Personal Information Collection Statement

In relation to the personal data collected in this claim form, I agree and acknowledge that:

(a) (unless specifically indicated otherwise in the above) the personal data requested in this form (or otherwise provided during the course of the claim process) is necessary for AIG Insurance Hong Kong Limited (“AIG HK”) to process the insurance claim and any such data not provided may mean the claim cannot be processed.

(b) the personal data collected in this form may be used by AIG HK for purposes which include 1)assessing, investigation, adjusting and making a decision on this claim; 2)otherwise for the purpose of administering the insured(s’) insurance policy (including pursuing recovery from reinsurers) and 3) for other purposes stated elsewhere in this form.

(c) AIG HK may transfer the personal data to the following classes of persons (whether based in Hong Kong or overseas) for the purposes identified in (b) above:
i) third parties providing services related to the administration of the Insured’s policy (including reinsurers);
ii) financial institutions for the purpose of processing this application and obtaining policy payments;
iii) loss adjustors, assessors, third party administrators, emergency providers, legal services providers, retailers, medical providers and travel carriers;
iv) another member of the AIG group (for all of the purposes stated in (b) ) in any country; or
v) other parties referred to in AIG HK’s Data Privacy Policy for the purposes stated therein.

(d) The Insured(s)/Claimant(s) may gain access to, or request correction of their personal data (in both cases, subject toa reasonable fee)at any time, bywriting tothe Privacy Compliance Officer of AIG Insurance Hong Kong Limited at GPO Box 456 or The same addresses maybe used to contact us with any comments on our service. The full version of AIG HK’s Data Privacy Policy can be found at



(a) 除非於本表格上另有訂明 ,本表格所要求提供的個人資料(或於處理索償時所要求提供的個人資料)是供美亞保險香港有限公司(“美亞保險”) 處理保險索償申請的所需資料, 若未能提 供任何所需資料索償申請則可能不被處理;

(b) 美亞保險可按列於其私隱政策的用途使用此表格所收集之個人資料,其用途包括:1)評核、調查、調整及就此索償申請作出決定; 2)管理受保人的保單(包括向再保險公司索取賠償) 及3) 任何於本表格其它位置列明的目的;

(c) 美亞保險亦可向以下類別的人士 (不論在香港或海外)轉交該些個人資料,作上述(b) 項所列明之用途:
      (i) 提供有關本人/吾等保單管理服務的第三者(包括再保險公司);
      (ii) 財務機構,作處理此申請及收取保費;
     (iii) 公證人、調查員、第三者管理人、緊急支援服務提供者、法律服務提供者、零售商、醫療提供者、及交通工具機構,以處理索償事宜;
    (iv) 其它在任何國家之AIG集團之成員公司,作上述(b)項所有列明之用途;或
     (v) 其它於美亞保險私隱政策所列明的人士,作於私隱政策列明之用途。

(d) 受保人/索償申請人可隨時致函到美亞保險香港有限公司之私隱事務主任(地址:香港郵政總局信箱456號或電郵查閱、或要求修改其個人資料(美亞保險可就查閱及修改要求收取合理費用)。如對美亞保險提供的服務有任何意見,可按上述地址聯絡美亞保險。美亞保險私隱政策的全文載於