Tokio Marine Credit Card Submission

Premium Payment Instruction (Credit Card)

Terms And Conditions

Any refund on the policy will be made to the Policyholder

Please note that administrative fees may be imposed by the bank in accordance to its respective terms and conditions in the event of premature cancellation or termination of the installment payment plan and/or credit card account.

* Required fields

Policyholder Details

Policyholder's Name *

Contact No

(HP)

(Home)

Payment Mode

Authorisation Type

Type

Instalment is only valid for Premium $500 and above.

Bank

Payment / Credit Card Details

Charge Amount *

Credit Card Number *

Expiry *

Cardholder Name *

Cardholder Signature *

* Required fields