Prepared by Department Melissa Chau Customer Care Tips to Simplify Submission Underwriting Process
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
David Leong Ken Li 820719-14-1183 PASavers Application Form
PASavers Application Form David David Leong Ken Li 12/10/17 Kow Chong Ah Kow 790110-05-5334 01234 12/10/17
Payment Form
EPP Full Payment Form David Leong Ken Li 820719-14-1184 Third Party Card Holder Information + NRIC Photocopy + Credit Card Photocopy 36 2688.00 2688.00 David Leong Ken Li 822719-14-1183 03-772128888 4500 1234 5678 1234 11/22 168 Citibank David 12/10/17 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 Nasional 1000 Yes
CIMB DDA Form Important! Compulsory for EPP via CIMB card David Leong Ken Li 8 2 0 7 1 9 1 4 1 1 8 3 2 1 1 1 1 1 1 2 2 1 1 1 1 1 1 2,416.20 4 5 0 0 1 2 3 4 5 6 7 8 1 2 3 4 1 1 2 2 David 12/10/17
UOB DDA Form Important! Compulsory for EPP via UOB card MediSavers Management Sdn Bhd David Leong Ken Li 820719-14-1184 012-2023322 03-772128888 4 5 0 0 1 2 3 4 5 6 7 8 1 2 3 4 11/22 12 Insurance 2,416.20 201.35 David 12/10/17
HLBB DDA Form Important! Compulsory for EPP via HLBB card D a v i d L e o n g K e n L i 4 5 0 0 1 2 3 4 5 6 7 8 1 2 3 4 1 1 2 2 0 1 2 2 1 1 1 1 1 1 2 4 1 6. 2 0 David 1 2 1 0 1 7
OCBC DDA Form Important! Compulsory for EPP via OCBC card. Must use original form (3 plies) David Leong Ken Li 4 5 0 0 1 2 3 4 5 6 7 8 1 2 3 4 1 1 2 2 201.25 12 2,416.20 11 201.35 Insurance David 12/10/17
Bank Simpanan Nasional 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 820719-14-1184 03-772128888 ali@gmail.com 4 5 0 0 1 2 3 4 5 6 7 8 1 2 3 4 1 1 2 2 Insurance 2,416.35 201.35 12 1 2 3 4 5 6 1 2 3 4 5 Ali 12/10/17
Agent Application Form
Agent Application Form Important and compulsory Important! Agent Account can not pair with Junior Membership David Leong Ken Li David Leong Ken Li 820719-14-1184 Businessman Selling car 1-1-01, Jalan 1-1, Taman 1, Kuala Lumpur. david@gmail.com 820719-14-1184 19/7/82 11100 012-2023322 David David Leong Ken Li 30-09-2017 Kow Chong Ah Kow 790110-05-5334 30-09-2017
Agent Application Form Damansara Utama 6555 1234 2222 1111 David David Leong Ken Li 820719-14-1184 012-2023322 4500 1234 5678 1234 11/22 Maybank David 12-10-2017
Proposal Form
Last entry age is 70 years (age of next birthday) Proposal Form
Proposal Form David Leong Ken Li 820719-14-1183 P P 160 60 1-1 Jalan 1 Taman A Kuala Lumpur 012-2111111 Businessman Selling car P David Leong Ken Li 820719-14-1183 P Businessman Selling car P P P david@gmail.com P 160 60 19/07/82 Malaysian 11500 19/07/82 Malaysian
Proposal Form P P P P P P P
David Proposal Form
Proposal Form Nomination must be completed Leong Ah Li 650818-14-1111 18/08/65 Father 100% David Kow David Leong Ken Li 820719-14-1183 1-1-01, Jalan 1-1, Taman 1, 11100, Kuala Lumpur. Chong Ah Kow 790110-05-5334 2-2-01, Jalan 1-1, Taman 1, 11100, Kuala Lumpur.
Chapter 3 Additional Information
Occupation
Occupation
Occupation
Occupation
MXM HQ - Contact Us Department / Area of Concerns PIC Contact No Fax No Email Address Agency Enquiry : Mr. Patrick Hew Mun Kitt 012-209 3322 03-7721 2975 Agency Sales & Marketing Mr. Johnny Wan Kam Meng 012-623 8902 03-7721 2991 03-7721 2969 salesteam@mxm.com.my Mr. Triston Ng Honng Wui 012-623 0262 03-7721 2986 Ms. Norhaslina Binti Hamidun 012-398 0326 03-7721 2984 Agency Support (Agency Commission & Agency Enquiry) Ms. Afiza Aznin Binti Salleh 018-368 2322 03-7721 2983 03-7721 2969 agencysupport@mxm.com.my Ms. Lim Jia Yng 012-639 0626 03-7721 2973
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 Month Payment & Collection Status (MSI & FPP) Ms. Josephine Leong Oi Choi Mr. Wong Hann Yeong Ms. Jessy Loke Line Line Ms. Norlian Bin Mohd Ali Ms. Angie Ng Yoke Ching Mr. Ken Woo Yew Keng Ms. Nursalina Sahira Binti Zulklifli Mr. Mazwan Bin Ros Mazalan Ms. Syazwani Binti Shamsuddin 012-631 6309 03-7721 2956 012-901 5238 03-7721 2957 012-628 0960 03-7721 2959 016-295 1928 03-7721 2960 016-295 3928 03-7721 2819 012-631 0938 03-7721 2814 012-710 7238 03-7721 2815 016-252 6232 03-7721 2817 016-305 7289 03-7721 2821 03-7721 2889 renewal@mxm.com.my 03-7721 2839 collections@mxm.com.my
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 Member Welcome Pack Enquiry (screening voucher & member card) Submission, Update Member Info & Policy Replacement Ms. Choo Yean Fun 012-928 3820 03-7721 2911 Ms. Kooi Li Yi 016-263 9289 03-7721 2912 Mr. Chan Lih Sin 012-390 6962 03-7721 2913 Mr. Yeoh Hong Shin 016-290 0289 03-7721 2915 Ms. Noorehan Binti Ramli 03-7721 2896 Mr. Shairilniza Bin Zulkifli 03-7721 2893 Ms. Mary Tan Chai Wah 03-7721 2892 Ms. Melissa Chau Geok 012-6393 812 Fen 03-7721 2914 Ms. Kathryn Wan Poh Yoke Ms. Hoo Bik Wen 016-235 9232 03-7721 2953 012-609 6733 03-7721 2954 Ms. Noor Liaza Bin Jaafar 03-7721 2952 Ms. Sharifah Kamariah Bin Syed Sheh 03-7721 2955 03-7721 2889 adm@mxm.com.my 03-7721 2889 database@mxm.com.my 03-7721 2969 cs@mxm.com.my