学生人身平安险投保书.PDFVIP

Page 1 of 4 PAS-A-2015-V06 學生人身平安險投保書 Student Personal Accident Insurance Proposal Form 香港中環德輔道中 71 號永安集團大廈 9 樓 9/F., Wing On House, 71 Des Voeux Road Central, Hong Kong. 電話 Tel : 3187 5100 傳真 Fax : 3906 9919 備註 NOTES: 1. 請以英文正楷填寫本投保書及在適當方格內加「?」號。本申請須經核保程序。投保書上如有任何更改，請於更正資料旁簽署作實。Please complete the form in English BLOCK LETTERS and please put a “?” in the box as appropriate. This application is subject to underwriting. Any changes in this Proposal Form should be endorsed. 2. 為保障受保學生的利益，若不清楚此投保書需要透露的資料內容，請致電中銀集團保險有限公司 (下稱“中銀集團保險”) 保險熱線 (852) 3187 5100 查 詢。若未能充份透露實情，將會使受保學生得不到所需的保障，甚至使保單失效。If you have any doubt on what should be disclosed in this Proposal Form, please contact Bank of China Group Insurance Company Limited (named below as “BOCG Insurance”) hotline (852) 3187 5100 for the interests of the Insured Student. Failure to disclose may mean that the policy will not provide the Insured Student with the coverage required, or may invalidate the policy altogether. 3. 若此投保書所含的內容與保單條款有任何歧異，概以保單為準。In the event that the information contained in this Proposal Form does not conform to the terms in any policy issued, the policy terms shall prevail. 4. 「學生人身平安險」(下稱“本計劃”) 由中銀集團保險承保。Student Personal Accident Insurance (named below as “this Plan”) is underwritten by BOCG Insurance. 5. 中國銀行（香港）有限公司、南洋商業銀行有限公司、集友銀行有限公司、中銀信用卡(國際)有限公司及其他代理銀行（各稱為“代理銀行/代理”） 以中銀集團保險的委任保險代理身份分銷本計劃，本計劃為中銀集團保險的產品，而非代理銀行/代理的產品。Bank of China (Hong Kong) Limited, Nanyang Commercial Bank, Limited, Chiyu Banking Corporation Limited, BOC Credit Card (International) Limited and other agent banks (each an “ agent Bank/agent”) are the appointed insurance agents of BOCG Insurance for distribution of this Plan. This Plan is a product of BOCG Insurance but not the agent Bank/agent. 6. 對於代理銀行/代理與客戶之間因銷售過程或處理有關交易而產生的合資格爭議(定義見金融糾紛調解計劃的金融糾紛調解中心職權範圍)，代理銀行/ 代理須與客戶進行金融糾紛調解計劃程序；而有關本計劃的合約條款的任何爭議，應由中銀集團保險與客戶直接解決。In respect of an eligible dispute (as defined in the Terms of Reference for th