AXXESS Mobility Protect

Coverage Period

Annual RM35.88
[only RM2.99 per month]

Name as per NRIC/PASSPORT

NRIC/PASSPORT

Mobile No

Nationality

Malaysian

Non-Malaysian

Premium Details

Premium	RM 35.88
8% Service Tax	RM 2.87
Total Premium	RM 38.75

1 The premium is inclusive of 25% commission/RM 8.97 to Perks Premier Sdn Bhd

2 The product is underwritten and provided by AIG Malaysia Insurance Berhad. Terms and conditions apply.

Please Accept Mobility Protect Terms

I confirm that I have an active Touch n Go card.

Please Confirm/Accept Terms & Conditions

I confirm that I am a resident of Malaysia and within the eligible age of 18 years to 75 years. I further confirm that I have fully read the Product Disclosure Sheet and Terms & Conditions, and acknowledge that I understand and accept the same, and the policy is suitable to my insurance needs.

Mobility Protect by AXXESS

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Email

Address

Mobility Protect by AXXESS

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