{"id":14987,"date":"2020-01-06T12:30:03","date_gmt":"2020-01-06T04:30:03","guid":{"rendered":"https:\/\/www.redcover.com.my\/%e5%b8%95%e9%87%91%e6%a3%ae%e7%97%85\/"},"modified":"2021-09-12T17:02:37","modified_gmt":"2021-09-12T09:02:37","slug":"%e5%b8%95%e9%87%91%e6%a3%ae%e7%97%85","status":"publish","type":"page","link":"https:\/\/www.redcover.com.my\/zh-hans\/aia-39-%e9%87%8d%e5%a4%a7%e7%96%be%e7%97%85%e4%bf%9d%e9%99%a9%e8%ae%a1%e5%88%92-%e9%a9%ac%e6%9d%a5%e8%a5%bf%e4%ba%9a\/%e5%b8%95%e9%87%91%e6%a3%ae%e7%97%85\/","title":{"rendered":"\u5e15\u91d1\u68ee\u75c5"},"content":{"rendered":"\n<p class=\"has-drop-cap\">\n\n\u5e15\u91d1\u68ee\u75c5\u548c\u6cbb\u7597\u4f1a\u5f71\u54cd\u4f60\u7684\u79fb\u52a8\u65b9\u5f0f\u3002 \u5b83\u53d1\u751f\u5728\u5927\u8111\u5185\u7279\u5b9a\u795e\u7ecf\u7ec6\u80de\u51fa\u73b0\u95ee\u9898\u65f6\u3002\n\n<\/p>\n\n<figure class=\"wp-block-embed-youtube wp-block-embed is-type-video is-provider-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\nhttps:\/\/youtu.be\/CeiafB1QFhI\n<\/div><\/figure>\n\n<div class=\"wp-block-buttons has-custom-font-size has-small-font-size is-horizontal is-content-justification-center is-layout-flex wp-container-core-buttons-is-layout-499968f5 wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button has-custom-font-size has-normal-font-size\"><a class=\"wp-block-button__link has-custom-background-color has-background wp-element-button\" href=\"#enquiry\">\u8be2\u95ee\u8bf7\u6c42<\/a><\/div>\n<\/div>\n\n<p>\u5e15\u91d1\u68ee\u75c5\u7684\u75c7\u72b6\u548c\u6cbb\u7597\u662f\u6e10\u8fdb\u7684\uff0c\u8fd9\u610f\u5473\u7740\u968f\u7740\u65f6\u95f4\u7684\u63a8\u79fb\uff0c\u5b83\u53d8\u5f97\u66f4\u7cdf\u3002 \u7136\u800c\uff0c\u8fd9\u901a\u5e38\u53d1\u751f\u7f13\u6162\uff0c\u5728\u51e0\u5e74\u5185\u3002<\/p>\n\n<h2 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class=\"wp-block-heading\">\u63a5\u89e6\u6bd2\u7d20<\/h3>\n\n<p>\u6301\u7eed\u63a5\u89e6\u9664\u8349\u5242\u548c\u6740\u866b\u5242\u53ef\u80fd\u4f1a\u4f7f\u60a8\u60a3\u5e15\u91d1\u68ee\u75c5\u7684\u98ce\u9669\u7565\u6709\u589e\u52a0\u3002<\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter is-resized\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/res.cloudinary.com\/redcover\/image\/upload\/f_jpg\/c_scale,w_419\/v1512971971\/PARKINSON_S_DISEASE2.webp\" alt=\"&#x5BB6;&#x5EAD;&#x4FDD;&#x9669;\" width=\"628\" height=\"397\"\/><\/figure><\/div>\n\n<h2 class=\"wp-block-heading\">\u5e15\u91d1\u68ee\u75c5\u7684\u75c7\u72b6\u53ca\u6cbb\u7597<\/h2>\n\n<p>\u5e15\u91d1\u68ee\u7684\u75c7\u72b6\u4e5f\u4e0e\u8fd0\u52a8\uff08\u8fd0\u52a8\u75c7\u72b6\uff09\u6216\u4e0e\u53d8\u5316\u65e0\u5173\uff08\u975e\u8fd0\u52a8\u75c7\u72b6\uff09\u76f8\u5173\u3002 \u6bcf\u4e2a\u5e15\u91d1\u68ee\u75c5\u60a3\u8005\u90fd\u4f1a\u6709\u4e0d\u540c\u7684\u75c7\u72b6\u3002 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class=\"wp-block-image\"><figure class=\"aligncenter\"><img decoding=\"async\" src=\"https:\/\/res.cloudinary.com\/redcover\/image\/upload\/f_jpg\/c_scale,w_601\/v1512971896\/PARKINSON_S_DISEASE.webp\" alt=\"\"\/><\/figure><\/div>\n\n<h2 class=\"wp-block-heading\">\u5982\u4f55\u8bca\u65ad\u5e15\u91d1\u68ee\u75c5<\/h2>\n\n<p>\u786e\u8ba4\u67d0\u4eba\u60a3\u6709\u5e15\u91d1\u68ee\u6c0f\u75c7\u5c06\u5360\u7528\u60a8\u7684\u65f6\u95f4\uff0c\u56e0\u4e3a\u5e15\u91d1\u68ee\u75c5\u7684\u75c7\u72b6\u548c\u6cbb\u7597\u6709\u4e0d\u540c\u7684\u60c5\u51b5\u3002 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gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_3' style='display:none'>\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Personal Life Insurance - Request for Quotation<\/h3>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_3'  action='\/zh-hans\/wp-json\/wp\/v2\/pages\/14987' data-formid='3' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_3_31\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_31'>LinkedIn<\/label><div class='ginput_container'><input name='input_31' id='input_3_31' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_3_31'>\u8fd9\u4e2a\u5b57\u6bb5\u662f\u7528\u4e8e\u9a8c\u8bc1\u76ee\u7684\uff0c\u5e94\u8be5\u4fdd\u6301\u4e0d\u53d8\u3002<\/div><\/li><li id=\"field_3_29\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><a name=\"enquiry\"><\/a><\/li><li id=\"field_3_12\" class=\"gfield gfield--type-checkbox gfield--type-choice gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Insurance Required<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_3_12'><li class='gchoice gchoice_select_all'>\n\t\t\t\t\t\t<input class='gfield-choice-input' type='checkbox' id='choice_12_select_all'   onclick='gformToggleCheckboxes( this )' onkeypress='gformToggleCheckboxes( this )' \/>\n\t\t\t\t\t\t<label for='choice_12_select_all' id='label_12_select_all' class='gform-field-label  gform-field-label--type-inline' data-label-select='\u9009\u62e9\u5168\u90e8' data-label-deselect='\u5168\u90e8\u53d6\u6d88'>\u9009\u62e9\u5168\u90e8<\/label>\n\t\t\t\t\t<\/li><li class='gchoice gchoice_3_12_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.1' type='checkbox'  value='Life Insurance'  id='choice_3_12_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_12_1' id='label_3_12_1' class='gform-field-label gform-field-label--type-inline'>Life Insurance<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_12_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.2' type='checkbox'  value='Critical Illness'  id='choice_3_12_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_12_2' id='label_3_12_2' class='gform-field-label gform-field-label--type-inline'>Critical Illness<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_12_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.3' type='checkbox'  value='Hospital Medical Card'  id='choice_3_12_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_12_3' id='label_3_12_3' class='gform-field-label gform-field-label--type-inline'>Hospital Medical Card<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_12_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.4' type='checkbox'  value='Personal Accident'  id='choice_3_12_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_12_4' id='label_3_12_4' class='gform-field-label gform-field-label--type-inline'>Personal Accident<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_12_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.5' type='checkbox'  value='Lady&#039;s Special Insurance'  id='choice_3_12_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_12_5' id='label_3_12_5' class='gform-field-label gform-field-label--type-inline'>Lady's Special Insurance<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_12_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.6' type='checkbox'  value='Prenatal (Preborn) Baby Care'  id='choice_3_12_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_12_6' id='label_3_12_6' class='gform-field-label gform-field-label--type-inline'>Prenatal (Preborn) Baby Care<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_12_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.7' type='checkbox'  value='Children Education Plan'  id='choice_3_12_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_12_7' id='label_3_12_7' class='gform-field-label gform-field-label--type-inline'>Children Education Plan<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_12_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.8' type='checkbox'  value='Retirement \/ Savings Plan'  id='choice_3_12_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_12_8' id='label_3_12_8' class='gform-field-label gform-field-label--type-inline'>Retirement \/ Savings Plan<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_3_25\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Lady&#039;s Special Insurance<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_3_25'><li class='gchoice gchoice_select_all'>\n\t\t\t\t\t\t<input class='gfield-choice-input' type='checkbox' id='choice_25_select_all'   onclick='gformToggleCheckboxes( this )' onkeypress='gformToggleCheckboxes( this 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gchoice_3_25_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.3' type='checkbox'  value='Confinement Allowance'  id='choice_3_25_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_25_3' id='label_3_25_3' class='gform-field-label gform-field-label--type-inline'>Confinement Allowance<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_25_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.4' type='checkbox'  value='Female Cancers'  id='choice_3_25_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_25_4' id='label_3_25_4' class='gform-field-label gform-field-label--type-inline'>Female Cancers<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_25_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.5' type='checkbox'  value='Female Diseases Care'  id='choice_3_25_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_25_5' id='label_3_25_5' class='gform-field-label gform-field-label--type-inline'>Female Diseases Care<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_25_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.6' type='checkbox'  value='Female Surgical Care'  id='choice_3_25_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_25_6' id='label_3_25_6' class='gform-field-label gform-field-label--type-inline'>Female Surgical Care<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_25_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.7' type='checkbox'  value='Menopause Care'  id='choice_3_25_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_25_7' id='label_3_25_7' class='gform-field-label gform-field-label--type-inline'>Menopause Care<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_25_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.8' type='checkbox'  value='Golden Age Benefit'  id='choice_3_25_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_25_8' id='label_3_25_8' class='gform-field-label gform-field-label--type-inline'>Golden Age Benefit<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_3_26\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Baby Special Insurance Coverage<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_3_26'><li class='gchoice gchoice_select_all'>\n\t\t\t\t\t\t<input class='gfield-choice-input' type='checkbox' id='choice_26_select_all'   onclick='gformToggleCheckboxes( this )' onkeypress='gformToggleCheckboxes( this )' \/>\n\t\t\t\t\t\t<label for='choice_26_select_all' id='label_26_select_all' class='gform-field-label  gform-field-label--type-inline' data-label-select='\u9009\u62e9\u5168\u90e8' data-label-deselect='\u5168\u90e8\u53d6\u6d88'>\u9009\u62e9\u5168\u90e8<\/label>\n\t\t\t\t\t<\/li><li class='gchoice gchoice_3_26_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.1' type='checkbox'  value='Prenatal (Preborn) Baby Care'  id='choice_3_26_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_26_1' id='label_3_26_1' class='gform-field-label gform-field-label--type-inline'>Prenatal (Preborn) Baby Care<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_26_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.2' type='checkbox'  value='Incubation Benefit'  id='choice_3_26_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_26_2' id='label_3_26_2' class='gform-field-label gform-field-label--type-inline'>Incubation Benefit<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_26_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.3' type='checkbox'  value='Baby ICU and HDU (Neonatal ICU) Coverage'  id='choice_3_26_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_26_3' id='label_3_26_3' class='gform-field-label gform-field-label--type-inline'>Baby ICU and HDU (Neonatal ICU) Coverage<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_26_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.4' type='checkbox'  value='Phototheraphy for Jaundice'  id='choice_3_26_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_26_4' id='label_3_26_4' class='gform-field-label gform-field-label--type-inline'>Phototheraphy for Jaundice<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_26_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.5' type='checkbox'  value='Birth Defects (15 Congenital Defects) up to age of 5'  id='choice_3_26_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_26_5' id='label_3_26_5' class='gform-field-label gform-field-label--type-inline'>Birth Defects (15 Congenital Defects) up to age of 5<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_26_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.6' type='checkbox'  value='Autism and ADHD up to age of 5'  id='choice_3_26_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_26_6' id='label_3_26_6' class='gform-field-label gform-field-label--type-inline'>Autism and ADHD up to age of 5<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_3_28\" class=\"gfield gfield--type-checkbox gfield--type-choice gf_right_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Others<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_3_28'><li class='gchoice gchoice_3_28_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.1' type='checkbox'  value='AIA Vitality Wellness Program'  id='choice_3_28_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_28_1' id='label_3_28_1' class='gform-field-label gform-field-label--type-inline'>AIA Vitality Wellness Program<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_28_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.2' type='checkbox'  value='Keyman Insurance'  id='choice_3_28_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_28_2' id='label_3_28_2' class='gform-field-label gform-field-label--type-inline'>Keyman Insurance<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_28_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.3' type='checkbox'  value='Income Replacement'  id='choice_3_28_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_28_3' id='label_3_28_3' class='gform-field-label gform-field-label--type-inline'>Income Replacement<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_28_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.4' type='checkbox'  value='Wealth Distribution'  id='choice_3_28_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_28_4' id='label_3_28_4' class='gform-field-label gform-field-label--type-inline'>Wealth Distribution<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_28_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.5' type='checkbox'  value='Family Wealth Trust Fund'  id='choice_3_28_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_28_5' id='label_3_28_5' class='gform-field-label gform-field-label--type-inline'>Family Wealth Trust Fund<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_28_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.6' type='checkbox'  value='Mortgage Reducing Term Assurance (MRTA)'  id='choice_3_28_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_28_6' id='label_3_28_6' class='gform-field-label gform-field-label--type-inline'>Mortgage Reducing Term Assurance (MRTA)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_28_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.7' type='checkbox'  value='Mortgage Life Term Assurance (MLTA)'  id='choice_3_28_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_28_7' id='label_3_28_7' class='gform-field-label gform-field-label--type-inline'>Mortgage Life Term Assurance (MLTA)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_28_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.8' type='checkbox'  value='Others - Home, Fire, Theft, Maid etc'  id='choice_3_28_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_28_8' id='label_3_28_8' class='gform-field-label gform-field-label--type-inline'>Others - Home, Fire, Theft, Maid etc<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_3_18\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_18'>City\/Town<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_3_18' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_3_1\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix no_first_name no_middle_name has_last_name no_suffix gf_name_has_1 ginput_container_name gform-grid-row' id='input_3_1'>\n                            \n                            \n                            \n       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