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 LIVIN' PAY PROPOSAL FORM (GS 2072) |
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Please click here (602kb) to download the latest ordinary proposal form for printing. After filling in the required particulars, kindly send back the proposal form to us through the following address:
KESATUAN PERKHIDMATAN PERGURUAN KEBANGSAAN,
SEMENANJUNG MALAYSIA
13-15, Jalan Murai Dua, Kompleks Batu,
Off Jalan Ipoh, 51100 Kuala Lumpur.
OR
TONY NG & ASSOCIATES
GREAT EASTERN LIFE ASSURANCE (M) BERHAD (93745-A)
39 (1st Floor), Lebuh Bishop,
10200 Pulau Pinang. |
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 LATEST LIVIN' PAY ORDINARY PROPOSAL FORM (2006) |
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| LATEST LIVIN' PAY SPECIAL PROMOTION PROPOSAL FORM (2006) |
| This form can only be used during special promotion. |
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| PREVIOUS ORDINARY PROPOSAL FORMS (FOR REFERENCE ONLY) |
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| PREVIOUS SPECIAL PROMOTION PROPOSAL FORMS (FOR REFERENCE ONLY) |
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1998 |
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1998 |
1999 |
2001 |
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| PREVIOUS SPECIAL PROMOTION PROPOSAL FORMS (TO UPGRADE EXISTING INSURANCE) |
| These special promotion forms are used to increase existing participant of monthly premium RM44 to RM88. |
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| LIVIN' PAY CLAIM FORMS (GS 2072) |
36 Critical Illnesses
1. Heart Attack
2. Stroke
3. Coronary Artery By-Pass Surgery
4. Cancer
5. Kidney Failure
6. Fulminant Hepatitis
7. Major Organ Transplant
8. Paralysis (Paraplegia, Tetraplegia)
9. Multiple Sclerosis
10. Primary Pulmonary Hypertension
11. Blindness
12. Heart Valve Surgery
13. Major Burns
14. Aorta Surgery
15. Loss of Speech
16. Alzheimer's Disease
17. Muscular Dystrophy
18. Deafness
19. Terminal Illness
20. Motor Neuron Disease
21. Chronic Liver Disease
22. HIV Infection from Blood Transfusion (By Life Assured, By Doctor)
23. Encephalitis
24. Asplatic Anaemia
25. Accidental Head Injury resulthing in Head Trauma
26. Parkinson's Disease
27. Poliomyelitis
28. Benign Brain Tumour
29. Chronic Lung Disease
30. Coma
31. Brain Surgery
32. Bacterial Meningitis
33. Other Serious Coronary Artery Disease
34. Appalic Syndrome
35. AIDS Cover for Medical Staff (By Life Assured, By Doctor)
36. Full Blown AIDS (By Life Assured , By Doctor)
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| OTHER CLAIM FORMS |
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Death Claim |
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Living Assurance Claim |
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Total And Permanent Disability Claim |
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Accidental Claim |
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Hospitalisation & Surgical Benefits Claim |
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Umum |
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| DANA RESTU PROPOSAL FORM (GS 2415) |
Please click here (602kb) to download the latest ordinary proposal form for printing. After filling in the required particulars, kindly send back the form to us through the following address :
KESATUAN PERKHIDMATAN PERGURUAN KEBANGSAAN,
SEMENANJUNG MALAYSIA
13-15, Jalan Murai Dua, Kompleks Batu,
Off Jalan Ipoh, 51100 Kuala Lumpur.
OR
TONY NG & ASSOCIATES
GREAT EASTERN LIFE ASSURANCE (M) BERHAD (93745-A)
39 (1st Floor), Lebuh Bishop,
10200 Pulau Pinang. |
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| LATEST DANA RESTU ORDINARY PROPOSAL FORM (2006) |
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Page 1 |
Page 2 |
Page 3 |
Page 4 |
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| LATEST DANA RESTU SPECIAL PROMOTION PROPOSAL FORM (2006) |
| This form can only be used during special promotion. |
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| PREVIOUS DANA RESTU PROPOSAL FORMS (FOR REFERENCE ONLY) |
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| DANA RESTU CLAIM FORMS (GS 2415) |
36 Critical Illnesses
1. Heart Attack
2. Stroke
3. Coronary Artery By-Pass Surgery
4. Cancer
5. Kidney Failure
6. Fulminant Hepatitis
7. Major Organ Transplant
8. Paralysis (Paraplegia, Tetraplegia)
9. Multiple Sclerosis
10. Primary Pulmonary Hypertension
11. Blindness
12. Heart Valve Surgery
13. Major Burns
14. Aorta Surgery
15. Loss of Speech
16. Alzheimer's Disease
17. Muscular Dystrophy
18. Deafness
19. Terminal Illness
20. Motor Neuron Disease
21. Chronic Liver Disease
22. HIV Infection from Blood Transfusion (By Life Assured, By Doctor)
23. Encephalitis
24. Asplatic Anaemia
25. Accidental Head Injury resulthing in Head Trauma
26. Parkinson's Disease
27. Poliomyelitis
28. Benign Brain Tumour
29. Chronic Lung Disease
30. Coma
31. Brain Surgery
32. Bacterial Meningitis
33. Other Serious Coronary Artery Disease
34. Appalic Syndrome
35. AIDS Cover for Medical Staff (By Life Assured, By Doctor)
36. Full Blown AIDS (By Life Assured , By Doctor)
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| OTHER CLAIM FORMS |
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Death Claim |
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Living Assurance Claim |
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Total And Permanent Disability Claim |
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Accidental Claim |
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Hospitalisation & Surgical Benefits Claim |
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General |
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| MUI DIAMOND ACCIDENT PROTECTOR PROPOSAL FORM |
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Please click here (950kb) to download the proposal form for MUI Diamond Accident Protector. After filling in the required particulars, kindly send back the form to us through the following address:
Phoenix Prestige Sdn. Bhd.
39 (1st Floor), Lebuh Bishop,
10200 Pulau Pinang, Malaysia. |
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| MUI DIAMOND ACCIDENT PROTECTOR CLAIM FORM |
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1. Accident Death Claim Form
2. Accident Claim Form |
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| PREVIOUS MUI PROPOSAL FORMS (FOR REFERENCE ONLY) |
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| NUTP HEALTH CARE PROPOSAL FORM |
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Please click here to download the proposal form for NUTP Health Care. After filling in the required particulars, kindly send it back to us through the following address:
KESATUAN PERKHIDMATAN PERGURUAN KEBANGSAAN, SEMENANJUNG MALAYSIA
13-15, Jalan Murai Dua, Kompleks Batu,
Off Jalan Ipoh, 51100 Kuala Lumpur. |
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| NUTP HEALTH CARE CLAIM FORM |
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1. Claim Form For Group Hospitalisation & Surgical Benefit (By Life Assured)
2. Hospitalisation & Surgical Claim Attending Physician Statement (By Physician/Surgeon) |
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