What is your name?
What is your email address?
Where are you travelling to?
When are you travelling to?
Who are you travelling with? Individual/GroupFamily
No of Traveller(s) Age 1 month – 60 yrs old 01234567891011121314151617181920
Age 61 – 85 yrs old 01234567891011121314151617181920
Remarks
Note: Only Malaysians and Permanent Residents are eligible for this travel insurance plan.
Where do you usually travel in a year? Cluster 1Cluster 2Cluster 3Cluster 4 CLUSTER 1: Here are the destinations covered under Cluster 1: China, Hong Kong, Indonesia, Japan, Macau, Singapore, South Korea, Taiwan, Thailand, Vietnam
CLUSTER 2: Here are the destinations covered under Cluster 1: Brunei,Cambodia India Lao People’s Democratic Republic, Maldives, Myanmar, New Zealand, Pakistan, Philippines, Sri Lanka, Including all countries in Cluster 1 CLUSTER 3: Here are the destinations covered under Cluster 1: Australia, Mauritius, Mongolia (Inner & Outer), Nauru, Uzbekistan, Europe (Exc. Montenegro & Serbia)Middle East (Exc. Iraq,Palestine & Yemen), Including all countries in Cluster 1 & 2 CLUSTER 4: Here are the destinations covered under Cluster 1: Worldwide (including Canada, Iraq, Montenegro, Palestine, Serbia, Tibet, United States of America, and Yemen), Including all countries in Cluster 1, 2 & 3
Choose your age group Age18 – 60 Years OldAge 61 – 70 Years Old
Warm Reminder:
Please provide a clear personal passport. The front of the passport should not be crooked when taking photos. This is the specific requirements from airlines or high speed rail stations in order to proceed.Â
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