1. Individual or Family  (If you want to be covered by Insurance, please fill this form in then send it to us
  2. Group or Company





(If you are a group or company incoming tourist please send us the list of your tourist names along with their KITAS (Limitted Stay Permit Card). Also please inform us which packages, dates & days that you will be going to.)

If you need assistance regarding insurance, please contact us at

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