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GPS Plan Application Form - Direct / 導航版申請表 - 直接客戶

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Insured Company Details

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Company Name / 公司名稱
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Other than Hong Kong
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for 1 year cover

Sections Cover

I. Personal Accident 人身意外保障
Annual premium for Personal Accident (per person) 人身意外全年保費(每位)
 

If more than 10 items, please send details via email to cs.hk@aig.com 如選擇多於10個項目,請電郵傳送詳細給客戶服務 cs.hk@aig.com 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Personal Accident Premium 人身意外保障保費


II. Business Travel 商務旅遊 

Annual Premium for Business Travel (Per Group) 團體商務旅遊保障之全年保費(每個團體)

Select the number of trips 請選擇旅程次數
 
Select your plan 請選擇計劃
 
Select your plan 請選擇計劃
 
Select your plan 請選擇計劃
 
Select your plan 請選擇計劃
 
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Business Travel Premium


Loss History (Past 3 years) 索償記錄(過往3年)
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Declaration 聲明

Direct Declaration 直接客戶聲明
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1. I/We understand that the statements in this application and the information received by AIG Insurance Hong Kong Limited (“AIG HK”) as to the employee’s subsequent changes shall form a part of this application, and shall be the basis for underwriting thereof. 本人╱吾等明白,本申請表內之陳述及美亞保險香港有限公司(「美亞香港」)所接獲關於僱員後續變動之資料,均構成本申請一部分,並為承保之依據。
2. All individuals, for whom an application for insurance is submitted, or may be submitted during the continuance of the policy, shall be the full-time salaried employees working for the applicant. 已提交投保申請或可能在保單存續期間提交投保申請之所有人士,必須為申請人僱用之全職受薪僱員。
3. If there is any untruth in furnishing the application or any other statement in connection with the insurance of the employees, AIG HK has the right to reject all claims for the amounts insured. 本申請表內所填資料或與僱員保險有關之任何其他陳述如有任何不實,美亞香港均有權拒絕賠付全部投保額。
4. I/We hereby agree and undertake to settle any medical expenses that is not payable or not covered by this insurance or any amount in excess of the insurance limit within 14 days after receiving the written notification from AIG HK. The credit facility will be suspended if I/We fail to reimburse AIG HK within the above the time limit. Upon suspension, I/We have to return all CHINA Assist Cards to AIG HK and will remain liable to AIG HK for any outstanding payment in arrears. In the event of loss of CHINA Assist Card, the covered employee should advise AIG HK within 48 hours and pay HK$30 for each replacement card. 本人╱吾等同意並承諾,對所有保障範圍以外之醫療費用或所有超出所定限額之醫療費用,於收到美亞香港之通知書 14 天內支付。如本人╱吾等未能於限期內向美亞香港付清款項,預繳服務將被終止,同時本人╱吾等須將「中國支援卡」歸還美亞香港,但對所有上述債項仍須負責。如遺失「中國支援卡」,受保僱員須於 48 小時內向美亞香港報失並繳付HK$30作補領費用。
5. I/We hereby understand that the arrangement for emergency cash transfer is subject to Travel Guard first securing payment from us. 本人╱吾等明白,享受緊急現金匯款安排須吾等╱本人支付Travel Guard先行保證金。
6. In relation to the personal data collected in this application form, I/we agree and acknowledge that: 就有關從此申請表所收集的個人資料,本人╱吾等同意及確認:
(a) (unless specifically indicated otherwise in this form) the personal data requested in this form is necessary for AIG HK to process this application and any such data not provided may mean this application cannot be processed. 除非於本表格上另有訂明,本表格所要求提供的個人資料是供美亞香港處理本申請的所需資料,若未能提供任何所需資料,申請可能不被處理;
(b) the personal data collected in this form may be used by AIG HK for the purposes stated in its Data Privacy Policy, which include underwriting and administering the insurance policy being applied for (including obtaining reinsurance, underwriting renewals, data matching, claim processing, investigation, payment and subrogation and any related purposes). 美亞香港可按列於其私隱政策的用途使用本申請表所收集之個人資料,其用途包括核保及管理已申請的保單(包括獲取再保險、核保續保之保單、資料配對、處理索賠、調查、付款及行使代位權,以及任何相關用途);
(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: 美亞香港亦可向以下類別的人士(不論在香港或海外)轉交個人資料,作上述(b)項所列明之用途
i) third parties providing services related to the administration of my/our policy (including reinsurance); 提供有關本人╱吾等保單管理服務的第三者(包括再保險);
ii) financial institutions for the purpose of processing this application and obtaining policy payments; 財務機構,作處理此申請及收取保費;
iii) in the event of a claim, loss adjustors, assessors, third party administrators, emergency providers, legal services providers, retailers, medical providers and travel carriers; 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) another member of the AIG group (for all of the purposes stated in (b)) in any country; or 其他在任何國家之AIG集團之成員公司,作上述(b)項所有列明之用途;或
v) other parties referred to in AIG HK’s Data Privacy Policy for the purposes stated therein. 其他於美亞香港之私隱政策所列明的人士,作於私隱政策列明之用途。
(d) I/we may gain access to, or request correction of my/our personal data (in both cases, subject to a reasonable fee), by writing to the Privacy Compliance Officer of AIG HK at GPO Box 456 or cs.hk@aig.com. The full version of AIG HK’s Data Privacy Policy can be found at www.aig.com.hk. 本人╱吾等可隨時致函到美亞香港之私隱事務主任(地址:香港郵政總局信箱456號或電郵cs.hk@aig.com)查閱、或要求修改本人∕吾等之個人資料(美亞香港可就查閱及修改要求收取合理費用)。美亞香港私隱政策的全文載於www.aig.com.hk。
7. I/We confirm that the employees have been informed and have agreed that their personal data will be released to AIG HK in accordance with the personal information collection statement in paragraph (6) above. 本人╱吾等確認,僱員已知悉並同意根據上文(6) 段之個人資料收集聲明,向美亞香港提供其個人資料。
8. I/We understand that in the event of differences between the English and Chinese version of this application for insurance, the English version shall prevail and that the insurance policy the Company will issue will only be in English. 本人╱吾等明白,如以上投保申請之中文本於意義上有任何爭議,一概以英文本為準,本公司亦僅提供英文保單。
9. I/We understand that this insurance application will not be in force until the application has been accepted by AIG HK. 本人╱吾等明白,在獲得美亞香港接納之前,本投保申請一律無效。

 


Please note that this insurance application will not be in force until it has been accepted by AIG Hong Kong and the premium has been paid. 此保險申請須待美亞保險覆核,接納投保書及繳付保費後才能生效。
Our Customer Service Team will get in touch with the contact person within 48 hours with next steps and details on how to pay premium. 我們的客戶服務團隊將於48小時內就接下來的步驟及支付保費方法聯絡聯絡人。

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