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EZ Cancer Care 365 EZ Critical Care
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EZ Cancer Care 365 Insurance

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Please fill in your Staff ID:

* Complete the Staff ID field.
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This insurance plan is for:
* Complete the relationship field.

Get Started

Please make sure you meet the following conditions:

  1. You are between {{productMinAge}} and {{productMaxAge}} years old at the time of application.
  2. You must be a Malaysian or Permanent Resident of Malaysia residing in Malaysia.
For policy renewal:

You may renew until you are 80 years old.

Please enter the details of Insured Person

* Complete the Country field.
* Complete the Passport No field.
* Complete the NRIC field. * Please check NRIC number. * Policyholder age must be between {{productMinAge}} and {{productMaxAge}} years.

Gender:

* Complete the gender field.
* Complete the Passport No field.
* Complete the date field. * Main policyholder age must be between {{productMinAge}} and {{productMaxAge}} Years.
* Complete the gender field.
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Let's Check Your Eligibility

Are you staying in Malaysia for more than 9 consecutive months in a year?

* Complete the Question 1.

Please enter the details to validate your BMI

Height (cm)

* Complete the Height field.

Weight (kg)

* Complete the Weight field.

BMI Result

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Have you ever had or do you intend to seek advice for any lump, growth, pre-cancerous condition, carcinoma in-situ or cancer (including leukemia, lymphoma, or tumor)?

* Complete the Question 3.

In the past 1 year, have you ever had or do you intend to seek advice for any abnormal result in your biopsy, endoscopy, cervical smear, mammogram, breast ultrasound, prostate examination, scan, blood test (limited to tumour markers, blood count, creatinine, liver enzymes and calcium), stool test or urine test (limited to blood in urine)?

* Complete the Question 4.

Do you have any Critical Illness, Hospital Income or other similar insurance?

* Complete the Question 5.

My healthcare insurance is with:

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  • {{ country }}
* Complete the Question 5.

Has any of your applications for Critical Illness or Hospital Income insurance been declined or had special terms imposed, or has any insurer refused to renew any such insurance?

* Complete the Question 6.

Period of Coverage

Start Date:

?
* Complete the Start Date. * Policy start date must be within 1 year starting from today.

End Date:

Please Select Your Preferred Plan

* Please Choose a Coverage Plan.

Optional Benefit: Hospital Income

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Before You Proceed, Just A Few More Questions

Have you ever consulted any medical practitioner / specialist or have had surgery or been hospitalised for any injury, disease or chronic illnesses?

* Complete the Question 1.

Are you considering to seek consultation, treatment, investigation of any kind or pending surgery or procedure in the coming 12 months?

* Complete the Question 2.

Have you ever been hospitalised for more than 5 consecutive days in the past 5 years?

* Complete the Question 3.

Personal Details
* Complete the Name as per NRIC field. * Please enter only alphabet, "-", "@", "/" and " ' " for Name. * Name cannot be greater than 70 characters.
* Complete the Email field. * Please enter a valid email address. * Email cannot be greater than 50 characters.
* Complete the Mobile field. * Please check mobile number.
* Complete the Address field. * Address field cannot be greater than 70 characters.
* Address 2 field cannot be greater than 70 characters.
* Complete the Postcode field. * Please enter a valid Postcode.
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Personal Details

* Complete the Country field.
* Complete the Name as per Passport field. * Please enter only alphabet, "-", "@", "/" and " ' " for Name. * Name cannot be greater than 70 characters.
* Complete the Email field. * Please enter a valid email address. * Email cannot be greater than 50 characters.
* Complete the Mobile field. * Please check mobile number.

Gender:

* Complete the Gender field.
* Complete the Address field. * Address field cannot be greater than 70 characters.
* Address 2 field cannot be greater than 70 characters.
* Complete the Postcode field. * Please enter a valid Postcode.
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Personal Details

Country (as per Passport):

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Name (as per {{step4PassportOrNric}}):

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{{step4PassportOrNric}} No.:

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Email:

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Mobile No.:

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Gender:

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Date of Birth:

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Address:

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MY.SHOP.COM Privileged Card ID

* Complete your Privileged Card ID. * Please enter at least 7 digits for your Privileged Card ID. * Please only enter a maximum of 10 digits for your Privileged Card ID.

Note: Please enter your Privileged Card ID number only.

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Payment

Payment Method:

Bank:

* Please select a valid bank.

Note: You need to have an active internet banking account with any of the FPX performing banks to use FPX.

Email Address: (For transaction status)

* Complete the Email field. * Please enter a valid email address.

Credit / Debit Card:

* Please select a Credit/Debit Card provider.

Select Your Preferred E-Wallet:

* Please select an e-Wallet Provider.

By clicking "Pay Now" button, you agree to FPX's Terms & Conditions.

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Sorry, we are unable to proceed with your application online.

Please download and fill out the application form here and submit it to us here.

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If you have any enquiries, you may contact our Customer Service Hotline at:

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enquiry_form

Or contact us through our

Online Enquiry Form

hour

Operating Hours

Monday - Friday

9.00am - 5.00pm (excluding public holidays)

Monday - Friday

9.00am - 6.00pm (excluding public holidays)

Monday - Friday

9.00am - 6.15pm (excluding public holidays)

Monday - Friday

8.30am - 5.00pm (excluding public holidays)

Monday - Friday

8.30am - 5.30pm (excluding public holidays)