Step 1 of 3 - Travel Insurance Online Form

33%
DD slash MM slash YYYY
DD slash MM slash YYYY
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Single Trip Plan/Individual/First

Hidden

Single Trip Plan/Individual/Executive

Hidden

Single Trip Plan/Family/First

Hidden

Single Trip Plan/Family/Executive

Hidden

Annual Plan/Individual/First

Hidden

Annual Plan/Individual/Executive

Hidden

Annual Plan/Family/First

Hidden

Annual Plan/Family/Executive

For detailed information, kindly download below:

Policy Wording

Schedule Benefit sheet

Name
Address
Nominee Details (Up to 6 Persons)
Name
IC Number
D.O.B
Address
Relationship
% of Share
 

Family Details

Children (Up to 9 Persons)
Name
IC Number
Relationship
 
Nominee Details (Up to 4 Persons)
Name
IC Number
Relationship
% of Share
 

Payment Method

All Premium Amount included SST 6%. We are now support online payment gateway through SecurePay for better experience. RM1.50 will be charge for every transaction. For Credit Card, you will be charged 0.3% per transaction.
Price: RM 0.00
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