Name:

New and improved!

Last Name First Name Middle Name
Now with COVID-19
Insurance

DATA PRIVACY I acknowledge that Malayan Insurance Company, Inc. (Malayan) may collect, use, process
and share my personal information to its employees, duly authorized representatives, other insurers,
reinsurers, adjusters, investigators, and other third party providers for purposes such as underwriting,
administration, claims adjudication and management, investment, data analytics, statistical analysis, risk
analysis/ assessment/management, financial and tax monitoring/review/reporting, protection against fraud,
errors, or misrepresentations, profiling, research, due diligence, company evaluation, studies/customer
satisfaction surveys, and compliance with legal, regulatory or contractual requirements. Further, I agree that
Malayan may notify and offer me any of its products and services that may be useful to me. In furtherance of
these purposes, my personal information, unless prohibited, may be processed outside the Philippines and
be subject to different data protection standards.
AUTHORITY TO VERIFY INFORMATION I also authorize Malayan to verify and investigate the information
given by me, including submitted documents from whatever source it may consider appropriate.
RIGHTS OF THE DATA SUBJECT I acknowledge that I have the right to access the given information and
I undertake to correct, rectify or supplement the same should any information be found to be inaccurate or
incomplete. I shall notify Malayan in writing of any changes in the information given above.
UNDERTAKING I hereby warrant that all personal information given by me are true, correct, updated to
the best of my knowledge, and freely and voluntarily given to Malayan. I agree and consent that the above
information are being collected, used, processed and recorded for purposes of securing insurance protection
or any other business transaction(s) with Malayan and for other purpose as indicated herein.
If purchasing, transacting and/or acting in behalf of other person(s), I hereby warrant that I have been duly
authorized to perform such acts and permitted to give their information to Malayan. I hereby bind myself
to advise all other persons in whose behalf I have acted, transacted with and/or purchased any product
or services from Malayan of all the terms and conditions herein. I will hold Malayan, directors, officers,
employees, agents, successors and assigns free and harmless from any liability that may arise as a result
of the authorization given above.
By signing this form, I hereby certify that I have read and understood the foregoing and this consent remains
valid and binding unless I submit a written notice to Malayan revoking or altering the same.
AUTHORITY TO DISCLOSE By ticking the box, I hereby authorize Malayan to grant the members
of the Yuchengco Group of Companies (YGC), their and Malayan’s affiliates, subsidiaries, contractors,
partners, agents and representatives, intermediaries, industry associations, and other third parties access
to my personal information, including this form, for purposes of marketing, sales or promotional information
campaigns, and provision of any products, services, or offers through mail/email/SMS/telephone, or any type
of electronic facility.

Signature: Signature:
(Client’s signature over Printed Name) (Broker, Agent or other Authorized Representative of Client) PA-A083-0221-16
(Date Signed) (Date Signed)

PRODUCT FEATURES AND BENEFITS
COVID-19 Coverage Endorsement
With the ongoing COVID-19 pandemic, compliance to safety
protocols whilst travelling may not be enough. Malayan’s Travel
Master provides coverage for hospitalization and medical
expenses due to COVID-19 infection.
*maximum of ninety (90) days travel
PERSONAL ACCIDENT
Traveling away from home comes with risks brought about by
unfamiliarity with people and places. Travel Master provides
benefit for accidental injury or loss of life.
EMERGENCY MEDICAL TREATMENT
In the event of accidental injury or sickness, this policy provides
cashless hospitalization* for medical emergencies.
PERSONAL LIABILITY
The thrill of being in a new and exciting place can sometimes
mislead a person to be carefree. Under Personal Liability cover,
expenses which the insured will be liable for due to damage to
third party property or injury to third parties can be recovered
from the policy.
RECOVERY OF TRAVEL EXPENSES
In the event of unexpected events necessitating cancellation
or premature termination of the trip, irrecoverable deposits or
charges paid in advance can be reimbursed from the policy.
TRAVEL INCONVENIENCE BENEFITS
To address hassles that sometimes come with travelling, the
Travel Master policy provides benefits for loss, delay or damage
to baggage, loss of travel documents, damage or loss of laptop,
loss of cash due to robbery, strikes or hijacking and flight delay.
VALUE-ADDED FEATURES
The Travel Master policy also comes with insurance cover for
damage to a rented car. Accidental injury sustained from trying
out a new sport or engaging in an adventure activity is also
covered.
24/7 TRAVEL ASSISTANCE BENEFITS
In partnership with Assist America, the policy provides access
to various services ranging from simple referrals (e.g. language
interpreter, legal assistance referral, etc.) to urgent and critical
exigencies (e.g. emergency medical evacuation, repatriation of
mortal remains, etc.). Other services include:
• Medical Consultation, Evaluation and Referral
• Hospital Admission Guarantee (Unlimited)
• Medical Repatriation (Unlimited)
• Critical Care Monitoring
• Transportation to Join patient (Economy round trip
ticket)
• Prescription Transfer or Replacement (Unlimited)
• Care and/or Transportation of minor children
(Unlimited)
• Emergency Message Transmission (Unlimited)
• Bail Bond Coordination (Unlimited)
• Pre-Trip and General Assistance Services (Unlimited)
Cashless Hospitalization
Just call the 24/7 Travel Assistance Hotline number of our
partner provider Assist America to directly coordinate with the
medical facility for the settlement of hospitalization expenses
incurred due to injury or sickness.
PRODUCT FEATURES AND BENEFITS PESO POLICY (PhP) DOLLAR POLICY ($)
PERSONAL ACCIDENT
Accidental Death, Dismemberment and Disablement ₱ 1,000,000.00 $ 50,000.00
Unprovoked Murder and Assault ₱ 1,000,000.00 $ 50,000.00
Including rape/sexual harrassment resulting to loss of life,
disablement and/or dismemberment
Terrorism ₱ 1,000,000.00 $ 50,000.00
Resulting to loss of life, disablement and/or dismemberment
Burial Benefit ₱ 10,000.00 $ 500.00
EMERGENCY MEDICAL TREATMENT (ACCIDENT/SICKNESS)
Local & Asian Travel ₱ 1,000,000.00 $ 50,000.00
Worldwide Travel ₱ 2,500,000.00 $ 50,000.00
EMERGENCY MEDICAL TREATMENT (COVID-19 COVER)
Asian Travel ₱ 1,500,000.00 $ 30,000.00
Worldwide Travel ₱ 2,500,000.00 $ 50,000.00
Worldwide Plus ₱ 5,000,000.00 $ 100,000.00
Follow-up Care Included Included
Hospital Cash Allowance ₱ 1,000.00 $ 75.00
Per day (due to sickness)/maximum 10 days per confinement
Hospital Cash Allowance with COVID-19 Cover
Asian Travel ₱ 3,000.00 $ 60.00
Worldwide Travel ₱ 4,000.00 $ 80.00
Worldwide Plus ₱ 5,000.00 $ 100.00
Per day (due to COVID-19)/maximum 14 days confinement
PERSONAL LIABILITY ₱ 1,000,000.00 $ 20,000.00
RECOVERY OF TRAVEL EXPENSES
Emergency Trip Cancellation ₱ 50,000.00 $ 1,000.00
Emergency Trip Termination ₱ 50,000.00 $ 1,000.00
TRAVEL INCONVENIENCE BENEFIT
Loss of Travel Documents ₱ 20,000.00 $ 500.00
Loss of Cash ₱ 5,000.00 $ 100.00
Following accidental injury; due to robbery or burglary
Damage to Laptop ₱ 5,000.00 $ 100.00
Following accidental injury of insured
Loss of Laptop ₱ 10,000.00 $ 200.00
Following accidental injury; due to robbery or burglary
Loss of Baggage ₱ 50,000.00 $ 1,000.00
Sub-limit of P5,000.00 per item Sub-limit of $ 100.00 per item
Damage of Checked-in Baggage ₱ 10,000.00 $ 200.00
Baggage Delay ₱ 5,000.00 $ 100.00
Strikes and Aircraft Hijacking ₱ 1,000.00 $ 100.00
Per day/maximum 10 days per occurrence
Flight Delay after six (6) hours waiting period ₱ 1,000.00 $ 100.00
Due to Severe Weather, Mechanical Trouble, Airline Strike Per day/maximum 10 days per occurrence
TRAVEL ASSISTANCE BENEFITS
Emergency Medical Repatriation Unlimited Unlimited
Emergency Medical Evacuation Unlimited Unlimited
Return of Mortal Remains Unlimited Unlimited
Care for Unattended Minors Unlimited Unlimited
Compassionate Visit Roundtrip Fare Roundtrip Fare
VALUE-ADDED FEATURES
Car Rental Protection ₱ 500,000.00 $ 10,000.00
Sports Activities Extension ₱ 100,000.00 $ 2,000.00
Extends Medical Treatment and Travel Assistance Benefits for
accidents due to include fitness, winter, water and extreme sports
Global Emergency Assistance During the COVID-19 Pandemic Download the Assist America Mobile App
Wherever your travels take you, you can conveniently access a wide range of
Our partner Assist America has adapted its global emergency service global emergency assistance services from your phone by downloading the
offering to provide support to members who remain away from home FREE Assist America Mobile App for iPhone and Android
during the ongoing COVID-19 pandemic. Services include:
DOWNLOAD & SET UP
 Information, Advice & Resources
 Download the Mobile App for free
 Medical Emergency Assistance  Set up your account by entering reference number for all
• Testing Site Referrals • Prescription Assistance Malayan Travel Master policyholders policy holder:
• Medical Monitoring • Return of Mortal Remains Reference No.: 63-AP-MIC-08031
Enter your home address to enable the Coverage Indicator feature
 Stranded Traveler Assistance
