Medical Insurance Application Form
You deserve your peace of mind while paying the medical bills when uncertainty happens.
Get covered with the right insurance and insurer.

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Disclaimer
We will use the information you provide to search our records for service relevant purposes in the future. We may access and use your information (including transactional information) to allow us to assess your premium. This will only be used with your best interest in mind.

Upon quotation, renewal and when some policy amendments are requested, we will contact respective insurer company to check your policy status and your identity. These searches do not affect your policy, and may be visible to other SamIValue Trading & Services representatives.
SamIValue Trading & Services Commitment
1.  Guarantee the privacy of client information.

2.   Handle service requests with due reasonable care based on registration information received. All service requests will be sent to the client for confirmation and they must contact SamIValue Trading & Services in case of error.

3.   Insurance terms, descriptions of coverage and other insurance information is for reference purposes only and is not meant to be a complete and thorough representation of the policy itself. The client should contact SamIValue Trading & Services or read their policy agreement for a detailed description of their policy.

4.  No changes will be considered binding until the client has received confirmation from SamIValue Trading & Services of such changes.

5.  While we do our best to physically and electronically safeguard our online service, we shall not be liable for, any damages to, or viruses that may infect, your computer equipment or other property as a result of your access to, use of, or browsing in our site or your downloading any materials, data, text, images, video or audio from our website.
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