PA Online Intake Form

Stay Protected, Wherever Life Takes You.

PremierUltra PA keeps you and your family covered around the clock — from just RM0.30/day.

1. Pick Your Plan 2. Fill In Details 3. Submit With Confidence
Start Application Compare Plans
Young family protected by PremierUltra PA

All-New

Tokio Marine PremierUltra PA

PremierUltra PA

Renewal Bonus up to 120% No-claim bonus that builds up every renewal year.
Weekly Income Replacement
Cashless Hospital Admission
Double Indemnity on Public Transport
24-Hour Worldwide Cover

Coverage Summary

What's Covered?

Tap a plan to pre-select it before you apply.

PremierUltra PA protects you and your family from accidental death, disability, and the financial impact of everyday injuries — 24 hours a day, worldwide.

Currently selected

Standard Plan

The most popular choice. Better limits and weekly benefit option for income replacement.

Continue With This Plan

Entry Plan

From RM284 / yr

Accidental Death
RM200,000
Permanent Disability
RM200,000
Medical Expenses
RM5,000
Weekly Benefit (opt.)
Available
Renewal Bonus
Up to 120%

Standard Plan

Popular

From RM496 / yr

Accidental Death
RM300,000
Permanent Disability
RM300,000
Medical Expenses
RM10,000
Weekly Benefit (opt.)
Available
Renewal Bonus
Up to 120%

Premier Plan

Best

From RM763 / yr

Accidental Death
RM500,000
Permanent Disability
RM500,000
Medical Expenses
RM20,000
Weekly Benefit (opt.)
Available
Renewal Bonus
Up to 120%

Elite Plan

Premium

From RM1,371 / yr

Accidental Death
RM1,000,000
Permanent Disability
RM1,000,000
Medical Expenses
RM30,000
Weekly Benefit (opt.)
Available
Renewal Bonus
Up to 120%

Apply Online

Get Covered in Minutes

A guided three-step application — clear, calm, and done in about 5 minutes.

Current Quote

Standard Plan
Individual RM—

Personal Details

We need your details to prepare the application. NRIC auto-fills your date of birth and gender.

Occupation Class *
Eligibility & Occupation Class Guide

Age eligibility

  • Individual / Family: 18 to 70 years old at entry
  • Renewable up to 80 years old

Class 1 & 2 (lower rate)

Office workers, managers, professionals, teachers, doctors, business owners supervising only, light admin roles.

Class 3 (higher rate, Plans 3 & 5 only)

Manual workers, mechanics, drivers, construction supervisors, food industry workers, and similar occupations.

Estimated Premium

RM—

Select a plan and complete your details to see your quote.

Choose Plan

Select your coverage level and add-ons. The premium updates live.

Plan selection * Standard is pre-selected — the most popular choice for individuals.
Coverage Type *
Weekly Income Benefit Add-on

Confirm & Pay

Check the premium, choose how to pay, and submit when ready.

Review Your Details

Double-check before payment.

Total payable RM—

Choose Payment Method

Payment Instructions

LEE MOU YEN Touch 'n Go: 012 612 3540 RHB Bank: 1040 2700 307120 Send the payment slip once done.

Before You Submit

  • You will see the final payable amount before submission.
  • Payment is checked before policy follow-up.
  • Henry reviews your details if anything looks incomplete.
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