General Guide

Form Filling Up Procedure View PDF NEW

MXM Suprema i- Series Application Forms

Suprema i-Series Membership Application Form View PDF NEW
MXM Agent Application Form View PDF NEW

Pacific Insurance Berhad (PIB) Proposal Forms

• PHM VIP Medical Plan Proposal Form View PDF
  PIB Product Disclosure Sheet View PDF
  PIB Modal Premium Form View PDF

MCIS Zurich Insurance Berhad (MZIB) Proposal Form

• MCIS Zurich Proposal Form View PDF
  Nomination Form (Eng & BM) View PDF

Direct Debit Authorisation Forms (DDA)

• UOB View PDF
  OCBC View PDF
  CIMB View PDF

PIB Questionnaire Forms

• Asthma Questionnaire View PDF

  Backache Questionnaire View PDF

  Hypertension Questionnaire View PDF

  Peptic Ulcer Questionnaire View PDF

Other PIB Forms

• Discharge Medical Report Claims View PDF

  Nomination form - PIB View PDF

  Personal Health Declaration View PDF

  Supplementary Confirmation For Child/Children Whose Age(s) Exceed(s) 18 yrs old View PDF

  Supplementary Questionnaire For Take-Over Policy View PDF

Takaful Ikhlas Questionnaire Forms

• Asthma Questionnaire View PDF

  Backache Questionnaire View PDF

  Hypertension Questionnaire View PDF

  Peptic Ulcer Questionnaire View PDF

Other Takaful Ikhlas Forms

• Letter for Cancellation of Previous Policy View PDF

  Nomination Form - Takaful View PDF

  Recovation of Nomination Form View PDF

  Supplementary Questionnaire for Take-Over Policy View PDF