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ABOUT
ABOUT US
OUR TESTIMONIALS
PRIVACY POLICY
DISCLAIMER
CONTACT US
APPLY NOW (INDEMNITY)
FAST TRACK ONLINE FORM
SPECIALIST ONLINE FORM
DENTIST ONLINE FORM
DOMESTIC MAID PA
MEDICAL ESTABLISHMENT ONLINE FORM
APPLY EMBEDDED PRODUCT
CHUBB’S HOME PLUS
CLINIC PROTECT FORM
TRAVEL INSURANCE ONLINE FORM
CHUBB CLINIC STAFF’S GROUP PA
MOTOR ZURICH ONLINE
CHUBB ESSENTIAL PLUS PA (COMING SOON) **
RESOURCES
DOCTOR-A
MANUAL FOR RENEWING APC
HOW TO FIND OUT APPLICATION APC HAS BEEN QUERIED
HOW TO DO APC AMENDMENT
DENTIST-B
APPLICATION FORM OF DENTIST APC
DENTAL ACTS 2018
ENFORCEMENT DENTAL ACTS 2018
FOREIGN DOCTOR-C
HOW TO APPLY TEMPORARY PRACTICING CERTIFICATE
HOW TO APPLY TRANSLATION OF CERTIFICATE
HOW TO APPLY CERTIFICATE OF GOOD STANDING
MEDICAL STUDENT-D
GARIS PANDUAN PENGGUNAAN FASILITI KKM OLEH PELATIH AMAL
GARIS PANDUAN KKM FACILITIES- FOREIGN STUDENT
GARIS PANDUAN KKM FACILITIES- LOCAL STUDENT
WHY NEED INDEMNITY
VIDEO 1, 2, 3
FAQ
Tax Treatment Public Ruling by LHDN
FAQs ON PROFESSIONAL INDEMNITY
POLICY WORDING & BROCHURE
INDIVIDUAL
Chubb Brochure
Chubb Policy Wording
Sykt Takaful policy wording
Sykt Takaful Application Form
Sykt Takaful Brochure
Chubb Product disclosure sheet
MEDICAL ESTABLISHMENT
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TRAVEL
INSURANCE ONLINE FORM
Step
1
of
3
- Travel Insurance Online Form
33%
Departure Date
DD slash MM slash YYYY
Arrival Date
DD slash MM slash YYYY
Type of Plan
First
Executive
Insured Types
Individual
Family
Trip Type
Single Trip
Annual Trip
Zone of Travel
Zone 1
Zone 2
Zone 3
Destination Countries
Australia
Bangladesh
Brunei Darussalam
Cambodia
China
Hong Kong
India
Indonesia
Japan
Korea
Laos
Macau
Maldives
Myanmar
New Zealand
Pakistan
Philippines
Singapore
Sri Lanka
Taiwan
Thailand
Vietnam
Destination Countries
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Destination Countries
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Age
Age 30 days - 69 years
Age above 70 years
Hidden
Single Trip Plan/Individual/First
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Hidden
Single Trip Plan/Individual/Executive
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Hidden
Single Trip Plan/Family/First
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Hidden
Single Trip Plan/Family/Executive
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Coverage Period Based On No of Days Travel
1 - 5 days
6 - 10 days
11 - 15 days
16 - 20 days
21 - 31 days
Hidden
Annual Plan/Individual/First
Age
Age 18 - 69 years
Renewable from age 70 - 80 years
Age
Age 18 - 69 years
Renewable from age 70 - 80 years
Age
Age 18 - 69 years
Renewable from age 70 - 80 years
Hidden
Annual Plan/Individual/Executive
Age
Age 18 - 69 years
Renewable from age 70 - 80 years
Age
Age 18 - 69 years
Renewable from age 70 - 80 years
Age
Age 18 - 69 years
Renewable from age 70 - 80 years
Hidden
Annual Plan/Family/First
Age
Age 18 - 69 years
Renewable from age 70 - 80 years
Age
Age 18 - 69 years
Renewable from age 70 - 80 years
Age
Age 18 - 69 years
Renewable from age 70 - 80 years
Hidden
Annual Plan/Family/Executive
Age
Age 18 - 69 years
Renewable from age 70 - 80 years
Age
Age 18 - 69 years
Renewable from age 70 - 80 years
Age
Age 18 - 69 years
Renewable from age 70 - 80 years
Your Yearly Premium is: (includes SST and stamp)
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Name
(Required)
First
IC Number
Phone
(Required)
Email
(Required)
Address
Street Address
Address Line 2
City
State
Poscode
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Nominee Details (Up to 6 Persons)
Name
IC Number
D.O.B
Address
Relationship
% of Share
Family Details
Wife Name
IC Number
Relationship
Children (Up to 9 Persons)
Name
IC Number
Relationship
Nominee Details (Up to 4 Persons)
Name
IC Number
Relationship
% of Share
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