New Travel Case

Tokio Marine Travel — proposal details

Capture the customer and trip details for the Tokio Marine Travel Insurance Proposal Form. Saved details belong to the case and are used to fill the official PDF template.

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Form completion

12 required details outstanding

Outstanding: Proposer name, Proposer NRIC / passport, Address, Postcode, Nationality, Trip type, Area of travel, Period from, Period to, Plan, Total premium, At least one insured person.

1. Proposer details

Proposer full name *NRIC / Passport No. *Tax identification numberAddress *Postcode *Nationality *RacePhone (home)MobileEmail

2. Trip details

Trip type *Area of travel *Destination countriesPeriod from *Period to *Number of days

The printed form’s tick boxes are currently calibrated for Single Trip, Area 1 and the Basic plan. Other selections are typed into the case and left for manual ticking on the printed form.

3. Insured persons

Name (proposer/self) *NRIC / Passport / Birth certRelationshipDate of birthPremium (RM)

NameNRIC / Passport / Birth certRelationshipDate of birthPremium (RM)

4. Plan and premium

Plan *Premium (RM)Total premium (RM) *

5. Nomination (optional)

Nominee 1 nameNRIC / PassportDate of birthAddressRelationshipShare %

Nominee 2 nameNRIC / PassportDate of birthAddressRelationshipShare %

Nominee 3 nameNRIC / PassportDate of birthAddressRelationshipShare %

Nominee 4 nameNRIC / PassportDate of birthAddressRelationshipShare %

Witness nameWitness NRICWitness addressWitness date

Nominee shares should total 100% when nomination is used. Witness and proposer signatures are collected manually on the printed form.

6. Payment (details only)

Payment methodPayment amount (RM)Payment date

BaoXianFlow records payment references only. Card numbers are never captured; the customer completes the card section on the printed form. No payment is collected through this system.

7. Declaration and verification

Customer consents to marketing communication (optional).

Declaration dateVerifying agent nameVerifying agent code / IDVerification date

Declaration, witness, agent and group signatures are marked “Signature required” on the prepared PDF and must be signed manually.

Before sending to insurer

Prepared document checklist

Prepared document only. Verify details before insurer submission.

☐Prepared document only. Verify details before insurer submission.
☐Review proposer, travel, insured person, plan and premium details on page 1.
☐Review nominee details on page 3 if nomination data is included.
☐Signature fields are marked as required in normal PDF output.
☐Debug PDF output may show labelled sample signature placeholders for layout review.
☐Review witness, proposer and payment details on page 4.
☐Review declaration consent, signature requirement and date on page 5.
☐Review agent and group verification details on page 6.
☐Verify the premium and insurer source before submission.

Signatures required

Page	Signature	Required when	Who signs
Page 4	Signature of Witness	Nomination section completed	Normal PDF marks this as signature required.
Page 4	Signature of Proposer	Nomination section completed	Normal PDF marks this as signature required.
Page 4	Payment / credit card signature	Payment is by credit card	Normal PDF marks this as signature required.
Page 5	Acknowledgement & Declaration - Signature of Proposer	Always	Normal PDF marks this as signature required.
Page 5	Date	Always	Filled from the saved declaration date when provided.
Page 6	Verification of Applicant's Identification - Signature / Name / IC No. / Date	Identity verification required	Normal PDF marks the signature as required; typed details are filled.
Page 6	Group Insurance verification signature	Group insurance applies	Normal PDF marks this as signature required.

Prepared PDF output marks signature fields as “Signature required”. Signatures are collected manually on the printed form.