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Insurance Application Follow-Up

The document is a letter from Hong Leong Assurance Berhad to Madam Liew Siau Moy requesting additional information to process her insurance application. It requests her to complete a Growths, Cysts, Lumps & Tumours Questionnaire related to a fibroid operation 10 years ago and submit copies of her latest pelvis ultrasound reports within 60 days, otherwise the application will be cancelled. It also provides contact information should she need assistance.

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nadia
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269 views1 page

Insurance Application Follow-Up

The document is a letter from Hong Leong Assurance Berhad to Madam Liew Siau Moy requesting additional information to process her insurance application. It requests her to complete a Growths, Cysts, Lumps & Tumours Questionnaire related to a fibroid operation 10 years ago and submit copies of her latest pelvis ultrasound reports within 60 days, otherwise the application will be cancelled. It also provides contact information should she need assistance.

Uploaded by

nadia
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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*UL201919114633*

UL201919114633

27 June 2019

MADAM LIEW SIAU MOY


1, JALAN TIARA 3, MUTIARA
BUKIT JALIL,
58200 KUALA LUMPUR
WILAYAH PERSEKUTUAN, MALAYSIA

A0101470 / KLANG / INDIVIDUAL AGENT

Dear Sir / Madam,

PENDING REQUIREMENT LETTER - UL201919114633

Thank you for your insurance application with us.

We would need additional information as shown below for us to process your application. Kindly note that the approval for this
application is not limited to the stated requirements below and that the Company's final underwriting decision therefore shall not
only be based on the receipt of the requirements mentioned in this letter.

LIFE ASSURED : LIEW SIAU MOY


1. Growths, Cysts, Lumps & Tumours Questionnaire pertaining to fibroid which was operated 10 years ago
2. Copy of latest pelvis ultrasound reports, if any.
Kindly complete the requirements within 60 days from the date of this letter, otherwise application will be cancelled.
Please contact our agent or our branch if you need any assistance. To ensure timely processing, please return this page with
your submitted documents.

Thank you for this opportunity to be of service.

Yours faithfully
For HONG LEONG ASSURANCE BERHAD
NEW BUSINESS DEPARTMENT

c.c. A0101470 / A0068603 / A0019903 / KLANG / / MANDY CHANG MAN YEE

This is a computer generated letter. No signature is required.

*COVERSHEET*
COVERSHEET

Hong Leong Assurance Berhad (94613-X)


Level 3, Tower B, PJ City Development, No. 15A, Jalan 219, Seksyen 51A, 46100 Petaling Jaya, Selangor, P.O. Box 120, 46710 Petaling Jaya.
Telephone +603-7650 1818 Facsimile +603-7650 1991
SIRIM
CERTIFIED TO ISO 9001 : 2008
CERT. NO. : AR 0861

Customer Service Hotline 03-7650 1288 Customer Service Hotfax 03-7650 1299 Website www.hla.com

YAPYLNB/ 27/06/2019 / MISNUIS Agency Portal / cindyng88 / 10-07-2019 3:00:23PM Page 1 of 1

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