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Title
Mr.
Mrs.
Ms.
Miss.
Dr.
Name
Email
Country of Coverage
Your country of coverage
Hong Kong
China
UAE (Abu Dhabi)
UAE (Dubai)
Singapore
Thailand
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bali
Bangladesh
Barbados
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia & Herzegovina
Botswana
Brazil
British Virgin Islands
British West Indies
Brunei
Bulgaria
Burkina Faso
Byanmar
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Chad
Chile
Colombia
Comoros
Costa Rica
Croatia
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Island (Islas Malvinas)
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Grenada
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Ireland
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Morocco
Mozambique
Namibia
Nauru
Nepal
Netherland Antilles
Netherlands
New Zealand
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papau New Guinea
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia & Montenegro
Seychelles
Sierra Leone
Slovakia
Slovenia
Solomon Islands
South Africa
South Korea
Spain
Sri Lanka
St Kitts & Nevis
St Lucia
St Martin
St Vincent & Grenadines
Suriname
Swaziland
Sweden
Switzerland
Taiwan
Tajikistan
Tanzania
The Republic of Congo
Togo
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Turks & Caicos
Tuvalu
UAE (Ajman)
UAE (Fujairah)
UAE (Ras al-Khaimah)
UAE (Sharjah)
UAE (Umm al-Qaiwain)
Uganda
UK
Ukraine
Uruguay
USA
Uzbekistan
Vanuatu
Venezuela
Venezuelan
Vietnam
Yugoslavia
Zambia
Nationality
Nationality
Chinese-Hong Kong
Singaporean
Thai
Albanian
Algerian
American
Andorran
Angolan
Antiguans, Barbudans
Argentinean
Armenian
Australian
Austrian
Azerbaijani
Bahamian
Bahraini
Bangladeshi
Barbadian
Basotho
Batswana, Motswana
Belgian
Belizean
Beninese
Bermudian
Bhutanese
Bolivian
Bosnian, Herzegovinian
Brazilian
British
British Virgin Islander
Bruneian
Bulgarian
Burkinabe
Cambodian
Cameroonian
Canadian
Cape Verdean
Caymanian
Chadian
Chilean
Chinese-China
Chinese-Hong Kong
Chinese-Macau
Colombian
Comoran
Costa Rican
Croatian
Cypriot
Czech
Danish
Djiboutian
Dominican
Dutch
Dutch Antillean
East Timorese
Ecuadorean
Egyptian
Emirati
Equatorial Guinean
Eritrean
Estonian
Ethiopian
Fijian
Filipino
Finnish
French
Gabonese
Gambian
Georgian
German
Ghanaian
Gibraltar
Greek
Grenadian
Guamanian
Guatemalan
Guinean
Guyanese
Haitian
Honduran
Hungarian
I-Kiribati
Icelandic
Indian
Indonesian
Irish
Israeli
Italian
Ivorian
Jamaican
Japanese
Jordanian
Kazakhstani
Kenyan
Kittitan and Nevisian
Korean
Kuwaiti
Kyrgyzstani
Laotian
Latvian
Liberian
Libyan
Liechtensteiner
Lithuanian
Luxembourger
Macedonian
Malagasy
Malawian
Malaysian
Maldivan
Malian
Maltese
Marshallese
Mauritanian
Mauritian
Mexican
Micronesian
Moldovan
Monacan
Mongolian
Moroccan
Mozambican
Namibian
Nauruan
Nepalese
New Zealander
Ni-Vanuati
Nigerian
Nigerien (Niger)
Norwegian
Omani
Pakistani
Palauan
Palestinian
Panamanian
Papua New Guinean
Paraguayan
Peruvian
Philippines
Polish
Portuguese
Puerto Rican
Qatari
Romanian
Russian
Rwandan
Saint Lucian
Saint Vincentian
Salvadoran
Sammarinese
Samoan
Sao Tomean
Saudi Arabian
Senegalese
Serbian
Seychellois
Sierra Leonean
Singaporean
Slovakian
Slovenian
Solomon Islander
South African
Spanish
Sri Lankan
Surinamese
Swazi
Swedish
Swiss
Taiwanese
Tajikistani
Tanzanian
Thai
Togolese
Tongan
Trinidadian, Tobagonian
Tunisian
Turkish
Turkmen
Turks and Caicos Islanders
Tuvaluan
Ugandan
Ukrainian
Uruguayan
Uzbekistani
Venezuelan
Vietnamese
Zambian
Zimbabwean
Country of Residence
Your Country of Residence
Hong Kong
China
UAE (Abu Dhabi)
UAE (Dubai)
Singapore
Thailand
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bali
Bangladesh
Barbados
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia & Herzegovina
Botswana
Brazil
British Virgin Islands
British West Indies
Brunei
Bulgaria
Burkina Faso
Byanmar
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Chad
Chile
Colombia
Comoros
Costa Rica
Croatia
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Island (Islas Malvinas)
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Grenada
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Ireland
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Morocco
Mozambique
Namibia
Nauru
Nepal
Netherland Antilles
Netherlands
New Zealand
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papau New Guinea
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia & Montenegro
Seychelles
Sierra Leone
Slovakia
Slovenia
Solomon Islands
South Africa
South Korea
Spain
Sri Lanka
St Kitts & Nevis
St Lucia
St Martin
St Vincent & Grenadines
Suriname
Swaziland
Sweden
Switzerland
Taiwan
Tajikistan
Tanzania
The Republic of Congo
Togo
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Turks & Caicos
Tuvalu
UAE (Ajman)
UAE (Fujairah)
UAE (Ras al-Khaimah)
UAE (Sharjah)
UAE (Umm al-Qaiwain)
Uganda
UK
Ukraine
Uruguay
USA
Uzbekistan
Vanuatu
Venezuela
Venezuelan
Vietnam
Yugoslavia
Zambia
Length of Coverage
0 to 3 months
3 to 6 months
6 to 12 months
1 year +
2 years +
Indefinite
Daytime number
Type of Coverage
Hospitalization cover
I require hospitalization and outpatient benefits
Maternity
I required maternity benefits
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