更改保单申请表—财务.PDF

《更改保单申请表—财务.PDF》由会员分享，可在线阅读，更多相关《更改保单申请表—财务.PDF（12页珍藏版）》请在得力文库 - 分享文档赚钱的网站上搜索。

1、INHK005R30 (0818)WPage 頁次 1/12Incorporated in Bermuda with limited liability 於百慕達註冊成立之有限公司Hong Kong SAR Office：18/F, Tower 1, HSBC Centre, 1 Sham Mong Road, Kowloon, Hong Kong香港特別行政區地址：香港九龍深旺道1號滙豐中心1座18樓HSBCFTXPolicy Number* 保單號碼*1 1 1 1 1 1 1 1 12 2 2 2 2 2 2 2 23 3 3 3 3 3 3 3 34 4 4 4 4 4 4 4 45

2、5 5 5 5 5 5 5 56 6 6 6 6 6 6 6 67 7 7 7 7 7 7 7 78 8 8 8 8 8 8 8 89 9 9 9 9 9 9 9 90 0 0 0 0 0 0 0 0ePolicy servicing _ You can now make online submission via HSBC Personal Internet Banking for transfer of funds (investment choices), change in premium allocation, policy value withdrawal and change o

3、f payment, giving you the convenience of 24/7 access for shorter turnaround time. Please visit .hk/1/2/hk/insurance for more details._cj _ 閣下可透過滙豐個人網上理財以更快捷及全天候24小時方式，隨時處理轉調基金（投資選擇）、更改保費分配、提取保單金額及更改繳付保費指示。詳情請瀏覽.hk/1/2/chinese/hk/insurance。applicable to some plans only. 只適用於相關保險。Request for Policy Ch

4、ange Financial a _ Plan Name計劃名稱Name of Policyholder in English(Surname first)保單持有人英文姓名（先填寫姓氏）# ID Type ULEP: Goal Access Universal Life Plan (Education) （駿富教育萬用壽險計劃）; WGIP: HSBC Wealth Goal Insurance Plan（滙溢保險計劃）；FGIP: HSBC Family Goal Insurance Plan（滙盛人生保險計劃）6. If the payments are paid in currenci

5、es other than the policy currencies/currency of levy cap i.e. HKD as provided by the Insurance Authority, the payments would be subject to change according to the prevailing exchange rate of policy currencies/HKD to payment currencies to be determined by the Company from time to time. Likewise any p

6、ayments settled in currencies other than the policy currencies/currency of levy cap i.e. HKD, the payments would be subject to the change according to the prevailing exchange rate of policy currencies/HKD to payment currencies to be determined by the Company from time to time. The fluctuation in exc

7、hange rates may have impact on the amount of payments including but not limited to premium payments, levy payments and benefit payments. By choosing the plans denominated in currencies other than local currency, you are subject to the exchange rate risks. Exchange rate fluctuates from time to time.

8、You may suffer a loss of your benefit values and the subsequent premium payments and/or levy payments (if any) may be higher than your initial premium payment as a result of the exchange rate fluctuations. 如繳付款項貨幣有別於保單貨幣或保險業監管局訂定徵費上限的貨幣（即港幣），該款項可能會受本公司不時釐定的保單貨幣港幣對繳付款項貨幣的匯率而改變。同樣，如任何款項的貨幣不是以保單貨幣或保險業監

9、管局訂定徵費上限的貨幣（即港幣）支付，該款項將會受本公司不時釐定的保單貨幣對支付貨幣港幣的匯率而改變。匯率之波動會對款額構成影響，包括但不限於以繳付保費，保費徵費及利益支付款項。選擇非本地貨幣結算的保單，閣下須承受匯率風險。匯率會不時波動，閣下可能因匯率之波動而損失部分的利益價值及繳交往後保費及或保費徵費（如有）可能會比繳交首次保費及保費徵費金額為高。7. The Bank has explained the product features to you including potential liquidity, time horizon, any currency implication

10、s, fees except for reduction of Sum Insured/Protection Amount and deletion of supplementary benefits. Please visit an HSBC branch to conduct the “Financial Planning Report/Financial Needs Analysis” and submit it together with this form.)基本計劃附加保障_ -XJX_ ._d 5 3aY KZ Kg i._H # J _fKWi._H # J _( S t_f_

11、a. New Sum Insured/Protection Amount is subject to maximum and minimum requirements.新保額保障額不得超越保障計劃之最高及最低限制。b. Not applicable to Major Illness Benefit (to age 65).不適用於嚴重疾病保障（至65歲）。Increase in Protection Amount is only applicable to supplementary benefits attached to SPP/SPL/LIVP/RIVP policies. Additi

12、on of Major Illness Benefit (Advance Payment) for ULPP only allows within premium payment period for regular premium policy. This request is not applicable to single premium policy. 增加保障額只適用於儲全保卓滙投資壽險計劃投資儲全保退休儲全保之附加保障。駿富保障萬用壽險計劃增加嚴重疾病保障（預支保額）只適用於定期保費的保單。此申請不適用於躉繳保費的保單。For HSBC Comprehensive Critical

13、 Illness Protection Plan, addition of supplementary benefits and increase of sum insured after policy issuance is not allowed.於保單生效後，增加附加保障和增加保額並不適用於滙安健危疾保障計劃。Addition of Female Benefit will result in simultaneous addition of Major Illness Benefit if the latter was not attached to the policy.如嚴重疾病保障

14、未曾附加於保單上，於附加女性保障時，嚴重疾病保障會自動附加於保單。c. Deletion of Major Illness Benefit will be accompanied by deletion of Female Benefit applied/added on or after Nov 2001 if such is attached to the policy.刪除嚴重疾病保障會自動刪除2001年11月以後簽發或附加於保單之女性保障。* For reduction of sum insured, the cash value/surrender value (if applica

15、ble)/special bonus (if applicable) and death benefit/critical illness benefit (if applicable) of the policy will be reduced accordingly. A full review of your existing policy is/are recommended before you make this decision. For ULPP and ULEP, addition/reduction of sum insured is allowed after the f

16、irst policy anniversary for single premium policy and after the 5th policy anniversary for regular premium policy. The addition/reduction of sum insured is subject to minimum and maximum amounts determined by us from time to time. Reduction of sum insured is subject to surrender charge (if any). Sur

17、render charge applies during the first 10 policy years for ULPP and 8 policy years for ULEP. The maximum surrender charge is up to 45% (ULPP)/55% (ULEP) for regular premium policy and 11% (ULPP)/12% (ULEP) for single premium policy of the account value on the date we receive the request times the pe

18、rcentage of reduction of sum insured. Please refer to the policy terms for the relevant details. 若減少投保額，保單的現金價值退保價值（如適用）特別獎賞（如適用）及身故死亡賠償嚴重疾病保障（如適用）將會相應調低。故我們建議閣下於提出此申請前作出全面之復審。駿富保障萬用壽險計劃及駿富教育萬用壽險計劃躉繳的保單可於首保單年度後增加減少保額，定期保費的保單可於第5個保單年度後增加減少保額。增加減少保額的最低及最高款額將由本公司不時訂定。減少保額須繳付退保費用（如適用）。退保費用分別適用於首十個保單年度（駿

19、富保障萬用壽險計劃）首八個保單年度（駿富教育萬用壽險計劃），定期保費保單的退保費用最高達當收到要求時戶口價值的45%（駿富保障萬用壽險計劃）55%（駿富教育萬用壽險計劃）乘以減少投保額的百分比及躉繳保費保單的退保費用最高達當收到要求時戶口價值的11%（駿富保障萬用壽險計劃）12%（駿富教育萬用壽險計劃）乘以減少投保額的百分比。閣下可查閱保單條款以得到相關的詳細資料。If “Standing Instruction” has been set up for premium payment arrangement, please be reminded that you should comple

20、te and return the “Standing Instruction Request form” to The Hongkong and Shanghai Banking Corporation Limited for the amendment/cancellation of the said arrangement. Normally, it takes 5 business days to processing such request.若上述保單已設立常行指示以繳付保費，請注意，閣下需填妥並交回常行指示申請表予香港上海滙豐銀行有限公司，以修改或取消有關常行指示的安排。有關安排

21、，一般需時5個工作天方可生效。 Not applicable to WIPP.不適用於財富投資人壽計劃。 Not applicable to Corporate customer. Under the addition of the Payors Benefit and the Payor is not the Policyholder, Nationalities 2 and 3 are optional. Otherwise, please state all your current Nationality(ies) if you have any revision. In additi

22、on, nationality proof is required if the change of nationality applied by non-permanent Hong Kong resident.不適用於公司客戶。如申請付款人供款保障及付款人並非保單持有人，國籍2及3為非必要填寫資料。否則，如修正任何國籍資料，請填寫閣下現在的所有國籍。此外，如非香港永久居民申請修正國籍資料，請附上國籍證明。Change Sum Insured/Protection Amounta Add Reduce New Amount更改保額保障額a 增加 減少 新保額Basic Plan * 基本計劃

23、Yearly Renewable Term Benefit N/A 續年定期壽險保障Term Protection Benefit N/A 定期壽險保障Addition of Amount Deletion of Deletion of Joint Life InsuredSupplementary SupplementaryBenefitsbBenefitsc增加附加保障b保額 取消附加保障c取消聯名受保人+Addition of Payors Benefit 申請付款人供款保障Relationship to Life Insured: Father Mother Other與受保人之關係：

24、 父親 母親 其他 +Addition of Joint Life Insured (applicable for MPP only) 申請增加聯名受保人（只適用於樂安居供樓保障計劃）Applicant Status: Home Loan Existing Home Guarantor申請人身份： Applicant Loan Customer 擔保人樓宇貸款申請人 現有樓宇貸款客戶 +Please complete item (i) to (viii), Part II and Part III. 請填寫以下(i)至(viii)項，第二及第三部分。(i) Mr 先生 Mrs 太太 Miss

25、小姐 Ms 女士(ii) Name in English (Surname first) 英文姓名（先填寫姓氏） (iii) Chinese Name 中文姓名(iv) Former Name/Alias (Surname first) (where applicable)前用姓名別名（先填寫姓氏）（如適用） Applicable when Policyholder is an Individual 適用於保單持有人為個人(v) Date of Birth 出生日期 (DD日/MM月/YYYY年)(vi) # ID Type 考慮產品及服務之申請及為客戶推薦、提供、維持及管理產品和服務，以及用

26、於客戶獲提供的產品及服務（包括但不限於保險、公積金或公積金計劃、信貸融通或其他金融產品或服務）的運作及行政，包括但不限於保單或保險產品的承保、行政或評估；(ii) conducting identity, medical or credit checks;進行身份審查、身體檢查或信用審查；(iii) creating and maintaining the credit and risk related models of HSBC and the HSBC Group;設立及維持滙豐及滙豐集團的信貸及風險相關準則;(iv) any purposes in connection with an

27、y claims made by or against or otherwise involving a customer in respect of any products and/or services provided by HSBC or a member of the HSBC Group including, without limitation, making, defending, analysing, investigating, processing, assessing, determining, responding to, resolving or settling

28、 such claims; 與任何由滙豐或滙豐集團成員提供的產品及或服務相關，而由客戶提出或對客戶作出的索償，或以其他形式涉及客戶的索償有關的任何用途，包括但不限於作出、辯護、分析、調查、處理、評估、釐定、回應、解決該等索償或就該等索償達成和解；(v) designing insurance and other financial products and/or services for customers use; 設計提供客戶使用的保險及其他金融產品及或服務；(vi) marketing services, products and other subjects as described

29、in paragraph (f) below; 推廣以下(f)段所述的服務、產品及其他標的；(vii) determining the amount of indebtedness owed to or by a customer and collecting amounts outstanding from a customer and those providing security for customers obligations; 釐定滙豐對客戶或客戶對滙豐的欠債金額，並向客戶及為客戶債務提供抵押的人士追討欠款；(viii) meeting obligations, requirem

30、ents or arrangements, whether compulsory or voluntary, of HSBC or any of its branches or any member of the HSBC Group to comply with, or in connection with: 遵守滙豐或其任何分行或任何滙豐集團成員就以下各項負上或有關的責任、要求或安排（不論強制或自願性質）：(1) any law, regulation, judgment, court order, voluntary code, sanctions regime, within or o

31、utside the Hong Kong Special Administrative Region (“Hong Kong”) existing currently and in the future (“Laws”) (e.g. the Inland Revenue Ordinance and its provisions including those concerning automatic exchange of financial account information); 現在及將來於香港特別行政區（0 ）境內或境外存在的任何法律、法規、判決、法院命令、自願守則、制裁制度（,）（

32、例如稅務條例及其條文，包括關於自動交換財務賬戶資料的條文）；(2) any guidelines, guidance or requests given or issued by any legal, regulatory, governmental, tax, law enforcement or other authorities, or self-regulatory or industry bodies or associations of financial services providers within or outside Hong Kong existing current

33、ly and in the future (e.g. guidelines, guidance or requests given or issued by the Inland Revenue Department including those concerning automatic exchange of financial account information) and any international guidance, internal policies or procedures; 現在及將來於香港境內或境外存在的任何法律、監管、政府、稅務、執法或其他機關，或財務服務供應商

34、的自律監管或行業組織或協會所提供或發出的任何指引、指導或要求（例如稅務局所提供或發出的指引、指導或要求，包括關於自動交換財務賬戶資料的指引、指導或要求），及任何國際指引、內部政策或程序；(3) any present or future contractual or other commitment with local or foreign legal, regulatory, judicial, administrative, public or law enforcement body, or governmental, tax, revenue, monetary, securitie

35、s or futures exchange, court, central bank or other authorities, or self-regulatory or industry bodies or associations of financial service providers or any of their agents with jurisdiction over all or any part of the HSBC Group (together the “Authorities” and each an “Authority”) that is assumed b

36、y, imposed on or applicable to HSBC or any of its branches or any member of the HSBC Group; or 滙豐或其任何分行或任何滙豐集團成員承擔的或被施加的或適用於彼等的、與對滙豐集團整體或任何部分具有司法權限的本地或外地法律、監管、司法、行政、公營或執法機關，或政府、稅務、納稅、財政、證券或期貨交易所、法院、中央銀行或其他機關，或財務服務供應商的自律監管或行業組織或協會或彼等的任何代理（統稱及各稱）訂立的任何現在或將來的合約承諾或其他承諾；或(4) any agreement or treaty betwee

37、n Authorities; 機關之間的任何協議或條約；(ix) complying with any obligations, requirements, policies, procedures, measures or arrangements for sharing data and information within the HSBC Group and/or any other use of data and information in accordance with any programmes for compliance with sanctions or prevent

38、ion or detection of money laundering, terrorist financing or other unlawful activities; 遵守就滙豐集團內共用資料及資訊的使用而指定的任何責任、要求、政策、程序、措施或安排及或任何符合制裁或預防或偵測清洗黑錢、恐怖分子融資活動或其他非法活動的任何方案；(x) conducting any action to meet obligations of HSBC or any member of the HSBC Group to comply with Laws or international guidance

39、 or regulatory requests relating to or in connection with the detection, investigation and prevention of money laundering, terrorist financing, bribery, corruption, tax evasion, fraud, evasion of economic or trade sanctions and/or any acts or attempts to circumvent or violate any Laws relating to th

40、ese matters; 採取任何行動以遵守滙豐或任何滙豐集團成員的責任以符合有關偵測、調查及預防清洗黑錢、恐怖分子融資活動、賄賂、貪污、逃稅、欺詐、逃避經濟或貿易制裁及或規避或違反有關此等事宜的任何法律的任何行為或企圖的法律或國際指引或監管要求；(xi) meeting obligations of HSBC or any member of the HSBC Group to comply with any demand or request from Authorities; 遵守滙豐或任何滙豐集團成員的任何責任，以符合有關機關的任何指令或要求；(xii) exercising any

41、rights HSBC or a member of the HSBC Group may have in connection with the products or services provided to a customer; 行使滙豐或滙豐集團成員與客戶獲提供的產品或服務相關的任何權利；(xiii) matching any data held by HSBC or a member of the HSBC Group relating to a data subject from time to time for any of the purposes listed in thi

42、s paragraph (d); 不時與滙豐或滙豐集團成員持有與資料當事人相關的任何資料核對，以供作本(d)段列明的任何一項用途；(xiv) enabling an actual or proposed assignee or transferee of HSBC or any member of the HSBC Group, or participant or sub-participant of HSBCs or any member of the HSBC Group companies rights to evaluate and/or undertake due diligence

43、 in relation to the transaction intended to be the subject of the assignment, transfer, participation or sub-participation; and 讓滙豐或任何滙豐集團成員的實際或建議承讓人或受讓人，或滙豐或任何滙豐集團成員公司權利的參與人或附屬參與人對擬議作為轉讓、出讓、參與或附屬參與之交易項目進行評核及或盡職查證；及(xv) purposes relating thereto. 與上述有關的用途。(e) Data held by HSBC or a member of the HSB

44、C Group relating to an individual will be kept confidential but HSBC or a member of the HSBC Group may provide such information to the following parties (whether within or outside Hong Kong) for the purposes set out in paragraph (d): 滙豐或滙豐集團成員持有的個人資料將予以保密，但滙豐或任何滙豐集團成員可就第(d)段列明的用途把該等資料提供予下列各方（不論在香港境內

45、或境外）：(i) any agents, contractors, sub-contractors, service providers, reinsurers or associates of the HSBC Group (including their employees, directors, officers, agents, contractors, service providers and professional advisers); 滙豐集團的任何代理人、承包商、次承包商、服務供應商、再保人或聯營人士（包括彼等的僱員、董事、職員、代理人、承包商、服務供應商及專業顧問）；(i

46、i) any third party service provider who provides administrative, telecommunications, computer, payment or securities clearing or other services to HSBC in connection with the operation of its businesses (including their employees, directors and officers); 就滙豐的業務運作向滙豐提供行政、電訊、電腦、付款或證券結算或其他服務的任何第三方服務供應

47、商（包括彼等的僱員、董事及職員）；(iii) any Authorities; 任何機關；(iv) any person under a duty of confidentiality to HSBC including a member of the HSBC Group which has undertaken to keep such information confidential; 任何對滙豐有保密責任的人，包括已承諾對該等資料保密的滙豐集團成員；(v) any person in the context of the sale or transfer by HSBC or any

48、member of the HSBC Group of all or part of its business or portfolio of products, policies or other assets or any proposed or confirmed transaction relating to such a sale or transfer; 由滙豐或任何滙豐集團成員出售或轉讓其全部或部分業務或產品組合、保單或其他資產或任何擬訂或確定的有關該出售或轉讓的交易的任何人士；(vi) credit reference agencies and, in the event of default, any debt collection agencies; 信貸資料服務機構，並且在客戶欠帳時，可將該等資料提供給任何追討欠款的代理公司；(vii) any person to whom HSBC or any of its branches or any member