HDFC Cancer Care Questionnaire

    Please answer the following questions:
  1. In the past 12 months have you smoked cigarette / beedi or consumed tobacco in any form?
    		2.
  2. Have you availed insurance cover under Stand-alone Cancer product through HDFC Life Insurance Company or through any other issuer in the Indian insurer market?
  3. Have you suffered from or received investigation or treatment for any form of cancer, sarcoma, tumor or pre cancerous conditions?
  4. Are you suffering from HIV/AIDS, Hepatitis B, Hepatitis C or Liver disease due to alcohol?
  5. Have you suffered from or been investigated for any of the following in the last 12 months?
    1. Recurrent cough, hoarseness of voice or difficulty in swallowing for a continuous period of 15 days?
    2. Any persistent loss of blood or unusual discharge from any body opening?
    3. Weight loss more than 5 kg in the last 6 months?
    4. Any ulceration, growth, cyst or lump in any part of the body?
    5. Any persistent headache, epileptic fits, sudden vision loss or hearing loss?
  6. Have you undergone any of the listed investigations in the last 6 months (if applicable)
    1. Ultrasound*
    2. Endoscopy/Colonoscopy
    3. CT Scan/ MRI
    4. Biopsy
    5. PAP Smear*
    6. Mammography
    7. Blood test for cancer diagnosis (Tumor Marker)
    *Other than those done as a part of executive health check or routine investigation
  7. Have any of your parents (below 60 years), sisters or brothers suffered from any form of cancer?
    		8.
  8. Has your proposal for life insurance, accident, medical or health related insurance ever been declined, postponed, withdrawn or accepted at extra premium?
    		9.
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You are not eligible to buy HDFC Cancer Care Plan

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You are eligible to buy HDFC Cancer Care Plan

Please fill up the below form