I confirm the information provided is accurate and complete. I understand that policy issuance is subject to Tokio Marine's acceptance and payment clearance, and that cover only commences once premium has been received. Henry Lee is my appointed insurance advisor for this application.

I declare that no Insured Person named in this application has, within the past 6 months, been hospitalized as an in-patient, received a terminal prognosis, or is currently awaiting hospital in-patient treatment — and that no Insured Person has been previously diagnosed with any anxiety state or mental illness. I understand pre-existing conditions are not covered, and that inaccurate disclosure may affect or void a claim.

I consent to Tokio Marine Insurans (Malaysia) Berhad and Henry Lee, as my appointed insurance advisor, collecting, using and sharing my personal data (including NRIC/passport and bank details) with the insurer, reinsurer, adjusters and ISM Insurance Services Malaysia Berhad, solely for arranging and administering this insurance, in accordance with the Personal Data Protection Act 2010.