Work Injury Compensation (Workmen Compensation) Insurance Quotation Request
 
Generally, Insurance Company does not accept standalone workmen compensation insurance application. It is advisable to apply your Fire Insurance or Public Liablity insurance or Foreign Worker Medical Insurance together to get more competitive quotation. If you need the quotation urgently, please contact us at 65-96826750.

 
Company Name *
Nature of Business *
Business Address *
Contact Number *
Email * (Quotation will be sent to this address)
Estimated Annual Turnover * (e.g. 500K, 1 Million)
Commencement Date (YYYY-MM-DD)
Public Liability Coverage Per Accident (If applicable, e.g. 1 million)
   
For Fire Insurance (Fill up only if you want to apply together with workmen compensation insurance)
Coverage Required (e.g. 100K)
Type of premises
Fire Protection
Fire Extinguisher Fire Alarm
Hosereel Sprinkler
Smoke Detector Heat Detector
If your premises shared with other companies? Yes No
 
About Your Employees (If there are employees based outside Singapore, please contact us) *
     
Singaporean    
Category of Employee No of Employees Estimated Total Annual Wages
     
Work Permit and S-Pass Holders
Category of Employee No of Employees Estimated Total Annual Wages Nationality
     
Check List (If any of the answer is "YES", Please provide more details at remarks)
1 Are there any claim in the past 5 years Yes No
2 Are any workers involved in works at a height of more than 30 feet above floor or ground? If Yes, please state maximum and average height involved. Yes No
2 Will there be any Scaffolding works &/or other related activities? Yes No
3 Are any workers involved in works involving explosives, dangerous or toxic chemicals e.g. chemicals that are under the Poison Act or Gases? Yes No
4 Are any workers involved in excavation works, work in manholes or tunnels etc? Yes No
5 Are any of the workers involved in using heavy industrial machines that involved cutting, pressing, grinding etc? Yes No
6 Are any of your workers involved in lifting or hoisting operations especially in public areas? Yes No
       
For Ship Yard workers only    
7 Are any workers required to work onboard vessels or oilrigs, etc? Yes No
8 what is the maximum no. of employees onboard any vessel any one time?
9 Will there be any Diving &/or related Underwater activities pertaining to your business? Yes No
10 Is the vessel docked at the shipyard / jetty or is it anchored at sea (offshore works)?
 Yes No
11 Is there any shipyard requirement to be fulfilled? If yes, please provide the necessary shipyard requirements. Yes No
       

Remarks

    
   
     

 
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