LUV Plan

ONLINE APPLICATION

LUV Plan
If you have any questions, you may call us at 6332 1133 or email us at healthcare@income.com.sg.

Statement under section 25(5) of Insurance Act, Cap. 142 (or any future amendments to it)
You must reveal all facts you know, or ought to know, which may affect the insurance cover you are applying. Otherwise, the insurance policy may not be valid.

Important
You will note that our legal responsibility does not start until this application has been accepted by us.

Details of proposer (NTUC member)

Have account with us? We'll fill up your details when you login to me@income.

As shown in NRIC
e.g. S1234567A
e.g. S1234567A



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Office
Home

MAS Notice 314 on Prevention of Money Laundering and Countering the Financing of Terrorism

You are required to provide the following documents for the insured person (or people) named in this application and who are covered under this plan:

  1. Singaporean or Singapore Permanent Resident

    1. Proposer and husband or wife of proposer: a clear copy (front and back) of the National Registration Identity Card (NRIC)

    2. Child(ren) of proposer: a clear copy (front and back) of the NRIC or birth certificate (for minors only) (whichever is applicable)

  2. Others

    1. Proposer: a clear copy (front and back) of the work pass and identity card

    2. Husband or wife of proposer: a clear copy (front and back) of the work pass or dependant’s pass (whichever is applicable)

    3. Child(ren) of proposer: a clear copy (front and back) of the dependant’s pass

You can only upload the following file formats: .jpg,.jpeg,.pdf

Maximum file size is 500 kb per file

Please note that personal particulars keyed in this form will not overwrite any existing records that you have with Income. For changes to be made to your particulars, please log into me@income, 'Manage My Particulars' section.

Particulars of lives insured

e.g. S1234567A
e.g. S1234567A
Metres
Kilograms
As shown in NRIC
e.g. S1234567A
e.g. S1234567A
Metres
Kilograms

You can only upload the following file formats: .jpg,.jpeg,.pdf

Maximum file size is 500 kb per file

The sum assured (type of plan) for your husband or wife must not be more than your sum assured unless we reduce your sum assured due to underwriting reasons. Your husband or wife can choose the same type of cover (Basic or Deluxe) as you but not a higher type of cover than you. If both you and your husband or wife choose the Deluxe cover, but we offer you a Basic cover due to underwriting reasons, your husband or wife can remain on Deluxe cover.

As shown in NRIC
e.g. S1234567A
e.g. S1234567A
Metres
Kilograms

You can only upload the following file formats: .jpg,.jpeg,.pdf

Maximum file size is 500 kb per file

The sum assured (type of plan) for child 1 must not be more than your sum assured unless we reduce your sum assured due to underwriting reasons. Your child can choose the same type of cover (Basic or Deluxe) as you but not a higher type of cover than you. If both you and your child choose the Deluxe cover, but we offer you a Basic cover due to underwriting reasons, your child can remain on Deluxe cover.

As shown in NRIC
e.g. S1234567A
e.g. S1234567A
Metres
Kilograms

You can only upload the following file formats: .jpg,.jpeg,.pdf

Maximum file size is 500 kb per file

The sum assured (type of plan) for child 2 must not be more than your sum assured unless we reduce your sum assured due to underwriting reasons. Your child can choose the same type of cover (Basic or Deluxe) as you but not a higher type of cover than you. If both you and your child choose the Deluxe cover, but we offer you a Basic cover due to underwriting reasons, your child can remain on Deluxe cover.

As shown in NRIC
e.g. S1234567A
e.g. S1234567A
Metres
Kilograms

You can only upload the following file formats: .jpg,.jpeg,.pdf

Maximum file size is 500 kb per file

The sum assured (type of plan) for child 3 must not be more than your sum assured unless we reduce your sum assured due to underwriting reasons. Your child can choose the same type of cover (Basic or Deluxe) as you but not a higher type of cover than you. If both you and your child choose the Deluxe cover, but we offer you a Basic cover due to underwriting reasons, your child can remain on Deluxe cover.

As shown in NRIC
e.g. S1234567A
e.g. S1234567A
Metres
Kilograms

You can only upload the following file formats: .jpg,.jpeg,.pdf

Maximum file size is 500 kb per file

The sum assured (type of plan) for child 4 must not be more than your sum assured unless we reduce your sum assured due to underwriting reasons. Your child can choose the same type of cover (Basic or Deluxe) as you but not a higher type of cover than you. If both you and your child choose the Deluxe cover, but we offer you a Basic cover due to underwriting reasons, your child can remain on Deluxe cover.

As shown in NRIC
e.g. S1234567A
e.g. S1234567A
Metres
Kilograms

You can only upload the following file formats: .jpg,.jpeg,.pdf

Maximum file size is 500 kb per file

The sum assured (type of plan) for child 5 must not be more than your sum assured unless we reduce your sum assured due to underwriting reasons. Your child can choose the same type of cover (Basic or Deluxe) as you but not a higher type of cover than you. If both you and your child choose the Deluxe cover, but we offer you a Basic cover due to underwriting reasons, your child can remain on Deluxe cover.

Questionnaire for the lives insured

Health declaration of
Deluxe cover questionnaire
Others

Payment details

Personal data collection statement

By signing up for this product or service, I give my consent to Income to collect, use and disclose my personal data, and contact me via email and post, for both rewards and privileges, marketing and promotional purposes.

In addition, by checking the boxes below, I consent to being contacted by you via telephone calls, SMS, and other phone number-based messaging about products and services offered by Income, regardless of my registration(s) with the Do Not Call registry

I agree that Income will use the contact particulars, including any update that I have given to Income, to contact me.

I may withdraw my above consent by contacting income Contact Centre at 6788 1777 or consentwithdrawal@income.com.sg.

Please refer to www.income.com.sg/privacy-policy for more information.

Declaration and authorisation

Others

Details of proposer (NTUC member)

<div class="row autoFillContainer"> <div class="col-12"> <div class="fill"> <label>Name</label> <p>{Name}</p> </div> <div class="fill"> <label>NRIC number or FIN</label> <p>{NRICFIN}</p> </div> <div class="fill"> <label>Date of birth</label> <p>{DOB}</p> </div> <div class="fill"> <label>Nationality</label> <p>{NationalDesc}</p> </div> <div class="fill"> <label>Nationality of SG PR</label> <p>{NationalPRDesc}</p> </div> <div class="fill"> <label>Gender</label> <p>{GenderDesc}</p> </div> <div class="fill"> <label>Marital status</label> <p>{MaritalStatusDesc}</p> </div> <div class="fill"> <label>Occupation</label> <p>{OccupationDesc}</p> </div> <div class="fill"> <label>Address</label> <p>{Address}</p> </div> <div class="row fill"> <div class="col-3"> <label>Postal code</label> <p>{PostalCode}</p> </div> <div class="col-3"> <label>Unit number</label> <p>{UnitNumber}</p> </div> </div> <div class="row fill"> <div class="col-12"> <label>Contact number</label></div> <div class="col-4 col-md-3"> <p>{MobilePhone}</p> <p class="optional">Mobile</p> </div> <div class="col-4 col-md-3"> <p>{OfficePhone}</p> <p class="optional">Office</p> </div> <div class="col-4 col-md-3"> <p>{HomePhone}</p> <p class="optional">Home</p> </div> </div> <div class="fill"> <label>Email</label> <p>{Email}</p> </div> </div> </div>

Particulars of life assured

<div class="row autoFillContainer"> <div class="col-12"> <div class="fill"> <label>Name of the proposer</label> <p>{Name}</p> </div> <div class="fill"> <label>NRIC number or FIN</label> <p>{NRICFIN}</p> </div> <div class="fill"> <label>Nationality</label> <p>{NationalDesc}</p> </div> <div class="fill"> <label>Nationality of SG PR</label> <p>{NationalPRDesc}</p> </div> <div class="fill"> <label>Gender</label> <p>{GenderDesc}</p> </div> <div class="fill"> <label>Race</label> <p>{Race}</p> </div> <div class="fill"> <label>Date of birth</label> <p>{DOB}</p> </div> <div class="row fill"> <div class="col-3"> <label>Height</label> <p>{Height}</p> </div> <div class="col-3"> <label>Weight</label> <p>{Weight}</p> </div> </div> <div class="fill"> <label>Name of company</label> <p>{CompanyNameStr}</p> </div> <div class="fill"> <label>Occupation</label> <p>{OccupationDesc}</p> </div> <div class="fill"> <label>Type of plan</label> <p>{PlanTypeDesc} ({CoverType})</p> </div> </div> </div>
<div class="row autoFillContainer"> <div class="col-12"> <div class="fill"> <label>Name of your husband or wife</label> <p>{Name}</p> </div> <div class="fill"> <label>NRIC number or FIN</label> <p>{NRICFIN}</p> </div> <div class="fill"> <label>Nationality</label> <p>{NationalDesc}</p> </div> <div class="fill"> <label>Nationality of SG PR</label> <p>{NationalPRDesc}</p> </div> <div class="fill"> <label>Gender</label> <p>{GenderDesc}</p> </div> <div class="fill"> <label>Race</label> <p>{Race}</p> </div> <div class="fill"> <label>Date of birth</label> <p>{DOB}</p> </div> <div class="row fill"> <div class="col-3"> <label>Height</label> <p>{Height}</p> </div> <div class="col-3"> <label>Weight</label> <p>{Weight}</p> </div> </div> <div class="fill"> <label>Name of company</label> <p>{CompanyNameStr}</p> </div> <div class="fill"> <label>Occupation</label> <p>{OccupationDesc}</p> </div> <div class="fill"> <label>Type of plan</label> <p>{PlanTypeDesc} ({CoverType})</p> </div> <div class="orange-container"> <p>The sum assured (type of plan) for your husband or wife must not be more than your sum assured unless we reduce your sum assured due to underwriting reasons. Your husband or wife can choose the same type of cover (Basic or Deluxe) as you but not a higher type of cover than you. If both you and your husband or wife choose the Deluxe cover, but we offer you a Basic cover due to underwriting reasons, your husband or wife can remain on Deluxe cover.</p> </div> </div> </div>
<hr> <div class="row autoFillContainer"> <div class="col-12"> <div class="fill"> <label>Name of your child {Index}</label> <p>{Name}</p> </div> <div class="fill"> <label>NRIC number or FIN</label> <p>{NRICFIN}</p> </div> <div class="fill"> <label>Nationality</label> <p>{NationalDesc}</p> </div> <div class="fill"> <label>Nationality of SG PR</label> <p>{NationalPRDesc}</p> </div> <div class="fill"> <label>Gender</label> <p>{GenderDesc}</p> </div> <div class="fill"> <label>Race</label> <p>{Race}</p> </div> <div class="fill"> <label>Date of birth</label> <p>{DOB}</p> </div> <div class="row fill"> <div class="col-3"> <label>Height</label> <p>{Height}</p> </div> <div class="col-3"> <label>Weight</label> <p>{Weight}</p> </div> </div> <div class="fill"> <label>Type of plan</label> <p>{PlanTypeDesc} ({CoverType}) </p> </div> </div> </div>

The sum assured (type of plan) for child 1 must not be more than your sum assured unless we reduce your sum assured due to underwriting reasons. Your child can choose the same type of cover (Basic or Deluxe) as you but not a higher type of cover than you. If both you and your child choose the Deluxe cover, but we offer you a Basic cover due to underwriting reasons, your child can remain on Deluxe cover.

Health declaration of

<div class="fill {Name}"> <label>{Question}</label><p>{Answer}.</p> {OtherHTML}</div></div>
<hr /> <h6>Deluxe cover questionnaire</h6>

Premium

<div class="row"><div class="col-sm-8" id="premium-name"> <label>Premium payment mode</label></div><div class="col-sm-4 text-right" id="cost-list"> <label>{PremiumMode}</label></div></div><hr /><div class="row"><div class="col-sm-8"><h5>Total premium for your cover</h5></div><div class="col-sm-4 text-right"><h5>{TotalPremiumCostStr}</h5></div></div>

The premium quoted for each insured is before any discounts (if applicable).

Premium quote

GIRO application

You must print, fill in the InterBank GIRO Application Form and mail the original signed and completed GIRO application form to "Group Business - Affinity Schemes, Income Centre, 75 Bras Basah Road, Singapore 189557".

Success!

<p>Thank you for insuring with us. We have received your LUV application</p><p> <label>Reference number:</label> {RefCode}</p><p>Your application will be sent for underwriting approval. If your application is approved, your premium will be deducted from your GIRO account with us.</p><p>Please refer to our <a href="https://www.income.com.sg/life-insurance/luv" class="notSquare">frequently asked questions</a> for more information on LUV plan</p><p>For any enquiries,<br>Please call us at Income (<a href="tel: 63321133">6332 1133</a>), (Mon - Fri 9.00 am – 5.50 pm) or email to <a href="mailto:healthcare@income.com.sg" class="notSquare">healthcare@income.com.sg</a>.</p><p>Thank you.</p><div class="row"><div class="col-12"><div class="orange-container"><p>Please note that personal particulars keyed in this form will not overwrite any existing records that you have with Income. For changes to be made to your particulars, please log into <a href="https://me.income.com.sg/" class="notSquare">me@income</a>, 'Manage My Particulars' section.</p></div></div></div><div class="row bannerImg"><div class="col-md-8 col-12 float-none mx-auto"><img src="/NTUCIncome/media/NTUCIncome/Banners/INCOME-Digital-Banner-627x287-3.jpg"></div></div>

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