Allianz Business Shield (cover selection panel) (By Grouping)Δ Notify BUSINESS INFORMATIONNew Business Registration no.Old Business Registration no.Business NameContact Person NameContact Person EmailContact Person Mobile NoBusiness Fixed Line NoBusiness AddressAddress Line 1CityStatePostcodeCountrySelect CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)ReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwePreviousNextPREMISE INFORMATIONBuilding storey 1 storey 2 storey 3 storey 4 storey 5 storey More than 5 storeyDo you roughly know the age of the building? 0 To 5 Years 6 To 10 Years 11 To 20 Years More Than 20 Years I am not sure (Unknown)Construction of wall Fully Brick Walls And/Or 2 Hours Fire Resistance Partly Brick Walls And Partly Of Non-Combustible Material And/Or Wholly Of Glass Partly Brick/Wood Walls Or Other Combustible Material Not Exceeding 50% Of Total Wall Area Partly Brick/Wood Walls Or Other Combustible Material Exceeding 50% Of Total Wall AreaConstruction of Roof Non-Combustible Material Combustible MaterialNature of Building- Select -Office Buildings And Contents- Not More Than 50% Of The Total Floor Area Occupied For Retail Trading PurposesGeneral MerchandiseGeneral StorageDoctors And Dentists Clinics/ Surgeries & Consulting RoomsBakeries, Biscuit, Confectionery And Candy ManufactureHair Dressing Salon/Beauty SalonPrintersPhotographic,Art & Advertising StudiosOptical Instrument And Lens ManufactureAnimal FarmsAbrasive Paper And Powder ManufactureAcid, Alkali And Dry Ice ManufactureAir Transport Premises Including HangarsAmusement Arcades/Parks, Billard Halls And Snooker CentresAssembly Or Manufacture Of Plastic Goods From Readymade Plastics Not Involving Processing Of Plastic Resins Or Compounds Or Extrusion, Blowing Or Injection MouldingBird Nest CultivationBottle/Packed Drinking Water And Soft Drink ManufactureBreweries Including BlendingBuildings In Course Of Construction (B.I.C.C) And Materials On Site (Other Than Woodworking Risks)Car ParksCement/Concrete Products ManufactureCinemas And TheatresCoffee Shops And RestaurantsCompressed And Liquefied Industrial And Domestic Gas (Other Than Liquefied Petroleum Gas) ManufactureCosmetics ManufactureCosmetics ManufactureCyber Café ( With Or Without Food Being Served)Dairy Produce ManufactureDepartmental Stores, Emporiums, Supermarkets, Mini-Markets And Shopping ComplexesDistilleriesEngineering Premises,Blacksmith ( General Metal Works)Exhibitions, Halls, Trade Fairs, Other Concert And Meeting Halls And Auctioneers' PremisesFuneral Parlour And CrematoriaHospitals,Nursing Homes,Orphanages,Welfare Homes,Veterinary Surgeries& Animals HospitalsHotels, Boarding Houses, Rest Houses And ChaletsLaundries/ Launderettes And Dry CleanersManufacture/Assembly Of Electronic Components, Equipment And Appliances & Semi-Conductor Risks (Excluding Wafer Manufacture)Manufacture/Assembly Of Mechanical Plant, Machinery, Tools, Equipment And Appliances, Incl Boilers, Turbines, Engines Etc.Manufacture/Assembly Of Motor Vehicles And Cycles, Bicycles, Trishaws And Vehicle Spare PartsMarket/Wholesale Market (Wet)Medicinal And Pharmaceutical Preparations Manufacture Including Herbal ProductsMeehoon, Noodles And Related ProductsMetal Cans And Containers ManufactureMetal Screws And Nails ManufactureMotor Repairs Workshops, Garages And Service Stations ( With Spray Painting)Motor Repairs Workshops, Garages And Service Stations ( Without Spray Painting)Motor Vehicles And Cycles, Bicycles And Agricultural Implements ( Premises Used As Showrooms And Salesroom Only)Motor Vehicles In The OpenOther Non-Metallic Mineral Products Manufacture Not Otherwise ClassifiedPetrol StationPottery Works, Tiles, Bricks, China, Earthenware ManufacturePower House/Generator House Pump House And Substation In Privately Owned Factories And/Or Undertaking Solely For Own Private ConsumptionRadio, Television Transmitting Stations And Studios; Wireless Paging Service CentresReligious Institutions, Libraries And MuseumsSauna,Turkish Baths And Massage ParloursSignboard Maker/Frame Maker PremisesSmelting Works And FoundriesSoaps And Washing Powder ManufactureSocial/Cultural/Political/Athletic And Sports Clubs, Water Theme ParksTreatment Of Metal Products; ElectroplatingUniversities, Colleges & SchoolWire And Cable ManufactureWire And Cable ManufactureType of Industry- Select -RetailHotel, Offices, Other Simple OccupanciesFood ProcessingMetal Work, EngineeringMotor Trade And Related RisksCinemas, Studios & Exhibition HallsPaper & PrintingPlasticsGeneral StorageConstructionBeveragesChemicalsNon-Metallic MineralsRestaurants, Places Of RecreationUtilitiesTransportOTHERSPreviousNextMAIN COVERAGE (FIRE INSURANCE PROTECTION)(You can select all, and minimum atleast 1 main coverage)MAIN COVER SELECTION PANEL BUILDING FURNITURE, FIXTURES AND FITTINGS PLANT/MACHINERY STOCK CONTENTS RENTAL REMOVAL OF DEBRIS MOVEABLE AND IMMOVEABLE PROPERTIES INCONVENIENCE RELIEF BENEFIT/PROFIT SHIELD ARCHITECTS, ENGINEERS, CONSULTANTS FEESDISCOUNTYou are entitled for discount if the below item installed in your premise: Fea - Portable Fire Extinguishers Or Buckets Fea - Hydraulic Hose Reels Or Internal Hydrants With Small Bore Hose Attached Complying With General RequirementsCOVERAGE : BUILDINGCOVERAGE : BUILDING On Building (Excluding Foundation) On Building (Including Foundation) NO. I don't need thisSum Insured for Building RMCOVERAGE : ON FURNITURE, FIXTURES & FITTINGSCOVERAGE : ON FURNITURE, FIXTURES & FITTINGS YES. I need this protection NO. I don't need thisSum Insured for Furnitures, Fixtures & FittingsRMCOVERAGE : ON PLANT & MACHINERYCOVERAGE : ON PLANT/MACHINERY YES. I need this protection NO. I don't need thisSum Insured for Plant & MachineryRMCOVERAGE : ON STOCKCOVERAGE : ON STOCK YES. I need this protection NO. I don't need thisSum Insured for StockRMCOVERAGE : ON CONTENTSCOVERAGE : ON CONTENTS YES. I need this protection NO. I don't need thisSum Insured for ContentsRMCOVERAGE : ON ARCHITECTS, SURVEYORS, ENGINEERS AND CONSULTANT FEESCOVERAGE : ON ARCHITECTS, SURVEYORS, ENGINEERS AND CONSULTANT FEES YES. I need this protection NO. I don't need thisSum Insured for Architects, Surveyors, Engineers, & Consultant FeesRMCOVERAGE : ON RENTALCOVERAGE : ON RENTAL YES. I need this protection NO. I don't need thisOccupier type- Select -Owner Non-OccupierOwner-OccupierTenant-OccupierMonth CoveredMonthSum Insured for Rental SumRMCOVERAGE : ON REMOVAL OF DEBRISCOVERAGE : ON REMOVAL OF DEBRIS YES. I need this protection NO. I don't need thisSum Insured for Removal of DebrisRMCOVERAGE : ON MOVEABLE AND IMMOVEABLE PROPERTIESCOVERAGE : ON MOVEABLE AND IMMOVEABLE PROPERTIES YES. I need this protection NO. I don't need thisSum Insured for Moveable & Immoveable propertiesRMCOVERAGE : ON INCONVENIENCE RELIEF BENEFIT OR ON PROFIT SHIELDCOVERAGE : ON INCONVENIENCE RELIEF BENEFIT OR ON PROFIT SHIELD On Inconvenience Relief Benefit On Profit Shield NO. I don't need thisSum Insured Per Day- Select -RM500RM1,000RM1,500RM2,000Number of Days Covered- Select -306090120150180Profit Before TaxRMAudited report period fromAudited report period toPreviousNextADDITIONAL COVERAGE1.PROTECTION AGAINST BUSINESS EXPOSURE(This is an optional coverage. You can ignore if you don't need such protection)SELECTION PANEL - PROTECT AGAINST BUSINESS EXPOSURE ALL RISK PUBLIC LIABILITY EMPLOYER'S LIABILITYALL RISKOn All Office Equipment And Machineries Of Every Description Which Is Owned / Leased Or Under The Control Or Custody Of Insured Whilst Contained Therein, Unless Specifically Excluded In This Cover.Coverage : All Risks YES. I need this protection NO. I don't need thisSum Insured for All RiskRMPUBLIC LIABILITYArising Out Of The Fault And Negligence Of The Insured Or Of Any Person In The Insured'S Service Whilst Engaged In The Insured'S Trade Or Business Or By Any Defect In The Buildings, Ways, Works, Plant Or Machinery At The Situation Of Risks Stated In The Schedule, Unless Specifically Excluded In This Cover.Coverage : Public Liability YES. I need this protection NO. I don't need thisLimit of Indemnity for Public Liability (Any one accident)RMEMPLOYER'S LIABILITYOn All Employees Of The Insured Excluding Socso Contributors/Contract Staff, Unless Specifically Excluded In This Cover.Coverage : Employer's Liability YES. I need this protection NO. I don't need thisEmployer's Estimated Earnings RMPreviousNextADDITIONAL COVERAGESAFEGUARD YOUR BUSINESS ASSETS(This is an optional coverage. You can ignore if you don't need such protection)SELECTION PANEL - SAFEGUARD YOUR BUSINESS ASSETS MOBILE PLANT & EQUIPMENT BURGLARY MONEY IN PREMISE MONEY IN TRANSIT GLASS FIDELITY MACHINERY BREAKDOWN DETERIORATION OF STOCK ELECTRONIC SHIELD GOODS IN TRANSITMOBILE PLANT & EQUIPMENTOn All Mobile Equipment Of Every Description Related To Insured'S Trade Or Business Whilst In The Insured'S Premises Or Within The Fenced Up Compound, Unless Specifically Excluded In This Cover.Coverage : Mobile Plant and Equipment YES. I need this protection NO. I don't need thisSum Insured for Mobile Plant & EquipmentRMBURGLARYOn All Property Of Every Description Including Goods Held In Trust Or On Commission Whilst In The Insured'S Premises, Unless Specifically Excluded In This Cover.Coverage : Burglary YES. I need this protection NO. I don't need thisFirst Loss Sum Insured for BurglaryRMMONEY IN PREMISESMoney In Premises, Unless Specifically Excluded In This Cover.Coverage : Money In Premises YES. I need this protection NO. I don't need thisLimit of Liability for Money In PremisesRMMONEY IN TRANSITMoney In Transit From Insured'S Premises To Bank And Vice Versa, Unless Specifically Excluded In This Cover.Coverage : Money In Transit YES. I need this protection NO. I don't need thisLimit of Liability for Money In TransitRMGLASSOn All Plate Glass Of Every Description Fixed In Insured Premises And Common Area Including Frames/Framework Carpentry Or Metal Works For The Necessary Reinstatement Embossing Or Lettering, Unless Specifically Excluded In This Cover.Coverage : Glass YES. I need this protection NO. I don't need thisSum Insured for GlassRMFIDELITYOn All Insured'S Employees Engaged In Connection With The Insured'S Trade Or Business, Unless Specifically Excluded In This Cover.Coverage : Fidelity YES. I need this protection NO. I don't need thisLimit of Guarantee for FidelityRMMACHINERY BREAKDOWNOn All Plant, Machinery, Mechanical Equipment And Apparatus Contained Therein, Unless Specifically Excluded In This Cover.Coverage : Machinery Breakdown YES. I need this protection NO. I don't need thisSum Insured for Machiney BreakdownRMDETERIORATION OF STOCKOn All Perishable Stock-In-Trade Held In Trust Or On Commission Related To The Insured'S Trade Or Business Stored In The Cold Room Or Freezer, Unless Specifically Excluded In This Cover.Coverage : Deterioration of Stock YES. I need this protection NO. I don't need thisSum Insured for Deterioration of StockRMELECTRONIC SHIELD - SECTION 1 - MATERIAL DAMAGEOn All Electronic Equipments By Theft Consequence Upon Violent And Forcible Entry And Accidental Damage Only, Unless Specifically Excluded In This Cover.Coverage : Electronic Shield - Section 1 - Material Damage YES. I need this protection NO. I don't need thisSum Insured for Electronic Shield - Section 1 - Material DamageRMELECTRONIC SHIELD - SECTION 2 - DATA MEDIA COVEROn Data And Data Media Cover Related To Insured'S Trade Or Business, Unless Specifically Excluded In This Cover.Coverage : Electronic Shield - Section 2 - Data Media Cover YES. I need this protection NO. I don't need thisSum Insured for Electronic Shield - Section 2 - Data Media CoverRMELECTRONIC SHIELD - SECTION 3 - INCREASED COST OF WORKINGOn Increased Cost Of Working Related To Insured'S Trade Or Business In Order To Avoid Business Interruption (Downtime) After An Indemnifiable Loss To Insured Items, Unless Specifically Excluded In This Cover.Coverage : Electronic Shield - Section 3 - Increased Cost Of Working YES. I need this protection NO. I don't need thisSum Insured for Electronic Shield - Section 3 - Increased Cost of WorkingRM(A) Maximum Indemnity Period(A) Maximum Indemnity Period Type- Select -WeeksMonths(B) Time Excess(B) Time Excess Type- Select -H - HoursD - DaysW - WeeksM - MonthsY - YearGOODS IN TRANSITOn All Legal General Merchandise/ Manufactured Products Shipped Conventionally, Fcl And Lcl Containers, Unless Specifically Excluded In This Cover.Coverage : Goods in Transit YES. I need this protection NO. I don't need thisMaximum anyone carrying Goods In TransitRMPreviousNextADDITIONAL COVERAGELOOK AFTER YOUR EMPLOYEES(This is an optional coverage. You can ignore if you don't need such protection)SELECTION PANEL - LOOK AFTER YOUR EMPLOYEES WORKMEN COMPENSATION GROUP PERSONAL ACCIDENT ALLIANZ HOSPITAL INCOMEWORKMEN'S COMPENSATIONOn All Insured'S Employees In Connection With The Insured'S Trade Of Business, Unless Specifically Excluded In This Cover.Coverage : Workmen's Compensation YES. I need this protection NO. I don't need thisSum Insured for Workmen's CompensationRMGROUP PERSONAL ACCIDENTYou can add different group of Group PA, for example [Group 1 - Clerical and below] , [Group 2 - Operation staff], [Group 3 - Upper Management Staff]Coverage : Group Personal Accident YES. I need this protection NO. I don't need thisGPA Group 1 add group checkbox I want to add another groupGroup NameNo. of EmployeeBenefit - Death & Permanent Disablement (RM per employee)RMper EmployeeCoverage : Group Personal Accident (Group 2) YES. I need this protectionGPA Group 2 add group checkbox I want to add another groupGroup 2 NameNo. of Employee in Group 2Benefit - Death & Permanent Disablement (RM per employee) for Group 2RMper EmployeeCoverage : Group Personal Accident (Group 3) YES. I need this protectionGPA Group 3 add group checkbox I want to add another groupGroup 3 nameNo. of Employee in Group 3Benefit - Death & Permanent Disablement (RM per employee) for Group 3RMper EmployeeCoverage : Group Personal Accident (Group 4) YES. I need this protection I need more groupGroup 4 nameBenefit - Death & Permanent Disablement (RM per employee) for Group 4RMper EmployeeNo. of Employee in Group 4ALLIANZ HOSPITAL INCOMEDo you need Allianz Hospital Income protection for you and your employee? YES. I want to opt for Allianz Hospital Income NO. I don't need Allianz Hospital IncomePlan 1 (RM100 benefit) : No. of employeeHow many person do you want to cover?Plan 1 : Total PremiumRMYearlyPlan 2 (RM300benefit) : No. of employeeHow many person do you want to cover?Plan 2 : Total PremiumRMYearlyPlan 3 (RM500benefit) : No. of employeeHow many person do you want to cover?Plan 3 : Total PremiumRMYearlyTotal Allianz Hospital Income Coverage PremiumRMYearlyPreviousNextPREFERRED PAYMENT METHODPreferred Payment Method Direct Transfer / Bank-in Online Payment (FPX) Offline Debit/Credit Card OR E-Wallet (For Klang Valley Customers Only)DECLARATION I have read and agree to the Terms and Conditions and Privacy Policy Previous
