汽车遇事报告书-亚洲保险.PDF

REPORT FORM REPORT FORM 重要事項 汽車遇事報告書 IMPORTANT Claims Department MOTOR VEHICLE ACCIDENT 8/F 118 Connaught Road West H.K. Tel: 3606 9193 Fax: 2810 7756 FOR OFFICE USE ONLY 1. 請詳細填報本表格上每一項目可避免延誤處理台端之賠償事宜。 To avoid delay in the execution of your claim it is imperative that each question on this report form be full answered. Claim No. ……………………. 2. 台端日後如接獲有關之一切文件及法律書信應儘速遞交敝公司辦理。 If you receive any legal documents/communications in any way connected with the accident please forward them to the HP: .……..……………………. company immediately. Excess: ……………………….. 3. 在該汽車未修理之前保戶應將此遇事報告書連同修理估價單乙份一併送交本公司並得本公司同意方可進行修理。 Prior to the commencement of repairs this Claim Form together with copies of estimate if available must be forwarded to the Expiry: ……………………….. Company and its consent obtained. A/C: …………………………... 保單號碼 Policy No. …………………………….……………… … 保戶 保戶姓名 職業 INSURED Policy Holder ………………………………………………………..