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DMS/09/FC/P/002/June LONPAC7th,INSURANCEBank, 6, Jalan Sultan Sulaiman, 50000 Kuala Lumpur, Malaysia. BHD (307414T) Head Office : LG, 6th, 21st to 26th Floor, Bangunan Public P.O. Box 10708, 50722.

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How to fill out the Lonpac Insurance online

Filling out the Lonpac Insurance proposal form online can seem daunting, but with a structured approach, it becomes manageable. This guide provides clear and detailed instructions to help you navigate each section of the form.

Follow the steps to successfully complete your Lonpac Insurance proposal form.

  1. Click ‘Get Form’ button to obtain the Lonpac Insurance proposal form and open it in your editor.
  2. Begin by filling in your Agency A/C No and Cover Note No, if applicable. If not, you can skip this section.
  3. Proceed to the 'Details of Proposer' section, and enter your name, correspondence address, postcode, NRIC number, date of birth, passport number (if applicable), gender, marital status, nationality, and contact details.
  4. Fill in the section regarding the 'Period of Insurance,' indicating the start and end dates, ensuring both are inclusive.
  5. If applicable, complete the 'Details of Spouse' section. Input the name, NRIC/passport number, date of birth, and occupation.
  6. Next, if seeking coverage for children, fill in the 'Details of Child(ren)' section by providing names, new NRIC/B.C. numbers, dates of birth, and occupations, if applicable.
  7. For the 'Coverage & Premium' section, select your sum insured options and benefits for both adults and children, ensuring you calculate the total premium correctly.
  8. Choose the plan options required for coverage, marking either Section 1, Section 1 & 2, or a combination as relevant.
  9. In the 'Details of Health & Claims History' section, answer the questions regarding past claims and current insurance status truthfully.
  10. Review and complete the 'Declaration by Proposer' confirming the accuracy of the information provided.
  11. Specify your preferred mode of payment in the 'Mode of Payment' section, filling in the necessary details for cheque or credit card payments.
  12. Finally, include any nominations required under Section 163 of the Insurance Act and indicate your choice.
  13. Once all sections are filled out, save any changes, and you can download or print the completed form for your records.

Complete your Lonpac Insurance proposal form online today!

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Lonpac Insurance Bhd (Lonpac), a wholly owned subsidiary of LPI Capital Bhd, was incorporated in Malaysia on 12 July 1994.

Lonpac Insurance Bhd is licensed under the Financial Services Act 2013 and regulated by Bank Negara Malaysia to transact all classes of general insurance business. Lonpac is a wholly-owned subsidiary of LPI Capital Bhd.

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