National Insurance Company Berhad - Buy Employees Package Protector (Consumer)

Employees Package Protector (EPP)

IMPORTANT: STATEMENT PURSUANT TO SECTION 37(4) OF THE INSURANCE ORDER 2006 – You are to disclose in this insurance application, fully and faithfully all the facts which you know or ought to know, otherwise the policy issued hereunder may be invalidated.

Please note that to purchase a policy for more than four employees, please consult with one of our agents or contact National Insurance Company Berhad at +673 222 6222 or email us at insurance@national.com.bn for further information.

General

Applicant (Employer)

Insured Employee(s)

Summary

Confirmation

PERIOD OF INSURANCE *

POLICY START DATE *

POLICY END DATE *

APPLICANT INFORMATION

APPLICANT TYPE *

TITLE

NAME *

RESIDENTIAL STATUS *

NATIONALITY *

ID TYPE *

NRIC/PASSPORT NUMBER *

DATE OF BIRTH *

GENDER *

OCCUPATION *

BUSINESS NAME

CONTACT PERSON

BUSINESS TYPE *

BUSINESS REG. NO. *

ADDRESS LINE 1 *

ADDRESS LINE 2

POSTAL CODE

CONTACT INFORMATION

CONTACT NUMBER *

EMAIL ADDRESS *

APPLICANT'S DOCUMENT(S)

									
										FILES UPLOADED SHOULD BE IN EITHER JPG, PNG, OR PDF FORMAT.
EACH INDIVIDUAL FILE SIZE SHOULD NOT EXCEED 3MB.
FOR BUSINESS LICENSE/IC, A MAXIMUM OF 2 DOCUMENTS ARE ALLOWED.
FOR LABOUR LICENCE, A MAXIMUM OF 1 DOCUMENT IS ALLOWED.
ALL DOCUMENTS MARKED WITH * ARE MANDATORY.

APPLICANT'S IC FRONT & BACK / PASSPORT *

BUSINESS REGISTRATION CERTIFICATE *

LABOUR LICENCE *

INSURED EMPLOYEE(S) INFORMATION

TO UPLOAD INSURED EMPLOYEE(S) LIST, PLEASE DOWNLOAD AND USE THIS EXCEL TEMPLATE.
EACH FILE SIZE SHOULD NOT EXCEED 3MB.

BULK UPLOAD INSURED EMPLOYEE(S) LIST *

Number of Employee Forms to Add:

Click 'Apply' to generate the forms.

INSURED EMPLOYEE

NAME *

NRIC/PASSPORT NUMBER *

DATE OF BIRTH *

OCCUPATION *

ANNUAL WAGES *

PROTECTOR PLAN *

							PLEASE REVIEW YOUR EMPLOYEES PACKAGE PROTECTOR SUBMISSION BELOW.
							IF YOU WISH TO MAKE ANY AMENDMENTS, PLEASE CLICK ‘BACK' TO MAKE THE NECESSARY CHANGES.
							

Declaration

We want you to know exactly how our service works and why we need your registration information. Please read and accept the terms and conditions before continuing,

Please read and accept the terms and conditions before continuing.

I/We hereby acknowledge and confirm the following: I have read the Terms and conditions and/or Policy Wordings and/or Product Disclosure Sheet provided by National Insurance Company Bhd.

I agree and consent to the collection, use and disclosure of my personal data (including NRIC details and passport number) by National Insurance Company Bhd, and business partners as well as their respective representatives and/or agents, in accordance with and for the purpose stated in the Privacy Policy including but not limited to assessment and processing of claims and fraud prevention.

I further agree that if I am submitting information relating to another individual, I represent and warrant that I have the authority to provide that information to National Insurance Company Bhd, and that I have informed such individual of the purposes for which his/her information is collected, used and disclosed.

I/We confirm that I/We have explained to the Policyholder the Terms and Conditions and/or Policy Wordings and/or Product Disclosure provided by National Insurance Company Bhd.
The Policyholder agrees and consents to the collection, use and disclosure of their personal data (including but not limited to, NRIC and passport details) by National Insurance Company Bhd, their representatives, registered agents and reinsurers. The consent given hereto is in line with the requirement set forth in the Privacy Policy and strictly for the purposes in relation to the insurance which the Policyholder has applied hereto.
The Policyholder further agrees that if he/she is submitting personal data or information relating to another individual, he/she represents and warrants that he/she has the authority to provide that information to National Insurance Company Bhd, and that he/she has informed such individual of the purposes for which the information is collected, used and disclosed.

								Initiate Secure Payment: Click the "Purchase" Button.
								To proceed, kindly click the "Purchase" button, which will redirect you to a secure payment window in your browser. 
Please refrain from closing the payment window while entering your payment information. 
Upon successful completion, you will be seamlessly returned to this page. 
In case you need to retry or if your transaction is canceled, click the "Purchase" button again. 
Note that you have a maximum of three attempts to complete your payment. 
Your security is our priority, and we appreciate your cooperation in ensuring a smooth and secure transaction process.

							

								Initiate Policy Submission: Click the "Complete Your Submission" Button Now.
								To proceed, kindly click the "Complete Your Submission" button. 
Please refrain from closing the browser window while processing your submission. 
Upon successful completion, you will see 'Policy Submission Acknowledgement' page.
In case you need to retry or if your transaction is cancelled, click the "Complete Your Submission" button again. 
Note that you have a maximum of three attempts to complete your submission. 
Your security is our priority, and we appreciate your cooperation in ensuring a smooth process.
For security reasons, we have assigned a unique token ID, valid for 30 minutes, to complete the process.
Note that if you would like to process another policy, please return to the dashboard and click the link again.

							

You will receive a PDF of the policy pack, sent to your email. If you do not wish to receive the policy pack via email, please uncheck the box on the left.

Coverage Details

BENEFIT	DETAILS

Please refer to the policy wording for the complete details of policy exclusions, terms, and conditions.

Tailored personal & business insurance products.

Our products

Employee personal accident protection

Employees Package Protector (EPP)

APPLICANT INFORMATION

CONTACT INFORMATION

APPLICANT'S DOCUMENT(S)

INSURED EMPLOYEE(S) INFORMATION

PLEASE REVIEW YOUR EMPLOYEES PACKAGE PROTECTOR SUBMISSION BELOW.

IF YOU WISH TO MAKE ANY AMENDMENTS, PLEASE CLICK ‘BACK' TO MAKE THE NECESSARY CHANGES.

Declaration

Initiate Secure Payment: Click the "Purchase" Button.

Initiate Policy Submission: Click the "Complete Your Submission" Button Now.

Claim Solutions

Motor Claim

Travel Claim

Workmen Compensation Protector Claim

Claim Solutions

Property Claim

Golfer Protector Claim

Other Claim

Tailored personal & business insurance products.

Contact Info

Latest Post

Employee personal accident protection

Employees Package Protector (EPP)

APPLICANT INFORMATION

CONTACT INFORMATION

APPLICANT'S DOCUMENT(S)

EMPLOYEES PACKAGE PROTECTOR

INSURED EMPLOYEE(S) INFORMATION

PLEASE REVIEW YOUR EMPLOYEES PACKAGE PROTECTOR SUBMISSION BELOW.

IF YOU WISH TO MAKE ANY AMENDMENTS, PLEASE CLICK ‘BACK' TO MAKE THE NECESSARY CHANGES.

Declaration

Initiate Secure Payment: Click the "Purchase" Button.

Initiate Policy Submission: Click the "Complete Your Submission" Button Now.

Policy submission is in-progress.

Did your browser block the pop-up that was intended to assist with the payment? Please adjust your browser settings to allow pop-ups for this website. Once you have allowed pop-ups in your browser settings, then close this pop-ups window and payment window, and click "Purchase" button again.

You will now be redirected from the National Insurance Company Berhad’s website to the payment gateway to enter your payment details.

Please wait, while we are processing your details.

Payment verification is in progress.

Please refrain from closing this window while we verify your payment. You can return to this page after completing the payment. If you accidentally close the popup window without making a payment, please click the "Purchase" button again.

Please be aware that the maximum time allowance for completing your payment is 3 minutes.

If you haven't made a payment and find yourself still on this page, please click the "Purchase" button again after allowance time is completed.

Please do not open multiple payment window.

Coverage Details

Claim Solutions

Motor Claim

Travel Claim

Workmen Compensation Protector Claim

Claim Solutions

Property Claim

Golfer Protector Claim

Other Claim

Tailored personal & business insurance products.

Contact Info

Latest Post