Products & Services



101 Kitchener Road
#02-30 Jalan Besar Plaza
Singapore 208511

Tel:  (65) 6297 2038
        (65) 6297 6732
Fax: (65) 6297 2836

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ONLINE QUOTATION FOR TRAVEL INSURANCE

The insurance will not be in force until the application and premium have been received and accepted by the company.



Important Notice:
Uder the Insurance Act, you must tell us all the facts that you know, or ought to know, about the risk that you are proposing. If you do not tell us everything that is relevant or if you mislead us, we may refuse to pay a claim or part of it, or cancel the policy.

Particulars of Proposer/Company
Title *
Name of Insured *
NRIC/Passport No. * e.g: S1234567A
Correspondence Address *
Contact No. * -
(contact no.)               - (ext no.)
Email Address 
Client Type * Individual     Corporate
Travel Details
Total No. of Days *        From   To  
                            (DD/MM/YYYY)                 (DD/MM/YYYY)
Geographical Area * Asia     Worldwide
Place to Travel  
Choice of Plan (Please select appropriate option)
Super * Individual     Family
Standard * Individual     Family
Insured Persons
1.     Title  Name  NRIC  DOB
2.     Title  Name  NRIC  DOB
3.     Title  Name  NRIC  DOB
4.     Title  Name  NRIC  DOB
5.     Title  Name  NRIC  DOB
6.     Title  Name  NRIC  DOB
Other
Remark
 


 
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