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CLINICPROTECT Preliminary Information Form



Duty of Disclosure: In addition to providing all basic information necessary to enable us to place the risk, you must ensure that you are complying with your legal duty of disclosure of all material matters relating to the risk. In particular you must satisfy yourself as to the accuracy and completeness of the information you provide to the Insurers.


In this respect, you must provide all information relating to the risk, whether favorable or not, which would influence the judgment of a prudent insurer in determining whether he will take the risk, and, if so, for what premium and on what terms.


If all such information is not disclosed by you, Insurers have the right to avoid the contract from its commencement which may lead to claims not being met.




  1. Sections A, B, C and D are mandatory. Please provide the Sums Insured for Sections A, B and C.
  2. A minimum premium of RM 75.00 will be charged for each Section (A, B and C) with a flat premium of RM 300.00 applicable for Section D.
  3. Premiums indicated are for clinics located on premises constructed with fully brick/concrete walls and concrete/ tiled roof and in buildings of not more than 5 stories tall.
    It is important that you notify us if your clinic is of different construction type as the rating may differ.
  4. Apart from Fire, you may wish to consider cover against the following perils:
    • Aircraft Impact Damage
    • Earthquake and Volcanic Eruption
    • Storm, Tempest
    • Flood
    • Explosion—Non Industrial without boilers
    • Impact Damage—including Insured’s own vehicle
    • Bursting or Overflowing of Water Tanks Apparatus or Pipes
    • Building exceeding 5 storeys
    • Others
    • Electrical Installation Clause (B)
    • Bush/Lalang Fire
    • Subsidence and Landslip
    • Spontaneous Combustion
      - By Fire only
      - Full Cover
    • Riot, Strike and Malicious Damage
    • Damage by Falling Trees or Branches and Objects therefrom
    • Smoke Damage
    • Sprinkler Leakage
      - On Buildings
      - On Contents
  5. It is important that you are aware of the all exclusions under the policy. Please read the policy jacket for further information.


EXCESS (applicable to each and every claim arising from a single occurrence or event)

  • Bursting or Overflowing of Water Tanks, Apparatus or Pipes—RM 1,000 or 1% subject to a minimum of RM 100 if the sum insured is less than RM 50,000
  • Flood—1% of Total Sum Insured or RM 2,500 whichever shall be the less
  • Impact Damage (Including own vehicle) - RM 250
  • Storm Tempest—1% of the total sum insured or RM 200 whichever shall be the less