.
All Rights Reserved.     |   CIN - U66000TN2011PTCO78831.
Direct Insurance (Life & General) Broker | IRDA/DB/498/11
Reg No. 432  |  Current valididty (27.04.2021 - 26.04.2024)