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TRANSCRIPT
Tips to Simplify Submission
Underwriting Process
Prepared by
Department
Melissa Chau
Customer Care
Content
Chapter 1 : Type of application form
Chapter 2 : Tips to simplify submission & underwriting
process
Chapter 3 : Additional Info
Chapter 1 Type of Application Form
PASavers Application Form
EPP | Full Payment Form
Proposal Form
Chapter 2 Tips to Simplify Submission
&
Underwriting Process
Application Form
PASavers Application Form
David Leong Ken Li
820719-14-1183
PASavers Application Form
David
David Leong Ken Li
12/10/17
Chong Ah Kow
Kow
790110-05-5334
01234
12/10/17
Payment Form
EPP | Full Payment Form
David Leong Ken Li 820719-14-1184
√
36 2688.00 2688.00
David Leong Ken Li 822719-14-118303-772128888
4500 1234 5678 1234 11/22168
Citibank12/10/17
√
David
Third Party Card
Holder Information
+
NRIC Photocopy
+
Credit Card
Photocopy
Cheque issue to
MediSavers
Management Sdn
Bhd√
David 12/10/17
David 12/10/17
EPP | Full Payment Form
Minimum amount for EPP
Bank 12 Months DDA
Ambank 1000 -
CitiBank 1000 -
Hong Leong 1000 Yes
HSBC 1000 -
Maybank 1000 -
Public Bank 500 -
RHB 1000 -
UOB 1000 Yes
OCBC 1000 Yes
SCB 1000 -
CIMB 1200 Yes
Bank Simpanan
Nasional1000 Yes
CIMB DDA Form
David Leong Ken Li
√
David
4 5 0 0 1 2 3 4 5 6 7 8 1 2 3 4
12/10/17
2,416.20
Important !
Compulsory for
EPP via CIMB card
1 1 2 2
2 2 1 1 1 1 1 1
2 1 1 1 1 1 1
8 2 0 7 1 9 4 1 1 8 31
UOB DDA Form
Important !
Compulsory for
EPP via UOB cardDavid Leong Ken Li 820719-14-1184
012-202332203-772128888
4 5 0 0 1 2 3 4 5 6 7 8 1 2 3 411/22
David 12/10/17
MediSavers Management Sdn Bhd
Insurance
201.3512
2,416.20
HLBB DDA Form
Important !
Compulsory for
EPP via HLBB card
4 5 0 0 1 2 3 4 5 6 7 8 1 2 3 41 1 2 2
0 1 2 2 11 1 1 1 1
2 4 1 6 . 2 0
√
David
1 2 1 0 1 7
D a v i d L e o K e Ln in g
David Leong Ken Li
Insurance
4 5 0 0 1 2 3 4 5 6 7 8 1 2 3 4 1 1 2 2
2,416.20 201.3511
201.25 12
David 12/10/17
Important !
Compulsory for
EPP via OCBC
card. Must use
original form (3
plies)
OCBC DDA Form
Important !
Compulsory for
EPP via Bank
Simpanan Nasional
card.
Important :1. Agents to call BSN to get the
Authorization Code & Staff ID(Card holder must be with agents as BSN will do verification with the card holder)
2. Agents to fill in the Authorization Code & Staff ID in BSN DDA Form
3. Agents to submit BSN DDA Form together with Application Form immediately to MXM HQ(Bank required the DDA Form to be submitted to them on the same day or next working days)
Ali Bin Ahmad 820719-14-118403-772128888
4 5 0 0 1 2 3 4 5 6 7 8 1 2 3 4
Insurance2,416.35
201.35 12
1 2 3 4 5 6 1 2 3 4 5
Ali 12/10/17
Bank Simpanan Nasional DDA Form
1 1 2 2
Agent Application Form
Important and
compulsory
Important !
Agent Account can
not pair with Junior
Membership
√David Leong Ken Li
David Leong Ken Li820719-14-1184
820719-14-1184
19/7/82
√√
√
√BusinessmanSelling car
1-1-01, Jalan 1-1, Taman 1, Kuala Lumpur.
√
11100
David
David Leong Ken Li
Kow
Chong Ah Kow790110-05-5334
30-09-201730-09-2017
Agent Application Form
Agent Application Form
√
David Leong Ken Li 820719-14-1184012-2023322
√
√
4500 1234 5678 1234 11/22Maybank
David 12-10-2017
Damansara Utama David6555 1234 2222 1111
Proposal Form
Proposal Form
Last entry age is
70 years (age of
next birthday)
Proposal Form
David Leong Ken Li
820719-14-1183
1-1 Jalan 1 Taman A Kuala Lumpur
P
P
P
Businessman
012-2111111
19/07/82
11500
Malaysian
Selling car
160 60
P
P
P
P
David Leong Ken Li820719-14-1183
PP160 60
Businessman
Selling car
19/07/82
Malaysian
P
P
P
P
P
P
PP
Proposal Form
David
Proposal Form
Leong Ah Li 650818-14-1111 18/08/65 Father 100%
David Leong Ken Li
1-1-01, Jalan 1-1, Taman 1, 11100, Kuala Lumpur.
820719-14-1183
Chong Ah Kow
2-2-01, Jalan 1-1, Taman 1, 11100, Kuala Lumpur.
790110-05-5334
KowDavid
Proposal Form
Nomination must
be completed
Chapter 3 Additional Information
Occupation
Occupation
Occupation
Occupation
Department / Area of
Concerns PIC Contact No Fax No Email Address
Agency Enquiry :
Agency Sales & Marketing
Mr. Patrick Hew Mun Kitt 012-209 3322
03-7721 2969 [email protected]
03-7721 2975
Mr. Johnny Wan Kam Meng012-623 8902
03-7721 2991
Mr. Triston Ng Honng Wui012-623 0262
03-7721 2986
Agency Support (Agency
Commission & Agency Enquiry)
Ms. Norhaslina Binti
Hamidun
012-398 0326
03-7721 2969 [email protected]
03-7721 2984
Ms. Afiza Aznin Binti Salleh018-368 2322
03-7721 2983
Ms. Lim Jia Yng012-639 0626
03-7721 2973
MXM HQ - Contact Us
MXM HQ - Contact Us
Department / Area of
Concerns PIC Contact No Fax No Email Address
Membership Renewal, Monthly Payment Collection, Customer Service & Claims Department
Membership Renewal
Ms. Josephine Leong Oi
Choi
012-631 6309
03-7721 2889 [email protected]
03-7721 2956
Mr. Wong Hann Yeong 012-901 5238
03-7721 2957
Ms. Jessy Loke Line
Line
012-628 0960
03-7721 2959
Ms. Norlian Bin Mohd
Ali
016-295 1928
03-7721 2960
Month Payment & Collection Status
(MSI & FPP)
Ms. Angie Ng Yoke
Ching
016-295 3928
03-7721 2839 [email protected]
03-7721 2819
Mr. Ken Woo Yew Keng012-631 0938
03-7721 2814
Ms. Nursalina Sahira
Binti Zulklifli
012-710 7238
03-7721 2815
Mr. Mazwan Bin Ros
Mazalan
016-252 6232
03-7721 2817
Ms. Syazwani Binti
Shamsuddin
016-305 7289
03-7721 2821
MXM HQ - Contact Us
Department / Area of Concerns PIC Contact No Fax No Email Address
Membership Renewal, Monthly Payment Collection, Customer Service & Claims Department
Medical Claims Enquiry & status
Ms. Choo Yean Fun012- 928 3820
03-7721 2889 [email protected]
03-7721 2911
Ms. Kooi Li Yi016-263 9289
03-7721 2912
Mr. Chan Lih Sin012- 390 6962
03-7721 2913
Mr. Yeoh Hong Shin016-290 0289
03-7721 2915
Member Welcome Pack Enquiry
(screening voucher & member card)
Ms. Noorehan Binti Ramli 03-7721 2896
03-7721 2889 [email protected]. Shairilniza Bin Zulkifli 03-7721 2893
Ms. Mary Tan Chai Wah 03-7721 2892
Submission, Update Member Info &
Policy Replacement
Ms. Melissa Chau Geok
Fen
012-6393 812
03-7721 2969 [email protected]
03-7721 2914
Ms. Kathryn Wan Poh
Yoke
016-235 9232
03-7721 2953
Ms. Hoo Bik Wen 012-609 6733
03-7721 2954
Ms. Noor Liaza Bin Jaafar 03-7721 2952
Ms. Sharifah Kamariah
Bin Syed Sheh 03-7721 2955
