MESPOUSECHILD

SIGN UP NOW!

Please enter your own information first, as you will be the contact person for this application.
iPlease ensure the accuracy of your contact information, as we will use it to contact you about your policy
First Name
Last Name
Gender
DOB
Mobile Number
Email Address
MY PAYMENT METHODS
 
PAY WITH MASTERCARD
Enjoy an extra 25%off now!
 
PAY WITH OTHER CREDIT CARD
Please select your payment method.
DECLARATION AND AUTHORIZATION

Please read and confirm you agree with the following.

By proceeding, you confirm the following:

  1. I declare that the information I provide in this application is complete, true and correct to the best of my knowledge.
  2. I agree to the Terms and Conditions of this promotion.
  3. I understand the provision of above information means I agree to Cigna's use and/or transfer of my personal data for direct marketing of its related insurance products and services. I have read and accepted the Personal Information Collection Statement of Cigna. I understand that I have the right to opt out of the use of my/our personal information in accordance with the options set out in the Statement. I understand that opting out will mean that Cigna or any third party provider of the specified classes of products and services will not be able to send me/us any direct marketing, targeted or special offers in the future.
Please agree the declarations to continue.
Next
SPOUSE'S DETAILS
First Name
Last Name
Gender
DOB
Identity type
Identity no.
What is your height?
cm
How much do you weigh?
kg
Smoking Habit
 YES
 NO
Next
CHILD  'S DETAILS
First Name
Last Name
Gender
DOB
Identity type
Identity no.
What is your height?
cm
How much do you weigh?
kg
Smoking Habit
 NO
Next
Payment

Do not refresh this page while your payment is being processed. The processing time may take a few minutes.

Proceed