I, the Life Assured, do hereby declare that all the foregoing answers are true, that I have not concealed nor withheld anything with which the assurer should be acquainted with in order to assess my eligibility for health insurance.

I agree that these and all statements I have made or shall make to the assurer or to its medical examiner(s) in connection with this or previous proposal(s) shall be the basis of this contract.

Pre-existing/Chronic medical condition is defined as an injury, illness, sickness, disease or other physical, medical, mental or nervous condition, disorder or ailment that with reasonable medical certainty existed at the time of purchase of the policy or prior to the purchase of the policy. In a case of non-disclosure, we reserve the right not to treat or to terminate this policy.

I agree that my personal information can be used in line with AXA Mansard's Data Privacy Policy. www.axamansard.com/privacy-policy
I have understood that AXA Mansard health does not authorize her agents to collect premium from customer in cash

AXA Mansard is joining the rest of the world in being environmentally responsible. We invite you to join us in this cause by using only the electronic copy of your policy document which will be sent to your registered email address. You can also access it from your online account at www.axamansard.com or on MyAXA Plus App (available on Play Store or IOS Store).

Should you still want to receive a hard copy of your document in addition to the electronic copy, please place a request with your account officer or send an email to insure@axamansard.com. Your choice to decline making such request will serve to indicate that you do not agree to partner with us to preserve the environment.