www.aia.com.my
Open in
urlscan Pro
104.126.37.179
Public Scan
Submitted URL: http://www.aia.com.my/en/index.html
Effective URL: https://www.aia.com.my/en/index.html
Submission: On July 24 via manual from IN — Scanned from DE
Effective URL: https://www.aia.com.my/en/index.html
Submission: On July 24 via manual from IN — Scanned from DE
Form analysis 3 forms found in the DOM
<form class="search-form" id="search-form1">
<input type="hidden" name="searchExecutor" value="/en/search" id="searchExecutor">
<input type="hidden" name="type" value="123" id="search_type">
<!--*/ end, by Ocean Lan */-->
<div class="search-col-left">
<input name="keyword" data-id="search-input" class="search-input" type="search" placeholder="Type your question" tabindex="9801"
data-search-options="{"hideAllFilter":false,"hideProductsFilter":false,"hideArticlesFilter":false,"hideFormsFilter":false}" autocomplete="off">
</div>
<div class="search-col-right">
<button class="btn btn-primary go-btn" tabindex="9802">Go</button>
<button class="btn dismiss-search-btn" tabindex="9803">
<svg title="Dismiss" class="icon icon-xs hide-on-fallback " role="img">
<g>
<title>Dismiss</title>
<use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="/content/dam/aia/icons/icons.svg#closewhite-glyph"></use>
<image class="icon icon-xs " src="/content/dam/aia/icons/glyph/closewhite-glyph.png" alt="undefined" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href=""></image>
</g>
</svg>
</button>
</div>
</form><form class="curator margin-bottom-4xl" data-toggle="curator" id="product-curator-form">
<select class="curator-select curator-field curator-measurer" data-curator="measurer" style="display: none;">
<option></option>
</select>
<div class="text-center" data-curator="goal-sentence">
<span class="bt6 shrinkbt6 p4 margin-bottom-xxs"><label for="goallooking_forid">I want to</label></span>
<select class="curator-select curator-goal curator-field margin-bottom-xxs" data-curator="goal" name="looking_for" id="goallooking_forid" style="width: 12px; min-width: 14px; background-position: -4px 50%;">
<option value="default" disabled="" selected="" data-option-placeholder="">please select...</option>
<option value="i_want_a_medical_cover_or_card">obtain a medical card</option>
<option value="i_want_to_prepare_for_critical_illness_challenges">prepare for unexpected health issues</option>
<option value="i_want_to_prepare_for_unexpected_accidents">protect myself against accidents</option>
<option value="i_want_to_protect_myself">protect me and my loved ones</option>
<option value="i_want_to_grow_my_money">grow my savings</option>
<option value="i_want_to_plan_for_my_retirement">plan for my retirement</option>
<option value="i_want_the_best_for_my_kids">plan for my children's future</option>
<option value="i_want_to_protect_my_home">protect my home</option>
</select>
</div>
<div class="text-center curator-age-sentence" data-curator="1-sentence"><span class="bt6 shrinkbt6 p4 margin-bottom-xxs"></span></div>
<div class="text-center curator-age-sentence" data-curator="2-sentence"><span class="bt6 shrinkbt6 p4 margin-bottom-xxs"></span></div>
<div class="text-center curator-age-sentence" data-curator="3-sentence"><span class="bt6 shrinkbt6 p4 margin-bottom-xxs"></span></div>
<div class="text-center curator-age-sentence" data-curator="4-sentence"><span class="bt6 shrinkbt6 p4 margin-bottom-xxs"></span></div>
<div class="text-center curator-age-sentence" data-curator="5-sentence"><span class="bt6 shrinkbt6 p4 margin-bottom-xxs"></span></div>
<div class="text-center curator-age-sentence" data-curator="6-sentence"><span class="bt6 shrinkbt6 p4 margin-bottom-xxs"></span></div>
<div class="text-center curator-age-sentence" data-curator="7-sentence"><span class="bt6 shrinkbt6 p4 margin-bottom-xxs"></span></div>
<div class="text-center curator-age-sentence" data-curator="8-sentence"><span class="bt6 shrinkbt6 p4 margin-bottom-xxs"></span></div>
<p class="bt4 u2 text-center curator-age-validation" data-curator="tss-return-error-message"></p>
<p class="bt4 u2 text-center curator-age-validation" data-curator="prompt-value-error-message"></p>
<div class="margin-top-4xl">
<div class="submit button aiabase parbase">
<div class="margin-bottom-l">
<div>
<button id="btn1543850512" class="btn btn-default btn-primary center-block " type="button" onclick="buttonClick(this)" data-target="_blank">Find my products</button>
</div>
</div>
</div>
</div>
</form><form id="aia521464904">
<div class="container-fluid">
<div>
<div class="html-script section">
<div id="leads-form-target"></div>
<script>
$(function() {
$('button[data-link="#leads-form"]').addClass("leads-form-scroll");
$('button[data-link="#leads-form"]').removeAttr("data-link");
$('.list-action').find('[title*=brochure], [title*=Brochure]').closest('a').click(function() {
event.stopImmediatePropagation();
$('html, body').animate({
scrollTop: $("#leads-form").offset().top
}, 1000);
});
$('button.leads-form-scroll').click(function(event) {
event.stopImmediatePropagation();
event.preventDefault();
$('html, body').animate({
scrollTop: $("#leads-form").offset().top
}, 1000);
});
});
</script>
</div>
<div class="html-script section">
<span id="leads-form"></span>
</div>
<div class="html-script section">
<div id="form-life-planner"></div>
</div>
<div class="sub-title section">
<h4 class="h4 text-center p4 margin-top-md-5xl margin-bottom-md-3xl margin-top-sm-5xl margin-bottom-sm-l margin-top-5xl margin-bottom-l">CONNECT ME WITH AN AIA LIFE PLANNER</h4>
</div>
<div class="grid-control-2-col section">
<div class="row edit-contact-crs">
<div class="col col-md-6 col-sm-6 col-xs-12 col-md-offset-0 col-sm-offset-0 col-xs-offset-0 ">
<div>
<div class="sub-title section">
<h6 class="h6 text-left p4 margin-bottom-md-l margin-bottom-sm-l margin-bottom-l">FULL NAME</h6>
</div>
<div class="form-input form-base section">
<input type="text" class="primary-select parent-width" id="aia499789896" name="name" placeholder="e.g. John Doe" required="true" validationtype="text">
<div class="fieldError label-error" id="aia499789896_msg" requiredmessage="*Name is required"></div>
</div>
<div class="sub-title section">
<h6 class="h6 text-left p4 margin-top-md-l margin-bottom-md-l margin-top-sm-l margin-bottom-sm-l margin-top-l margin-bottom-l">Mobile Number</h6>
</div>
<div class="grid-control-2-col section">
<div class="row lead-select">
<div class="col col-md-6 col-sm-6 col-xs-6 col-md-offset-0 col-sm-offset-0 col-xs-offset-0 ">
<div>
<div class="form-dropdown form-base section">
<select class="primary-select parent-width" name="countryList" id="aia1271979061" required="true" style="color: #;">
<option value="" disabled="" selected="" data-option-placeholder="">Please Select</option>
<option value="AFG" data-code="93">Afghanistan (93)<!-- option--></option>
<option value="ALD" data-code="358">Aland Islands (358)<!-- option--></option>
<option value="ALB" data-code="355">Albania (355)<!-- option--></option>
<option value="ALG" data-code="213">Algeria (213)<!-- option--></option>
<option value="AMS" data-code="1684">American Samoa (1684)<!-- option--></option>
<option value="AND" data-code="376">Andorra (376)<!-- option--></option>
<option value="ANG" data-code="244">Angola (244)<!-- option--></option>
<option value="AGL" data-code="1264">Anguilla (1264)<!-- option--></option>
<option value="ANT" data-code="672">Antarctica (672)<!-- option--></option>
<option value="ANB" data-code="1268">Antigua and Barbuda (1268)<!-- option--></option>
<option value="ARG" data-code="54">Argentina (54)<!-- option--></option>
<option value="ARM" data-code="374">Armenia (374)<!-- option--></option>
<option value="ARU" data-code="297">Aruba (297)<!-- option--></option>
<option value="AUS" data-code="61">Australia (61)<!-- option--></option>
<option value="AUT" data-code="43">Austria (43)<!-- option--></option>
<option value="AZE" data-code="994">Azerbaijan (994)<!-- option--></option>
<option value="BHM" data-code="1242">Bahamas (1242)<!-- option--></option>
<option value="BRN" data-code="973">Bahrain (973)<!-- option--></option>
<option value="BGD" data-code="880">Bangladesh (880)<!-- option--></option>
<option value="BDS" data-code="1246">Barbados (1246)<!-- option--></option>
<option value="BLR" data-code="375">Belarus (375)<!-- option--></option>
<option value="BEL" data-code="32">Belgium (32)<!-- option--></option>
<option value="BLZ" data-code="501">Belize (501)<!-- option--></option>
<option value="BEN" data-code="229">Benin (229)<!-- option--></option>
<option value="BER" data-code="1441">Bermuda (1441)<!-- option--></option>
<option value="BHU" data-code="975">Bhutan (975)<!-- option--></option>
<option value="BOL" data-code="591">Bolivia (591)<!-- option--></option>
<option value="BOS" data-code="387">Bosnia and Herzegovina (387)<!-- option--></option>
<option value="BOT" data-code="267">Botswana (267)<!-- option--></option>
<option value="BOU" data-code="47">Bouvet Island (47)<!-- option--></option>
<option value="BRZ" data-code="55">Brazil (55)<!-- option--></option>
<option value="BIO" data-code="246">British Indian Ocean Territory (246)<!-- option--></option>
<option value="BVI" data-code="1284">British Virgin Islands (1284)<!-- option--></option>
<option value="BRU" data-code="673">Brunei Darussalam (673)<!-- option--></option>
<option value="BUL" data-code="359">Bulgaria (359)<!-- option--></option>
<option value="BUF" data-code="226">Burkina Faso (226)<!-- option--></option>
<option value="BRD" data-code="257">Burundi (257)<!-- option--></option>
<option value="CAM" data-code="855">Cambodia (855)<!-- option--></option>
<option value="CMR" data-code="237">Cameroon (237)<!-- option--></option>
<option value="CDN" data-code="1">Canada (1)<!-- option--></option>
<option value="CPV" data-code="238">Cape Verde (238)<!-- option--></option>
<option value="CAY" data-code="1345">Cayman Islands (1345)<!-- option--></option>
<option value="RCA" data-code="236">Central African Republic (236)<!-- option--></option>
<option value="CHD" data-code="235">Chad (235)<!-- option--></option>
<option value="CHI" data-code="56">Chile (56)<!-- option--></option>
<option value="CHN" data-code="86">China (86)<!-- option--></option>
<option value="CXM" data-code="61">Christmas Island (61)<!-- option--></option>
<option value="COC" data-code="61">Cocos (Keeling) Islands (61)<!-- option--></option>
<option value="COL" data-code="57">Colombia (57)<!-- option--></option>
<option value="COM" data-code="269">Comoros (269)<!-- option--></option>
<option value="CON" data-code="242">Congo (242)<!-- option--></option>
<option value="COO" data-code="682">Cook Islands (682)<!-- option--></option>
<option value="CTR" data-code="506">Costa Rica (506)<!-- option--></option>
<option value="CRO" data-code="385">Croatia (385)<!-- option--></option>
<option value="CUB" data-code="53">Cuba (53)<!-- option--></option>
<option value="CUW" data-code="599">Curacao (599)<!-- option--></option>
<option value="CYP" data-code="357">Cyprus (357)<!-- option--></option>
<option value="CZH" data-code="420">Czech Republic (420)<!-- option--></option>
<option value="DRC" data-code="243">Dem. Republic of The Congo (243)<!-- option--></option>
<option value="DNM" data-code="45">Denmark (45)<!-- option--></option>
<option value="DJI" data-code="253">Djibouti (253)<!-- option--></option>
<option value="DMC" data-code="1767">Dominica (1767)<!-- option--></option>
<option value="DOM" data-code="1">Dominican Republic (1)<!-- option--></option>
<option value="ECD" data-code="593">Ecuador (593)<!-- option--></option>
<option value="EGT" data-code="20">Egypt (20)<!-- option--></option>
<option value="ELS" data-code="503">El Salvador (503)<!-- option--></option>
<option value="ENG" data-code="44">England (44)<!-- option--></option>
<option value="EQG" data-code="240">Equatorial Guinea (240)<!-- option--></option>
<option value="ERI" data-code="291">Eritrea (291)<!-- option--></option>
<option value="EST" data-code="372">Estonia (372)<!-- option--></option>
<option value="ETH" data-code="251">Ethiopia (251)<!-- option--></option>
<option value="FAL" data-code="500">Falkland Islands (Malvinas) (500)<!-- option--></option>
<option value="FAR" data-code="298">Faroe Islands (298)<!-- option--></option>
<option value="FSM" data-code="691">Federated States of Micronesia (691)<!-- option--></option>
<option value="FJI" data-code="679">Fiji (679)<!-- option--></option>
<option value="FIN" data-code="358">Finland (358)<!-- option--></option>
<option value="FRN" data-code="33">France (33)<!-- option--></option>
<option value="FRG" data-code="594">French Guiana (594)<!-- option--></option>
<option value="FRP" data-code="689">French Polynesia (689)<!-- option--></option>
<option value="FST" data-code="262">French Southern Territories (262)<!-- option--></option>
<option value="GAB" data-code="241">Gabon (241)<!-- option--></option>
<option value="GAM" data-code="220">Gambia (220)<!-- option--></option>
<option value="GEO" data-code="32">Georgia (32)<!-- option--></option>
<option value="GMN" data-code="49">Germany (49)<!-- option--></option>
<option value="GHN" data-code="233">Ghana (233)<!-- option--></option>
<option value="GIB" data-code="350">Gibraltar (350)<!-- option--></option>
<option value="GBR" data-code="44">Great Britain (44)<!-- option--></option>
<option value="GRE" data-code="30">Greece (30)<!-- option--></option>
<option value="GLD" data-code="299">Greenland (299)<!-- option--></option>
<option value="GRN" data-code="1473">Grenada (1473)<!-- option--></option>
<option value="GUA" data-code="590">Guadeloupe (590)<!-- option--></option>
<option value="GUM" data-code="671">Guam (671)<!-- option--></option>
<option value="GCA" data-code="502">Guatemala (502)<!-- option--></option>
<option value="GUE" data-code="441481">Guernsey (441481)<!-- option--></option>
<option value="GUI" data-code="224">Guinea (224)<!-- option--></option>
<option value="GUB" data-code="245">Guinea-Bissau (245)<!-- option--></option>
<option value="GUY" data-code="592">Guyana (592)<!-- option--></option>
<option value="HAI" data-code="509">Haiti (509)<!-- option--></option>
<option value="HMI" data-code="#N/A">Heard Is. And Mcdonald Is. (#N/A)<!-- option--></option>
<option value="HON" data-code="504">Honduras (504)<!-- option--></option>
<option value="HKG" data-code="852">Hong Kong (852)<!-- option--></option>
<option value="HUN" data-code="36">Hungary (36)<!-- option--></option>
<option value="ICE" data-code="354">Iceland (354)<!-- option--></option>
<option value="IND" data-code="91">India (91)<!-- option--></option>
<option value="INA" data-code="62">Indonesia (62)<!-- option--></option>
<option value="IRN" data-code="98">Iran (98)<!-- option--></option>
<option value="IRQ" data-code="964">Iraq (964)<!-- option--></option>
<option value="IRL" data-code="353">Ireland (353)<!-- option--></option>
<option value="ISL" data-code="441624">Isle of Man (441624)<!-- option--></option>
<option value="ISR" data-code="972">Israel (972)<!-- option--></option>
<option value="ITL" data-code="39">Italy (39)<!-- option--></option>
<option value="IVC" data-code="225">Ivory Coast (225)<!-- option--></option>
<option value="JAM" data-code="1876">Jamaica (1876)<!-- option--></option>
<option value="JPN" data-code="81">Japan (81)<!-- option--></option>
<option value="JER" data-code="441534">Jersey (441534)<!-- option--></option>
<option value="JOR" data-code="962">Jordan (962)<!-- option--></option>
<option value="KAZ" data-code="7">Kazakhstan (7)<!-- option--></option>
<option value="KEN" data-code="254">Kenya (254)<!-- option--></option>
<option value="KIR" data-code="686">Kiribati (686)<!-- option--></option>
<option value="KWT" data-code="965">Kuwait (965)<!-- option--></option>
<option value="KYR" data-code="996">Kyrgyzstan (996)<!-- option--></option>
<option value="LAO" data-code="856">Laos (856)<!-- option--></option>
<option value="LAT" data-code="371">Latvia (371)<!-- option--></option>
<option value="LEB" data-code="961">Lebanon (961)<!-- option--></option>
<option value="LES" data-code="266">Lesotho (266)<!-- option--></option>
<option value="LBR" data-code="231">Liberia (231)<!-- option--></option>
<option value="LAR" data-code="218">Libya (218)<!-- option--></option>
<option value="LIE" data-code="423">Liechtenstein (423)<!-- option--></option>
<option value="LIT" data-code="370">Lithuania (370)<!-- option--></option>
<option value="LUX" data-code="352">Luxembourg (352)<!-- option--></option>
<option value="MAC" data-code="853">Macau (853)<!-- option--></option>
<option value="MCD" data-code="389">Macedonia (389)<!-- option--></option>
<option value="MAD" data-code="261">Madagascar (261)<!-- option--></option>
<option value="MLW" data-code="265">Malawi (265)<!-- option--></option>
<option value="MAL" data-code="60">Malaysia (60)<!-- option--></option>
<option value="MDV" data-code="960">Maldives (960)<!-- option--></option>
<option value="MLI" data-code="223">Mali (223)<!-- option--></option>
<option value="MTA" data-code="356">Malta (356)<!-- option--></option>
<option value="MAR" data-code="692">Marshall Islands (692)<!-- option--></option>
<option value="MTQ" data-code="596">Martinique (596)<!-- option--></option>
<option value="MRT" data-code="222">Mauritania (222)<!-- option--></option>
<option value="MAU" data-code="230">Mauritius (230)<!-- option--></option>
<option value="MAY" data-code="262">Mayotte (262)<!-- option--></option>
<option value="MEX" data-code="52">Mexico (52)<!-- option--></option>
<option value="MNC" data-code="377">Monaco (377)<!-- option--></option>
<option value="MON" data-code="976">Mongolia (976)<!-- option--></option>
<option value="MTG" data-code="382">Montenegro (382)<!-- option--></option>
<option value="MSR" data-code="1664">Montserrat (1664)<!-- option--></option>
<option value="MOR" data-code="212">Morocco (212)<!-- option--></option>
<option value="MOZ" data-code="258">Mozambique (258)<!-- option--></option>
<option value="MYN" data-code="95">Myanmar (95)<!-- option--></option>
<option value="NAM" data-code="264">Namibia (264)<!-- option--></option>
<option value="NAU" data-code="674">Nauru (674)<!-- option--></option>
<option value="NEP" data-code="977">Nepal (977)<!-- option--></option>
<option value="NTL" data-code="31">Netherlands (31)<!-- option--></option>
<option value="NTA" data-code="599">Netherlands Antilles (599)<!-- option--></option>
<option value="NCA" data-code="687">New Caledonia (687)<!-- option--></option>
<option value="NZL" data-code="64">New Zealand (64)<!-- option--></option>
<option value="NIC" data-code="505">Nicaragua (505)<!-- option--></option>
<option value="NGR" data-code="227">Niger (227)<!-- option--></option>
<option value="NIG" data-code="234">Nigeria (234)<!-- option--></option>
<option value="NIU" data-code="683">Niue (683)<!-- option--></option>
<option value="NFI" data-code="672">Norfolk Island (672)<!-- option--></option>
<option value="NKO" data-code="850">North Korea (850)<!-- option--></option>
<option value="NMI" data-code="1670">Northern Mariana Islands (1670)<!-- option--></option>
<option value="NOR" data-code="47">Norway (47)<!-- option--></option>
<option value="OPT" data-code="970">Occupied Palestinian Territory (970)<!-- option--></option>
<option value="OMN" data-code="968">Oman (968)<!-- option--></option>
<option value="PAK" data-code="92">Pakistan (92)<!-- option--></option>
<option value="PAL" data-code="680">Palau (680)<!-- option--></option>
<option value="PAN" data-code="507">Panama (507)<!-- option--></option>
<option value="PNG" data-code="675">Papua New Guinea (675)<!-- option--></option>
<option value="PAR" data-code="595">Paraguay (595)<!-- option--></option>
<option value="PER" data-code="51">Peru (51)<!-- option--></option>
<option value="PHI" data-code="63">Philippines (63)<!-- option--></option>
<option value="PIT" data-code="64">Pitcairn (64)<!-- option--></option>
<option value="POL" data-code="48">Poland (48)<!-- option--></option>
<option value="POR" data-code="351">Portugal (351)<!-- option--></option>
<option value="PUE" data-code="1787">Puerto Rico (1787)<!-- option--></option>
<option value="QTR" data-code="974">Qatar (974)<!-- option--></option>
<option value="MOL" data-code="373">Republic of Moldova (373)<!-- option--></option>
<option value="REU" data-code="262">Reunion (262)<!-- option--></option>
<option value="ROM" data-code="40">Romania (40)<!-- option--></option>
<option value="RUS" data-code="7">Russia (7)<!-- option--></option>
<option value="RWA" data-code="250">Rwanda (250)<!-- option--></option>
<option value="BAR" data-code="590">Saint Barthelemy (590)<!-- option--></option>
<option value="HEL" data-code="290">Saint Helena (290)<!-- option--></option>
<option value="SKN" data-code="1-869">Saint Kitts and Nevis (1-869)<!-- option--></option>
<option value="LUC" data-code="1758">Saint Lucia (1758)<!-- option--></option>
<option value="STM" data-code="590">Saint Martin (590)<!-- option--></option>
<option value="SPM" data-code="508">Saint Pierre and Miquelon (508)<!-- option--></option>
<option value="SVG" data-code="1-784">Saint Vincent and the Grenadines (1-784)<!-- option--></option>
<option value="SAM" data-code="685">Samoa (685)<!-- option--></option>
<option value="SMR" data-code="378">San Marino (378)<!-- option--></option>
<option value="STP" data-code="239">Sao Tome and Principe (239)<!-- option--></option>
<option value="SAU" data-code="966">Saudi Arabia (966)<!-- option--></option>
<option value="SEN" data-code="221">Senegal (221)<!-- option--></option>
<option value="SER" data-code="381">Serbia (381)<!-- option--></option>
<option value="SEY" data-code="248">Seychelles (248)<!-- option--></option>
<option value="SIE" data-code="232">Sierra Leone (232)<!-- option--></option>
<option value="SGP" data-code="65">Singapore (65)<!-- option--></option>
<option value="SXM" data-code="1-721">Sint Maarten (1-721)<!-- option--></option>
<option value="SLV" data-code="421">Slovakia (421)<!-- option--></option>
<option value="SLO" data-code="386">Slovenia (386)<!-- option--></option>
<option value="SOL" data-code="677">Solomon Islands (677)<!-- option--></option>
<option value="SOM" data-code="252">Somalia (252)<!-- option--></option>
<option value="RSA" data-code="27">South Africa (27)<!-- option--></option>
<option value="SGS" data-code="500">South Georgia & S.Sandwich Is. (500)<!-- option--></option>
<option value="KOR" data-code="82">South Korea (82)<!-- option--></option>
<option value="SPN" data-code="34">Spain (34)<!-- option--></option>
<option value="SLK" data-code="94">Sri Lanka (94)<!-- option--></option>
<option value="SUD" data-code="249">Sudan (249)<!-- option--></option>
<option value="SUR" data-code="597">Suriname (597)<!-- option--></option>
<option value="SJM" data-code="47">Svalbard and Jan Mayen (47)<!-- option--></option>
<option value="SWA" data-code="268">Swaziland (268)<!-- option--></option>
<option value="SWD" data-code="46">Sweden (46)<!-- option--></option>
<option value="SWI" data-code="41">Switzerland (41)<!-- option--></option>
<option value="SYR" data-code="963">Syria (963)<!-- option--></option>
<option value="TAI" data-code="886">Taiwan (886)<!-- option--></option>
<option value="TAJ" data-code="992">Tajikistan (992)<!-- option--></option>
<option value="TAN" data-code="255">Tanzania (255)<!-- option--></option>
<option value="THN" data-code="66">Thailand (66)<!-- option--></option>
<option value="TIM" data-code="670">Timor-Leste (670)<!-- option--></option>
<option value="TOG" data-code="228">Togo (228)<!-- option--></option>
<option value="TOK" data-code="690">Tokelau (690)<!-- option--></option>
<option value="TON" data-code="676">Tonga (676)<!-- option--></option>
<option value="TRI" data-code="1-868">Trinidad and Tobago (1-868)<!-- option--></option>
<option value="TUN" data-code="216">Tunisia (216)<!-- option--></option>
<option value="TUR" data-code="90">Turkey (90)<!-- option--></option>
<option value="TMN" data-code="993">Turkmenistan (993)<!-- option--></option>
<option value="TCI" data-code="1-649">Turks and Caicos Islands (1-649)<!-- option--></option>
<option value="TUV" data-code="688">Tuvalu (688)<!-- option--></option>
<option value="MOI" data-code="1">U.S Minor Outlying Islands (1)<!-- option--></option>
<option value="UGA" data-code="256">Uganda (256)<!-- option--></option>
<option value="UKR" data-code="380">Ukraine (380)<!-- option--></option>
<option value="UAE" data-code="971">United Arab Emirates (971)<!-- option--></option>
<option value="UKG" data-code="44">United Kingdom (44)<!-- option--></option>
<option value="USA" data-code="1">United States of America (1)<!-- option--></option>
<option value="URU" data-code="598">Uruguay (598)<!-- option--></option>
<option value="USV" data-code="340">US Virgin Islands (340)<!-- option--></option>
<option value="UZB" data-code="998">Uzbekistan (998)<!-- option--></option>
<option value="VAN" data-code="678">Vanuatu (678)<!-- option--></option>
<option value="VAT" data-code="379">Vatican City State (379)<!-- option--></option>
<option value="VEN" data-code="58">Venezuela (58)<!-- option--></option>
<option value="VIE" data-code="84">Vietnam (84)<!-- option--></option>
<option value="WAF" data-code="681">Wallis and Futuna (681)<!-- option--></option>
<option value="WSA" data-code="212">Western Sahara (212)<!-- option--></option>
<option value="YMN" data-code="967">Yemen (967)<!-- option--></option>
<option value="ZAM" data-code="260">Zambia (260)<!-- option--></option>
<option value="ZIM" data-code="263">Zimbabwe (263)<!-- option--></option>
</select>
<div class="fieldError label-error" id="aia1271979061_msg" requiredmessage="Please select your country calling code."></div>
<script type="text/javascript">
+ function($) {
"use strict";
$("#aia1271979061").click(function() {
var current = $(this).val();
if (current != null) {
$("#aia1271979061").css('color', '#554344');
}
});
$("#aia1271979061").change(function() {
$(this).css({
'color': '#554344'
});
});
}(jQuery);
</script>
</div>
</div>
</div>
<div class="col col-md-6 col-sm-6 col-xs-6 ">
<div>
<div class="form-input form-base section">
<input type="text" class="primary-select parent-width" id="aia1262479867" name="phone_number" placeholder="e.g. 123456677" required="true" re="^.{9,12}$" validationtype="text">
<div class="fieldError label-error" id="aia1262479867_msg" requiredmessage="*Mobile number is required" remessage="*Mobile number length is invalid"></div>
</div>
</div>
</div>
</div>
</div>
<div class="sub-title section">
<h6 class="h6 text-left p4 margin-top-md-l margin-bottom-md-l margin-top-sm-l margin-bottom-sm-l margin-top-l margin-bottom-l">Home/Work Phone Number</h6>
</div>
<div class="grid-control-2-col section">
<div class="row lead-select">
<div class="col col-md-6 col-sm-6 col-xs-6 col-md-offset-0 col-sm-offset-0 col-xs-offset-0 ">
<div>
<div class="form-dropdown form-base section">
<select class="primary-select parent-width" name="countryListHome" id="aia355775065" style="color: #;">
<option value="" disabled="" selected="" data-option-placeholder="">Please Select</option>
<option selected="">Please Select</option>
<option value="AFG" data-code="93">Afghanistan (93)<!-- option--></option>
<option value="ALD" data-code="358">Aland Islands (358)<!-- option--></option>
<option value="ALB" data-code="355">Albania (355)<!-- option--></option>
<option value="ALG" data-code="213">Algeria (213)<!-- option--></option>
<option value="AMS" data-code="1684">American Samoa (1684)<!-- option--></option>
<option value="AND" data-code="376">Andorra (376)<!-- option--></option>
<option value="ANG" data-code="244">Angola (244)<!-- option--></option>
<option value="AGL" data-code="1264">Anguilla (1264)<!-- option--></option>
<option value="ANT" data-code="672">Antarctica (672)<!-- option--></option>
<option value="ANB" data-code="1268">Antigua and Barbuda (1268)<!-- option--></option>
<option value="ARG" data-code="54">Argentina (54)<!-- option--></option>
<option value="ARM" data-code="374">Armenia (374)<!-- option--></option>
<option value="ARU" data-code="297">Aruba (297)<!-- option--></option>
<option value="AUS" data-code="61">Australia (61)<!-- option--></option>
<option value="AUT" data-code="43">Austria (43)<!-- option--></option>
<option value="AZE" data-code="994">Azerbaijan (994)<!-- option--></option>
<option value="BHM" data-code="1242">Bahamas (1242)<!-- option--></option>
<option value="BRN" data-code="973">Bahrain (973)<!-- option--></option>
<option value="BGD" data-code="880">Bangladesh (880)<!-- option--></option>
<option value="BDS" data-code="1246">Barbados (1246)<!-- option--></option>
<option value="BLR" data-code="375">Belarus (375)<!-- option--></option>
<option value="BEL" data-code="32">Belgium (32)<!-- option--></option>
<option value="BLZ" data-code="501">Belize (501)<!-- option--></option>
<option value="BEN" data-code="229">Benin (229)<!-- option--></option>
<option value="BER" data-code="1441">Bermuda (1441)<!-- option--></option>
<option value="BHU" data-code="975">Bhutan (975)<!-- option--></option>
<option value="BOL" data-code="591">Bolivia (591)<!-- option--></option>
<option value="BOS" data-code="387">Bosnia and Herzegovina (387)<!-- option--></option>
<option value="BOT" data-code="267">Botswana (267)<!-- option--></option>
<option value="BOU" data-code="47">Bouvet Island (47)<!-- option--></option>
<option value="BRZ" data-code="55">Brazil (55)<!-- option--></option>
<option value="BIO" data-code="246">British Indian Ocean Territory (246)<!-- option--></option>
<option value="BVI" data-code="1284">British Virgin Islands (1284)<!-- option--></option>
<option value="BRU" data-code="673">Brunei Darussalam (673)<!-- option--></option>
<option value="BUL" data-code="359">Bulgaria (359)<!-- option--></option>
<option value="BUF" data-code="226">Burkina Faso (226)<!-- option--></option>
<option value="BRD" data-code="257">Burundi (257)<!-- option--></option>
<option value="CAM" data-code="855">Cambodia (855)<!-- option--></option>
<option value="CMR" data-code="237">Cameroon (237)<!-- option--></option>
<option value="CDN" data-code="1">Canada (1)<!-- option--></option>
<option value="CPV" data-code="238">Cape Verde (238)<!-- option--></option>
<option value="CAY" data-code="1345">Cayman Islands (1345)<!-- option--></option>
<option value="RCA" data-code="236">Central African Republic (236)<!-- option--></option>
<option value="CHD" data-code="235">Chad (235)<!-- option--></option>
<option value="CHI" data-code="56">Chile (56)<!-- option--></option>
<option value="CHN" data-code="86">China (86)<!-- option--></option>
<option value="CXM" data-code="61">Christmas Island (61)<!-- option--></option>
<option value="COC" data-code="61">Cocos (Keeling) Islands (61)<!-- option--></option>
<option value="COL" data-code="57">Colombia (57)<!-- option--></option>
<option value="COM" data-code="269">Comoros (269)<!-- option--></option>
<option value="CON" data-code="242">Congo (242)<!-- option--></option>
<option value="COO" data-code="682">Cook Islands (682)<!-- option--></option>
<option value="CTR" data-code="506">Costa Rica (506)<!-- option--></option>
<option value="CRO" data-code="385">Croatia (385)<!-- option--></option>
<option value="CUB" data-code="53">Cuba (53)<!-- option--></option>
<option value="CUW" data-code="599">Curacao (599)<!-- option--></option>
<option value="CYP" data-code="357">Cyprus (357)<!-- option--></option>
<option value="CZH" data-code="420">Czech Republic (420)<!-- option--></option>
<option value="DRC" data-code="243">Dem. Republic of The Congo (243)<!-- option--></option>
<option value="DNM" data-code="45">Denmark (45)<!-- option--></option>
<option value="DJI" data-code="253">Djibouti (253)<!-- option--></option>
<option value="DMC" data-code="1767">Dominica (1767)<!-- option--></option>
<option value="DOM" data-code="1">Dominican Republic (1)<!-- option--></option>
<option value="ECD" data-code="593">Ecuador (593)<!-- option--></option>
<option value="EGT" data-code="20">Egypt (20)<!-- option--></option>
<option value="ELS" data-code="503">El Salvador (503)<!-- option--></option>
<option value="ENG" data-code="44">England (44)<!-- option--></option>
<option value="EQG" data-code="240">Equatorial Guinea (240)<!-- option--></option>
<option value="ERI" data-code="291">Eritrea (291)<!-- option--></option>
<option value="EST" data-code="372">Estonia (372)<!-- option--></option>
<option value="ETH" data-code="251">Ethiopia (251)<!-- option--></option>
<option value="FAL" data-code="500">Falkland Islands (Malvinas) (500)<!-- option--></option>
<option value="FAR" data-code="298">Faroe Islands (298)<!-- option--></option>
<option value="FSM" data-code="691">Federated States of Micronesia (691)<!-- option--></option>
<option value="FJI" data-code="679">Fiji (679)<!-- option--></option>
<option value="FIN" data-code="358">Finland (358)<!-- option--></option>
<option value="FRN" data-code="33">France (33)<!-- option--></option>
<option value="FRG" data-code="594">French Guiana (594)<!-- option--></option>
<option value="FRP" data-code="689">French Polynesia (689)<!-- option--></option>
<option value="FST" data-code="262">French Southern Territories (262)<!-- option--></option>
<option value="GAB" data-code="241">Gabon (241)<!-- option--></option>
<option value="GAM" data-code="220">Gambia (220)<!-- option--></option>
<option value="GEO" data-code="32">Georgia (32)<!-- option--></option>
<option value="GMN" data-code="49">Germany (49)<!-- option--></option>
<option value="GHN" data-code="233">Ghana (233)<!-- option--></option>
<option value="GIB" data-code="350">Gibraltar (350)<!-- option--></option>
<option value="GBR" data-code="44">Great Britain (44)<!-- option--></option>
<option value="GRE" data-code="30">Greece (30)<!-- option--></option>
<option value="GLD" data-code="299">Greenland (299)<!-- option--></option>
<option value="GRN" data-code="1473">Grenada (1473)<!-- option--></option>
<option value="GUA" data-code="590">Guadeloupe (590)<!-- option--></option>
<option value="GUM" data-code="671">Guam (671)<!-- option--></option>
<option value="GCA" data-code="502">Guatemala (502)<!-- option--></option>
<option value="GUE" data-code="441481">Guernsey (441481)<!-- option--></option>
<option value="GUI" data-code="224">Guinea (224)<!-- option--></option>
<option value="GUB" data-code="245">Guinea-Bissau (245)<!-- option--></option>
<option value="GUY" data-code="592">Guyana (592)<!-- option--></option>
<option value="HAI" data-code="509">Haiti (509)<!-- option--></option>
<option value="HMI" data-code="#N/A">Heard Is. And Mcdonald Is. (#N/A)<!-- option--></option>
<option value="HON" data-code="504">Honduras (504)<!-- option--></option>
<option value="HKG" data-code="852">Hong Kong (852)<!-- option--></option>
<option value="HUN" data-code="36">Hungary (36)<!-- option--></option>
<option value="ICE" data-code="354">Iceland (354)<!-- option--></option>
<option value="IND" data-code="91">India (91)<!-- option--></option>
<option value="INA" data-code="62">Indonesia (62)<!-- option--></option>
<option value="IRN" data-code="98">Iran (98)<!-- option--></option>
<option value="IRQ" data-code="964">Iraq (964)<!-- option--></option>
<option value="IRL" data-code="353">Ireland (353)<!-- option--></option>
<option value="ISL" data-code="441624">Isle of Man (441624)<!-- option--></option>
<option value="ISR" data-code="972">Israel (972)<!-- option--></option>
<option value="ITL" data-code="39">Italy (39)<!-- option--></option>
<option value="IVC" data-code="225">Ivory Coast (225)<!-- option--></option>
<option value="JAM" data-code="1876">Jamaica (1876)<!-- option--></option>
<option value="JPN" data-code="81">Japan (81)<!-- option--></option>
<option value="JER" data-code="441534">Jersey (441534)<!-- option--></option>
<option value="JOR" data-code="962">Jordan (962)<!-- option--></option>
<option value="KAZ" data-code="7">Kazakhstan (7)<!-- option--></option>
<option value="KEN" data-code="254">Kenya (254)<!-- option--></option>
<option value="KIR" data-code="686">Kiribati (686)<!-- option--></option>
<option value="KWT" data-code="965">Kuwait (965)<!-- option--></option>
<option value="KYR" data-code="996">Kyrgyzstan (996)<!-- option--></option>
<option value="LAO" data-code="856">Laos (856)<!-- option--></option>
<option value="LAT" data-code="371">Latvia (371)<!-- option--></option>
<option value="LEB" data-code="961">Lebanon (961)<!-- option--></option>
<option value="LES" data-code="266">Lesotho (266)<!-- option--></option>
<option value="LBR" data-code="231">Liberia (231)<!-- option--></option>
<option value="LAR" data-code="218">Libya (218)<!-- option--></option>
<option value="LIE" data-code="423">Liechtenstein (423)<!-- option--></option>
<option value="LIT" data-code="370">Lithuania (370)<!-- option--></option>
<option value="LUX" data-code="352">Luxembourg (352)<!-- option--></option>
<option value="MAC" data-code="853">Macau (853)<!-- option--></option>
<option value="MCD" data-code="389">Macedonia (389)<!-- option--></option>
<option value="MAD" data-code="261">Madagascar (261)<!-- option--></option>
<option value="MLW" data-code="265">Malawi (265)<!-- option--></option>
<option value="MAL" data-code="60">Malaysia (60)<!-- option--></option>
<option value="MDV" data-code="960">Maldives (960)<!-- option--></option>
<option value="MLI" data-code="223">Mali (223)<!-- option--></option>
<option value="MTA" data-code="356">Malta (356)<!-- option--></option>
<option value="MAR" data-code="692">Marshall Islands (692)<!-- option--></option>
<option value="MTQ" data-code="596">Martinique (596)<!-- option--></option>
<option value="MRT" data-code="222">Mauritania (222)<!-- option--></option>
<option value="MAU" data-code="230">Mauritius (230)<!-- option--></option>
<option value="MAY" data-code="262">Mayotte (262)<!-- option--></option>
<option value="MEX" data-code="52">Mexico (52)<!-- option--></option>
<option value="MNC" data-code="377">Monaco (377)<!-- option--></option>
<option value="MON" data-code="976">Mongolia (976)<!-- option--></option>
<option value="MTG" data-code="382">Montenegro (382)<!-- option--></option>
<option value="MSR" data-code="1664">Montserrat (1664)<!-- option--></option>
<option value="MOR" data-code="212">Morocco (212)<!-- option--></option>
<option value="MOZ" data-code="258">Mozambique (258)<!-- option--></option>
<option value="MYN" data-code="95">Myanmar (95)<!-- option--></option>
<option value="NAM" data-code="264">Namibia (264)<!-- option--></option>
<option value="NAU" data-code="674">Nauru (674)<!-- option--></option>
<option value="NEP" data-code="977">Nepal (977)<!-- option--></option>
<option value="NTL" data-code="31">Netherlands (31)<!-- option--></option>
<option value="NTA" data-code="599">Netherlands Antilles (599)<!-- option--></option>
<option value="NCA" data-code="687">New Caledonia (687)<!-- option--></option>
<option value="NZL" data-code="64">New Zealand (64)<!-- option--></option>
<option value="NIC" data-code="505">Nicaragua (505)<!-- option--></option>
<option value="NGR" data-code="227">Niger (227)<!-- option--></option>
<option value="NIG" data-code="234">Nigeria (234)<!-- option--></option>
<option value="NIU" data-code="683">Niue (683)<!-- option--></option>
<option value="NFI" data-code="672">Norfolk Island (672)<!-- option--></option>
<option value="NKO" data-code="850">North Korea (850)<!-- option--></option>
<option value="NMI" data-code="1670">Northern Mariana Islands (1670)<!-- option--></option>
<option value="NOR" data-code="47">Norway (47)<!-- option--></option>
<option value="OPT" data-code="970">Occupied Palestinian Territory (970)<!-- option--></option>
<option value="OMN" data-code="968">Oman (968)<!-- option--></option>
<option value="PAK" data-code="92">Pakistan (92)<!-- option--></option>
<option value="PAL" data-code="680">Palau (680)<!-- option--></option>
<option value="PAN" data-code="507">Panama (507)<!-- option--></option>
<option value="PNG" data-code="675">Papua New Guinea (675)<!-- option--></option>
<option value="PAR" data-code="595">Paraguay (595)<!-- option--></option>
<option value="PER" data-code="51">Peru (51)<!-- option--></option>
<option value="PHI" data-code="63">Philippines (63)<!-- option--></option>
<option value="PIT" data-code="64">Pitcairn (64)<!-- option--></option>
<option value="POL" data-code="48">Poland (48)<!-- option--></option>
<option value="POR" data-code="351">Portugal (351)<!-- option--></option>
<option value="PUE" data-code="1787">Puerto Rico (1787)<!-- option--></option>
<option value="QTR" data-code="974">Qatar (974)<!-- option--></option>
<option value="MOL" data-code="373">Republic of Moldova (373)<!-- option--></option>
<option value="REU" data-code="262">Reunion (262)<!-- option--></option>
<option value="ROM" data-code="40">Romania (40)<!-- option--></option>
<option value="RUS" data-code="7">Russia (7)<!-- option--></option>
<option value="RWA" data-code="250">Rwanda (250)<!-- option--></option>
<option value="BAR" data-code="590">Saint Barthelemy (590)<!-- option--></option>
<option value="HEL" data-code="290">Saint Helena (290)<!-- option--></option>
<option value="SKN" data-code="1-869">Saint Kitts and Nevis (1-869)<!-- option--></option>
<option value="LUC" data-code="1758">Saint Lucia (1758)<!-- option--></option>
<option value="STM" data-code="590">Saint Martin (590)<!-- option--></option>
<option value="SPM" data-code="508">Saint Pierre and Miquelon (508)<!-- option--></option>
<option value="SVG" data-code="1-784">Saint Vincent and the Grenadines (1-784)<!-- option--></option>
<option value="SAM" data-code="685">Samoa (685)<!-- option--></option>
<option value="SMR" data-code="378">San Marino (378)<!-- option--></option>
<option value="STP" data-code="239">Sao Tome and Principe (239)<!-- option--></option>
<option value="SAU" data-code="966">Saudi Arabia (966)<!-- option--></option>
<option value="SEN" data-code="221">Senegal (221)<!-- option--></option>
<option value="SER" data-code="381">Serbia (381)<!-- option--></option>
<option value="SEY" data-code="248">Seychelles (248)<!-- option--></option>
<option value="SIE" data-code="232">Sierra Leone (232)<!-- option--></option>
<option value="SGP" data-code="65">Singapore (65)<!-- option--></option>
<option value="SXM" data-code="1-721">Sint Maarten (1-721)<!-- option--></option>
<option value="SLV" data-code="421">Slovakia (421)<!-- option--></option>
<option value="SLO" data-code="386">Slovenia (386)<!-- option--></option>
<option value="SOL" data-code="677">Solomon Islands (677)<!-- option--></option>
<option value="SOM" data-code="252">Somalia (252)<!-- option--></option>
<option value="RSA" data-code="27">South Africa (27)<!-- option--></option>
<option value="SGS" data-code="500">South Georgia & S.Sandwich Is. (500)<!-- option--></option>
<option value="KOR" data-code="82">South Korea (82)<!-- option--></option>
<option value="SPN" data-code="34">Spain (34)<!-- option--></option>
<option value="SLK" data-code="94">Sri Lanka (94)<!-- option--></option>
<option value="SUD" data-code="249">Sudan (249)<!-- option--></option>
<option value="SUR" data-code="597">Suriname (597)<!-- option--></option>
<option value="SJM" data-code="47">Svalbard and Jan Mayen (47)<!-- option--></option>
<option value="SWA" data-code="268">Swaziland (268)<!-- option--></option>
<option value="SWD" data-code="46">Sweden (46)<!-- option--></option>
<option value="SWI" data-code="41">Switzerland (41)<!-- option--></option>
<option value="SYR" data-code="963">Syria (963)<!-- option--></option>
<option value="TAI" data-code="886">Taiwan (886)<!-- option--></option>
<option value="TAJ" data-code="992">Tajikistan (992)<!-- option--></option>
<option value="TAN" data-code="255">Tanzania (255)<!-- option--></option>
<option value="THN" data-code="66">Thailand (66)<!-- option--></option>
<option value="TIM" data-code="670">Timor-Leste (670)<!-- option--></option>
<option value="TOG" data-code="228">Togo (228)<!-- option--></option>
<option value="TOK" data-code="690">Tokelau (690)<!-- option--></option>
<option value="TON" data-code="676">Tonga (676)<!-- option--></option>
<option value="TRI" data-code="1-868">Trinidad and Tobago (1-868)<!-- option--></option>
<option value="TUN" data-code="216">Tunisia (216)<!-- option--></option>
<option value="TUR" data-code="90">Turkey (90)<!-- option--></option>
<option value="TMN" data-code="993">Turkmenistan (993)<!-- option--></option>
<option value="TCI" data-code="1-649">Turks and Caicos Islands (1-649)<!-- option--></option>
<option value="TUV" data-code="688">Tuvalu (688)<!-- option--></option>
<option value="MOI" data-code="1">U.S Minor Outlying Islands (1)<!-- option--></option>
<option value="UGA" data-code="256">Uganda (256)<!-- option--></option>
<option value="UKR" data-code="380">Ukraine (380)<!-- option--></option>
<option value="UAE" data-code="971">United Arab Emirates (971)<!-- option--></option>
<option value="UKG" data-code="44">United Kingdom (44)<!-- option--></option>
<option value="USA" data-code="1">United States of America (1)<!-- option--></option>
<option value="URU" data-code="598">Uruguay (598)<!-- option--></option>
<option value="USV" data-code="340">US Virgin Islands (340)<!-- option--></option>
<option value="UZB" data-code="998">Uzbekistan (998)<!-- option--></option>
<option value="VAN" data-code="678">Vanuatu (678)<!-- option--></option>
<option value="VAT" data-code="379">Vatican City State (379)<!-- option--></option>
<option value="VEN" data-code="58">Venezuela (58)<!-- option--></option>
<option value="VIE" data-code="84">Vietnam (84)<!-- option--></option>
<option value="WAF" data-code="681">Wallis and Futuna (681)<!-- option--></option>
<option value="WSA" data-code="212">Western Sahara (212)<!-- option--></option>
<option value="YMN" data-code="967">Yemen (967)<!-- option--></option>
<option value="ZAM" data-code="260">Zambia (260)<!-- option--></option>
<option value="ZIM" data-code="263">Zimbabwe (263)<!-- option--></option>
</select>
<div class="fieldError label-error" id="aia355775065_msg" requiredmessage="Please select your country calling code."></div>
<script type="text/javascript">
+ function($) {
"use strict";
$("#aia355775065").click(function() {
var current = $(this).val();
if (current != null) {
$("#aia355775065").css('color', '#554344');
}
});
$("#aia355775065").change(function() {
$(this).css({
'color': '#554344'
});
});
}(jQuery);
</script>
</div>
</div>
</div>
<div class="col col-md-6 col-sm-6 col-xs-6 ">
<div>
<div class="form-input form-base section">
<input type="text" class="primary-select parent-width" id="aia1822059501" name="home_number" placeholder="e.g. 328889342" re="^.{8,12}$" validationtype="text">
<div class="fieldError label-error" id="aia1822059501_msg" requiredmessage="*Home or work number is required" remessage="*Home or work number length is invalid"></div>
</div>
</div>
</div>
</div>
</div>
<div class="sub-title section">
<h6 class="h6 text-left p4 margin-top-md-xxl margin-bottom-md-l margin-top-sm-xxl margin-bottom-sm-l margin-top-l margin-bottom-l">Email Address</h6>
</div>
<div class="form-input form-base section">
<input type="text" class="primary-select parent-width" id="aia1407677752" name="email" placeholder="e.g. john.doe@email.com" required="true" re="^(?=^.{1,50}$)[a-zA-Z0-9.!#$%&’*+/=?^_`{|}~-]+@[a-zA-Z0-9-]+(?:\.[a-zA-Z0-9-]+)*$"
validationtype="text">
<div class="fieldError label-error" id="aia1407677752_msg" requiredmessage="*Email address is required" remessage="Please enter a valid email address."></div>
</div>
<div class="grid-control-1-col section">
<div class="row margin-bottom-sm-l margin-bottom-l">
<div class="col col-md-12 col-sm-12 col-xs-12 col-md-offset-0 col-sm-offset-0 col-xs-offset-0 ">
<div>
</div>
</div>
</div>
</div>
<div class="form-hidden-field form-base section">
<div class="margin-bottom-l" style="display: none;">
<label class="form-label margin-bottom-xxs p3 bt4">hiddenfield</label>
<input type="text" id="aia829712130" name="query_string">
<div class="fieldError label-error" id="aia829712130_msg"></div>
</div>
</div>
<div class="form-hidden-field form-base section">
<div class="margin-bottom-l" style="display: none;">
<label class="form-label margin-bottom-xxs p3 bt4">hiddenfield</label>
<input type="text" id="aia724924391" name="product_detail_name">
<div class="fieldError label-error" id="aia724924391_msg"></div>
</div>
</div>
</div>
</div>
<div class="col col-md-6 col-sm-6 col-xs-12 ">
<div>
<div class="sub-title section">
<h6 class="h6 text-left p4 margin-bottom-md-l margin-bottom-sm-l margin-bottom-l">AIA Customer?</h6>
</div>
<div class="grid-control-1-col section">
<div class="row ">
<div class="col col-md-8 col-sm-10 col-xs-12 col-md-offset-0 col-sm-offset-0 col-xs-offset-0 ">
<div>
<div class="form-toggle-box form-base section">
<input type="hidden" id="toggle-group-448159699" name="is_existing_customer" value="yes" required="true">
<div data-target="toggle-group" class="btn-toggle-group parent-width" id="448159699" name="is_existing_customer">
<button type="button" class="btn btn-toggle btn-selected" value="yes">yes</button>
<button type="button" class="btn btn-toggle " value="no">no</button>
</div>
<div id="toggle-group-448159699" class="fieldError label-error"></div>
<script type="text/javascript">
// Toggle buttons init
$("body").ready(function() {
$("#448159699 .btn-toggle").off("click");
$("#448159699").each(function(i, e) {
var groupID = $(e).attr("id");
$(this).find(".btn-toggle").on('click', function(e) {
$("#toggle-group-" + groupID).attr("value", $(this).attr("value"));
var toggleButtons = $("#" + groupID + " .btn-toggle");
var selectedToggleButtons = $("#" + groupID + " .btn-toggle.btn-selected");
var currentToggleIndex = toggleButtons.index(this);
selectToggleButton448159699(toggleButtons, currentToggleIndex);
});
});
});
</script>
<script type="text/javascript">
function selectToggleButton448159699(toggleButtons, currentToggleIndex) {
toggleButtons.removeClass("btn-selected");
toggleButtons.eq(currentToggleIndex).addClass("btn-selected");
}
</script>
</div>
<div class="html-script section">
<script type="text/javascript">
var toggleName = "is_existing_customer";
var icNumber = "ic_number";
$(function() {
function requireICNo() {
if ($('[name=' + toggleName + ']').val() == "yes") {
$('[name=' + icNumber + ']').prop('required', true);
$('[name=' + icNumber + ']').prop('disabled', false);
} else {
$('[name=' + icNumber + ']').prop('required', false);
$('[name=' + icNumber + ']').prop('disabled', true);
$('[name=' + icNumber + ']').removeClass("field-error");
var toggleId = $('[name=' + icNumber + ']').attr('id') + "_msg";
$('#' + toggleId).html("");
$('input[name="ic_number"]').val(null);
}
}
$('[name="is_existing_customer"]').click(function() {
requireICNo();
});
});
</script>
<style>
input[disabled] {
background-color: #CDD3D9;
}
</style>
</div>
</div>
</div>
</div>
</div>
<div class="sub-title section">
<h6 class="h6 text-left p4 margin-top-md-l margin-bottom-md-l margin-top-sm-l margin-bottom-sm-l margin-top-l margin-bottom-l">ID Number</h6>
</div>
<div class="form-input form-base section">
<input type="text" class="primary-select parent-width" id="aia849233255" name="ic_number" placeholder="e.g. 881202142345" required="true" re="^.{12,14}$" validationtype="text">
<div class="fieldError label-error" id="aia849233255_msg" requiredmessage="*IC Number is required for AIA customers" remessage="*IC Number must be 12 to 14 characters"></div>
</div>
<div class="text parbase section">
<div class="aia-text text-left p4 bt5 margin-bottom-md-l margin-bottom-sm-l margin-bottom-l" data-emptytext="Text">
<p>*Only applicable to AIA customers</p>
</div>
</div>
<div class="sub-title section">
<h6 class="h6 text-left p4 margin-bottom-md-l margin-bottom-sm-l margin-bottom-l">Preferred Location To Meet</h6>
</div>
<div class="form-dropdown form-base section">
<select class="primary-select parent-width" name="Location" id="aia805954284" required="true" style="color: #;">
<option selected="">Select location</option>
<option value="Alor Setar" style="color: rgb(85, 67, 68);">Alor Setar</option>
<option value="Batu Pahat" style="color: rgb(85, 67, 68);">Batu Pahat</option>
<option value="Bukit Mertajam" style="color: rgb(85, 67, 68);">Bukit Mertajam</option>
<option value="Ipoh" style="color: rgb(85, 67, 68);">Ipoh</option>
<option value="Johor Bahru" style="color: rgb(85, 67, 68);">Johor Bahru</option>
<option value="Klang" style="color: rgb(85, 67, 68);">Klang</option>
<option value="Kluang" style="color: rgb(85, 67, 68);">Kluang</option>
<option value="Kota Bharu" style="color: rgb(85, 67, 68);">Kota Bharu</option>
<option value="Kota Kinabalu" style="color: rgb(85, 67, 68);">Kota Kinabalu</option>
<option value="Kuala Lumpur" style="color: rgb(85, 67, 68);">Kuala Lumpur</option>
<option value="Kuantan" style="color: rgb(85, 67, 68);">Kuantan</option>
<option value="Kuching" style="color: rgb(85, 67, 68);">Kuching</option>
<option value="Kulim" style="color: rgb(85, 67, 68);">Kulim</option>
<option value="Melaka" style="color: rgb(85, 67, 68);">Melaka</option>
<option value="Miri" style="color: rgb(85, 67, 68);">Miri</option>
<option value="Muar" style="color: rgb(85, 67, 68);">Muar</option>
<option value="Petaling Jaya" style="color: rgb(85, 67, 68);">Petaling Jaya</option>
<option value="Penang" style="color: rgb(85, 67, 68);">Penang</option>
<option value="Sandakan" style="color: rgb(85, 67, 68);">Sandakan</option>
<option value="Segamat" style="color: rgb(85, 67, 68);">Segamat</option>
<option value="Seremban" style="color: rgb(85, 67, 68);">Seremban</option>
<option value="Sibu" style="color: rgb(85, 67, 68);">Sibu</option>
<option value="Sungai Petani" style="color: rgb(85, 67, 68);">Sungai Petani</option>
<option value="Taiping" style="color: rgb(85, 67, 68);">Taiping</option>
<option value="Tawau" style="color: rgb(85, 67, 68);">Tawau</option>
<option value="Teluk Intan" style="color: rgb(85, 67, 68);">Teluk Intan</option>
<option value="Temerloh" style="color: rgb(85, 67, 68);">Temerloh</option>
<option value="Terengganu" style="color: rgb(85, 67, 68);">Terengganu</option>
</select>
<div class="fieldError label-error" id="aia805954284_msg" requiredmessage="*Location is required"></div>
<script type="text/javascript">
+ function($) {
"use strict";
$("#aia805954284").click(function() {
var current = $(this).val();
if (current != null) {
$("#aia805954284").css('color', '#554344');
}
});
$("#aia805954284").change(function() {
$(this).css({
'color': '#554344'
});
});
}(jQuery);
</script>
</div>
<div class="sub-title section">
<h6 class="h6 text-left p4 margin-bottom-md-l margin-bottom-sm-l margin-top-l margin-bottom-l">Preferred Day and Time</h6>
</div>
<div class="grid-control-2-col section">
<div class="row lead-select">
<div class="col col-md-6 col-sm-6 col-xs-6 col-md-offset-0 col-sm-offset-0 col-xs-offset-0 ">
<div>
<div class="form-dropdown form-base section">
<select class="primary-select parent-width" name="day" id="aia1561794732" required="true" style="color: #;">
<option style="color: rgb(85, 67, 68);">Select day</option>
<option value="Weekend" style="color: rgb(85, 67, 68);">Weekend</option>
<option value="Weekday" style="color: rgb(85, 67, 68);">Weekday</option>
</select>
<div class="fieldError label-error" id="aia1561794732_msg" requiredmessage="*Location is required"></div>
<script type="text/javascript">
+ function($) {
"use strict";
$("#aia1561794732").click(function() {
var current = $(this).val();
if (current != null) {
$("#aia1561794732").css('color', '#554344');
}
});
$("#aia1561794732").change(function() {
$(this).css({
'color': '#554344'
});
});
}(jQuery);
</script>
</div>
</div>
</div>
<div class="col col-md-6 col-sm-6 col-xs-6 ">
<div>
<div class="form-dropdown form-base section">
<select class="primary-select parent-width" name="time" id="aia96902097" required="true" style="color: #;">
<option style="color: rgb(85, 67, 68);">Select time</option>
<option value="Office hours" style="color: rgb(85, 67, 68);">Office hours</option>
<option value="Non-office hours" style="color: rgb(85, 67, 68);">Non-office hours</option>
</select>
<div class="fieldError label-error" id="aia96902097_msg" requiredmessage="*Location is required"></div>
<script type="text/javascript">
+ function($) {
"use strict";
$("#aia96902097").click(function() {
var current = $(this).val();
if (current != null) {
$("#aia96902097").css('color', '#554344');
}
});
$("#aia96902097").change(function() {
$(this).css({
'color': '#554344'
});
});
}(jQuery);
</script>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="text parbase section">
<div class="aia-text p4 bt4 margin-bottom-md-l margin-bottom-sm-l margin-top-xxl margin-bottom-l" data-emptytext="Text">
<p>To receive the information regarding promotions and offers from AIA Bhd., AIA General Berhad, AIA PUBLIC Takaful Bhd., AIA Pension and Asset Management Sdn. Bhd. and AIA Health Services Sdn. Bhd. (“AIA Malaysia”), please tick below:</p>
</div>
</div>
<div class="form-checkbox form-base section">
<label class="checkbox margin-bottom-s" for="5861480361">
<input type="checkbox" id="5861480361" name="agreement" value="0" groupid="1128825285" index="0">
<span class="indicator"><span class="tick"></span></span> I agree that any personal information collected or held by AIA Malaysia may be disclosed by AIA Malaysia to any selected third party for the purposes of cross marketing, direct
marketing and to communicate with me for such purpose. I understand that I have a right to obtain access to and to request correction of any personal information held by AIA Malaysia concerning me and such request can be made at
<a href="mailto:my.contact@aia.com">my.contact@aia.com.</a>
</label>
<div id="1128825285_msg" class="fieldError label-error" requiredmessage="This field is required."></div>
</div>
<div class="grid-control-1-col section">
<div class="row onlyFhr">
<div class="col col-md-12 col-sm-12 col-xs-12 col-md-offset-0 col-sm-offset-0 col-xs-offset-0 ">
<div>
<div class="form-checkbox form-base section">
<label class="checkbox margin-bottom-s" for="5518308221">
<input type="checkbox" id="5518308221" name="consentIndicator" value="0" groupid="1788748049" index="0" checked="true">
<span class="indicator"><span class="tick"></span></span> I agree to share my Financial Health Check results with my pre-assigned AIA life planner. </label>
<div id="1788748049_msg" class="fieldError label-error" requiredmessage="This field is required."></div>
</div>
</div>
</div>
</div>
</div>
<div class="html-script section">
<br>
<!-- PROD <div class="g-recaptcha" data-sitekey="6LcDjjoUAAAAACXtvjtk8aNPyQtbR5pcfwuPjQMc"></div>-->
<!-- localhost -->
<!--<div class="g-recaptcha" data-sitekey="6Ldn3lUUAAAAANZHXLoYA5Mp0jSiBeC8Zj8EGjT7"></div> -->
<!-- SIT -->
<!--<div class="g-recaptcha" data-sitekey="6LeMzWAUAAAAAEsQeWq9W0x2LyiX4vuBt4mS1BD5"></div>-->
<!-- SIT PUBLISHER -->
<!-- <div class="g-recaptcha" data-sitekey="6LfIG3QUAAAAAMu9N6gJRGNnjA70R2DERya629Pj"></div> -->
<!-- UAT -->
<!-- <div class="g-recaptcha" data-sitekey="6LcdazYUAAAAAIMErY_H3eI59ehDyTrmY_8moK88"></div> -->
<div class="g-recaptcha" data-sitekey="6LcDjjoUAAAAACXtvjtk8aNPyQtbR5pcfwuPjQMc">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LcDjjoUAAAAACXtvjtk8aNPyQtbR5pcfwuPjQMc&co=aHR0cHM6Ly93d3cuYWlhLmNvbS5teTo0NDM.&hl=de&v=iRvKkcsnpNcOYYwhqaQxPITz&size=normal&cb=cvxyotftc4iq"
width="304" height="78" role="presentation" name="a-rharvqp8el25" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox"></iframe></div><textarea id="g-recaptcha-response" name="g-recaptcha-response"
class="g-recaptcha-response" style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div>
<script>
$(function() {
var captchaKey = [{
'domain': 'localhost',
'key': '6Ldn3lUUAAAAANZHXLoYA5Mp0jSiBeC8Zj8EGjT7'
}, {
'domain': 'aia-my.growthops-fs.com',
'key': '6Lf_gMcZAAAAABDXPO2Mp9REIYXDnq-4oEJmoB-J'
}, {
'domain': 'hkgdctlapp020.aia.biz',
'key': '6LfIG3QUAAAAAMu9N6gJRGNnjA70R2DERya629Pj'
}, {
'domain': 'wwwuat2.aia.com.my',
'key': '6LcdazYUAAAAAIMErY_H3eI59ehDyTrmY_8moK88'
}, {
'domain': 'www.aia.com.my',
'key': '6LcDjjoUAAAAACXtvjtk8aNPyQtbR5pcfwuPjQMc'
}]
var getHost = window.location.hostname;
var result = captchaKey.filter(a => a.domain.indexOf(getHost) !== -1);
// console.log('xxx', getHost, result)
$('.g-recaptcha').attr('data-sitekey', result[0].key);
})
</script>
</div>
<div class="html-script section">
<script>
$(function() {
$('input[name="g-recaptcha-check"]').parent().children(':not(div)').hide();
$('input[name="g-recaptcha-check"]').parent().show();
setTimeout(function() {
$('.submit button').bind("click mouseenter mouseleave", function() {
$('input[name="g-recaptcha-check"]').val($('[name="g-recaptcha-response"]').val());
});
}, 3000)
});
</script>
<script src="https://www.google.com/recaptcha/api.js" defer=""></script>
</div>
<div class="form-input form-base section">
<input type="text" class="primary-select parent-width" id="aia1350785472" name="g-recaptcha-check" required="true" validationtype="text" style="display: none;">
<div class="fieldError label-error" id="aia1350785472_msg" requiredmessage="*Please verify the reCAPTCHA and tick the check box before submission"></div>
</div>
<div class="html-script section">
<br>
<style>
.onlyFhr,
.thank-you-cont {
display: none;
}
.thank-you-page img {
margin: auto;
}
.lead-select .col:nth-child(1) {
padding-right: 8px;
}
.lead-select .col:nth-child(2) {
padding-left: 8px;
}
.submit.disable-btn>div {
position: relative;
}
.submit.disable-btn>div:before {
content: '';
display: block;
width: 100%;
height: 100%;
position: absolute;
top: 0;
left: 0;
z-index: 1;
background: white;
opacity: 0.5;
}
</style>
</div>
<div class="html-script section">
<p data-validation="return-error-message" class="bt4 u2 text-center generic-form-validation margin-top-l label-error "></p>
</div>
<div class="html-script section">
<script type="text/javascript">
let fhrConsent = false;
let isFhr = getQueryVariable("isfhr");
let isContestFlag = false;
let contentObj = {}
let isCampaign = false;
let campaignInfo = {};
var hasChannel = sessionStorage.getItem('oaop_fhrRcData');
if (sessionStorage.getItem('luckDrawData')) {
isFhr = true;
contentObj = JSON.parse(sessionStorage.getItem('luckDrawData'));
$('input[name="name"]').val(contentObj.CustomerName);
$('input[name="email"]').val(contentObj.Email);
$('input[name="phone_number"]').val(contentObj.MobTel);
$('select[name="countryList"]').val(contentObj.CountryCode);
}
//Added for campaign
const url = new URL(window.location.href);
const encodedUrlParam = url.searchParams.get('infoParam');
const source = url.searchParams.get('source');
if (source?.toLowerCase() == 'campaign') {
//$('.navbar-three').addClass('hidden');
//$('.navbar-sub-spacer').addClass('hidden');
isCampaign = true;
console.log(isCampaign);
}
if (encodedUrlParam) {
const decodedObjInString = JSON.parse(atob(decodeURIComponent(encodedUrlParam)));
const decodedObj = common_stringParamsToObject(decodedObjInString);
campaignInfo = decodedObj;
}
/* if(hasChannel){
$('.onlyFhr').show();
}
*/
/*if (isFhr) {
$('.onlyFhr').show();
}*/
//===============GET MOBILE & HOME NO============================
// Retrieve the country code list from common.js
setTimeout(function() {
countryCode();
}, 1000);
var mobileCountryCode;
var HWCountryCode;
//Dropdown list field, retrive the country
$('select[name="countryList"]').on('change', function() {
mobileCountryCode = $('option:selected', this).attr('data-code');
});
$('select[name="countryListHome"]').on('change', function() {
HWCountryCode = $('option:selected', this).attr('data-code');
});
//console.log(crsSrcType)
//=================QUERY STRING=====================
function countryCode() {
var obj = {};
var formUrl = $.myAiaCommonUrl.retrieveCountry();
var dataPackage = {};
$.ajax({
type: formUrl.action,
url: formUrl.endpoint,
headers: portal_getHeader('post-login', false),
data: JSON.stringify(dataPackage),
contentType: $.sspCommonUrl.getContentTypeServlet()
}).done(function(data, textStatus, jqXHR) {
if (!data.errorCode) {
$(data.country).each(function() {
$('select[name="countryList"]').append('<option value="' + this.countryCode + '" data-code="' + this.countryPhoneCode + '">' + this.countryName + ' (' + this.countryPhoneCode + ')' + '</ option>');
$('select[name="countryListHome"]').append('<option value="' + this.countryCode + '" data-code="' + this.countryPhoneCode + '">' + this.countryName + ' (' + this.countryPhoneCode + ')' + '</ option>');
});
if (sessionStorage.getItem('luckDrawData')) {
//contentObj = JSON.parse(sessionStorage.getItem('luckDrawData'));
$('select[name="countryList"]').val(contentObj.countryCode);
console.log('xxxxxxxxxxxxx', contentObj.countryCode, $('select[name="countryList"]').val())
}
}
}).fail(function(jqXHR, textStatus, errorThrown) {});
// var url = $.sspCommonUrl.getRetrieveCountryURL();
// $.sspManager.BasicPost(url, obj, 'application/json', getHeader()).done(function (data) {
// if (!data.ErrorCode) {
// $(data.Country).each(function () {
// $('select[name="countryList"]').append('<option value="' + this.CountryCode +
// '" data-code="' + this.CountryPhoneCode + '">' + this.Country + ' (' + this
// .CountryPhoneCode + ')' + '</ option>');
// $('select[name="countryListHome"]').append('<option value="' + this.CountryCode +
// '" data-code="' + this.CountryPhoneCode + '">' + this.Country + ' (' + this
// .CountryPhoneCode + ')' + '</ option>');
// });
// if (sessionStorage.getItem('luckDrawData')) {
// //contentObj = JSON.parse(sessionStorage.getItem('luckDrawData'));
// $('select[name="countryList"]').val(contentObj.CountryCode);
// console.log('xxxxxxxxxxxxx', contentObj.CountryCode, $('select[name="countryList"]').val())
// }
// }
// });
}
function getQueryVariable(variable) {
var query = window.location.search.substring(1);
var vars = query.split("&");
for (var i = 0; i < vars.length; i++) {
var pair = vars[i].split("=");
if (pair[0] == variable) {
if (pair[1].indexOf('%20') != -1) {
var fullName = pair[1].split('%20')
return fullName[0] + ' ' + fullName[1]
} else {
return pair[1];
}
}
}
return (false);
}
//var result = getQueryVariable("cmpid");
//$('input[name="query_string"]').val(result);
//get product title
$('input[name="product_detail_name"]').val($('.product-detail-type-banner').parent().find('.h2').text().trim());
$('input[name="product_detail_name"]').val();
//===============SUBMIT BUTTON================================
$(".form-container-leadcapture > form").submit(function() {
//var epUrl = "https://www.aia-uat.com.my/MyAIASIT/services/submitCRMProdLead";
var epUrl = $.sspCommonUrl.getSubmitCRMProdLeadURL();
var name = $('input[name="name"]').val();
var cont = $('input[name="phone_number"]').val();
var HWcont = $('input[name="home_number"]').val();
var dateTime = getDate();
var McountryCode = $('select[name="countryList"]').find(':selected').attr('data-code');
var HWcountryCode = $('select[name="countryListHome"]').find(':selected').attr('data-code');
var Mcountry = McountryCode + cont;
var HWcountry = HWcountryCode + HWcont;
var Email = $('input[name="email"]').val();
var Customer = $('input[name="is_existing_customer"]').val();
var NRIC = $('input[name="ic_number"]').val();
var Location = $('select[name="Location"]').val();
var GIT = $('input:checkbox[name=agreement]').is(':checked');
var Product = $('input[name="product_detail_name"]').val();
//var result = getQueryVariable("cmpid");
//$('input[name="query_string"]').val(result);
var qstring = $('input[name="query_string"]').val();
// 08082020 - 1a1p amend lead form for fhr
//Anisah - 20201203 - default consentIndicator to false cause the checkbox is hidden for R2 relase. uncomment this for next release
//fhrConsent = $('input:checkbox[name=consentIndicator]').is(':checked');
var _preferredDay = $('select[name="day"]').val();
var _preferredTime = $('select[name="time"]').val();
//grab URL until .html omit after '?'
var URL = window.location.href.split('?')[0];
//capture the path language /EN/ from /content/my/en/our-products/life-protection/a-life-link.html
var lang = getCurrentLanguage();
var $form = $('.form-container-leadcapture')
if (false) {
scrollToElement($($form).find('.field-error').first(), 10, 500);
$(".contact-err").text('').hide();
return false;
}
//if all the input field are correctly filled
else {
if (!isFhr && !isCampaign) {
var lead_data = {};
var preference = {
location: Location,
preferredDate: _preferredDay,
preferredTimeSlot: _preferredTime
};
lead_data.contactNo = Mcountry;
lead_data.preferredLanguague = lang;
lead_data.name = name;
lead_data.email = Email;
//lead_data.PreferredLocation = Location;
lead_data.preference = {
location: Location,
preferredDate: _preferredDay,
preferredTimeSlot: _preferredTime
};
lead_data.consentIndicator = GIT;
lead_data.preferredProduct = Product;
lead_data.leadSubmissionDate = dateTime;
lead_data.leadSource = "product_page";
lead_data.leadSubSource = "product_leads_form";
lead_data.leadType = "Sales";
if (qstring !== "false") {
lead_data.productPage = URL;
lead_data.urlParam = qstring;
} else {
lead_data.productPage = URL;
}
if (Customer == "yes" && NRIC !== "") {
lead_data.IC = NRIC;
lead_data.coverageFlag = true;
} else {
lead_data.coverageFlag = false;
}
if (HWcountry !== "undefined") {
lead_data.alternateContactNo = HWcountry;
}
// 08082020 - 1a1p amend lead form for fhr
lead_data.marketingConsent = fhrConsent;
//lead_data.PreferredDay = _preferredDay;
//lead_data.PreferredTimeSlot = _preferredTime;
//overlay, prevent multiple submission
$('.submit button').parent().parent().addClass('disable-btn');
$.getScript('/etc/designs/aia-my-app-portal/clientlib-footer/js/portalCommon.js').done(function(data) {
var formUrl = $.myAiaCommonUrl.submitLeadPreLogin();
$.ajax({
type: formUrl.action,
url: formUrl.endpoint,
cache: false,
headers: portal_getHeader('pre-login', false),
contentType: $.sspCommonUrl.getContentTypeServlet(),
data: JSON.stringify(lead_data),
}).done(function(data, textStatus, jqXHR) {
if (typeof data.errorCode !== "undefined") {
$(".generic-form-validation[data-validation='return-error-message']").text(data.Errordescription);
$(".generic-form-validation[data-validation='return-error-message']").show();
//enable button again
$('.submit.disable-btn').removeClass('disable-btn');
} else {
sendDirectCall("lead-gen-form-completion");
window.location.href = '/content/my/en/our-products/thank-you.html?strProduct=' + Product;
}
}).fail(function(jqXHR, textStatus, errorThrown) {
console.log('Server Error', jqXHR, textStatus, errorThrown);
//ajaxFailPreLoginHandler(jqXHR, textStatus, errorThrown);
//enable button again
$('.submit.disable-btn').removeClass('disable-btn');
});
});
} else {
$('.submit button').parent().parent().addClass('disable-btn');
$.getScript('/etc/designs/aia-my-app-portal/clientlib-footer/js/portalCommon.js').done(function(data) {
var formUrl = $.myAiaCommonUrl.submitLeadPreLogin();
var fromStorage = sessionStorage.getItem('oaop_fhrCompletedResultData');
fromStorage = JSON.parse(fromStorage);
/*if (hasChannel) {
fhrConsent = $('input:checkbox[name=consentIndicator]').is(':checked');
}*/
var dataPackage = {
name: name,
//IC: '',
type: "OTHERS",
email: Email,
contactNo: Mcountry,
preference: {
location: Location,
preferredDate: _preferredDay,
preferredTimeSlot: _preferredTime
},
consentIndicator: fhrConsent,
marketingConsent: GIT,
fhrResultId: fromStorage?.result?.fhrResultId
};
if (hasChannel) {
dataPackage.type = "RC";
dataPackage.agentInfo = {
code: JSON.parse(hasChannel).agentCode
};
}
if (HWcountry !== "undefined") {
dataPackage.alternateContactNo = HWcountry;
}
if (Customer == "yes" && NRIC !== "") {
dataPackage.IC = NRIC;
dataPackage.coverageFlag = true;
} else {
dataPackage.coverageFlag = false;
}
if (isCampaign) {
//dataPackage.channel = campaignInfo.templateKey; //o2o 2.0
dataPackage.leadSource = campaignInfo.leadSource;
dataPackage.leadSubSource = campaignInfo.leadSubSource;
dataPackage.templateKey = campaignInfo.templateKey;
dataPackage.specialForYou = campaignInfo.specialForYou == 'true' ? true : false;
}
$.ajax({
type: formUrl.action,
url: formUrl.endpoint,
cache: false,
headers: portal_getHeader('pre-login', false),
contentType: $.sspCommonUrl.getContentTypeServlet(),
data: JSON.stringify(dataPackage),
}).done(function(data, textStatus, jqXHR) {
// show fhr thank you interface.
$('#postLoginForm').hide();
$('.form-cont').hide();
$('.thank-you-cont').show();
$('.submit.disable-btn').removeClass('disable-btn');
}).fail(function(jqXHR, textStatus, errorThrown) {
$('.submit.disable-btn').removeClass('disable-btn');
});
});
}
}
});
function validateEmail(email) {
var filter = /^([a-zA-Z0-9_.-])+@(([a-zA-Z0-9-])+.)+([a-zA-Z0-9]{2,4})+$/;
if (!filter.test(email)) {
//alert('Please provide a valid email address');
return false;
}
}
function ContactNoMatch(ContactNo) {
var pattern = "^.{9,12}$";
var re = new RegExp(pattern);
var m = re.exec(ContactNo);
if (m == null) {
return false;
} else {
return true;
}
}
function getDate() {
var today = new Date();
var dd = today.getDate();
var mm = today.getMonth() + 1; //January is 0!
var time = today.toTimeString().substr(0, 8); //output: 18:19:14
var yyyy = today.getFullYear();
if (dd < 10) {
dd = '0' + dd;
}
if (mm < 10) {
mm = '0' + mm;
}
var submitDate = yyyy + '-' + mm + '-' + dd + " " + time;
return submitDate;
}
function getQueryVariable(variable) {
var query = window.location.search.substring(1);
var vars = query.split("&");
for (var i = 0; i < vars.length; i++) {
var pair = vars[i].split("=");
if (pair[0] == variable) {
if (pair[1].indexOf('%20') != -1) {
console.log(pair[1].indexOf('%20'))
var fullName = pair[1].split('%20')
console.log(fullName)
return fullName[0] + ' ' + fullName[1]
} else {
return pair[1];
}
}
}
return (false);
}
</script>
</div>
<div class="html-script section">
<!-- <h5 id="maintenanceMessage" class="label-error maintenance-err-msg">Dear customers, please be informed that we will be performing a major system upgrade from Friday, 7 July 11:00 PM (MYT) till Saturday, 8 July 3:00PM (MYT) Sorry for the inconvenient
</h5> -->
</div>
</div>
<p class="bt4 u2 text-center lead-form-validation" data-validation="tss-return-error-message"></p>
<div class="submit btn parent-width margin-bottom-xl">
<div class="margin-top-md-l margin-top-sm-l margin-top-l submit">
<div>
<button id="btn801156161" class="btn btn-default btn-primary center-block " type="button" onclick="" data-link="/content/my/en/our-products/thank-you.html" data-target="_blank">Contact Me</button>
</div>
</div>
</div>
</div>
</form>Text Content
Skip to main content
* EN
* BM
* Search
* AIA Malaysia
* Our Products
* Life Protection
* Medical Protection
* Critical Illness Protection
* Savings & Investment
* Accident Protection
* Property Solutions
* Motor Insurance
* Online Products
* AIA Vitality
* Employee Benefits
* Commercial Insurance
* AIA Vitality
* How It Works
* REWARDS & BENEFITS
* Member’s Testimonial
* Join AIA Vitality
* What Matters
* Health & Wellness
* Finance & Insurance
* Video Gallery
* Mental Wellbeing
* Health Statistics
* About AIA
* About AIA Bhd.
* About AIA Public Takaful Bhd
* About AIA General Berhad
* About AIA Pension & Asset Management
* Career Opportunities
* Community & Partnerships
* Media Centre
* Events & Promotions
* Customer Charter
* Help & Support
* Contact Us
* Locate Us
* Claims Process And Guides
* Premium Payment
* FAQ
* Important Announcements
* Form Library
* How to Guides
* Special Privileges and Offers Exclusively for AIA Customers
* My AIA
* CUSTOMER LOGIN
* CUSTOMER REGISTRATION
* CORPORATE LOGIN
* Investment-Linked Funds
AIA
* Our Products
OUR PRODUCTS
Select from one of the categories on the right or click here for a
recommendation based on your needs.
Let us help you
INVESTMENT-LINKED FUNDS
Get the latest updates on our funds and their performance.
Click here to view AIA Investment Linked Funds Performance Report 2022
For Individuals
For Business
* LIFE PROTECTION
Protect yourself and your loved ones from life's uncertainties with AIA's
life insurance and takaful plans.
* MEDICAL PROTECTION
Avoid unforeseen medical expenses with AIA's medical insurance and takaful
plans.
* CRITICAL ILLNESS PROTECTION
Focus on your recovery and not your financial commitments when you have
AIA's critical illness insurance or takaful plans.
* SAVINGS & INVESTMENT
Stay protected while you secure your future with AIA's savings and
investment plans.
* ACCIDENT PROTECTION
Safeguard yourself from accidents with AIA's personal accident insurance
plans.
* PROPERTY SOLUTIONS
Finance your dream property and ensure your household contents are
well-protected.
* MOTOR INSURANCE
Get comprehensive protection for your motor vehicles.
* ONLINE PRODUCTS
Sign-up for our insurance and takaful plans online for immediate
protection.
* AIA VITALITY
AIA Vitality is the science-backed wellness programme that works with you
and rewards you for the healthy choices you make. Find out more
* EMPLOYEE BENEFITS
Secure your company's most important asset through our market-leading
solutions.
* COMMERCIAL INSURANCE
Secure your business against mishaps and damages.
Dismiss
* AIA Vitality
AIA VITALITY
We support you in taking charge of your health.
FIND OUT MORE
* HOW IT WORKS
Discover how AIA Vitality motivates you to make healthy choices
sustainably.
* REWARDS & BENEFITS
Find out what are the rewards and benefits that you can enjoy as an AIA
Vitality member.
* MEMBER’S TESTIMONIAL
Be inspired by the stories of our members 's journey with AIA Vitality
* JOIN AIA VITALITY
Kickstart your journey towards better health today!
Dismiss
* What Matters
WHAT MATTERS
Guides and tips on the latest Health & Finance topics.
VIEW ALL IN WHAT MATTERS
* HEALTH & WELLNESS
Wholesome & healthy living starts today.
* FINANCE & INSURANCE
Discover our wide range of insurance and finance topics
* VIDEO GALLERY
Short videos on the latest Health & Finance topics.
* MENTAL WELLBEING
Start taking care of your mental health today.
* HEALTH STATISTICS
Learn more about the current health statistic.
Dismiss
* About AIA
ABOUT AIA
For almost a century, AIA has served the ever-changing needs of millions of
people all across the Asia-Pacific region.
Read More
* ABOUT AIA BHD.
Who we are, what we do, our vision and awards.
* ABOUT AIA PUBLIC TAKAFUL BHD
Who we are, what we do, our vision and awards.
* ABOUT AIA GENERAL BERHAD
Who we are, what we do, our vision and awards.
* ABOUT AIA PENSION & ASSET MANAGEMENT
Who we are, what we do, our vision and awards.
* CAREER OPPORTUNITIES
Interested to join our AIA family? Look for a role that suits you.
* COMMUNITY & PARTNERSHIPS
Giving back to the community is important to us.
* MEDIA CENTRE
Financials, press releases and other info about AIA.
* EVENTS & PROMOTIONS
Events & Promotions
* CUSTOMER CHARTER
Our Commitment to our Customers
Dismiss
* Help & Support
HELP & SUPPORT
We strive to assist you with any inquiries you might have with a high touch
customer service experience.
Contact AIA
* CONTACT US
Cannot find the answer in our FAQ section? Contact us now.
* LOCATE US
Find us and our panel healthcare partners on Google Map
* CLAIMS PROCESS AND GUIDES
Find Claims related information and guides here.
* PREMIUM PAYMENT
Find information and guides on how to pay premiums here.
* FAQ
Have a question? You may find the answer here.
* IMPORTANT ANNOUNCEMENTS
Useful information for our customers
* FORM LIBRARY
Need a form? Check our form library.
* HOW TO GUIDES
Learn how to perform self serve transaction online at My AIA Portal.
* SPECIAL PRIVILEGES AND OFFERS EXCLUSIVELY FOR AIA CUSTOMERS
Enjoy special privileges and preferential rates on a range of services
offered by our healthcare partners.
Dismiss
* My AIA
MY AIA
Manage your AIA plans, employee benefits, stay healthy with AIA Vitality, and
access healthcare services.
* CUSTOMER PORTAL
Manage your AIA plans, employee benefits, stay healthy with AIA Vitality,
and access healthcare services.
Register Login
* CORPORATE PORTAL
For HR personnel and Intermediaries to manage the company's employee
benefits portfolio effectively.
Login
Dismiss
* Language Select
* EN
* BM
* Search
* Go Dismiss
* Contact Us
* CONTACT US
Operating hours :
Monday - Thursday : 8.30am - 5.30pm
Friday : 8.30am - 4.30pm
*
* AIA BHD.
*
* AIA PUBLIC TAKAFUL BHD.
*
* AIA GENERAL BERHAD
*
* AIA ROADSIDE ASSIST
Back to Top
{{title}}
{{label}}
MY AIA
Manage your AIA plans, employee benefits, stay healthy with AIA Vitality, and
access healthcare services.
* CUSTOMER PORTAL
Manage your AIA plans, employee benefits, stay healthy with AIA Vitality, and
access healthcare services.
Register Login
* CORPORATE PORTAL
For HR personnel and Intermediaries to manage the company's employee benefits
portfolio effectively.
Login
TOTAL HEALTH & WEALTH SOLUTIONS
At AIA, we want to empower you to create a brighter future for yourself and your
loved ones.
That’s why we are committed to support you every step of the way with our Total
Health & Wealth Solutions so you and your loved ones can live Healthier, Longer
and Better Lives.
TOTAL HEALTH SOLUTION
TOTAL WEALTH SOLUTION
SUBSCRIBE TO
A BETTER LIFE
Get so much more when you
Live With Vitality.
LEARN MORE
MOTOR INSURANCE
CASHBACK CAMPAIGN
Get complimentary Touch 'n Go eWallet Credit with AIA's Private Car Motor
Insurance.
LEARN MORE
CAMPAIGNS AND OFFERS
We have curated these campaigns and offers to help you and your loved ones live
Healthier, Longer, Better Lives!
LATEST OFFERS & PROMOTIONS
ANAKKU SIHAT NEGARAKU HEBAT
TOTAL HEALTH & WEALTH SOLUTIONS
At AIA, we want to empower you to create a brighter future for yourself and your
loved ones.
That’s why we are committed to support you every step of the way with our Total
Health & Wealth Solutions so you and your loved ones can live Healthier, Longer
and Better Lives.
TOTAL HEALTH SOLUTION
TOTAL WEALTH SOLUTION
SUBSCRIBE TO
A BETTER LIFE
Get so much more when you
Live With Vitality.
LEARN MORE
* LIVE WITH VITALITY
AIA Malaysia
* MOTOR INSURANCE CASHBACK CAMPAIGN
AIA Malaysia
* CAMPAIGNS AND OFFERS
AIA Malaysia
* TOTAL HEALTH & WEALTH SOLUTIONS
AIA Malaysia
onloadPopUpTesting
DISCOVER YOUR NEEDS
I want to please select... obtain a medical card prepare for unexpected health
issues protect myself against accidents protect me and my loved ones grow my
savings plan for my retirement plan for my children's future protect my home
Find my products
2022 FUND PERFORMANCE REPORTS ARE NOW AVAILABLE
The AIA Investment-Linked Funds Performance Report 2022 and AIA PUBLIC Takaful
Bhd. Investment-Linked Funds Report 2022 are now available. Click here to view.
100% ONLINE RENEWAL PAYMENT
Effective 1st September 2023, please pay your renewal premium/ contribution
payments via My AIA app as walk-in payment will no longer be accepted at AIA
Customer Centres. Read the Important Announcement
OUR PRODUCTS
* Life <br>Protection
Life
Protection
* Medical Protection
Medical Protection
* Critical Illness Protection
Critical Illness Protection
* Savings and Investment
Savings and Investment
* Accident Protection
Accident Protection
* Home Solutions
Home Solutions
* Motor Insurance
Motor Insurance
* Online Products
Online Products
FIND THE RIGHT INSURANCE FOR YOU AND YOUR LOVED ONES
Let's Help You get started
CONNECT ME WITH AN AIA LIFE PLANNER
FULL NAME
MOBILE NUMBER
Please Select Afghanistan (93)Aland Islands (358)Albania (355)Algeria
(213)American Samoa (1684)Andorra (376)Angola (244)Anguilla (1264)Antarctica
(672)Antigua and Barbuda (1268)Argentina (54)Armenia (374)Aruba (297)Australia
(61)Austria (43)Azerbaijan (994)Bahamas (1242)Bahrain (973)Bangladesh
(880)Barbados (1246)Belarus (375)Belgium (32)Belize (501)Benin (229)Bermuda
(1441)Bhutan (975)Bolivia (591)Bosnia and Herzegovina (387)Botswana (267)Bouvet
Island (47)Brazil (55)British Indian Ocean Territory (246)British Virgin Islands
(1284)Brunei Darussalam (673)Bulgaria (359)Burkina Faso (226)Burundi
(257)Cambodia (855)Cameroon (237)Canada (1)Cape Verde (238)Cayman Islands
(1345)Central African Republic (236)Chad (235)Chile (56)China (86)Christmas
Island (61)Cocos (Keeling) Islands (61)Colombia (57)Comoros (269)Congo (242)Cook
Islands (682)Costa Rica (506)Croatia (385)Cuba (53)Curacao (599)Cyprus
(357)Czech Republic (420)Dem. Republic of The Congo (243)Denmark (45)Djibouti
(253)Dominica (1767)Dominican Republic (1)Ecuador (593)Egypt (20)El Salvador
(503)England (44)Equatorial Guinea (240)Eritrea (291)Estonia (372)Ethiopia
(251)Falkland Islands (Malvinas) (500)Faroe Islands (298)Federated States of
Micronesia (691)Fiji (679)Finland (358)France (33)French Guiana (594)French
Polynesia (689)French Southern Territories (262)Gabon (241)Gambia (220)Georgia
(32)Germany (49)Ghana (233)Gibraltar (350)Great Britain (44)Greece (30)Greenland
(299)Grenada (1473)Guadeloupe (590)Guam (671)Guatemala (502)Guernsey
(441481)Guinea (224)Guinea-Bissau (245)Guyana (592)Haiti (509)Heard Is. And
Mcdonald Is. (#N/A)Honduras (504)Hong Kong (852)Hungary (36)Iceland (354)India
(91)Indonesia (62)Iran (98)Iraq (964)Ireland (353)Isle of Man (441624)Israel
(972)Italy (39)Ivory Coast (225)Jamaica (1876)Japan (81)Jersey (441534)Jordan
(962)Kazakhstan (7)Kenya (254)Kiribati (686)Kuwait (965)Kyrgyzstan (996)Laos
(856)Latvia (371)Lebanon (961)Lesotho (266)Liberia (231)Libya (218)Liechtenstein
(423)Lithuania (370)Luxembourg (352)Macau (853)Macedonia (389)Madagascar
(261)Malawi (265)Malaysia (60)Maldives (960)Mali (223)Malta (356)Marshall
Islands (692)Martinique (596)Mauritania (222)Mauritius (230)Mayotte (262)Mexico
(52)Monaco (377)Mongolia (976)Montenegro (382)Montserrat (1664)Morocco
(212)Mozambique (258)Myanmar (95)Namibia (264)Nauru (674)Nepal (977)Netherlands
(31)Netherlands Antilles (599)New Caledonia (687)New Zealand (64)Nicaragua
(505)Niger (227)Nigeria (234)Niue (683)Norfolk Island (672)North Korea
(850)Northern Mariana Islands (1670)Norway (47)Occupied Palestinian Territory
(970)Oman (968)Pakistan (92)Palau (680)Panama (507)Papua New Guinea
(675)Paraguay (595)Peru (51)Philippines (63)Pitcairn (64)Poland (48)Portugal
(351)Puerto Rico (1787)Qatar (974)Republic of Moldova (373)Reunion (262)Romania
(40)Russia (7)Rwanda (250)Saint Barthelemy (590)Saint Helena (290)Saint Kitts
and Nevis (1-869)Saint Lucia (1758)Saint Martin (590)Saint Pierre and Miquelon
(508)Saint Vincent and the Grenadines (1-784)Samoa (685)San Marino (378)Sao Tome
and Principe (239)Saudi Arabia (966)Senegal (221)Serbia (381)Seychelles
(248)Sierra Leone (232)Singapore (65)Sint Maarten (1-721)Slovakia (421)Slovenia
(386)Solomon Islands (677)Somalia (252)South Africa (27)South Georgia &
S.Sandwich Is. (500)South Korea (82)Spain (34)Sri Lanka (94)Sudan (249)Suriname
(597)Svalbard and Jan Mayen (47)Swaziland (268)Sweden (46)Switzerland (41)Syria
(963)Taiwan (886)Tajikistan (992)Tanzania (255)Thailand (66)Timor-Leste
(670)Togo (228)Tokelau (690)Tonga (676)Trinidad and Tobago (1-868)Tunisia
(216)Turkey (90)Turkmenistan (993)Turks and Caicos Islands (1-649)Tuvalu
(688)U.S Minor Outlying Islands (1)Uganda (256)Ukraine (380)United Arab Emirates
(971)United Kingdom (44)United States of America (1)Uruguay (598)US Virgin
Islands (340)Uzbekistan (998)Vanuatu (678)Vatican City State (379)Venezuela
(58)Vietnam (84)Wallis and Futuna (681)Western Sahara (212)Yemen (967)Zambia
(260)Zimbabwe (263)
HOME/WORK PHONE NUMBER
Please Select Please Select Afghanistan (93)Aland Islands (358)Albania
(355)Algeria (213)American Samoa (1684)Andorra (376)Angola (244)Anguilla
(1264)Antarctica (672)Antigua and Barbuda (1268)Argentina (54)Armenia (374)Aruba
(297)Australia (61)Austria (43)Azerbaijan (994)Bahamas (1242)Bahrain
(973)Bangladesh (880)Barbados (1246)Belarus (375)Belgium (32)Belize (501)Benin
(229)Bermuda (1441)Bhutan (975)Bolivia (591)Bosnia and Herzegovina (387)Botswana
(267)Bouvet Island (47)Brazil (55)British Indian Ocean Territory (246)British
Virgin Islands (1284)Brunei Darussalam (673)Bulgaria (359)Burkina Faso
(226)Burundi (257)Cambodia (855)Cameroon (237)Canada (1)Cape Verde (238)Cayman
Islands (1345)Central African Republic (236)Chad (235)Chile (56)China
(86)Christmas Island (61)Cocos (Keeling) Islands (61)Colombia (57)Comoros
(269)Congo (242)Cook Islands (682)Costa Rica (506)Croatia (385)Cuba (53)Curacao
(599)Cyprus (357)Czech Republic (420)Dem. Republic of The Congo (243)Denmark
(45)Djibouti (253)Dominica (1767)Dominican Republic (1)Ecuador (593)Egypt (20)El
Salvador (503)England (44)Equatorial Guinea (240)Eritrea (291)Estonia
(372)Ethiopia (251)Falkland Islands (Malvinas) (500)Faroe Islands (298)Federated
States of Micronesia (691)Fiji (679)Finland (358)France (33)French Guiana
(594)French Polynesia (689)French Southern Territories (262)Gabon (241)Gambia
(220)Georgia (32)Germany (49)Ghana (233)Gibraltar (350)Great Britain (44)Greece
(30)Greenland (299)Grenada (1473)Guadeloupe (590)Guam (671)Guatemala
(502)Guernsey (441481)Guinea (224)Guinea-Bissau (245)Guyana (592)Haiti
(509)Heard Is. And Mcdonald Is. (#N/A)Honduras (504)Hong Kong (852)Hungary
(36)Iceland (354)India (91)Indonesia (62)Iran (98)Iraq (964)Ireland (353)Isle of
Man (441624)Israel (972)Italy (39)Ivory Coast (225)Jamaica (1876)Japan
(81)Jersey (441534)Jordan (962)Kazakhstan (7)Kenya (254)Kiribati (686)Kuwait
(965)Kyrgyzstan (996)Laos (856)Latvia (371)Lebanon (961)Lesotho (266)Liberia
(231)Libya (218)Liechtenstein (423)Lithuania (370)Luxembourg (352)Macau
(853)Macedonia (389)Madagascar (261)Malawi (265)Malaysia (60)Maldives (960)Mali
(223)Malta (356)Marshall Islands (692)Martinique (596)Mauritania (222)Mauritius
(230)Mayotte (262)Mexico (52)Monaco (377)Mongolia (976)Montenegro
(382)Montserrat (1664)Morocco (212)Mozambique (258)Myanmar (95)Namibia
(264)Nauru (674)Nepal (977)Netherlands (31)Netherlands Antilles (599)New
Caledonia (687)New Zealand (64)Nicaragua (505)Niger (227)Nigeria (234)Niue
(683)Norfolk Island (672)North Korea (850)Northern Mariana Islands (1670)Norway
(47)Occupied Palestinian Territory (970)Oman (968)Pakistan (92)Palau (680)Panama
(507)Papua New Guinea (675)Paraguay (595)Peru (51)Philippines (63)Pitcairn
(64)Poland (48)Portugal (351)Puerto Rico (1787)Qatar (974)Republic of Moldova
(373)Reunion (262)Romania (40)Russia (7)Rwanda (250)Saint Barthelemy (590)Saint
Helena (290)Saint Kitts and Nevis (1-869)Saint Lucia (1758)Saint Martin
(590)Saint Pierre and Miquelon (508)Saint Vincent and the Grenadines
(1-784)Samoa (685)San Marino (378)Sao Tome and Principe (239)Saudi Arabia
(966)Senegal (221)Serbia (381)Seychelles (248)Sierra Leone (232)Singapore
(65)Sint Maarten (1-721)Slovakia (421)Slovenia (386)Solomon Islands (677)Somalia
(252)South Africa (27)South Georgia & S.Sandwich Is. (500)South Korea (82)Spain
(34)Sri Lanka (94)Sudan (249)Suriname (597)Svalbard and Jan Mayen (47)Swaziland
(268)Sweden (46)Switzerland (41)Syria (963)Taiwan (886)Tajikistan (992)Tanzania
(255)Thailand (66)Timor-Leste (670)Togo (228)Tokelau (690)Tonga (676)Trinidad
and Tobago (1-868)Tunisia (216)Turkey (90)Turkmenistan (993)Turks and Caicos
Islands (1-649)Tuvalu (688)U.S Minor Outlying Islands (1)Uganda (256)Ukraine
(380)United Arab Emirates (971)United Kingdom (44)United States of America
(1)Uruguay (598)US Virgin Islands (340)Uzbekistan (998)Vanuatu (678)Vatican City
State (379)Venezuela (58)Vietnam (84)Wallis and Futuna (681)Western Sahara
(212)Yemen (967)Zambia (260)Zimbabwe (263)
EMAIL ADDRESS
hiddenfield
hiddenfield
AIA CUSTOMER?
yes no
ID NUMBER
*Only applicable to AIA customers
PREFERRED LOCATION TO MEET
Select location Alor Setar Batu Pahat Bukit Mertajam Ipoh Johor Bahru Klang
Kluang Kota Bharu Kota Kinabalu Kuala Lumpur Kuantan Kuching Kulim Melaka Miri
Muar Petaling Jaya Penang Sandakan Segamat Seremban Sibu Sungai Petani Taiping
Tawau Teluk Intan Temerloh Terengganu
PREFERRED DAY AND TIME
Select day Weekend Weekday
Select time Office hours Non-office hours
To receive the information regarding promotions and offers from AIA Bhd., AIA
General Berhad, AIA PUBLIC Takaful Bhd., AIA Pension and Asset Management Sdn.
Bhd. and AIA Health Services Sdn. Bhd. (“AIA Malaysia”), please tick below:
I agree that any personal information collected or held by AIA Malaysia may be
disclosed by AIA Malaysia to any selected third party for the purposes of cross
marketing, direct marketing and to communicate with me for such purpose. I
understand that I have a right to obtain access to and to request correction of
any personal information held by AIA Malaysia concerning me and such request can
be made at my.contact@aia.com.
I agree to share my Financial Health Check results with my pre-assigned AIA life
planner.
Contact Me
Dismiss
THANK YOU
Submitted Successfully
We will be in touch!
Done
FINANCIAL HEALTH CHECK
Understanding your financial health and how well you are covered is the first
step to achieving a healthier, longer and better life.
Get started now
MY AIA APP
From managing your AIA insurance and takaful plans to keeping track of your
fitness and health with AIA Vitality, enjoy a seamless and personalised health
journey on the My AIA app today.
Read more
onloadPopUpTesting
Dismiss
DEBIT CARD NOTIFICATION
WHAT MATTERS
GUIDES AND TIPS ON THE LATEST HEALTH & FINANCE TOPICS
18 July 2023
6 POWER JUICES FOR AN IMMUNITY BOOST AND SYSTEM DETOX
--------------------------------------------------------------------------------
Did you have one too many nights out, or been on a weekend bender with an
overload of greasy food? Or perhaps you’re simply craving for something clean,
green and healthy?
06 July 2023
TERM LIFE VS. WHOLE LIFE POLICY: EVERYTHING YOU NEED TO KNOW
--------------------------------------------------------------------------------
Term life? Whole life? How do you determine which type of insurance plan is
suited for your life? Here’s a breakdown of all the key differences to help you
make the best decision.
08 June 2023
SWEET & SAVOURY: OUR FOOD CRAVINGS & THEIR MEANINGS
--------------------------------------------------------------------------------
We all get food cravings occasionally. For example, when you came across videos
of yummy food. The question is, how do we turn our cravings into something
healthier?
No more articles to load.
Load More
HEALTHIER, LONGER, BETTER LIVES
We want to genuinely engage in your life, providing the right financial
solutions for you and your family in a constantly changing world.
GET TO KNOW US
CELEBRATING OUR 100-YEAR JOURNEY
100% FOCUSED ON ASIA-PACIFIC
AIA was founded in Asia, is headquartered in Asia and present in 18 markets
across the Asia-Pacific region.
OUR FOOTPRINTS OF EXCELLENCE
Read More
AIA GROUP'S SIZE AND STRENGTH
Read More
Enjoy hassle free first premium payment
Make first payment for your NEW insurance application and get covered today!
AIA EPAY
PHONE
AIA Bhd.
1300-88-1899
AIA PUBLIC Takaful Bhd.
1300-88-8922
AIA General Berhad
1300-88-1899
ADDRESS
Menara AIA, 99 Jalan Ampang, 50450
Kuala Lumpur
LOCATE US
Find our nearest branches and panel healthcare partners
ASK A QUESTION
FEEL FREE TO CONTACT US
--------------------------------------------------------------------------------
Start Your Career with AIA Malaysia
JOIN OUR AIA FAMILY!
We’re seeking bright, vibrant and passionate individuals to join us on our
journey to becoming the preeminent Life Insurer in Malaysia.
Discover your passion
FOR THE PRESS
PRESS RELEASES
* DATUK NICOL DAVID EMBRACES MULTIPLE ROLES IN AIA MALAYSIA'S "SUBSCRIBE TO A
BETTER LIFE" CAMPAIGN
03 July 2023
* TAN SRI DATO’ (DR) WEE HOE SOON @ GOOI HOE SOON APPOINTED AS BOARD CHAIRMAN
OF AIA BHD.
21 June 2023
* AIA MALAYSIA COMMITTED TO PROMOTING FAMILY FITNESS AS PART OF TACKLING
CHRONIC DISEASE IN MALAYSIA
16 March 2023
PRESS CLIPPINGS
* KOSMO – NICOL BIMBING PENGAMAL MEDIA MAIN SKUASY
20 June 2023
* SIN CHEW DAILY – AIA MALAYSIA PROMOTES DIGITAL HEALTHCARE PLATFORM
08 June 2023
* THE STAR – BRIDGING THE GAP IN HEALTHCARE ACCESS
14 May 2023
FINANCIAL INFORMATION
* REPORTS AND FINANCIAL STATEMENTS FOR THE FINANCIAL YEAR ENDED 31 DECEMBER
2022 - AIA BHD.
21 June 2023
* REPORTS AND FINANCIAL STATEMENTS FOR THE FINANCIAL YEAR ENDED 31 DECEMBER
2022 - AIA PUBLIC TAKAFUL BHD.
21 June 2023
* REPORTS AND FINANCIAL STATEMENTS FOR THE FINANCIAL YEAR ENDED 31 DECEMBER
2022 - AIA GENERAL BERHAD
21 June 2023
VIEW MORE
OUR PRODUCTS
Life Protection
Medical Protection
Critical Illness Protection
Savings & Investment
Accident Protection
Property Solution
Motor Insurance
Online Products
OUR PRODUCTS
Life Protection
Medical Protection
Critical Illness Protection
Savings & Investment
Accident Protection
Property Solution
Motor Insurance
Online Products
This website uses cookies for the purpose of enhancing your user experience. You
can find more information on the types of cookies we collect, what we use these
for, and how to manage your cookie settings in our Cookies Policy and Privacy
Statement.
WHAT MATTERS
Health & Wellness
Finance & Insurance
Video Gallery
Mental Wellbeing
Health Statistics
ABOUT US
About AIA Bhd.
About AIA PUBLIC Takaful Bhd.
About AIA General Berhad
About AIA Pension and Asset Management Sdn. Bhd.
Careers
Community & Partnership
Events & Promotions
Sitemap
HELP & SUPPORT
Contact Us
FAQ
Important Announcement
Form Library
AIA MALAYSIA
Menara AIA, 99, Jalan Ampang,
50450 Kuala Lumpur
AIA Bhd.
1300-88-1899
For Overseas Customers
603 2056 1111
AIA PUBLIC Takaful Bhd.
1300-88-8922
AIA General Berhad
1300-88-1899
AIA Pension and Asset Management Sdn. Bhd.
1300-22-7771
AIA Auto Assist / Roadside Assist
1-800-88-8733
WHAT MATTERS
Health & Wellness
Finance & Insurance
Video Gallery
Mental Wellbeing
Health Statistics
ABOUT US
About AIA Bhd.
About AIA PUBLIC Takaful Bhd.
About AIA General Berhad
About AIA Pension and Asset Management Sdn. Bhd.
Careers
Community & Partnership
Events & Promotions
Sitemap
This website uses cookies for the purpose of enhancing your user experience. You
can find more information on the types of cookies we collect, what we use these
for, and how to manage your cookie settings in our Cookies Policy and Privacy
Statement.
HELP & SUPPORT
Contact Us
FAQ
Important Announcement
Form Library
AIA MALAYSIA
Menara AIA, 99, Jalan Ampang,
50450 Kuala Lumpur
AIA Bhd.
1300-88-1899
For Overseas Customers
603 2056 1111
AIA PUBLIC Takaful Bhd.
1300-88-8922
AIA General Berhad
1300-88-1899
AIA Pension and Asset Management Sdn. Bhd.
1300-22-7771
AIA Roadside Assist
1-800-88-8733
www.aia.com.my/roadsideAssist
--------------------------------------------------------------------------------
Copyright © 2023 AIA Group Limited and its subsidiaries. AIA Bhd. 200701032867
(790895-D) AIA PUBLIC Takaful Bhd. 201101007816 (935955-M) AIA General Berhad
201001040438 (924363-W) AIA Pension and Asset Management Sdn. Bhd. 201201027147
(1011637-P) AIA Health Services Sdn. Bhd. 199601016211 (388561-T). All rights
reserved.
Terms of Use | Privacy Statement | Code of Conduct | Sitemap
Dismiss
ARE YOU STILL HERE?
SESSION EXPIRED
LOGOUT CONFIRMATION
Your session is about to expire, do you want to remain logged in?
Your session has expired. Please log in again.
Are you sure you want to log out ?
Please ensure that you have saved all your information.
OK
Log Out
Yes, Stay
CANCEL
YES, LOGOUT
Dismiss
DEBIT CARD NOTIFICATION
ARE YOU A DEBIT CARD USER?
This is an important notice to our customers using debit cards.
Find out more!
Dismiss
AIA GROUP'S SIZE AND STRENGTH
Dismiss
AWARDS
Gold Award in Trusted Brand 2017
Reader's Digest Trusted Brands Awards
Most Valuable Brand Award
The Brand Laureate Best Brand Awards
Gold Winner in Excellence in Content Marketing / Native Advertising / Branded
Content The Marketing Excellence Awards 2016
Silver Award for Effort for Good - Brands Malaysia Effie Awards 2016
More prestigious Awards & Mark of Excellence