香港汇丰银行一般保险条款、声明、细则.doc

Declaration, Terms and Conditions AccidentSurance Declaration for AccidentSurance I, on behalf of each of myself, my spouse and my child/children (if any), hereby declare as follows: 1. I (Insured)/We (Insured, insured spouse and insured child/children) hereby apply for AccidentSurance within the Hong Kong Special Administrative Region and declare that the statements and particulars given in this application are to the best of my/our knowledge and belief, true and complete, and that this application will form the basis of my/our contract with AXA General Insurance Hong Kong Limited. 2. I/We further declare that: (i) I am/We are in good health and free from physical impairment or deformity. (ii) I and my insured spouse are both under 60 years of age and the insured child/children is/are six months of age or over but under 18 years of age or is a/are full-time student(s) at a school, college or university under 23 years of age. (iii) I am/We are Hong Kong Special Administrative Region residents. (iv) I/We have never been denied personal accident insurance. (v) I/We do not have any in-force AccidentSurance policy with AXA General Insurance Hong Kong Limited that was effected after 27 October 2002, and have not had any AccidentSurance policy cancelled during the last six months. 3. I/We understand that insured person(s) who engage in work or activities listed in the Hazardous Activities List, will receive no benefits under the policy for Accidental Injury, Death or Medical Expenses which result from or are caused directly or indirectly by an Accident whilst carrying out such work or activity. 4. I/We have read and understood the Personal Information Collection Statement, Terms and Conditions and the Policy Wording of this AccidentSurance and agree to be bound by the same. Terms and Conditions for AccidentSurance 1. Eligibility (age limits) Applicants family members are: legally married spouse under 60 years of age all legally dependent unmarried children, incl