Get a Quotation Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *Occupation *Smoker / Non Smoker *--- Select Choice ---Non SmokerSmokerDate of Birth *Phone Number *Please ensure this number is connected to WhatsApp to receive your quotation.Do You Need a Medical Card? *YesNoHow Much Life Insurance Do You Need? *12,000 (Minimum Coverage)100,000 (Basic Coverage)300,000 (Moderate Coverage)500,000 (High Coverage)More than 500,000Not Sure, Please Advise MeFinancial protection for your family if anything happens to you How Much Critical Illness Do You Need? *None50,000 (Basic Coverage)150,000 (Moderate Coverage)250,000 (High Coverage)More than 250,000Not Sure, Please Advise MeLump sum payout upon diagnosis of major illnesses like cancer, stroke, or heart attackDo You Need Early Critical Illness Coverage? *YesNoNot Sure, Please Advise MePays a lump sum if you are diagnosed at an early stage of illnesses like cancer, stroke, or heart disease Date / How What Is Your Comfortable Monthly Budget? *Below RM 150RM 150 - RM 300RM 300 - RM 500RM 500 - RM 1,000Above RM 1,000Submit support@helpmyinsurance.com 010 - 3745700 Directly Contact Us!
