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Personal Accident Insurance

Accidents resulting in prolonged or permanent injury bring life to a halt, especially if you’re providing for someone else. Total One Protection provides coverage for expenses or loss of income as a result of injury or death from an accident. Enter your information below and pay for your personal accident insurance instantly.
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PRIMARY ASSURED CONTACT DETAILS

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Name

Birthday

Address

Contact Info

Beneficiary

CHOOSE YOUR ACCIDENT INSURANCE PACKAGE

Please choose if you are purchasing for yourself or for the whole family.

If the Principal Assured is Married, the following family members are covered by insurance:
Spouse: provided he/she is not more than 65 years old as of the date of application. Child/children (maximum of 4): provided the child is not more than 55 years old as of the date of application.  
 
If the Principal Assured is Single, the following family members are covered by insurance:
Parent/s: provided he/she is not more than 65 years old as of the date of application. Sibling/s (maximum of 4): provided the sibling is not more than 65 years old, as of the date of application.

Name

Birthday

Beneficiary

Declaration

I hereby warrant that all personal information and sensitive personal information given by me are true, correct and updated to the best of my knowledge, freely and voluntarily given to Malayan Insurance Company, Inc. (MICO). I agree and consent that above information are being collected, used, processed and recorded for purposes which are relevant and necessary in securing an insurance contract or transacting a business or any activity with MICO. I hereby authorize MICO, its directors, officers, consultants, employees, and duly authorized representatives to keep, store, update, use, access and process the information given to it, and to share, transfer or disclose the information, including this form to the Yuchengco Group of Companies (YGC Companies), their and MICO's affiliates, subsidiaries, contractors, partners, agents and representatives, intermediaries, industry associations , and third parties such as but not limited to outsourced service providers, adjusters, salvage buyers, banks, external auditors, and local and foreign regulatory authorities for purposes of marketing or promotional information campaign, provision of any products, services, or offers through mail/email/fax/SMS/telephone or any type of electronic facility, profiling, research, studies/customer satisfaction surveys, statistical and risk analysis, tax monitoring, review, and reporting, compliance with court and other lawful order and requirements, with Anti-Money Laundering Act, Credit Information System Act, and all other regulatory laws, and all other activities consistent with the provisions of the Data Privacy Act and subject to appropriate security safeguards. If purchasing, transacting and/or acting in behalf of other person(s), I hereby warrant that I am duly authorized to perform such acts and that I am duly allowed to give their information to MICO. I hereby bind myself to advise all other persons in whose behalf I have acted, transacted with and/or purchased any product from MICO of all the terms and conditions herein. I also authorize MICO and the YGC Companies to verify and investigate the information given by me, including submitted documents from whatever source it may consider appropriate. I have the right to access the given information, and I undertake to correct, rectify or supplement information should any information be found to be inaccurate or incomplete. I shall notify MICO in writing of any changes in the information given above. I will hold MICO free and harmless from any liability that may arise as a result of the authorization given above.

Agreement

I acknowledge and agree to the data sharing declaration above.

Anti-Fraud: Section 251 of the lnsurance Code, as amended, imposes a fine not exceeding twice the amount claimed and/or imprisonment of two (2) years, or both, at the discretion of the court, to any person who presents or causes to be presented any fraudulent claim for the payment of a loss under a contract of insurance, and who fraudulently prepares, makes or subscribes any writing with intent to present or use the same, or to allow it to be presented in support of any claim.