Rahmah
Personal Accident Insurance

Before you begin, please make sure you meet the following conditions:

You are a Malaysian or a Permanent Resident

You are 16 to 65 years old

The Policy Coverage Period is 1 year

This agency will receive a commission for providing insurance-related service to you. If you do not wish to receive the service from this agent, you may visit RHB INSURANCE ONLINE or download RHB Insurance mobile app for a self-service insurance purchase with a direct rebate.

RHB Insurance is a member of PIDM. The benefit(s) payable under eligible certificate/policy/product is(are) protected by PIDM up to limits. Please refer to PIDM’s TIPS Brochure or contact RHB Insurance or PIDM (visit www.pidm.gov.my).

1. Please fill in your details

Full Name

MyKad Number

Address 1

Address Line 2(Optional)

Address Line 3 (Optional)

Postcode

State

+60

Contact Number

Email

Occupation

Nominate your beneficiaries for hassle-free claims!

Ensure that your loved ones receive the policy's benefits without any legal disputes or delays.

2. Please select a plan

RM9.90/Year

RM5,000 Accidental Death/Permanent Disablement (due to accident)
RM5/day Hospital Cash Income up to 30 days (due to accident)
RM500 "Bereavement allowance (due to accident)

RM25.00/Year

RM20,000 Accidental Death/Permanent Disablement (due to accident)
RM30/day Hospital Cash Income up to 30 days (due to accident)
RM1,000 "Bereavement allowance (due to accident)

"4. Please fill in this questionnaire

Do you engage in any hazardous activities or pursuits which may render you liable to accidents or to any disease or sickness?

Yes No

Do you presently possess any personal accident with RHB Insurance?

Yes No

Have you ever had your application for Personal Accident declined, canceled, refused renewal or subjected to special terms by another Insurance Company / Takaful Operator?

Yes No

Have you ever made a claim against any insurer?

Yes No

Terms and Conditions

RHB INSURANCE BERHAD

You understand that RHB INSURANCE BERHAD ("RHB") will use, collect, record, store, share and/or process your personal information, including, without limitation, your contact details, background information, financial data, vehicle registration number, personal information of your family members/beneficiaries/nominees and other information relevant to your application for the insurance product and/or service (“Personal Information”) which: You have provided in this form or through any other contact with RHB Banking Group (which shall include its holding company, subsidiary(s), and any associated company(s), including any company as a result of any restructuring, merger, sale or acquisition); or has been obtained from analysis of your payment and other transactions/services within the RHB Banking Group, or has been obtained from third parties such as employers, joint applicants, legal representatives, industry/financial related associations, government/regulatory authorities, credit bureaus or credit reporting agencies, retailers, social networks and fraud prevention agencies or other organizations; or (d) your relationship with RHB and RHB Banking Group, for example information provided by you in application forms when applying for your products or services, when transacting on your insurance policy, when using RHB’s online or electronic services, when taking part in customer surveys, competitions and promotions; or (e) your verbal, written and/or electronic communications with RHB or RHB’s authorised agents. for any and/or all of the following purposes (“Purpose”), which include: (i) handling applications to purchase insurance policies and/or requests for advice and product recommendations; (ii) preparing, issuing and handling other administrative matters relating to the insurance policies; (iii) collecting premiums/contributions and submitting other bills; (iv) processing and settling claims and paying other benefits; (v) regular assessment after purchase of insurance products; (vi) performing re-insurance; (vii) performing co-insurance; (viii) preventing, investigating, reporting or otherwise in relation to actual or suspected money laundering, terrorist financing, bribery, corruption, actual or suspected fraud including but not limited to insurance fraud, tax evasion, evasion of economic or trade sanctions, and criminal activities generally or other unlawful activities; (ix) establishing, exercising or defending a legal claim; (x) meeting other specific legal or contractual obligation; (xi) prospecting new insurance, including research for product and service development; (xii) internal management of RHB; (xiii) disclosure to third parties in connection to the Purpose; (xiv) audit, risk assessment, survey, statistical and analytical studies relating to the insurance business; (xv) discharging regulatory or legislative obligations; (xvi) actuarial activities; (xvii) marketing (including direct marketing) of insurance products or services by RHB; (xviii) cooperating with the Personal Data Protection Commission,BankNegara Malaysia or any other relevant authority to conduct an audit, examination or investigation which is authorised under any applicable Malaysian laws or international treaties/agreements affecting RHB, whether directly or through RHB Banking Group; (xix) the performance of obligations including customer service under a written agreement, complaints handling, conservation, including any value-added services that are connected but not directly connected to such agreement, where such agreement shall include but not be limited to general insurance, medical insurance, group insurance policies, agency contract, broking arrangements, and employment contract; (xx) investigation during underwriting and claims assessment or at any time during the concurrence of the insurance policy that is necessary and reasonable to identify any possible non-disclosure of material information in an insurance or conspiracy claim, including but not limited to the purposes of medical/health insurance, requesting and verifying information with any medical practitioner, hospital, medical institution or any person (whether incorporated or not) who has ever attended to you or has your health records; the purposes of motor insurance, requesting and verifying information with any motor companies, workshops, or any person (whether incorporated or not) who has ever attended to you or has your motor vehicles records; and RHB and/or its relevant third party service providers may keep such records for future possible cases of underwriting and claims assessment (xxi) compliance with the requirements of any law, any regulations or guidelines, any present or future contractual or other commitment with any legal, regulatory, judicial, administrative, public or law enforcement body, whether in or outside Malaysia, that are issued by regulatory or other authorities with which RHB or any other group members of RHB Banking Group need or are expected to comply, including but not limited to making any enquiries, any investigation, disclosure or reporting requirements and/or meeting obligations pursuant to such law, regulations guidelines and/or the relevant authorities; (xxii) matching of any of your Personal Information held by RHB from time to time for any of the Purpose; (xxiii) research, auditpurposesandriskassessment/survey, includingstatistical/actuarialresearchordataanalytics/study. Intheevent such data was required for this purpose, your Personal Information are not to be published, and only figures, statistics and general information in the findings of the study/research are to be published; (xxiv) the performance of obligations under any lawful scheme of transfer of business; (xxv) cooperating or assisting in investigations undertaken by another insurer or any of the Insurance and Takaful Associations (which includes Life Insurance Association of Malaysia (“LIAM”), General Insurance Association of Malaysia (“PIAM”); and Malaysian Takaful Association (“MTA”))

BM_Trans You understand that RHB INSURANCE BERHAD ("RHB") will use, collect, record, store, share and/or process your personal information, including, without limitation, your contact details, background information, financial data, vehicle registration number, personal information of your family members/beneficiaries/nominees and other information relevant to your application for the insurance product and/or service (“Personal Information”) which: You have provided in this form or through any other contact with RHB Banking Group (which shall include its holding company, subsidiary(s), and any associated company(s), including any company as a result of any restructuring, merger, sale or acquisition); or has been obtained from analysis of your payment and other transactions/services within the RHB Banking Group, or has been obtained from third parties such as employers, joint applicants, legal representatives, industry/financial related associations, government/regulatory authorities, credit bureaus or credit reporting agencies, retailers, social networks and fraud prevention agencies or other organizations; or (d) your relationship with RHB and RHB Banking Group, for example information provided by you in application forms when applying for your products or services, when transacting on your insurance policy, when using RHB’s online or electronic services, when taking part in customer surveys, competitions and promotions; or (e) your verbal, written and/or electronic communications with RHB or RHB’s authorised agents. for any and/or all of the following purposes (“Purpose”), which include: (i) handling applications to purchase insurance policies and/or requests for advice and product recommendations; (ii) preparing, issuing and handling other administrative matters relating to the insurance policies; (iii) collecting premiums/contributions and submitting other bills; (iv) processing and settling claims and paying other benefits; (v) regular assessment after purchase of insurance products; (vi) performing re-insurance; (vii) performing co-insurance; (viii) preventing, investigating, reporting or otherwise in relation to actual or suspected money laundering, terrorist financing, bribery, corruption, actual or suspected fraud including but not limited to insurance fraud, tax evasion, evasion of economic or trade sanctions, and criminal activities generally or other unlawful activities; (ix) establishing, exercising or defending a legal claim; (x) meeting other specific legal or contractual obligation; (xi) prospecting new insurance, including research for product and service development; (xii) internal management of RHB; (xiii) disclosure to third parties in connection to the Purpose; (xiv) audit, risk assessment, survey, statistical and analytical studies relating to the insurance business; (xv) discharging regulatory or legislative obligations; (xvi) actuarial activities; (xvii) marketing (including direct marketing) of insurance products or services by RHB; (xviii) cooperating with the Personal Data Protection Commission,BankNegara Malaysia or any other relevant authority to conduct an audit, examination or investigation which is authorised under any applicable Malaysian laws or international treaties/agreements affecting RHB, whether directly or through RHB Banking Group; (xix) the performance of obligations including customer service under a written agreement, complaints handling, conservation, including any value-added services that are connected but not directly connected to such agreement, where such agreement shall include but not be limited to general insurance, medical insurance, group insurance policies, agency contract, broking arrangements, and employment contract; (xx) investigation during underwriting and claims assessment or at any time during the concurrence of the insurance policy that is necessary and reasonable to identify any possible non-disclosure of material information in an insurance or conspiracy claim, including but not limited to the purposes of medical/health insurance, requesting and verifying information with any medical practitioner, hospital, medical institution or any person (whether incorporated or not) who has ever attended to you or has your health records; the purposes of motor insurance, requesting and verifying information with any motor companies, workshops, or any person (whether incorporated or not) who has ever attended to you or has your motor vehicles records; and RHB and/or its relevant third party service providers may keep such records for future possible cases of underwriting and claims assessment (xxi) compliance with the requirements of any law, any regulations or guidelines, any present or future contractual or other commitment with any legal, regulatory, judicial, administrative, public or law enforcement body, whether in or outside Malaysia, that are issued by regulatory or other authorities with which RHB or any other group members of RHB Banking Group need or are expected to comply, including but not limited to making any enquiries, any investigation, disclosure or reporting requirements and/or meeting obligations pursuant to such law, regulations guidelines and/or the relevant authorities; (xxii) matching of any of your Personal Information held by RHB from time to time for any of the Purpose; (xxiii) research, auditpurposesandriskassessment/survey, includingstatistical/actuarialresearchordataanalytics/study. Intheevent such data was required for this purpose, your Personal Information are not to be published, and only figures, statistics and general information in the findings of the study/research are to be published; (xxiv) the performance of obligations under any lawful scheme of transfer of business; (xxv) cooperating or assisting in investigations undertaken by another insurer or any of the Insurance and Takaful Associations (which includes Life Insurance Association of Malaysia (“LIAM”), General Insurance Association of Malaysia (“PIAM”); and Malaysian Takaful Association (“MTA”))

Terms and Conditions

RHB INSURANCE BERHAD

You understand that RHB INSURANCE BERHAD ("RHB") will use, collect, record, store, share and/or process your personal information, including, without limitation, your contact details, background information, financial data, vehicle registration number, personal information of your family members/beneficiaries/nominees and other information relevant to your application for the insurance product and/or service (“Personal Information”) which: You have provided in this form or through any other contact with RHB Banking Group (which shall include its holding company, subsidiary(s), and any associated company(s), including any company as a result of any restructuring, merger, sale or acquisition); or has been obtained from analysis of your payment and other transactions/services within the RHB Banking Group, or has been obtained from third parties such as employers, joint applicants, legal representatives, industry/financial related associations, government/regulatory authorities, credit bureaus or credit reporting agencies, retailers, social networks and fraud prevention agencies or other organizations; or (d) your relationship with RHB and RHB Banking Group, for example information provided by you in application forms when applying for your products or services, when transacting on your insurance policy, when using RHB’s online or electronic services, when taking part in customer surveys, competitions and promotions; or (e) your verbal, written and/or electronic communications with RHB or RHB’s authorised agents. for any and/or all of the following purposes (“Purpose”), which include: (i) handling applications to purchase insurance policies and/or requests for advice and product recommendations; (ii) preparing, issuing and handling other administrative matters relating to the insurance policies; (iii) collecting premiums/contributions and submitting other bills; (iv) processing and settling claims and paying other benefits; (v) regular assessment after purchase of insurance products; (vi) performing re-insurance; (vii) performing co-insurance; (viii) preventing, investigating, reporting or otherwise in relation to actual or suspected money laundering, terrorist financing, bribery, corruption, actual or suspected fraud including but not limited to insurance fraud, tax evasion, evasion of economic or trade sanctions, and criminal activities generally or other unlawful activities; (ix) establishing, exercising or defending a legal claim; (x) meeting other specific legal or contractual obligation; (xi) prospecting new insurance, including research for product and service development; (xii) internal management of RHB; (xiii) disclosure to third parties in connection to the Purpose; (xiv) audit, risk assessment, survey, statistical and analytical studies relating to the insurance business; (xv) discharging regulatory or legislative obligations; (xvi) actuarial activities; (xvii) marketing (including direct marketing) of insurance products or services by RHB; (xviii) cooperating with the Personal Data Protection Commission,BankNegara Malaysia or any other relevant authority to conduct an audit, examination or investigation which is authorised under any applicable Malaysian laws or international treaties/agreements affecting RHB, whether directly or through RHB Banking Group; (xix) the performance of obligations including customer service under a written agreement, complaints handling, conservation, including any value-added services that are connected but not directly connected to such agreement, where such agreement shall include but not be limited to general insurance, medical insurance, group insurance policies, agency contract, broking arrangements, and employment contract; (xx) investigation during underwriting and claims assessment or at any time during the concurrence of the insurance policy that is necessary and reasonable to identify any possible non-disclosure of material information in an insurance or conspiracy claim, including but not limited to the purposes of medical/health insurance, requesting and verifying information with any medical practitioner, hospital, medical institution or any person (whether incorporated or not) who has ever attended to you or has your health records; the purposes of motor insurance, requesting and verifying information with any motor companies, workshops, or any person (whether incorporated or not) who has ever attended to you or has your motor vehicles records; and RHB and/or its relevant third party service providers may keep such records for future possible cases of underwriting and claims assessment (xxi) compliance with the requirements of any law, any regulations or guidelines, any present or future contractual or other commitment with any legal, regulatory, judicial, administrative, public or law enforcement body, whether in or outside Malaysia, that are issued by regulatory or other authorities with which RHB or any other group members of RHB Banking Group need or are expected to comply, including but not limited to making any enquiries, any investigation, disclosure or reporting requirements and/or meeting obligations pursuant to such law, regulations guidelines and/or the relevant authorities; (xxii) matching of any of your Personal Information held by RHB from time to time for any of the Purpose; (xxiii) research, auditpurposesandriskassessment/survey, includingstatistical/actuarialresearchordataanalytics/study. Intheevent such data was required for this purpose, your Personal Information are not to be published, and only figures, statistics and general information in the findings of the study/research are to be published; (xxiv) the performance of obligations under any lawful scheme of transfer of business; (xxv) cooperating or assisting in investigations undertaken by another insurer or any of the Insurance and Takaful Associations (which includes Life Insurance Association of Malaysia (“LIAM”), General Insurance Association of Malaysia (“PIAM”); and Malaysian Takaful Association (“MTA”))

BM_Trans You understand that RHB INSURANCE BERHAD ("RHB") will use, collect, record, store, share and/or process your personal information, including, without limitation, your contact details, background information, financial data, vehicle registration number, personal information of your family members/beneficiaries/nominees and other information relevant to your application for the insurance product and/or service (“Personal Information”) which: You have provided in this form or through any other contact with RHB Banking Group (which shall include its holding company, subsidiary(s), and any associated company(s), including any company as a result of any restructuring, merger, sale or acquisition); or has been obtained from analysis of your payment and other transactions/services within the RHB Banking Group, or has been obtained from third parties such as employers, joint applicants, legal representatives, industry/financial related associations, government/regulatory authorities, credit bureaus or credit reporting agencies, retailers, social networks and fraud prevention agencies or other organizations; or (d) your relationship with RHB and RHB Banking Group, for example information provided by you in application forms when applying for your products or services, when transacting on your insurance policy, when using RHB’s online or electronic services, when taking part in customer surveys, competitions and promotions; or (e) your verbal, written and/or electronic communications with RHB or RHB’s authorised agents. for any and/or all of the following purposes (“Purpose”), which include: (i) handling applications to purchase insurance policies and/or requests for advice and product recommendations; (ii) preparing, issuing and handling other administrative matters relating to the insurance policies; (iii) collecting premiums/contributions and submitting other bills; (iv) processing and settling claims and paying other benefits; (v) regular assessment after purchase of insurance products; (vi) performing re-insurance; (vii) performing co-insurance; (viii) preventing, investigating, reporting or otherwise in relation to actual or suspected money laundering, terrorist financing, bribery, corruption, actual or suspected fraud including but not limited to insurance fraud, tax evasion, evasion of economic or trade sanctions, and criminal activities generally or other unlawful activities; (ix) establishing, exercising or defending a legal claim; (x) meeting other specific legal or contractual obligation; (xi) prospecting new insurance, including research for product and service development; (xii) internal management of RHB; (xiii) disclosure to third parties in connection to the Purpose; (xiv) audit, risk assessment, survey, statistical and analytical studies relating to the insurance business; (xv) discharging regulatory or legislative obligations; (xvi) actuarial activities; (xvii) marketing (including direct marketing) of insurance products or services by RHB; (xviii) cooperating with the Personal Data Protection Commission,BankNegara Malaysia or any other relevant authority to conduct an audit, examination or investigation which is authorised under any applicable Malaysian laws or international treaties/agreements affecting RHB, whether directly or through RHB Banking Group; (xix) the performance of obligations including customer service under a written agreement, complaints handling, conservation, including any value-added services that are connected but not directly connected to such agreement, where such agreement shall include but not be limited to general insurance, medical insurance, group insurance policies, agency contract, broking arrangements, and employment contract; (xx) investigation during underwriting and claims assessment or at any time during the concurrence of the insurance policy that is necessary and reasonable to identify any possible non-disclosure of material information in an insurance or conspiracy claim, including but not limited to the purposes of medical/health insurance, requesting and verifying information with any medical practitioner, hospital, medical institution or any person (whether incorporated or not) who has ever attended to you or has your health records; the purposes of motor insurance, requesting and verifying information with any motor companies, workshops, or any person (whether incorporated or not) who has ever attended to you or has your motor vehicles records; and RHB and/or its relevant third party service providers may keep such records for future possible cases of underwriting and claims assessment (xxi) compliance with the requirements of any law, any regulations or guidelines, any present or future contractual or other commitment with any legal, regulatory, judicial, administrative, public or law enforcement body, whether in or outside Malaysia, that are issued by regulatory or other authorities with which RHB or any other group members of RHB Banking Group need or are expected to comply, including but not limited to making any enquiries, any investigation, disclosure or reporting requirements and/or meeting obligations pursuant to such law, regulations guidelines and/or the relevant authorities; (xxii) matching of any of your Personal Information held by RHB from time to time for any of the Purpose; (xxiii) research, auditpurposesandriskassessment/survey, includingstatistical/actuarialresearchordataanalytics/study. Intheevent such data was required for this purpose, your Personal Information are not to be published, and only figures, statistics and general information in the findings of the study/research are to be published; (xxiv) the performance of obligations under any lawful scheme of transfer of business; (xxv) cooperating or assisting in investigations undertaken by another insurer or any of the Insurance and Takaful Associations (which includes Life Insurance Association of Malaysia (“LIAM”), General Insurance Association of Malaysia (“PIAM”); and Malaysian Takaful Association (“MTA”))

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