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EZShield and HospeeFamily

Registration form exclusively for Shopee customers who wish to get coverage from Great Eastern Takaful at a special price.
ezhield

Sign up and get yourself and your loved ones covered for 3 months.


EZShield and HospeeFamily Registration Form

Fields marked with (*) are mandatory.

 

Voucher Information

General Information

Contact Information

Questionnaires


1. Are you currently receiving treatment or taking regular prescribed medication for any medical conditions (other than for common cold or flu)?
2. Have you ever been diagnosed with, consulted a medical practitioner or been given treatment for any of the following conditions: Heart attack, chest pain, high cholesterol, stroke, hypertension, diabetes, cancer, tumour or abnormal growth, hepatitis, HIV infection or AIDS, any disease or disorder of the heart, brain or nervous system, eyes or ears, thyroid, lung or respiratory system, liver, digestive system or gastrointestinal tract, kidney or urinary system, genital organs, spine or joints, immune system, blood disorder, hereditary disease or congenital abnormality, mental health or psychiatric illness, physical impairment or deformity, drug or alcohol abuse?
3. In the past 2 years, have you ever been hospitalised (except for giving birth), undergone any surgical operation, consulted a specialist or had an abnormal result from a medical investigation or diagnostic test or been advised to have any of these in future?

Important Notice

You must disclose all material facts correctly. Your application may be rejected if there is any misrepresentation, invalid voucher code, or if your application didn’t pass our customer screening against sanction listing.

Yes, I want to participate for EZShield/HospeeFamily. I confirm that I have read and understood the respective Product Disclosure Sheet and accept the Data Privacy Notice and terms and conditions of the Master Certificate. I also understand that I can only participate in only one (1) coverage at a time under this product.

For EZShield:
Product Disclosure Sheet
Data Privacy Notice
Master Certificate

For HospeeFamily:
Product Disclosure Sheet
Data Privacy Notice
Master Certificate

I agree to authorise the Takaful Operator to invest monies in the Tabarru' Fund based on Mudharabah principle. Mudharabah refers to a profit sharing agreement under the Shariah contract whereby the Takaful Operator acts as an Entrepreneur (Mudharib) that manages the collected funds in the Tabarru' Fund. In return, the Takaful Operator will be entitled to a pre agreed share of the investment profit arising from the Tabarru' Fund. The profit sharing between the Person Covered and Takaful Operator on the investment profit from the Tabarru' Fund is based on the proportion of 50% and 50% respectively. The portion distributable to the Person Covered will be channelled to any charitable organisation(s) approved by Shariah Committee of the Takaful Operator due to the short-term nature of this product and the expected amount may be too small to be distributed to the Person Covered.

I agree that after each of the finanancial year, the Underwriting Surplus (if any) arising from the Tabarru' Fund will first be allocated for contingency purposes as deemed fit by the Takaful Operator before it is shared between Person Covered and the Takaful Operator in the proportion of 50% and 50% respectively. The portion distributable to the Person Covered will be channelled to any charitable organisation(s) approved by Shariah Committee of the Takaful Operator due to the short-term nature of this product and the expected amount may be too small to be distributed to the Person Covered.

I agree to the Wakalah fees deduction (as to be mentioned in the Master Certificate) to pay for Distribution related charge which consists of management expenses.

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