Fin Crew

Full name

Mobile No

I want a personal accident plan for

Start Effective Date

No. of Policy Holder(s)

Age 1 month - 99 yrs old

Group Age?

Occupation

Select Occupation

Yearly Budget

Spouse

Spouse's date of birth

Spouse's Occupation

Child 1

Child's date of birth

Child's Occupation

+ Add Child

- Remove Child

I am hereby confirmed and acknowledged that my occupation is not fall under the occupation exclusion list

The personal data you provide us within these questions will be retained to provide you with details of our insurance services. If at any time you want your data removed from our systems please let us know. Our privacy notice lets you know how we look after your data.

*All Personal Accident Insurances are Eligible for Malaysians, Permanent Residents, Employment Pass/Work Permit Holders and Dependant(s) of Pass Holders, excluding overseas secondment & students studying overseas.

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