«Agree»

You confirm that the information provided above is true and correct, and that you have registered with the Ministry of Industry, Science, Technology and Innovation.  Manulife may use the information we collect from you to administer your insurance policies, sell additional insurance products, and file reports with competent authorities. You understand that Manulife protects your information with appropriate data protection measures and retains it only for as long as necessary or as required by law. You have the right to obtain a copy and amend your information and consent to Manulife contacting you by telephone

You authorize any licensed physician, medical professional, hospital, clinic, or other health entity, whether in or outside of Cambodia, that has health records or information and your medical history, shared with Manulife and for the company to collect and use that information to assess claims or other related issues related to your insurance policy. You agree to cooperate with the Company and its sales representatives to enable the Company to verify all information provided as necessary for any purposes related to the insurance policy and payment of compensation. Your records will be strictly and appropriately managed in accordance with Company policy or applicable law, and will only be used for the purpose of conducting Company business and with your consent.

By submitting this form, you will automatically enroll in Manulife's Financial Strength Program and receive the benefits listed above. If you provide incorrect information, you will not receive these benefits without notice.

Please click "Agree" and "Submit" to register.