Activate your insurance

Thank you for purchasing your Personal Accident card from Go lang! Insurance. Fill out the form below to activate your policy. It takes about 2 minutes.

Your name (as printed on your government ID)

First name * Middle name (optional)

Last name *

Personal details

Date of birth * You must be at least 18 years old. Sex *

Mobile number * Email *

Occupation *

Home address (must match your government ID) Region * Province (leave blank if NCR) City / Municipality * Barangay * Street / House / Unit number *

Government ID

Choose your ID type, then enter the ID number exactly as printed. The format will be checked before submission.

Government ID type *

Card delivery Date your physical card was delivered * Your policy starts 3 days after the date your card was delivered. Date must be within the last 30 days.

Eligibility

Personal Accident coverage from Go lang! Insurance excludes high-risk occupations. Please confirm your work.

Are you currently employed in any of the following fields: military, law enforcement, or private security? *

No — I do not work in those fields Yes — I work in one of those fields

Privacy notice and consent

Go lang! Insurance Privacy Notice (v1.0 — placeholder, pending legal review)

Go lang! Insurance collects the personal information you provide on this form to activate your Personal Accident insurance policy, verify your identity, communicate with you about your policy, process claims, and comply with applicable laws.

Your data will be stored securely, encrypted at rest, and retained for one (1) year from the date of policy expiry in accordance with the Data Privacy Act of 2012 (RA 10173). After this period, your data will be securely deleted or anonymized.

Your data may be shared with our insurance underwriter and authorized service providers strictly for the purposes above. It will not be sold or used for marketing without your separate consent.

You have the right to access, correct, object to, or request deletion of your personal data. To exercise these rights, contact our Data Protection Officer at [DPO EMAIL].

I have read and understood the Privacy Notice above, and I consent to Go lang! Insurance collecting and processing my personal data for the purposes stated. *