Policy type 保单类别 - Business TravelCare公干万全保.pdf

HSBC Insurance (Asia) Limited 滙豐保險(亞洲)有限公司 Hong Kong SAR Office: 18/F, Tower 1, HSBC Centre, 1 Sham Mong Road, Kowloon, Hong Kong 香港九龍深旺道 1號滙豐中心 1 座 18 樓 Business TravelCare 公幹萬全保 / Business Accidentcare 僱員意外萬全 / OfficeSurance 辦公室萬全保 / RetailerSurance 零售萬全保 Page 頁次 1/6 Amendment / Cancellation request form 更改/取消保單申請表 Business TravelCare 公幹萬全保 / Business AccidentCare 僱員意外萬全 / OfficeSurance 辦公室萬全保 / RetailerSurance 零售萬全保 Amendment / Cancellation request form 更改/取消保單申請表 Please complete all related questions; failure to do so may result in your request being delayed. 請填妥有關部分﹐如有遺漏可能延誤有關申請。 Please note that the proposed amendment(s) will be effective only upon approval by HSBC Insurance (Asia) Limited and please allow 10 working days from the date of this instruction to update your records. 此申請表得經滙豐保險(亞洲)有限公司批核後﹐方為生效﹐另需時十個工作天更新您的紀錄。 Details of policy (Please “?” the appropriate box 請在適當的方格內加“?”號) Policy type 保單類別 ? Business Travelcare 公幹萬全保 ? Business Accidentcare 僱員意外萬全保 ? OfficeSurance 辦公室萬全保 ? RetailerSurance 零售萬全保 Policy number 保單號碼 Name of company/business entity (in English) 公司/機構名稱（英文名稱） Contact person 聯絡人姓名 Contact phone number 通訊電話號碼 Fax number 傳真號碼 E-mail 電郵地址 Amendment details 更改詳情 ? Change of correspondence address 更改通訊地址 Effective date 生效日期 New correspondence address (in block letters) 新通訊地址（請用英文正楷填寫） Telephone number 電話號碼 (if different) E-mail address 電郵地址 HSBC Insurance (Asia) Limited 滙豐保險(亞洲)有限公司 Hong Kong SAR Office: 18/F, Tower 1, HSBC Centre, 1 Sham Mong Road, Kowloon, Hong Kong 香港九龍深旺道 1號滙豐中心 1 座 18 樓 Business TravelCare 公幹萬全保 / Business Accidentcare 僱員意外萬全 / OfficeSurance 辦公室萬全保 / RetailerSurance 零售萬全保 Page 頁次 2/6 Amendment / Cancellation request form 更改/取消保單申請表 ? Change of premium payment account number Effective date 更改繳付保費戶口號碼 生效日期 New premium payment account number 繳付保費新戶口號碼 ? Account number with HSBC 滙豐賬戶號碼 Ple