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Insurance Enquiry Form

Please select the insurance products you're interested in.
1. Home & Content  
  Mortgage Reducing Term Assurance (MRTA)
Mortgage Takaful
Fire Insurance
Fire Takaful
Maxihome Contents
Home Building Takaful
2. Personal & Family  
  Premier Education Savers
Yippie Care 2
Takaful Insan
Takaful Alif
Takaful Amal
Takaful PA Plus
Takaful Privilege PA
Takaful MediRider
PremierPA Plus
Privilege PA
Prestige PA
Senior PA
Bijak Malaysia
Premier Life Income
Premier Cash Refund
Premier Care
Premier Term
Graduate Life
Single Premium Endowment Plan
Premier Capital Income
Lifestyle Security Plan via ATM
Premier Life
3. Investment-Linked  
  ASEQ Capital Guaranteed
Premier Lady Savers
Premier Invest Single Premium
Precious Asian
Maybank Global Invest
Premier Capital Guarantee
Premier Value Savers
Maybank-Linked Invest
FD Premier
4. Car & Vehicle  
  Motor (Private car)
Motor takaful (e-Motortakaful)
5. Travel  
  Air Travel Care
Domestic Travel Care
Please fill in your personal details and any queries you may have. Our Financial Executive will get back to you shortly.
  * Name
* IC no.
  * Sex
* Date of birth (dd/mm/yyyy)
/ /
  * Address

* City
  * State
    * Postcode
  Office phone no.
* E-mail address
  Home phone no.
* Type your query here:

(max 1,000 characters)
  Mobile phone no.
  Fax no.
Preferred communication mode:
Office phone
Home phone
Mobile phone
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