Notice of Cancellation
                                               Customer Care Department
             To:                                                                                                                                                  
                                               Chubb Insurance Malaysia Berhad
                                               Wisma Chubb
                                               38 Jalan Sultan Ismail
                                               50250 Kuala Lumpur
             Subject:                         Policy Cancellation
             Policyholder’s Name:
             NRIC No.:
             Policy No.(s) 
             I/We hereby give you, Chubb Insurance Malaysia Berhad (“Chubb”) one (1) month’s written notice to cancel the abovementioned Policy(ies), 
             subject always to the terms and conditions of the Policy(ies).
             Reason for cancellation:
             Thank you.
             Yours faithfully,
             Policyholder’s Signature
             Name:
             NRIC No.:
             Mobile No.:
             Email:
             Date:
             Note: Kindly email the completed Notice of Cancellation to CustomerCare.MY@chubb.com. Alternatively, you may fax it to 03-20583088. 
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            Published 01/21/V1