Declaration

Disclaimer

I/We hereby declare that the statements made by me/us in this Proposal Form are true and complete in all respects to the best of my/our knowledge and belief and that there is no other information, which is relevant to my application for insurance that has not been disclosed to you. I/We hereby agree that statements made by me and this declaration shall form the basis of the contract between me/us and Gulf Union Insurance & Reinsurance Co BSC© , herein called ‘ the Company” and I/We agree to accept a policy, subject to the conditions prescribed by “ The Company” and to pay premium on the amount estimated.

I /We hereby authorize Gulf Union Insurance & Reinsurance Co BSC© Bahrain ,herein called” The Company” to conduct any investigation it deems appropriate concerning my application/information/proposal related to vehicle insurance.

I/We undertake to exercise all ordinary and reasonable precautions for safety of the Vehicle as if it were uninsured.

I/We understand that the policy issued by the Company shall be voidable at the option of the Company in the event of any mis-representation, mis-description or non-disclosure/concealing of any material particulars by me/us. My/our failure to comply with this obligation now may result in the rejection of my/our claim and the avoidance of my/our policy when a claim is made. I/We hereby undertake that if any additions/alterations are carried out in the risk proposed after the submission of this Proposal Form then the same shall be conveyed to “The Company” immediately by me/us. I/We understand that “The Company” is under no obligation to accept my/our Proposal for insurance and the liability of “The Company” does not commence on the receipt of this Proposal by “The Company” and it does not result in a concluded contract of insurance until the proposal has been accepted by “The Company” and upon full realization of the premium by “The Company”. If “The Company” does not accept this Proposal, it will inform me/us and refund any payment received from me/us without interest. I/We hereby give my/our consent to “The Company” that it can disclose/use/handle, directly or through a third party, the information (including the sensitive personal data or information, if any) provided in this Proposal Form, whereas I/we have the option not to provide this consent or withdraw it at a later stage, for the purpose of and in relation to the insurance coverage and benefits requested by me/us.