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1、.:.;Declaration, Terms and ConditionsAccidentSuranceDeclaration for AccidentSurance I, on behalf of each of myself, my spouse and my child/children (if any), hereby declare as follows:1.I (Insured)/We (Insured, insured spouse and insured child/children) hereby apply for AccidentSurance within the Ho
2、ng Kong Special Administrative Region and declare that the statements and particulars given in this application are to the best of my/our knowledge and belief, true and complete, and that this application will form the basis of my/our contract with AXA General Insurance Hong Kong Limited.2.I/We furt
3、her declare that: (i)I am/We are in good health and free from physical impairment or deformity.(ii)I and my insured spouse are both under 60 years of age and the insured child/children is/are six months of age or over but under 18 years of age or is a/are full-time student(s) at a school, college or
4、 university under 23 years of age.(iii)I am/We are Hong Kong Special Administrative Region residents.(iv)I/We have never been denied personal accident insurance.(v)I/We do not have any in-force AccidentSurance policy with AXA General Insurance Hong Kong Limited that was effected after 27 October 200
5、2, and have not had any AccidentSurance policy cancelled during the last six months.3.I/We understand that insured person(s) who engage in work or activities listed in the HYPERLINK hsbc.hk/1/2/hk/insurance/accident/accidhighlights t _blank Hazardous Activities List, will receive no benefits under t
6、he policy for Accidental Injury, Death or Medical Expenses which result from or are caused directly or indirectly by an Accident whilst carrying out such work or activity.4.I/We have read and understood the HYPERLINK javascript:pws_popupPdf(/content/hongkongpws/insurance/pdf/pics_axa.pdf%20,popWin,%
7、20width=680,height=440,scrollbars=yes,resizable=yes); Personal Information Collection Statement, HYPERLINK hsbc.hk/1/2/hk/insurance/tc l accid#accid Terms and Conditions and the HYPERLINK javascript:pws_popupPdf(/content/hongkongpws/insurance/pdf/accide.pdf%20,popWin,%20width=680,height=440,scrollba
8、rs=yes,resizable=yes); Policy Wording of this AccidentSurance and agree to be bound by the same.Terms and Conditions for AccidentSurance 1.Eligibility (age limits)Applicants family members are:legally married spouse under 60 years of age all legally dependent unmarried children, including step child
9、ren and legally adopted children, who are six months of age or over but under 18 years of age or full-time students at a school, college or university under 23 years of age 2.Benefits Payable(i)Spouse:Same as the Insureds(ii)Children:Cash Benefit for Accidental Injury or Death: 20% of the InsuredMed
10、ical expenses: 20% of the Insureds (Daily limit same as the Insureds)Chinese bonesetter expenses: 20% of the Insureds (Daily limit same as the Insureds)3.Premium Payment MethodPremiums may be paid by direct debit to a designated credit card account.4.Renewal AgreementAccidentSurance will be renewed
11、upon payment of premium when due, otherwise it will be cancelled automatically.5.Refund of Premium (i)For monthly payment policyThis policy is subject to minimum payment of two months premium in advance which is not refundable upon termination unless the policy is cancelled within 15 days of the rec
12、eipt of the policy (i.e. from the date of application). (ii)For annual payment policyThis policy is subject to the payment of the annual premium in advance. All premium paid will at all times be subject to the Premium Refund Rules upon the termination of AccidentSurance except where AccidentSurance
13、is cancelled within 15 days of the receipt of the policy (i.e. from the date of application), where a full refund will be made. 6.Privacy and Security StatementOnce you submit an online application of this AccidentSurance, you shall be deemed to have read, understood and agreed to the Privacy and Se
14、curity Statement. If you have not already read this Statement, please do so by clicking HYPERLINK hsbc.hk/1/2/privacy-security t _blank here.Please refer to HYPERLINK javascript:pws_popupPdf(/content/hongkongpws/insurance/pdf/accide.pdf%20,popWin,%20width=680,height=440,scrollbars=yes,resizable=yes)
15、; Policy Wording for full detailed terms and conditions. For more information, please call Insurance Service Hotline on (852) 2867 8678.不测万全保不测万全保声明本人,并代表配偶及子女如适用,作出以下声明:1.本人投保人/本人等投保人及受保配偶与子女于香港特别行政区境内恳求不测万全保并声明就本人等所知所信,本恳求书内的各项陈说及细节均属真实无讹及完好,且本恳求书将会成为本人等与安盛保险所签署合约的根据。2.本人等更作以下声明:(i)本人等如今身体安康,身体无任何
16、的缺陷。(ii)本人和受保配偶的年龄均低于60岁,受保子女的年龄那么介乎六个月或以上及18岁以下,或23岁以下而在本保险生效日时在学校、学院或大学就读的全日制学生。(iii)本人等均是香港特别行政区居民。(iv)本人等从未被回绝恳求任何个人不测保险。(v)本人等现时并未持有由安盛保险于2002年10月27日或以后发出的不测万全保保单,亦未有在过去六个月内取消任何不测万全保保单。3.本人等明白此保单将不承保从事任何 HYPERLINK hsbc.hk/1/2/simplified/hk/insurance/accident/accidhighlights t _blank 高危活动类别的受保人,
17、在受雇于或在执行此等任务或活动时直接或间接产生或招致的不测受伤、不测身亡或医疗费用。4.本人等已阅读及明白 HYPERLINK javascript:pws_popupPdf(/content/hongkongpws/zh/insurance/pdf/pics_axa.pdf%20,popWin,%20width=680,height=440,scrollbars=yes,resizable=yes); 搜集个人资料声明及此不测万全保之 HYPERLINK hsbc.hk/1/2/simplified/hk/insurance/tc l accid#accid 条款及规定及 HYPERLINK
18、 javascript:pws_popupPdf(/content/hongkongpws/chinese/insurance/pdf/accidc.pdf%20,popWin,%20width=680,height=440,scrollbars=yes,resizable=yes); 保单内容,并赞同接受其约束。不测万全保条款及细那么 1.投保资历 年龄限制 恳求人的合资历家属只限于:60岁以下的合法配偶。 一切未婚并受供养的合法子女,包括继子女和合法领养的子女,唯年龄须在六个月或以上及18岁以下,或23岁以下而在学校、学院或大学就读的全日制学生。 2.赔偿额 (i)配偶:与投保人一样(ii
19、)子女:不测受伤或身亡的现金赔偿: 根本保额之20%医疗费用: 投保人之20% 每日赔偿额与投保人一样。跌打费用: 投保人之20% 每日赔偿额与投保人一样。3.保费缴付方法保费将直接在指定的信誉卡户口内扣除。4.续保协议不测万全保将于保费到期日于缴付保费时自动续保,否那么将自动被终止。5.保费退还 (i)月缴保单胜利恳求人须预缴最少两个月保费。除非接获保单后15天内由恳求日期起计算取消该保单,否那么一切预缴保费将不获退还。 (ii)年缴保单胜利恳求人须预缴全年保费。如在接获保单后15天内由恳求日期起计算取消该保单,保费会全数退还,否那么保费退还将根据退还保费条款而定。 6.私隐与保安声明您在网
20、上恳求不测万全保时,将被视为已阅读、明白及赞同所列之私隐与保安声明。倘假设您尚未阅读该声明,请按 HYPERLINK hsbc.hk/1/2/simplified/privacy-security 此处。有关条款及规定之概略,请参阅 HYPERLINK javascript:pws_popupPdf(/content/hongkongpws/chinese/insurance/pdf/accidc.pdf%20,popWin,%20width=680,height=440,scrollbars=yes,resizable=yes); 保单。如有查询,请致电保险效力热线 (852) 2867 8
21、678。Fire InsuranceDeclaration for Fire Insurance 1.I (Applicant) have read and understood the HYPERLINK javascript:pws_popupPdf(/content/hongkongpws/insurance/pdf/pics_axa.pdf%20,popWin,%20width=680,height=440,scrollbars=yes,resizable=yes); Personal Information Collection Statement.2.I hereby apply
22、for Fire Insurance within the Hong Kong Special Administrative Region and declare that the statements and particulars given in this application are to the best of my knowledge and belief, true and complete, and this application will form the basis of my contract with AXA General Insurance Hong Kong
23、Limited. I further declare that: (i)My insured property is built of bricks, stone and concrete and roofed with concrete.(ii)My insured property is less than 40 years of age.(iii)My insured property is not used for commercial purposes and is located in a permanent building in Hong Kong SAR.(iv)I am/w
24、ill be the legal owner of this insured property by the Policy Commencement Date.(v)I have never had any fire insurance applications rejected or accepted on special terms by any insurance company.(vi)I do not have any Fire Insurance policy of my insured property with AXA General Insurance Hong Kong L
25、imited cancelled during the last six months.(vii)I understand that, in respect my choice of sum insured, this HYPERLINK JavaScript:pws_popupPdf(/content/hongkongpws/insurance/pdf/firee.pdf%20,popWin,%20width=680,height=440,scrollbars=yes,resizable=yes); Policy Wording is subject to Average clause (r
26、efer to clause 11 of the policy) and Reinstatement Value Insurance (refer to clause A19 of the policy) in the event of under-insurance.Terms and Conditions for Fire Insurance 1.EligibilityApplicant must be 18 (by last birthday) or over.2.Insurance Coverage and Clauses ClausesStandard CoverComprehens
27、ive CoverA7Foundations ExclusionFoundations ExclusionA12Mortgagee/Non-Occupying Landlord ClauseMortgagee/Non-Occupying Landlord ClauseA13Mortgagee ClauseMortgagee ClauseA19Reinstatement Value Insurance(not applicable to stock)Reinstatement Value Insurance(not applicable to stock)B24Occupancy Warrant
28、y AOccupancy Warranty AB25Occupancy Warranty BOccupancy Warranty BX02N/AAircraftX04ExplosionExplosionX5AN/ARiot and StrikeX06N/AMalicious DamageX8AN/AVehicle Impact (by third party vehicle)X10EarthquakeEarthquakeX12Typhoon, Windstorm and FloodTyphoon, Windstorm and FloodX13N/AWater Tanks, Apparatus
29、and PipesE15Landslide and SubsidenceLandslide & Subsidence3.Premium Payment MethodPremium can be paid by direct debit to designated credit card account.4.Renewal AgreementRenewal letter will be sent to your last known correspondence address about 45 days prior to your policys annual expiry date. The
30、 policy will be automatically renewed for another year on successfully debiting the annual premium from your designated direct debit account.5.Refund of PremiumThis HYPERLINK JavaScript:pws_popupPdf(/content/hongkongpws/insurance/pdf/firee.pdf%20,popWin,%20width=680,height=440,scrollbars=yes,resizab
31、le=yes); Policy Wording is subject to minimum payment of HK$400 or following short period refund rate, whichever is higher. Period of InsurancePremium PaymentExceedingNot exceeding-5 days2.5% of annual premium5 days15 days5%15 days1 month10%1 month45 days15%45 days2 months20%2 months3 months30%3 mon
32、ths4 months40%4 months5 months50%5 months6 months60%6 months7 months70%7 months8 months80%8 months9 months85%9 months10 months90%10 months11 months95%11 months-Full annual premium6.Privacy and Security StatementOnce you submit an online application of this Fire Insurance, you shall be deemed to have
33、 read, understood and agreed to the Privacy and Security Statement. If you have not already read this Statement, please do so by clicking HYPERLINK hsbc.hk/1/2/privacy-security t _blank here.Please refer to the HYPERLINK JavaScript:pws_popupPdf(/content/hongkongpws/insurance/pdf/firee.pdf%20,popWin,
34、%20width=680,height=440,scrollbars=yes,resizable=yes); Policy Wording for details on Exclusions, Geographical limits, Termination notice, Governing Version and terms and conditions. For further information, please call Insurance Service Hotline on (852) 2867 8678.火险火险声明1.本人知悉及明白 HYPERLINK javascript
35、:pws_popupPdf(/content/hongkongpws/zh/insurance/pdf/pics_axa.pdf%20,popWin,%20width=680,height=440,scrollbars=yes,resizable=yes); 搜集个人资料声明的内容。2.本人于香港特别行政区境内恳求火险并声明就本人所知所信,本恳求书内的各项陈说及细节均真实无讹及完好,且本恳求书将会构本钱人与安盛保险所签署合约的根据。本人更作出以下声明 : (i)本人的居所是用砖、石及混凝土筑成,屋顶那么用混凝土建造。(ii)本人的居所楼龄不超越40年。(iii)本人的居所是非商业用途及位于香港
36、特别行政区的永久落成住宅大厦内。(iv)本人现时或在保单生效时是此住所的合法户主。(v)本人从未被回绝恳求火险或接受其它保险公司之特别条款。(vi)本人没有在过去六个月内取消此居所与安盛保险之火险保单。(vii)本人明白如本人定之投保额缺乏时,是会根据本 HYPERLINK javascript:pws_popupPdf(/content/hongkongpws/chinese/insurance/pdf/firec.pdf%20,popWin,%20width=680,height=440,scrollbars=yes,resizable=yes); 保单之比例分摊(请参阅保单条款11)及修
37、复价值保险 (请参阅保单条款A19) 条款。火险条款及细那么 1.投保资历恳求人年龄必需18岁或以上。2.承保工程及条款 条款根本保证全面保证A7地基除外责任地基除外责任A12承押人/非居住业主条款承押人/非居住业主条款A13承押人条款承押人条款A19修复价值保险(不适用于存货)修复价值保险(不适用于存货)B24居住保证A居住保证AB25居住保证B居住保证BX02不适用空难X04爆炸爆炸X5A不适用暴动及罢工X06不适用恶意损毁X8A不适用汽车碰撞(由第三者的汽车引致者)X10地震地震X12台风、暴风及洪水台风、暴风及洪水X13不适用水箱、输水安装或水管E15山泥倾泻及地陷山泥倾泻及地陷3.保
38、费缴付方法保费将直接从指定的信誉卡户口扣除。4.续保协议续保通知书会于您的火险保单到期日之前45天内将寄往最后所知的通讯地址。只需胜利从您所指定的户口扣除保费,保单即会自动续保。5.保费退还本 HYPERLINK javascript:pws_popupPdf(/content/hongkongpws/chinese/insurance/pdf/firec.pdf%20,popWin,%20width=680,height=440,scrollbars=yes,resizable=yes); 保单是根据最低收费款项港币400元或以下的短期退还保费表,以较高者计算。 已受保期需缴交保费超越不超越
39、-5日2.5%的年费5日15日5%15日1个月10%1个月45日15%45日2个月20%2个月3个月30%3个月4个月40%4个月5个月50%5个月6个月60%6个月7个月70%7个月8个月80%8个月9个月85%9个月10个月90%10个月11个月95%11个月-全数保费6.私隐与保安声明您在网上恳求火险时,应已参阅、明白及赞同所列的私隐与保安声明。您假设未参阅该声明,请按 HYPERLINK hsbc.hk/1/2/simplified/privacy-security t _blank 此处。有关不受保工程、终止保单及适用文本、条款及细那么的概略,请参阅 HYPERLINK javasc
40、ript:pws_popupPdf(/content/hongkongpws/chinese/insurance/pdf/firec.pdf%20,popWin,%20width=680,height=440,scrollbars=yes,resizable=yes); 保单。查询概略,请致电保险效力热线(852) 2867 8678。Terms and Conditions for FirstCare 1.EligibilityThe following family members of the applicant who are eligible for coverage: Legall
41、y married spouse under 75 years of age (or under 65 years of age if applying for Company Top-up Plan or Outpatient benefit) All legally dependent unmarried children, including step children and legally adopted children, who are aged 15 days to 17 years (inclusive) or in full-time education at a scho
42、ol, college or university under 23 years of age 2.Premium PaymentPremium must be paid by direct debit from a designated credit card account. 3.Renewal Arrangement Renewal letter will be sent to your last known correspondence address about 45 days prior to your policy expiry. Renewal and subsequent a
43、nnual premiums will be collected from your designated credit card account. Upon receipt of your renewal premium, we will issue new medical card(s) and schedule of benefits to you. Renewal is arranged automatically and is guaranteed for life. The premium payable upon policy renewal and the terms of a
44、ny renewal may not be the same as for the expiring policy and will be determined by AXA General Insurance Hong Kong Limited at its absolute discretion. 4.Change of planChange of plan type is not allowed during the policy period. For change of plan type upon policy renewal, you should submit your req
45、uest for change at least one month before policy expiry. Any change if approved will only be effective upon policy renewal.5.Refund of premiumThis policy is subject to the payment of the annual premium in advance which is subject to premium refund rule of the policy unless the policy is cancelled wi
46、thin 15 days of the receipt of the policy.6.Privacy and Security StatementOnce you submit an online application for FirstCare, you shall be deemed to have read, understood and agreed to the Personal Information Collection Statement and Privacy and Security Statement. If you have not read these State
47、ments, please do so by clicking HYPERLINK javascript:pws_popupPdf(/content/hongkongpws/insurance/pdf/pics_axa.pdf%20,popWin,%20width=680,height=440,scrollbars=yes,resizable=yes); Personal Information Collection Statement and HYPERLINK hsbc.hk/1/2/privacy-security Privacy and Security Statement. 7.Ou
48、tpatient BenefitIf you have selected the optional outpatient benefit, the valid FirstCare Card must be presented on registration at the network clinic in order to receive the outpatient benefit.Please refer to the HYPERLINK javascript:pws_popupPdf(/content/hongkongpws/insurance/pdf/firstcaree.pdf%20
49、,popWin,%20width=680,height=440,scrollbars=yes,resizable=yes); Policy Wording for full policy terms and conditions. For further information, please call Insurance Service Hotline on (852) 2867 8678.挚关怀医疗方案挚关怀医疗方案条款及细那么 1.投保资历以下恳求人的家属,有资历受保此方案: 75岁以下的合法配偶 (假设投保公司增值方案或门诊保证那么为65岁以下) 一切未婚并受供养的合法子女,包括继子女
50、和合法领养的子女,唯年龄须介乎15天至17岁包括首尾年龄或23岁以下而在学校、学院或大学就读的全日制学生。 2.保费缴付方法保费须直接在指定的信誉卡户口内扣除。 3.续保安排 续保通知书会于您的挚关怀医疗方案保单到期日之前45天内寄往最后所知的通讯地址。随后应缴付的每年保费会根据您投保时所指定的信誉卡户口内扣除。当收到续保保费后,我们会发出新的医疗卡及保证工程表。 本保单将自动及保证可终身续保。续保保费及条款能够与到期之保单不同及会由安盛保险全权厘定。 4.更改投保方案在保单承保期内,不能更改保证方案。您可于续保时更改保证方案,但必需于保单到期日前1个月递交有关恳求。有关更改将于批核后才开场生
51、效。5.保费退还恳求人须预缴全年保费,而有关保费的退回安排,将根据保单退还保费条款而定。除非恳求人于接获保单后15天内要求取消该保单。6.私隐与保安声明您在网上恳求挚关怀医疗方案时,将被视为已阅读、明白及赞同所列之搜集个人资料声明及私隐与保安声明。倘假设您尚未阅读该声明,请按 HYPERLINK javascript:pws_popupPdf(/content/hongkongpws/chinese/insurance/pdf/pics_axa.pdf%20,popWin,%20width=680,height=440,scrollbars=yes,resizable=yes); 搜集个人资料
52、声明及 HYPERLINK hsbc.hk/1/2/simplified/privacy-security 私隐与保安声明。 7.门诊保证假设您己拣选门诊保证于网络医生求诊时必需出示有效挚关怀医疗卡,否那么有关门诊保证将不获赔偿。有关条款及细那么的概略,请参阅 HYPERLINK javascript:pws_popupPdf(/content/hongkongpws/chinese/insurance/pdf/firstcarec.pdf%20,popWin,%20width=680,height=440,scrollbars=yes,resizable=yes); 保单。查询概略,请致电保
53、险效力热线(852) 2867 8678。Golfers Insurance PackageDeclaration for Golfers Insurance Package1.I (Insured)/We (Insured and insureds spouse) have read and understood the HYPERLINK javascript:pws_popupPdf(/content/hongkongpws/insurance/pdf/pics_axa.pdf%20,popWin,%20width=680,height=440,scrollbars=yes,resiza
54、ble=yes); Personal Information Collection Statement.2.I/We understand that this application will form the basis of my/our contract with AXA General Insurance Hong Kong Limited.3.I/We hereby apply for Golfers Insurance Package within the Hong Kong Special Administrative Region and declare that the st
55、atements made in or in connection with this application are true and complete and that I/we have not withheld any material facts which are likely to affect acceptance or assessment of the insurance cover requested. I/We understand that in case of doubt as to whether AXA General Insurance Hong Kong L
56、imited should be informed of certain facts, I/we should call Insurance Service Hotline on (852) 2867 8678. Failure to disclose any material facts referred to above may mean that the Policy will not provide the Insured Person(s) with the required coverage, or may invalidate the Policy altogether. I/W
57、e further declare that(i)I am /We are both aged between 18 to 65.(ii)I am/We are amateur golfer(s).(iii)I am/We are residents of the Hong Kong Special Administrative Region.(iv)I/We have never had any of my/our applications for personal insurance rejected or have had any of such insurance policies c
58、ancelled by any insurance companies.(v)I/We have never made any claim relating to golfers equipment, personal effects, hole-in one expenses, personal liability or personal accident under any insurance in the last 3 years.4.I/We understand and agree that no refund of premium will be made once the ins
59、urance is effected.5.I/We understand that AXA General Insurance Hong Kong Limited will send an invitation to renew to us regarding renewal of the Policy in the future and my/our application for renewal of the Policy is subject to the approval of AXA General Insurance Hong Kong Limited.6.I/We have re
60、ad and understand the HYPERLINK hsbc.hk/1/2/hk/insurance/tc l golfer#golfer Terms and Conditions and the HYPERLINK JavaScript:pws_popupPdf(/content/hongkongpws/insurance/pdf/golfere.pdf%20,popWin,%20width=680,height=440,scrollbars=yes,resizable=yes); Policy Wording of this Golfers Insurance Package
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