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| Click the items below to view the details of each request. You may also download the corresponding form(s). | |
| 1. Nomination (Agency) |
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Duly completed form and additional document required:
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Nomination Form
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| 1. Nomination (Banca) |
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Duly completed form and additional document required:
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Nomination Form
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| 3. Change of Address / Contact Details |
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Duly completed form and additional document required:
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Request for Change Form
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| 5. Change in Mode |
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Duly completed form and additional document required:
- Request for Change Form
- to be submitted about a month before the appropriate effective date i.e. the next due date and one of the due dates must coincide with the anniversary of the commencement date of the certificate
- Notification of Payment
- For payment method via Biro Perkhidmatan Angkasa (BPA) that involves changes to the premium, the following are required:
- For all other payment methods that involve changes to the contribution, where applicable, these documents are required:
- Request for Change Form with an appropriate instruction form based on the payment method indicating the change in the contribution limit.
- For Standing Instruction, the certificate holder would need to advise the banker on changes to the contribution limit.
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Request for Change Form
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| 6. Increase in Basic / Rider Sum Assured |
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Duly completed form and additional document required:
- Request for Change Form
- Health Declaration Form
- to be submitted about a month before the certificate anniversary day
- Notification of Payment
- For payment method via Biro Perkhidmatan Angkasa (BPA) that involves changes to the premium, the following are required:
- For all other payment methods that involve changes to the premium, where applicable, these documents are required:
- Request for Change Form with an appropriate instruction form based on the payment method indicating the change in the contribution limit.
- For Standing Instruction, the certificate holder would need to advise the banker on changes to the contribution limit.
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Request for Change Form
Health Declaration Form
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| 7. Decrease in Basic / Rider Sum Assured |
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Duly completed form and additional document required:
- Request for Change Form
- to be submitted about a month before the next contribution due
- Notification of Payment
- For payment method via Biro Perkhidmatan Angkasa (BPA) that involves changes to the premium, the following are required:
- For all other payment methods that involve changes to the premium, where applicable, these documents are required:
- Request for Change Form with an appropriate instruction form based on the payment method indicating the change in the contribution limit.
- For Standing Instruction, the certificate holder would need to advise the banker on changes to the contribution limit.
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Request for Change Form
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| 8. Inclusion of Rider(s) |
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Duly completed form and additional document required:
- Request for Change Form
- Health Declaration Form
- to be submitted about a month before the certificate anniversary day
- Notification of Payment
- For payment method via Biro Perkhidmatan Angkasa (BPA) that involves changes to the premium, the following are required:
- For payment method via Biro Perkhidmatan Angkasa (BPA) that involves changes to the premium, the following are required:
- For all other payment methods that involve changes to the premium, where applicable, these documents are required:
- Request for Change Form with an appropriate instruction form based on the payment method indicating the change in the contribution limit.
- For Standing Instruction, the certificate holder would need to advise the banker on changes to the contribution limit.
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Request for Change Form
Health Declaration Form
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| 9. Deletion of Rider(s) |
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Duly completed form and additional document required:
- Request for Change Form
- to be submitted about a month before the next premium due
- Notification of Payment
- For payment method via Biro Perkhidmatan Angkasa (BPA) that involves changes to the premium, the following are required:
- For all other payment methods that involve changes to the premium, where applicable, these documents are required:
- Request for Change Form with an appropriate instruction form based on the payment method indicating the change in the contribution limit.
- For Standing Instruction, the certificate holder would need to advise the banker on changes to the contribution limit.
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Request for Change Form
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| 13. Sarjana Cash Award |
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For participants of our Sarjana plan who achieve exceptional results in their UPSR, PMR, SPM or STPM examinations, we recognize and reward their effort by way of a cash award, subject to terms and conditions.
Kindly visit the nearest Etiqa Takaful Berhad branch or contact your Takaful Agent for more information. |
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| 14. Reinstatement |
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Documents required:
- Health Declaration Form duly completed and signed by the participant, certificate holder and witness
- Full remittance of all outstanding contributions including reinstatement fee, if any
- Medical report, if applicable (the expense is to be borne by the certificate holder)
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Health Declaration Form
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NOTE: The above are standard guidelines and when the need arises, the Company would request for further information/documents in accordance to company guidelines. Each request for change is subject to the terms and conditions of the respective policy.
For any further assistance on above please get in touch with your agent or call our Customer Service at 1300-13-8888 or email us at info@etiqa.com.my. |
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Connect with us
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You can see one of our 23,000 agents around the country or call our Etiqa Oneline call centre at
1300 13 8888 (for Malaysians only).
For our international branches, please contact:
Singapore : +65 6336 0477
Brunei : +673 244 3393
Labuan : +60 87 417 672
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Locate our branches
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Walk-in to any of our branches around Malaysia to make a claim, enquire or purchase our insurance and takaful plans. Find a branch that is nearest to you
here
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