aiesec hk travel insurance summary
DESCRIPTION
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Dilys Li Senior Client Manager Marsh (Hong Kong) Limited 26/F, Central Plaza, 18 Harbour Road Wanchai Hong Kong Tel : 852 2301 7210 Fax: 852 3009 4159 www.marsh.com
10 April 2014 TRAVEL INSURANCE SUMMARY
Class of Insurance : Group Travel Insurance Name of Insured : AIESEC Hong Kong Period of Insurance : From departure date to the end of the trip Aggregate Limit of Liability : HKD185,000,000 per accident Insured Person : For any “unnamed” participants while participating / attending the designated activities supervised / organized / arranged by the Policyholder Category/ Plan Type : Community Projects Category A1 – Duration up to 8 weeks Category A2 – Duration up to 10 weeks Category A3 – Duration up to 12 weeks Working Abroad Internship Category B1 – Duration up to 7 months Category B2 – Duration up to 12 months Eligibility Period : 1st day of registration with the Insured
Scope of Coverage : 24 hours worldwide covering the Insured Person against Accidental Death, Bodily
Injury and any coverage specified hereunder while on the business of the Policyholder outside the territory of Hong Kong.
Beneficiary : Insured Person’s Estate Trips Insured : Such trip commences at the time during the Period of Insurance the
Insured Person is travelling directly from the place of residence or school in the Stationed Location to the immigration counter within 5 hours before the scheduled departure time of the Public Common Carrier in which the Insured Person has arranged to travel for the purpose of commencement of such trip; and to cease at the time he/she is travelling directly from the immigration counter in the Stationed Location to his/her place of residence or school within 5 hours after the actual arrival time of the Public Common Carrier in which the Insured Person has arranged to travel upon the completion of such trip. In the event of no immigration counter situated in the Stationed Location, such trip shall be deemed to commence at the time he/she leaves the boundary of the Stationed Location; and terminated at the time of his/her arrival at the boundary of the Stationed Location. The maximum period of such trip shall not exceed Category A1, A2 & A3 – 8 weeks, 10 weeks or 12 weeks and Category B1 & B2 - 7 months or 12 months.
Page 2 10 April 2014 AIESEC Hong Kong Group Travel Insurance for Participants
Trip Pattern : 1. Community Projects Category A1, A2 & A3 No. of Insured Persons : 330 Students Estimated no. of trip : 330 per year
Destination: Worldwide but mainly Asia Pacific / Africa / Central and Eastern Europe / South America
Duration : up to 8 weeks (A1) up to 10 weeks (A2) up to 12 weeks (A3) 2. Working Aboard Internship Category B1 & B2 No. of Insured Persons : 50 Students Estimated no. of trip : 50 per year Destination: Worldwide but mainly Asia, Australia, USA, Central and Eastern Europe Duration : up to 7 months (B1) up to 12 months (B2) Clauses / Conditions : 1) 60 Days Cancellation Notice by Insurer / Immediate Cancellation
Notice by Insured Clause subject to the premium calculation as below:-
Minimum Premium Short Period Rates 2 months 40% 3 months 50% 4 months 60% 5 months 70% 6 months 75% over 6 months 100%
2) Full Terrorism Extension 3) Sanction Clause
Page 3 10 April 2014 AIESEC Hong Kong Group Travel Insurance for Participants
SCHEDULE OF BENEFITS (Category A & B) Insuring Clause
Amount of Benefit Per Person
(HKD) 1. Personal Accident and Medical A) Personal Accident
B) Medical Expenses - Follow-up treatment within 120 days - Injury caused: up to 100% of unused portion - Sickness caused: up to 10% of unused portion - Expenses payable to Chinese bonesetter, acupuncturist, Chinese Medical
Practitioner, up to HKD200.00 Per Visit Per Day max HKD5,000 in aggregate
750,000 750,000
C) Emergency Medical Evacuation Unlimited D) Return of Mortal Remains Unlimited E) Transport Hazards - In Public Common Carriers 750,000 F) Hospital Income (Daily Limit of benefit: HKD500)
G) Burns Benefit (2nd and 3rd degree) 5,000
250,000 2. Personal Belongings A) Personal Baggage
- Per item limit HKD3,000 - Laptop computer per set/item limit HKD10,000 - Sports equipment per set/pair/item limit HKD5,000
20,000
B) Personal Money 5,000
C) Emergency Cash - Daily limit of benefit : HKD500
10,000
3. Travel Inconvenience A) Trip Cancellation 30,000 B) Trip Curtailment 30,000 C) Trip Re-route (Eligible duration period 12 hours) 15,000 D) Travel Delay
- Eligible duration period 6 hours - Sub-limit per time interval: HKD500
5,000
E) Baggage Delay - Eligible duration period 6 hours
25,000
F) Document Loss 30,000 4. Special Care A) Care Visit
B) Credit Card Protection C) Emergency Mobile Phone Charges
30,000 30,000
1,000
5. Legal Liability Personal Liability
2,000,000
Special Insuring Clause 1. Broken Bones Benefit 2. Corporate Traveller’s Family Assistance 3. Cosmetic Damage 4. Deviated Travel
- Eligible duration period 12 hours - Sub-limit per time interval: HKD500
5. Drowning and Suffocation by Gas, Poisonous Fumes or Smoke 6. Funeral Expense Benefit
300,000 50,000 50,000 10,000
50,000 20,000
Page 4 10 April 2014 AIESEC Hong Kong Group Travel Insurance for Participants
Insuring Clause
Amount of Benefit Per Person
(HKD) 7. Kidnap and Ransom Coverage
- up to per policy year 8. Mobility Extension
200,000 1,000,000
30,000
* Free Worldwide 24 hours SOS Hotline Service
Include “Natural Catastrophe” as one of the named perils Terms and Conditions 1. MEDICAL GUARANTEE DEPOSIT FACILITY – CHINA
Addition of In-hospital Medical Guarantee Facility in China: HKD50 per person. (China Re-entry Permit or Passport copy is NOT REQUIRED for card issuance.)
2. DECLARATION
This clause is applicable to: All Insured Persons Although no individual name or prior trip declaration is required for this Policy, the Company reserves the right to verify the list of Insured Persons in the book of records kept by the Policyholder in the event of loss.
3. AGE LIMIT
The Coverage under this Policy is not applicable to Insured Person(s) whose age is over 80 years or under 16 years.
4. BUSINESS LEISURE TRAVEL EXTENSION
This clause is applicable to: All Insured Persons This Policy is extended to cover any incidental leisure travel during and/or immediately before or after the business trip designated by the Policyholder.
5. PRC CITIZEN
This Policy does not cover PRC citizen unless he/she is employed by the Policyholder in Hong Kong with working permit in Hong Kong and/or Hong Kong Identity Card. PRC means People’s Republic of China.
Page 5 10 April 2014 AIESEC Hong Kong Group Travel Insurance for Participants
6. BROKEN BONES BENEFIT
If as a result of an Accident occurring during a Covered Trip the Insured Person sustains an injury listed hereunder, the Company will pay the Insured Person in respect of the following injuries according to the percentage bearing hereunder. Injury Percentage of Compensation (a) Broken Hip or Pelvis 100% (b) Broken Thigh or Heel 50% (c) Broken Skull, Collarbone, Lower Leg, 40% Ankle, Arm, Elbow, Wrist (d) Broken Lower Jaw 30% (e) Broken Vertebrae, Shoulder Blade, 20% Knee Cap, Sternum, Hand, Foot (f) Broken Upper Jaw, Cheek Bone, Nose, 15% Ribs, Coccyx, Toes, Fingers Compensation shall not be payable for more than one of the above injuries arising from the same Accident. Should more than one of the injuries occur from the same Accident, the Company shall only be liable for the greatest compensation. “Broken Bones” shall mean a complete break across a bone and must be diagnosed by a registered medical practitioner and supported by X-ray, but excludes greenstick, pathological, avulsion, hairline and stress fractures.
7. CORPORATE TRAVELLER’S FAMILY ASSISTANCE (only for spouse)
If during a Covered Trip an Insured Person’s Spouse, while in his/her permanent residence, suffers Accidental Bodily Injury which results in death, the Company will pay the Amount of Benefit stated in the Schedule.
8. COSMETIC DAMAGE
If during a Covered Trip the Insured Person suffers Accidental Bodily Injury but does not qualify for compensation in terms of Permanent Disablement cover or Medical Expenses cover, the Company will reimburse reasonable and customary charges incurred by an Insured Person, up to the Amount of Benefit stated in the Schedule, for treatments and applications aimed at reducing or eliminating any cosmetic damage, including plastic and cosmetic surgery.
9. DEVIATED TRAVEL
If during a Covered Trip, the route of the aircraft or sea vessel in which the Insured Person is riding on is deviated from the original route to another airport or sea port as specified in the itinerary due to drunk passenger, Emergency Medical Treatment of a passenger or bomb threat, resulting in the late arrival of the Insured Person on the final destination as specified in the itinerary, the Company will pay the Amount of Benefit stated in the Schedule for each and every full 12 hours of continuous late arrival, up to the maximum stated in the Schedule.
Page 6 10 April 2014 AIESEC Hong Kong Group Travel Insurance for Participants
10. DROWNING AND SUFFOCATION BY GAS, POISONOUS FUMES OR SMOKE
If during a Covered Trip, the Insured Person suffers an Accidental Bodily Injury due to drowning or suffocation by gas, poisonous fumes or smoke, which directly and independently of all other causes, results in death or Permanent Total Disablement, the Company will pay the Amount of Benefit stated in the Schedule, provided that such injury does not arise out of the Insured Person’s wilful and intentional act.
11. FUNERAL EXPENSE BENEFIT
If the Insured Person suffers loss of life during a Covered Trip, as a result of Accidental Bodily Injury or Sickness the Company will pay the costs of the Insured Person’s funeral and related expenses up to the Amount of Benefit stated in the Schedule.
12. KIDNAP AND RANSOM COVERAGE
In the event an Insured Person is travelling on a Covered Trip outside of their Country of Permanent Residence or Country of Secondment the Company shall indemnify the Policyholder on behalf of the Insured Person for Kidnap for ransom Consultant’s Costs and any ransom payment by the Policyholder on behalf of the Insured Person up to the Amount of Benefit stated in the Schedule. Any incident that could potentially give rise to a claim under this Insuring Clause should be notified immediately to the consultants appointed by the Company. The Company shall also indemnify the Policyholder on behalf of the Insured Person in respect of:
a) reasonable travel and accommodation expenses incurred by the Policyholder; b) any reward paid by the Policyholder to an Informant for information that leads to the arrest
and conviction of person(s) responsible; c) reasonable fees and expenses of an independent public relations consultant with the approval of
the Company; d) the salary the Policyholder continues to pay the Insured Person subject to a maximum of six
(6) continuous months; e) reasonable fees for independent legal and medical advice incurred by the Policyholder with the
approval of the Company; f) the Company shall reimburse the Policyholder up to the Amount of Benefit stated in the
Schedule for all property or other consideration paid as part or in whole as a ransom payment. 13. MOBILITY EXTENSION
If during a Covered Trip an Insured Person sustains Accidental Bodily Injury which directly and independently of all other causes results in Permanent Total Disablement and such Insured Person needs and can operate: 1. a self-powered, climbing wheelchair; and/or 2. his/her motor vehicle only with the controls suitably adjusted; and/or 3. a lift, necessary ramps and railings within the Insured Person usual place of residence, the Company will pay the costs of such equipment and the installation thereof in the case of 1) and 3), and the costs of adjustment in the case of 2), up to the Amount of Benefit stated in the Schedule.
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14. RUN OFF CLAUSE This policy is extended to cover a trip commenced with the period of insurance until the end of that
particular trip, up to maximum duration of travel allowed in this policy, regardless this policy is expired or not.
15. TRIP CANCELLATION
The Company will pay for loss of travel and/or accommodation expenses paid in advance or forfeited by the Insured Person and for which the Insured Person is legally liable and which are non-refundable and not recoverable from any other source upon cancellation prior to the Covered Trip. The cause of the cancellation must be the Death, Accidental Bodily Injury, Sickness or confinement of the Insured Person or the Insured Person’s Immediate Family Members within 30 days before the departure of the Covered Trip, or the unexpected outbreak of strike, riot, civil commotion, or Natural Catastrophe arising out of events beyond the Insured Person’s control, the Insured Person being called up for jury service or the Insured Person’s residence being seriously damaged in bad weather.
16. TRIP CURTAILMENT
The Company will pay for additional travelling expenses or board incurred, and loss of travel and/or accommodation expenses paid in advance or forfeited by the Insured Person after the commencement of a Covered Trip in the case that the Insured Person must return directly to Hong Kong following Accidental Bodily Injury or Sickness of the Insured Person or the Insured Person’s Immediate Family Member who is resident in Hong Kong or the unexpected outbreak of strike, riot, civil commotion, or Natural Catastrophe. This coverage is effective only if the Insured Person has commenced the Covered Trip before becoming aware of any circumstances which could lead to the disruption of the Covered Trip.
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In addition, we would like to draw your attention to the following: 1. The Policyholder should declare to the Company by written notice regarding the actual number of Insured
Persons together with their full names, date of birth, position/occupation, passport or other identification document number before the coverage of master policy being effective.
2. Insured Person(s) will not be covered if stationed outside Hong Kong Territories which is not notified and with consent by the Company.
3. This Policy will not cover any Insured Persons involving in Manual/Labour Works 4. All claims must be verified by the Policyholder. 5. Please provide the nationality, stationed country and destination for those students are not stationed in
Hong Kong before departure. Other terms and conditions are subject to our Group Business Travel Scale 2 Insurance policy wordings.
COVERAGE This Insurance Program also provides full protection for the following: 1. All Sports Cover (subject to no income received) * Hockey * Horseback Riding * Climbing and Mountaineering * All Water Sports * Winter Sports * Rugby and Soccer * Hunting * Parachuting * Bungee Jumping * Judo and Karate 2. Special Situations Cover * Hijacking * Riot and Civil Commotion * Food Poisoning * Gas Poisoning * Full Terrorism * Motor-Cycling 3. Exposure and Disappearance 4. Air Travel Cover
Full protection while flying as a passenger in all forms of licensed private and commercial aircraft including helicopter.
Page 9 10 April 2014 AIESEC Hong Kong Group Travel Insurance for Participants
TABLE OF BENEFITS For the Insuring Clause of Personal Accident stated in the Schedule, the Percentage of Compensation of Amount of Benefit is specified hereunder: COVERAGES COMPENSATION
Proper Law: This insurance shall be governed by Hong Kong SAR law. Each party agrees to submit to the jurisdiction of any court of competent jurisdiction within Hong Kong SAR and to comply with all requirements necessary to give such court jurisdiction. All matters arising hereunder shall be determined in accordance with the law and the practice of such court.
Scale 2 1. Death 100% 2. Permanent Total Disablement 100% 3. Permanent and Incurable Paralysis of all Limbs 100% 4. Permanent Total Loss of Sight of both Eyes 100% 5. Permanent Total Loss of Sight of one Eye 100% 6. Loss of or the Permanent Total Loss of use of two Limbs 100% 7. Loss of or the Permanent Total Loss of use of one Limb
(a) Right Hand (b) Left Hand (c) One foot
100% 100% 100%
8. Loss of Speech and Hearing 100% 9. Permanent and Incurable Insanity 100% 10. Permanent Total Loss of Hearing in
(a) both Ears (b) one Ear
75% 15%
11. Loss of Speech 50% 12. Permanent Total Loss of the Lens of one Eye 50% 13. Loss of or the Permanent Total Loss of use of four Fingers and Thumb of
(a) Right Hand (b) Left Hand
70% 50%
14. Loss of or the Permanent Total Loss of use of four Fingers of (a) Right Hand (b) Left Hand
40% 30%
15. Loss of or the Permanent Total Loss of use of one Thumb (a) both Right Joints (b) one Right Joint (c) both Left Joints (d) one Left Joint
30% 15% 20% 10%
16. Loss of or the Permanent Total Loss of use of Fingers (a) three Right Joints (b) two Right Joints (c) one Right Joint (d) three Left Joints (e) two Left Joints (f) one Left Joint
15% 10% 7.5% 10% 7.5% 5%
17. Loss of or the Permanent Total Loss of use of Toes (a) all – one Foot (b) great - both Joints (c) great – Joint
20% 7.5% 5%
18. Fractured Leg or Patella with established non-union 15% 19. Shortening of Leg by at least 5 cm 10% 20. Permanent Disability not otherwise provided for under Events 10 to 19 inclusive. Such
percentage of the Principal Sum Insured as the Company shall in its absolute discretion determine and being in its opinion not inconsistent with the Compensation provided under Events 10 to 19 inclusive.
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Insurer: Federal Insurance Company (Chubb Group of Insurance Companies) Standard & Poor's Rating : AA Premium Per Person: Category A1 – HKD450.00 Category A2 – HKD550.00 Category A3 – HKD650.00 Category B1 – HKD1,450.00 Category B2 – HKD1,850.00
Travel Claims - Procedures
Group Travel policies are in many forms. Insurers offer their own unique policies with different combination of covers in the market. However there is always a list of common covers which are included in almost all group travel policies. The common covers are:
! Personal accident (fatal and permanent disabilities) ! Medical expenses (hospital and clinical expenses included) ! Baggage (loss of or damage to baggage, loss of money and document) ! Travel interruption (trip cancellation, curtailment and delay) ! Personal liability ! Emergency assistances (major illness or injury while overseas) ! General travel advices
There are insurers who offer covers which are not common in the market place. This document only intends to handle claims procedures for the common covers as mentioned above only. Emergency assistances Your insurer will usually provide you with an emergency hotline number (SOS emergency assistance hotline) to provide support when an insured member is in distress. This emergency hotline will lead an insured member to a hotline centre which provides 24/7 service worldwide. In case an insured member met with a serious accident or illness requiring immediate medical assistance, he/she or his/her representatives should place a collect call to the emergency hotline. The caller is required to provide the following information
• Name of the insured member concerned • Your policy number • Contact number of the insured member and/or his/her representatives • Location of the incident – if the insured member is already hospitalised, the name and
location of the hospital • Description of the injury condition or symptoms of the illness • Nature of assistance required e.g. the insured member may require advice on how to get to
the nearest hospital If the medical condition of the insured member warrants an immediate transfer from the current location to another more appropriate location (including but not limited to the possibility of returning to Hong Kong) for treatment etc, the hotline centre will arrange for it, The hotline centre will assist the insured member to provide the necessary service as soon as possible. However it is important to ensure that all services must be approved by the hotline centre in order to guarantee payment by your insurer. If circumstances require, ensure that the insured member or his/her representatives report the incident to the local authorities such as the police or the emergency medical unit immediately.
Page 2 1. Reporting a new claim
! Report to the police immediately if the following situation occurs ! there is a fatal or seriously injury ! if any important documents (e.g. the passport) are lost ! if any criminal activity has taken place e.g. a suspect theft or a robbery
! If an emergency service is required, advise the insured member to call collect the hotline
centre as detailed in the Emergency assistances section above.
! Notify Marsh by telephone immediately if you are aware of a fatal or serious injury/illness happening to an insured member. If an investigation is required or healthcare management is offered by your insurer, Marsh will inform you shortly.
! Complete a claim form and send it to Marsh with the following documents as soon as
possible. ! For all claims – stub of the used boarding pass, train tickets or the like, copy of the
original itinerary or travel agency receipt ! Personal accident claims – copy of any medical reports, medical certificates or medical
information already in your possession ! Medical expenses claims – original medical receipts and copy of any medical reports or
medical certificates stating the diagnosis of the illness or injury, if already in your possession
! Baggage claims – original of any proof of loss or damage such as the police report or confirmation slip from the carrier or the hotel operator, original receipts to prove amount of loss or damage if already in your possession
! Travel interruption claims – written proof from the carrier or other relevant parties to prove the trip interruption, original receipt to prove the amount of loss suffered if already in your possession
! Personal liability claims – all documents received from the third party suffering from a loss, damage or an injury
More detailed descriptions of what documents are required to report a claim may be found in the Document Checklist.
! If your insurer requires an authorisation form (usually provided by your insurer) to be
completed by the insured member, ask him/her to sign and return the authorisation form to Marsh together with the completed claim form.
2. Actions to protect your interests
! Some insurers require claims to be submitted within a time limitation (e.g. 30 days after date of accident) specified in the policy. Failing to report within the time limitation may mean a loss of insurance protection.
! Remind the insured member to retain the stub of the used boarding passes, train tickets or the
like as far as possible. Some insurers may insist on the production of such documents as proof of travel. The lack of them may mean a delay in the claims settlement.
! Ensure that the insured member report to the local police in case of any loss of properties,
documents or money within 24 hours. A claim of this nature which is not supported with a proper local police report is usually excluded by the policy.
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! Remind the insured member that all medical related documents must be signed and issued by registered medical practitioners. Most insurance policies pay for claims incurred for treatments offered by local registered medical practitioners only.
! Send Marsh all writs, summons or any other form of proceedings received either by you or
the insured member immediately upon receipt. Your insurer may appoint legal representation for you. If that is the case, you will be advised of the identity of the solicitors, who will contact you directly if further information or documents are required.
! Do not acknowledge any letter received from the third party, his/her solicitors or
representatives without the approval of your insurer. Send Marsh any correspondence received in connection with the incident immediately upon receipt, unanswered.
! Do not admit liability without your insurer’s approval even if you believe that the insured
member might have caused the accident. No discussion should take place with any party without the authority of your insurer. Doing so could mean a loss of insurance protection as your insurer’s position may be prejudiced. If the insured member requires immediate assistance in this respect while he/she is overseas, advise him/her to call the insurer’s hotline centre.
! Do not pay the third party in case of a personal liability claim. If the insured member
requires immediate assistance in this respect while he/she is overseas, advise him/her to call the insurer’s hotline centre. A payment without the insurer’s consent could mean a loss of insurance protection as your insurer’s position may be prejudiced.
! If the accident is work related, it may be a claim under your Employees’ Compensation (EC)
insurance as well. Make sure that proper procedures have been taken to report it to the Labour Department (or the relevant local authority as required) and your EC insurer.
! If you also have any other insurance which may cover part of the consequences of the
accident e.g. a medical policy to cover the related medical expenses, make sure that you report the claim to your medical insurer.
! If the injured member is receiving treatment from a government hospital in Hong Kong as an
impatient, remind him/her to obtain the Discharge Summary before he/she leaves the hospital. Failure to do so will delay any claim settlement. Although the insured member can obtain the relevant medical information from the Hospital Authority at a later stage, he/she will be liable for a fee.
! If the insured member is receiving treatment from a government hospital in Hong Kong as an
out-patient, remind him/her to obtain a sick leave certificate from the attending doctor after each visit. Make sure that the doctor marks on the sick leave certificate the diagnosis of his/her illness or injury. Failing to do so may mean that he/she cannot obtain reimbursement of the relevant medical expenses.
! Take action to obtain all relevant information and documentations from the local authorities
of the place where the accident happened as soon as possible. This would include report and statement taken by the local police or medical reports or certificates from the local hospital/clinic.
! If your insurer has appointed a healthcare manager and a loss adjuster to inquire into the
matter, ensure that the insured member co-operates with them.
Page 4 3. Other procedures to secure claim settlement from your insurer
I. Personal accident claims
A. Fatal accident ! Send Marsh or your insurer’s representative the following information
! Contact details of the deceased insured member’s family ! Copy of the Death Certificate, if available ! Copy of any post mortem report, if available ! Copy of any investigation report compiled by the local authorities of the place of
death, if available
Before a fatal claim is paid by your insurer, the insurer will usually ask for documentary evidence to prove who has the legal right to receive the compensation money. Acceptable proof includes copy of either the will left by the deceased or a letter of administration issued by the Court of Hong Kong. There are prescribed legal steps involved before such documents can be obtained and submitted to your insurer. Consult your lawyer or your insurer for the necessary formalities.
B. Serious Injury
! Keep Marsh and your insurer’s representatives, if any, informed of the medical status of the insured member.
! When the attending doctor opine that the insured member has either fully recovered
or the injury is unlikely to improve further despite of medical intervention, obtain a medical report from the attending doctor. The attending doctor will usually charge a fee for the report. You may contact Marsh or your insurer’s representatives to check whether the report should be obtained now or later to minimize the costs involved. Send the medical report together with any related laboratory reports, when available, to Marsh or your insurer’s representatives.
! If a loss adjuster or a healthcare manager has been appointed by your insurer, your
insurer or its representatives may arrange and pay for a medical report directly with the attending doctor. In this case, the insured member will need to sign an authorisation form to allow your insurer to do so.
! If the injury was treated in a government hospital in Hong Kong, send the original
Discharge Summary to Marsh or your insurer’s representatives. ! If the injury was treated overseas without involving the emergency assistances
offered under your policy, send Marsh or your insurer’s representatives all original medical related documents and contact details of the hospital or attending doctor concerned.
! If the injury was treated overseas with the Emergency assistances triggered, the
assistance service provider will liaise directly with your insurer and keep you advised of the necessary claims procedures.
! If the accident is work-related, send Marsh a copy of the Certificate of Assessment
(Form 7) or Certificate of Review of Assessment (Form 9) when available.
C. Minor Injury
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! Request the insured member to obtain from his/her attending doctor a medical certificate stating the extent of injury and percentage of disability of the whole person, if any, upon full recovery. Send the original medical certificate to Marsh.
! If the injury was treated in a government hospital in Hong Kong, send the original
Discharge Summary to Marsh or your insurer’s representatives. ! If the injury was treated overseas, send Marsh or your insurer’s representatives all
original medical related documents and contact details of the hospital or attending doctor concerned.
! If the accident is work-related, send Marsh a copy of the Certificate of Assessment
(Form 7) or Certificate of Review of Assessment (Form 9) when available.
II. Medical expenses claims
! Send Marsh the originals of all medical receipts, hospital bills, medical reports and medical certificates. Diagnosis of the injury or illness must be shown somewhere in these documents.
! If the insured member was treated as in-patient in a government hospital in Hong Kong,
send the original Discharge Summary to Marsh or your insurer’s representatives.
! If the insured member was treated as out-patient by a government hospital in Hong Kong, send Marsh the originals of all sick leave certificates marked with diagnosis of the injury.
III. Baggage claims
! If you are entitled to some form of compensation from any party e.g. your carrier for the
loss or damage to your property, keep Marsh informed of the progress of the compensation process.
! Send Marsh the originals of the following documents, if relevant
! Purchase receipt of the lost property ! Repair quotation and/or receipt of the damaged property ! Photos of damaged or lost properties, if available ! Replacement receipt for any lost document ! Receipt of any additional accommodation and travelling costs spent if the insured
member was compelled to stay for extra days waiting for the replacement of an essential document e.g. the passport
! Any documentary proof for the amount of lost money ! If baggage is delayed by the carrier
! The original of a written proof from the carrier to confirm the delay and the duration
! Receipts for emergency purchase of all essential items
IV. Travel interruption claims
A. If the insured trip is cancelled, send Marsh the following documents ! Original receipt of any pre-paid travel or accommodation costs or deposits ! Original written proof of trip cancellation and that the paid costs or deposits are not
refundable by travel agency or the like ! If the trip is cancelled because of an illness or death of a person
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! Original proof of such illness e.g. a medical report showing nature and extent of illness, if relevant. (If the person suffering from such illness is an insured person, insurers will normally require a comment from the attending doctor to confirm that the insured person is medically not suitable to go on a trip)
! copy of the death certificate, if relevant ! proof of relationship between the insured member and the person (if not the
insured member) suffering the illness or the deceased respectively
B. If the insured trip is curtailed, send Marsh the following documents ! Original receipt of any pre-paid travel or accommodation costs or deposits ! Copy documentary proof of original planned itinerary and the actual trip travelled ! Original written proof of any additional expenses or forfeited costs or deposits ! If the trip is curtailed because of an illness or death of a person
! Original proof of such illness e.g. a medical report showing nature and extent of illness, if relevant (If the person suffering from such illness is an insured person, insurers will normally require a comment from the attending doctor to confirm that the insured person is medically not suitable to continue with a trip)
! copy of the death certificate, if relevant ! proof of relationship between the insured member and the person (if not the
insured person) suffering the illness or the deceased respectively
C. If the insured trip is delayed, send Marsh the following documents ! Original document from the carrier confirming the reason and duration of delay
V. Personal liability claims
! Send Marsh all third party correspondences, including any writ, summons or other forms
of proceedings received by you or the insured member immediately, unanswered.
In all circumstances, your insurer may request for further information and documents as the case may require. It is an obligation under the insurance policy to provide all possible assistance to your insurer.
Page 7 Travel Claims - Document Checklist 1. Document to report a new claim
! Completed claim form ! Stub of the used boarding pass, train ticket or the like
! Copy of original itinerary or travel agency receipt
! Copy of passport showing the relevant chops from Immigration, if relevant
! Signed authorisation form by an insured member if required by your insurer
! Copy of medical report or medical certificate, if available (for Personal accident or Medical
expenses claims)
! Original medical/hospital bills or receipts with details of diagnosis signed by registered medical practitioners (for Medical expenses claims)
! Original proof of loss or damage such as police report or confirmation slip from the carrier or
hotel operator (for Baggage - loss of or damage to property claims, loss of document claims and loss of money claims)
! Original receipt from relevant authorities for replacement of documents (for Baggage - loss
of document claims)
! Original document from carrier confirming reason of travel delay and duration of delay (for Baggage delay and Travel delay claims)
! Original receipts for emergency purchase of essential items (for Baggage delay claims)
! Original proof from the carrier or other relevant parties to support why the trip was
interrupted (for Travel cancellation and Travel curtailment claims) ! Copy of any documents from the third party suffering from a loss or an injury, unanswered
(for Personal liability claims)
2. Other documents required to complete the claim process
! Copy of police report or police statement, if accident was reported to police ! Contact details of the deceased insured member’s family (for fatal Personal accident claims) ! Copy of Death Certificate of the insured member (for fatal Personal accident claims) ! Copy of any post mortem report of the insured member (for fatal Personal accident claims)
! Copy of any investigation report compiled by the local authorities of the place of death (for
fatal Personal accident claims)
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! Copy of Will of the insured member or Letter of Administration (for fatal Personal accident claims)
! Original medical certificate stating the extent of injury and percentage of permanent disability
(for Personal accident claims) ! Contact details of hospital or attending doctor if treatment was provided overseas (for
Personal accident claims) ! Original medical report and laboratory reports (for Personal accident claims)
! Original Discharge Summary from Hong Kong government hospitals (for Personal accident
and Medical expenses claims)
! Copy of the Certificate of Assessment (Form 7) or Certificate of Review of Assessment (Form 9) if accident is work related and permanent disability occurs (for Personal accident claims)
! All original medical receipts or hospital bills with diagnosis marked (for Medical expenses
claims) ! All original medical certificates marked with diagnosis of the injury (for Medical expenses
claims)
! Original purchase receipts of lost properties (for Baggage Claims – loss of properties)
! Original repair quotation/receipt of damaged properties (for Baggage – damage to property claims)
! Photos of damaged or lost properties (for Baggage – loss of or damage to property claims)
! Original replacement receipt for any lost document (for Baggage – loss of document claims)
! Original receipt of any additional accommodation and travelling costs if insured member
compelled to stay to wait for replacement of documents (for Baggage – lost of document claims)
! Any documentary proof for the amount of lost money (for Baggage – loss of money claims)
! Original receipt for emergency purchase of essential items (for Baggage delay claims)
! Original receipt of any pre-paid travel or accommodation costs or deposits (for Travel
cancellation and Travel curtailment claims) ! Original written proof of trip cancellation and that the paid costs or deposits are not
refundable by travel agency or the like (for Travel cancellation claims)
! Original proof of illness if a trip is interrupted by the illness of a person e.g. a medical report showing nature and extent of illness. If the person suffering from illness is an insured member, a comment is required in the medical report to confirm that he/she is not suitable to travel (for Travel cancellation and Travel curtailment claims)
Page 9
! Copy of the death certificate if trip is interrupted by the death of a person (for Travel cancellation and Travel curtailment claims)
! Proof of relationship between the insured member and the person (if not an insured member)
suffering the illness or the deceased if a trip is interrupted by the illness of death of a person (for Travel cancellation and Travel curtailment claims)
! Copy documentary proof of original planned itinerary and the actual trip travelled (for Travel
curtailment claims)
! Original written proof of any additional expenses or forfeited costs or deposits (for Travel curtailment claims)
! Original document from the carrier confirming reason and duration of delay (for Travel delay
and Baggage delay claims)
3. Documents which might be requested by your insurer
! Any other documents as your insurer may deem necessary – owing to the vast number of different covers provided under a travel policy, the nature of travel claims can vary significantly. Your insurer will request for different information or documents depending on the actual nature of the claim.
Page 10 Travel Claims – Flowchart
Incident Occurred
Insurer’s confirmation of
settlement
Call collect to the Emergency
Assistances hotline in case of
serious illness or injury
Complete a claim form, sign the
authorization form if required by insurer
and provide documents to prove reason
of loss or damage
Notify Marsh by telephone if a fatal
or serious bodily injury occurs
Keep Marsh informed of medical status of
insured member
Provide documents – medical certificate,
medical report, Discharge Summary, Form 7 or
Form 9
Keep Marsh informed of development of any
compensation process from carrier or other parties
Provide documents – original purchase receipt,
repair/replacement quotation/receipt, any other proof of
loss amount, photos of damaged properties, if available
Provide documents - original medical or
hospital bills with diagnosis marked,
Discharge Summary if insured member
treated by government hospital in HK
Personal Accident
Provide documents – contact details of
deceased member’s family, copy of death
certificate, post mortem report and Letter of
Administration or the deceased’s will
Report to police in case of a fatal or
serious bodily injury, loss of important
documents or if criminal activities
involved e.g. theft
Non-fatal Fatal
Provide documents – any
correspondences from third
party suffering from a loss,
damage or injury, unanswered
Travel Interruption Medical Expenses
Personal Liability Baggage
Provide documents – written proof of travel
interruption (reason and duration, if
appropriate), documents to prove amount of
loss. If interrupted by death, copy death
cert. If interrupted by illness, medical report
FAQ for Travel Insurance Policy (AIESEC Hong Kong Limited) Q1 Who is eligible for this Travel Policy?
All participants who undertake the aboard as part of the Community Projects or Working
Aboard Internship will be covered by this Travel insurance policy. Q2 Who is the insurance company for the Travel Insurance Policy?
Federal Insurance Company is the insurer for the Travel Insurance Policy. Federal
Insurance Company is part of the CHUBB Group of Insurance Companies. Some documents are under CHUBB company’s letter head.
Q3 When will the insurance cover begin and end?
The period of insurance is from departure date to the end of the trip. It will cover the
period of travel which commence four (4) hours before the insured student departs from the home country and creases at the earlier of the expiry of the period of insured or four (4) hours after the insured person’s arrival at the home country.
Q4 What is the maximum duration of each trip?
The maximum duration for each trip are
8 weeks, 10 weeks or 12 weeks for Category A; 7 months or 12 months for Category B
Q5 Will the insurance cover participant’s leisure / vacation / holiday trips?
This travel policy will provide insurance protection for the whole trip including leisure /
vacation / holiday trips within the insured period. Q6 Why does the policy require claimants to provide the information on other insurance
policies?
This is a general insurance policy condition to avoid any claimant obtaining compensation from multiple insurance companies.
GBT Wording-1013 Section C – Policy Wording: Page 1 of 12
SECTION C – POLICY WORDING
INSURING AGREEMENT
In consideration of the payment of the premium payable under this Policy, Federal Insurance Company (herein called
“Company”) agrees to insure eligible Insured Persons to the extent hereto provided and subject to the exclusions and
all other limitations and provisions of this Policy.
THIS POLICY WILL NOT BE VALID UNLESS THE SCHEDULE OF BENEFITS SIGNED BY AN AUTHORISED REPRESENTATIVE OF FEDERAL INSURANCE COMPANY IS ATTACHED HERETO. CERTAIN WORDS AND PHRASES THAT APPEAR IN BOLD PRINT HAVE SPECIAL MEANINGS. DEFINITIONS APPEAR IN PART I: DEFINITIONS OF THIS POLICY. PLEASE READ THIS POLICY CAREFULLY.
Federal Insurance Company [hereinafter called “The Company”] agrees to insure the Insured Person subject to
Amendment No. 1 against loss covered under this Policy subject to and in accordance with the exclusions, limitations,
provisions, and terms described herein.
Scope of Coverage
Such insurance as is afforded to an Insured Person shall apply only to loss described and defined in the Insuring
Clauses of this Policy which is sustained by such Insured Person while travelling outside Hong Kong on a bona fide
Business Trip which is intended at its outset to last no longer than a period of one hundred and eighty two (182) days.
PART I: DEFINITIONS
Accident or Accidental means a sudden, unforeseen and unexpected event happening by chance.
Accidental Bodily Injury means physical bodily injury which is Accidental and is the direct and independent cause of the
loss for which claim is made during the Covered Trip.
Actual Cash Value means the Replacement Cost for lost or damaged property, less allowance for physical deterioration
and depreciation, including obsolescence.
Amount of Benefit means the amount selected by the Policyholder in the proposal and shown in the Schedule, and for
which the premium has been paid.
Burn means tissue damage caused by extreme heat, flame, or contact with a heated object.
Close Business Companion means a business companion who travels with the Insured Person for the same business
purpose, and whose presence is necessary for the Policyholder’s business.
Company means Federal Insurance Company, Hong Kong Branch.
Covered Trip means the period of travel commencing four (4) hours before the Insured Person departs from Hong Kong
on the departure date for the purpose of commencement of the Business Trip and ceases at the earlier of the expiry of
the Period of Insurance specified in the Schedule or four (4) hours after the Insured Person’s arrival at Hong Kong. Time
of departure from and arrival to Hong Kong means the scheduled time of the trip unless the Insured Person provides
proof of a different departure or arrival time.
Emergency Medical Treatment means necessary medical treatment of any sudden, life threatening Accidental Bodily
Injury or Sickness during a Covered Trip, where time is of the essence.
Fractured Leg or Patella with Established Non-union means a complete break into two pieces; the broken leg does not
mend properly and function normally, and this condition will last for the remainder of the Insured Person's life.
Hijack or Hijacking means the unlawful seizure or wrongful exercise of control of an aircraft or conveyance and its crew,
in which the Insured Person is travelling.
GBT Wording-1013 Section C – Policy Wording: Page 2 of 12
Hong Kong means the Hong Kong Special Administrative Region, or such other place of residence and employment as
may be specified in the Scope of Coverage, provided that no Insured Person shall have more than one place of
residence and employment for the purpose of the Policy.
Immediate Family Member means spouse, children, siblings, parents, parents-in-law, grandparents, grandchildren,
nieces or nephews. For purposes of Insuring Clauses 3A, 3B and 4A only, Immediate Family Member shall also include
a Close Business Companion.
Indemnity means amounts the Insured Person shall be legally obligated to pay to an injured party for (a) loss or damage
to property of others; (b) expenses incurred for first aid or land/marine ambulance service; or (c) expenses incurred in
the conduct of suit, lawyer’s fees for arbitration, compromise or conciliation, all incurred by the Insured Person with the
consent of the Company.
Insured Person means the person or persons named in the Schedule and for whom the required premium has been
paid.
Loss of Fingers or Toes means complete severance through or above the metacarpophalangeal joints or
metatarsophalangeal joints.
Loss of Hearing means Permanent irrecoverable loss of hearing where one sixth of a+2b+2c+d is above 80 dB. (a dB =
hearing loss at 500 Hertz, b dB = hearing loss at 1,000 Hertz, c dB = hearing loss at 2,000 Hertz, d dB = hearing loss at
4,000 Hertz)
Loss of Limb means loss by physical severance of a hand at or above the wrist or of a foot at or above the ankle.
Loss of Speech means the inability to articulate any three of the four sounds which contribute to speech, as follows: the
Labial sounds, the Alveololabial sounds, the Palatal sounds and the Velar sounds. Loss of Speech also means total
loss of use of vocal cords or damage to the speech centre in the brain, resulting in Aphasia.
Loss of Sight means complete blindness which is Permanent and incurable.
Medical Facility means a licensed clinic, hospital or similar institution operating primarily for the reception, care and
treatment of sick, ailing or injured persons as inpatients and providing 24-hour nursing service by licensed, registered,
or graduate nurses, and having a staff of one or more licensed Physicians available at all times and which provides
organised facilities for diagnosis and surgical procedures.
Natural Catastrophe means a landslide, lightning, typhoon, earthquake, volcanic eruption, tsunami, hurricane or
sandstorm that occurs in the destination listed under the travel itinerary.
Permanent means lasting twelve (12) consecutive months from the date of Accident and at the expiry of that period
being beyond hope of improvement.
Permanent Total Disablement means the Insured Person is prevented from engaging in each and every occupation or
employment for compensation or profit for which the Insured Person is reasonably qualified by reason of education,
training or experience, or if the Insured Person has no business or occupation, from attending to any duties which
would normally be carried out by the Insured Person in the Insured Person’s daily life, and such disability has continued
for twelve (12) consecutive months. This condition must be certified by a Physician.
Physician means a person who is recognised by the laws of the jurisdiction in which treatment is received as qualified
to treat the Sickness or Accidental Bodily Injury, and who is not a relative of the Insured Person.
Policyholder means the organisation/people stated in the corresponding item in the Schedule.
Program Medical Advisor means International SOS or its authorised representatives.
Public Common Carrier means any mechanically propelled conveyance operated by a company or an individual,
licensed to carry passengers for hire.
Replacement Cost means the cost on the date of loss to repair or replace lost or damaged property with material of like
kind and quality, including customs duties, but not more than the Insured Person actually spends to repair or replace
GBT Wording-1013 Section C – Policy Wording: Page 3 of 12
the property at the same or other premises for the same use in the same country. There is no deduction for
depreciation.
Robbery means loss of or damage to baggage or personal property caused by use of intimidation or force to deprive
the Insured Person of such baggage or personal property.
Second Degree Burn means a Burn in which both the epidermis and the underlying dermis are damaged.
Sickness means illness or disease which is the direct and independent cause of loss for which claim is made, and
which requires the attendance of a Physician and Physician’s certificate can be provided.
Theft means loss or damage to baggage or personal property caused by the taking of such baggage or personal
property without the Insured Person’s consent, other than Robbery.
Third Degree Burn means a Burn resulting in the damage or destruction of the skin to its full depth and damage to the
tissues beneath.
Transfer means the least expensive means of scheduled Public Common Carrier transportation available and necessary
to effect cover of Emergency Medical Evacuation, Return of Mortal Remains or Care Visit or Child Escort for the Insured
Person, as per Insuring Clauses 1C, 1D and 4A.
Transfer Expenses means direct out of pocket expenses determined to be reasonable and necessary to provide the
Insured Person with Special Care, Emergency Medical Evacuation or Return of Mortal Remains Services, less any
monies refundable for the original return fare, as per Insuring Clauses 1C, 1D and 4A.
Travel Provider means a firm in the travel industry that arranges travel for a fee.
PART II: DESCRIPTION OF COVERAGE
INSURING CLAUSE 1: PERSONAL ACCIDENT AND MEDICAL
A. PERSONAL ACCIDENT
If Accidental Bodily Injury to the Insured Person, sustained during the Covered Trip, causes loss of life or loss as stated
below within 365 days from the date of Accident, the Company will pay compensation in the form of a percentage of
the Amount of Benefit stated in the Schedule, as set forth below:
EVENT COVERAGE COMPENSATION
1. Loss of Life 100%
2. Permanent Total Disablement 100%
3. Permanent and Incurable Paralysis of all Limbs 100%
4. Permanent Total Loss of Sight of both Eyes 100%
5. Permanent Total Loss of Sight of one Eye 100%
6. Loss of or the Permanent Total Loss of use of two Limbs 100%
7. Loss of or the Permanent Total Loss of use of one Limb
(a) Right Hand 100%
(b) Left Hand 100%
(c) One Foot 100%
8. Loss of Speech and Hearing 100%
9. Permanent and Incurable Insanity 100%
10. Permanent Total Loss of Hearing in
(a) both Ears
(b) one Ear
75%
15%
11. Loss of Speech 50%
12. Permanent Total Loss of the Lens of one Eye 50%
13. Loss of or the Permanent Total Loss of use of four Fingers and Thumb of
(a) Right Hand
(b) Left Hand
70%
50%
14. Loss of or the Permanent Total Loss of use of four Fingers of
(a) Right Hand
(b) Left Hand
40%
30%
GBT Wording-1013 Section C – Policy Wording: Page 4 of 12
15. Loss of or the Permanent Total Loss of use of one Thumb
(a) both Right Joints
(b) one Right Joint
(c) both Left Joints
(d) one Left Joint
30%
15%
20%
10%
16. Loss of or the Permanent Total Loss of use of Fingers
(a) three Right Joints
(b) two Right Joints
(c) one Right Joint
(d) three Left Joints
(e) two Left Joints
(f) one Left Joint
15%
10%
7.5%
10%
7.5%
5%
17. Loss of or the Permanent Total Loss of use of Toes
(a) all - one Foot
(b) great - both Joints
(c) great – Joint
20%
7.5%
5%
18. Fractured Leg or Patella with established non-union 15%
19. Shortening of Leg by at least 5 cm 10%
20. Permanent Disability not otherwise provided for under Events 10 to 19 inclusive.
Such percentage of the Principal Sum Insured as the Company shall in its absolute
discretion determine and being in its opinion not inconsistent with the
Compensation provided under Events 10 to 19 inclusive.
Permanent and total loss includes Permanent and total loss of use of such organ(s). The Company shall pay
compensation under this clause, whichever the greatest amount, for only one item of loss among Event 1-9 in the same
Accident. The Company will not pay more than the Amount of Benefit stated in the Schedule, for all of the Accidental
Bodily Injuries resulting from one Accident.
After the occurrence of any one of the Events 2 to 9 or the total compensation payable for the Events 10 to 20 equal to
100% whichever the first occur save for the liability already incurred hereunder there shall be no further liability under
this Policy in respect of the same Insured Person for Injury sustained thereafter.
If the Insured Person is left-handed the percentages set out above from Events 13 to 16 for the various disabilities of
right hand and left hand will be transposed.
Compensation shall not be payable unless an Insured Person shall as soon as possible after the happening of any
Accidental Bodily Injury giving rise to a claim under this policy conditions and follow proper medical advice from a
Physician.
Any difference arising between the Policyholder or any claimant and the Company with respect to a claim under
insuring clause 1(A) shall be referred to an arbitrator to be appointed by the parties or if they cannot agree upon a single
arbitrator to the decision of two arbitrators one to be appointed by each of the parties or in case of disagreement of an
umpire to be appointed by the arbitrators before entering on the reference. The making of an award shall be a
condition precedent to any liability of or right of action against the Company in respect of such difference. If the
Company shall disclaim liability for any claim and such claim shall not within twelve (12) months from the date of such
disclaimer have been referred to arbitration under these provisions the claim shall then for all purposes be deemed to
have been abandoned and shall not thereafter be recoverable.
Disappearance: If the Insured Person’s body has not been found within one (1) year after the date of the disappearance,
sinking or wrecking of the aircraft or other conveyance either on the ground or at sea in which the Insured Person was
travelling at the time of the injury and under such circumstances as would otherwise be covered hereunder, it will be
presumed that the Insured Person suffered loss of life resulting from Bodily Injury caused by an Accident covered by
this Policy at the time of such disappearance, sinking or wrecking.
B. MEDICAL EXPENSES
If Accidental Bodily Injury or Sickness suffered by an Insured Person during a Covered Trip requires treatment by a
Physician, confinement in a Medical Facility, treatment performed by a health care service if continued hospitalisation
would otherwise have been required, x-ray examination, medicines and/or required consumables, the use of
land/marine ambulance or any dental treatment as a result of an Accidental Bodily Injury to sound and natural teeth, the
Company will reimburse the reasonable costs of such goods and services actually rendered overseas (except meals
and foodstuffs) within 365 days from the date of loss, up to the Amount of Benefit stated in the Schedule.
GBT Wording-1013 Section C – Policy Wording: Page 5 of 12
Follow-up medical expenses incurred after returning to Hong Kong, and for which treatment has been initially sought
overseas, will be covered for up to 90 days after return to Hong Kong. For treatment of an Accidental Bodily Injury
suffered overseas, the Company will reimburse the reasonable costs up to the balance of the unused portion of the
Amount of Benefit stated in the Schedule. For treatment of a Sickness suffered overseas, the Company will reimburse
the reasonable costs for up to 10% of the unused portion of the Amount of Benefit stated in the Schedule.
Such follow-up medical expenses shall include expenses payable to Registered or Listed Chinese bonesetter,
acupuncturist and Chinese Medicine Practitioner up to HKD150 per visit per day, and not exceeding HKD3,000 in
aggregate.
In no circumstances shall the overall reimbursement payable under this insuring clause exceed 100% of the Amount of
Benefit stated in the Schedule.
C. EMERGENCY MEDICAL EVACUATION
If Accidental Bodily Injury or Sickness of an Insured Person occurs during a Covered Trip and requires Emergency
Medical Treatment not available locally, the Company will pay up to the Amount of Benefit stated in the Schedule, the
Transfer Expenses incurred if it becomes medically necessary to Transfer the Insured Person to a more appropriate
Medical Facility, or return to Hong Kong if necessary, less any monies refundable from the original return airfare. The
Transfer shall be approved by the Program Medical Advisor.
D. RETURN OF MORTAL REMAINS
If an Insured Person dies during a Covered Trip as a result of Accidental Bodily Injury or Sickness, the Company will
pay the Transfer Expenses incurred for the Transfer of mortal remains to Hong Kong. The Transfer shall be approved
by the Program Medical Advisor.
E. TRANSPORT HAZARDS
If, during a Covered Trip:
(i) the Insured Person sustains Accidental Bodily Injury which arises out of an Accident occurring while the Insured
Person is riding as a fare paying passenger in or on, boarding or alighting from a Public Common Carrier; and
(ii) the Accidental Bodily Injury sustained causes the Insured Person to suffer loss of life, Permanent Total Disablement
or other loss,
then the Company will pay under this Insuring Clause 1E, the same percentages as set forth under Insuring Clause 1A,
on the Amount of Benefit under Insuring Clause 1E as stated in the Schedule.
F. HOSPITAL INCOME
The Company will pay the Insured Person the daily Amount of Benefit stated in the Schedule, for confinement outside
Hong Kong as a result of covered Accidental Bodily Injury or Sickness, up to the Amount of Benefit stated in the
Schedule. Such confinement shall be as an in-patient in a Medical Facility under treatment by any Physician. One day
of confinement shall mean a period for which a Medical Facility makes a daily charge for room and board. Payment
shall be made after the period of confinement ends.
G. BURNS BENEFIT
If as a result of Accidental Bodily Injury sustained during the Covered Trip, the Insured Person is diagnosed by
Physician to have suffered any of the Events listed hereunder, the Company will pay the Insured Person in respect of
the following Events according to the percentage bearing hereunder.
Events Percentage of Compensation
Burns, Second Degree or Third Degree
On 45% or more of body surface 100%
On 27% or more of body surface 60%
On 18% or more of body surface 50%
On 9% or more of body surface 30%
On 4.5% or more of body surface 20%
Compensation shall not be payable for more than one of the above Events in respect of the same Accidental Bodily
Injury. Should more than one of the Events occur from the same Accidental Bodily Injury, the Company shall only be
liable for the greatest applicable Percentage of Compensation.
GBT Wording-1013 Section C – Policy Wording: Page 6 of 12
The Compensation payable for loss of life under Insuring Clause 1A, if any, shall be reduced by any Compensation
payable under this Insuring Clause 1G in respect of the same Accidental Bodily Injury.
INSURING CLAUSE 2: PERSONAL BELONGINGS
A. PERSONAL BAGGAGE
NOTIFY ANY LOSS IMMEDIATELY TO THE PROPER AUTHORITIES: Obtain a Police Report! This is Required to Process Your Claim!
The Company will reimburse the Insured Person up to the Amount of Benefit stated in the Schedule for each set/pair of
item, subject to the total Amount of Benefit stated in the Schedule for all items, arising out of Accidental loss of or
damage to the Insured Person’s baggage and personal property contained in such baggage which occurs during a
Covered Trip. The Company’s liability will be the Actual Cash Value of the article at the time of loss. The Insured
Person must take every possible step to safeguard their accompanied baggage or personal property, and not leave
them unattended. The loss or damage must occur: (a) as a result of an Accident; or (b) while the baggage or personal
property is in the possession of hotel staff or a Public Common Carrier; or (c) as a result of Robbery or Theft. Proof of
such losses or damage must be obtained in writing from the hotel management, the Public Common Carrier, or through
making a report to the police having jurisdiction over the place of the loss. The police report must be filed within 24
hours of the loss. All such proofs and receipts and proofs of possession must be made available to the Company.
For Accidental loss of or damage to laptop computer, the maximum Amount of Benefit for each whole set/item will be
HKD10,000. For sports equipment, the maximum Amount of Benefit for each whole set/pair/item will be HKD5,000. In
no circumstances shall the overall reimbursement payable under this Insuring Clause 2A exceed 100% of the Amount
of Benefit stated in Schedule.
B. PERSONAL MONEY
If during a Covered Trip, the Insured Person experiences a loss of cash or banknotes, the Company shall pay up to the
Amount of Benefit stated in the Schedule to compensate for actual loss incurred. The loss must be reported to the
police having jurisdiction over the place of loss within 24 hours of the loss. Any claim must be accompanied by written
documentation from the police. The Insured Person must take every possible precaution to ensure the security of the
Insured Person’s cash or banknotes.
C. EMERGENCY CASH
If the Insured Person experiences a loss of essential travel documents that prevents the Insured Person from
completing the commenced Covered Trip, the Company will pay the daily Amount of Benefit per calendar day up to the
maximum Amount of Benefit stated in the Schedule, until the earliest of the following: (a) the document is
replaced/recovered; or (b) the Insured Person can continue the Covered Trip; or (c) the Insured Person can leave the
place of loss. Proof of such loss must be obtained by a report to the police having jurisdiction over the place of loss.
The police report should be filed within 24 hours of the loss.
INSURING CLAUSE 3: TRAVEL INCONVENIENCE
A. TRIP CANCELLATION
The Company will pay for loss of travel and/or accommodation expenses paid in advance or forfeited by the Insured
Person and for which the Insured Person is legally liable and which are non-refundable and not recoverable from any
other source upon cancellation prior to the Covered Trip. The cause of the cancellation must be the Death, Accidental
Bodily Injury, Sickness or confinement of the Insured Person or the Insured Person’s Immediate Family Members within
30 days before the departure of the Covered Trip, or the unexpected outbreak of strike, riot, civil commotion, or Natural
Catastrophe arising out of events beyond the Insured Person’s control, the Insured Person being called up for jury
service or the Insured Person’s residence being seriously damaged in bad weather.
B. TRIP CURTAILMENT
The Company will pay for additional travelling expenses or board incurred, and loss of travel and/or accommodation
expenses paid in advance or forfeited by the Insured Person after the commencement of a Covered Trip in the case
GBT Wording-1013 Section C – Policy Wording: Page 7 of 12
that the Insured Person must return directly to Hong Kong following Accidental Bodily Injury or Sickness of the Insured
Person or the Insured Person’s Immediate Family Member who is resident in Hong Kong or the unexpected outbreak of
strike, riot, civil commotion, or Natural Catastrophe. This coverage is effective only if the Insured Person has
commenced the Covered Trip before becoming aware of any circumstances which could lead to the disruption of the
Covered Trip.
C. STAFF REPLACEMENT
If the Insured Person is hospitalised outside Hong Kong for over 24 hours as a result of Accidental Bodily Injury or
Sickness, or suffers loss of life, the Company will reimburse the Transfer Expenses to include a round-trip, economy
class air ticket and accommodation to bring one Close Business Companion, chosen by the Policyholder, to the place
of hospitalisation, provided the Transfer is considered necessary by the Program Medical Advisor. The Company’s
liability for all Transfers as described above shall not exceed the maximum Amount of Benefit stated in the Schedule.
D. TRIP RE-ROUTE
In the event the Insured Person’s Covered Trip is delayed by the Public Common Carrier for over 12 hours from the
time specified in the itinerary after the commencement of the Covered Trip, and the delay causes the Insured Person to
miss another scheduled conveyance, the Company will pay up to the amount stated in the Schedule, for the Insured
Person’s necessarily and reasonably incurred additional travel costs.
E. TRAVEL DELAY
In the event the Insured Person’s Covered Trip is delayed by a Public Common Carrier due to bad weather, Natural
Catastrophe, strike, unavailability of machinery or Hijacking after the commencement of the Insured Person’s Covered
Trip, and the delay exceeds 6 consecutive hours from the time specified in the itinerary, the Company will pay the
Amount of Benefit stated in the Schedule for each and every full 6 consecutive hours delayed, up to the maximum
stated in the Schedule.
F. BAGGAGE DELAY
NOTIFY ANY LOSS IMMEDIATELY TO THE PUBLIC COMMON CARRIER: Obtain a Property Irregularity Form! This is Required to Process Your Claim!
The Company will pay the Insured Person up to the Amount of Benefit stated in the Schedule for the emergency
purchase of essential toiletries and clothing if checked-in baggage is delayed, misdirected or temporarily misplaced by
the Public Common Carrier for a period of 6 consecutive hours after the Insured Person’s arrival at the airport of the
scheduled destination abroad during a Covered Trip. Claims shall not be made under both Insuring Clauses 2A and 3F
of this Policy.
If loss occurs while the Insured Person is returning to Hong Kong, the Company will only be liable up to 50% of the
Amount of Benefit stated in the Schedule.
G. DOCUMENT LOSS
If the Insured Person experiences a loss of travel documents that leads to delay of his/her Covered Trip, the Company
shall pay up to the Amount of Benefit stated in the Schedule to compensate for actual loss incurred, including
additional travelling expenses, accommodation expenses and replacement fees. Any claim must be accompanied by
written documentation from the police having jurisdiction over the place of loss and reported within 24 hours of the loss.
INSURING CLAUSE 4: SPECIAL CARE
A. CARE VISIT
If the Insured Person is hospitalised outside Hong Kong for over 24 hours, the Company will reimburse the Transfer
Expenses to include a round-trip, economy class air ticket and accommodation to bring one Immediate Family Member,
or a person whose presence is necessary, chosen by the Insured Person, to the place of hospitalisation, provided the
Transfer is considered necessary by the Program Medical Advisor. The Company’s liability for all Transfers as
described above shall not exceed the maximum Amount of Benefit stated in the Schedule.
GBT Wording-1013 Section C – Policy Wording: Page 8 of 12
B. CREDIT CARD PROTECTION
The Company will pay up to the Amount of Benefit stated in the Schedule for the outstanding balance of the Insured
Person’s credit card(s) for purchases by Insured Person during a Covered Trip and services charges, if the Insured
Person suffers loss of life during a Covered Trip, where benefit under Insuring Clause 1A, Event 1 is payable.
C. EMERGENCY MOBILEPHONE CHARGES
If during a Covered Trip the Insured Person incurs telephone charges for personal mobile phone usage for the sole
purpose of engaging the services of International SOS during a medical assistance/ emergency, for which a Medical
Expenses claim has been submitted under the Medical Expenses section, the Company will reimburse the Insured
Person up to the Amount of Benefit stated in the Policy Schedule. No reimbursement will be payable for telephone calls
made via standard fixed line, data rooming and public telephone using an International Calling Card (ICC).
INSURING CLAUSE 5: PERSONAL LIABILITY
The Company will pay the Indemnity for damages which the Insured Person becomes legally liable to pay because of
bodily injury to any other person or destruction of property of others caused by an Accident occurring on a Covered
Trip during the Period of Insurance stated in the Schedule. The Company’s liability shall be limited to the maximum
Amount of Benefit stated in the Schedule.
PART III: GENERAL CONDITIONS
Age Limit: Coverage is available to persons between 18 and 80 years of age.
Aggregate Limit of Liability:
Except as provided hereunder, the total liability of the Company under the Policy in respect of any one Accident or
series of Accidents arising out of any one event shall not exceed the Aggregate Limit of Liability as set out in the
Schedule.
In the event the Aggregate Limit of Liability for any one Accident is insufficient to pay the full amount of compensation
for each Insured Person arising out of that Accident, then the amount payable for each Insured Person shall be reduced
proportionately, based on the ratio of the Aggregate Limit of Liability to the total amount of compensation that would
have been payable except for such Aggregate Limit of Liability. In the event of a claim which exhausts the Aggregate
Limit of Liability, it is agreed that the limit shall be automatically reinstated in respect of coverage for other Accidents.
Beneficiary: The loss of life Amount of Benefit will be paid to the Insured Person’s estate. All other Amounts of Benefit
are payable to the Insured Person, except the Amounts of Benefit payable under Insuring Clauses 1C, 1D and 4A,
which are payable to an emergency assistance provider or other provider of services rendered to the Insured Person.
Payment of any amount payable under this Policy by the Company in accordance with this clause shall effectively
discharge the Company from any further liability in respect thereof.
Cancellation: The Company may cancel this Policy by giving seven (7) days notice to the Policyholder by registered
letter sent to his last known address; and the Company making to the Policyholder a return of premium proportionate to
the unexpired part of the period of insurance. This Policy may be cancelled at any time by the Policyholder on seven (7)
days notice to the Company and in such event the Policyholder shall be entitled to a return premium less premium at
the Company’s Short Period Rates for the time this Policy has been in force during the Period of Insurance, but in no
circumstance shall the deposit premium be refunded.
Period Short Period Rates
2 months (Minimum) 40%
3 months 50%
4 months 60%
5 months 70%
6 months 75%
over 6 months 100%
All coverage under this Policy will be terminated on the next premium due date following the attainment of eighty (80)
years of age of the Insured Person.
GBT Wording-1013 Section C – Policy Wording: Page 9 of 12
Claims Investigation: In the event of a claim, the Company may make any investigation it deems necessary and both
the Insured Person and the Policyholder shall co-operate fully with such investigation. Failure by the Insured Person or
the Policyholder to co-operate with the Company’s investigation may result in denial of the claim or cancellation of the
Policy.
Compliance with Policy Provisions: Failure by the Policyholder or the Insured Person to comply with any of the
provisions contained in this Policy shall invalidate all claims hereunder.
Entire Contract: The Policy, together with all amendments and other attachments, if any, constitutes the entire contract
of insurance. The Policy shall not be modified except by written amendment attached hereto and signed by an
authorised representative of the Company.
Examination of Books and Records: The Company may examine the Insured Person’s or the Policyholder’s books and
records relating to this Policy at any time during the Policy term and up to three (3) years after the expiration of the
Policy or until final adjustment and settlement of all claims under the Policy.
Grace Period: A grace period of thirty-one (31) days will be granted for the payment of each premium falling due after
the first premium, during which time the Policy shall be continued in force, unless the Policy has been cancelled in
accordance with the provisions of this Policy. However, if loss occurs within this grace period, any premium then due
and unpaid will be deducted in settlement.
Jurisdiction: This Policy shall be governed and construed in accordance with the laws of Hong Kong Special
Administrative Region. Any dispute under this Policy shall be settled in accordance with the laws of Hong Kong Special
Administrative Region.
Legal Action: No legal action shall be brought to recover on this Policy until 60 days after the Company has been given
written Proof of Loss. No such action shall be brought after 2 years from the date of loss.
Legality: This insurance shall not apply to the extent it is illegal in any jurisdiction, outside the Hong Kong Special
Administrative Region, for the citizens of such jurisdiction to be insured by an insurer which is not registered within such
jurisdiction. This insurance does not apply to the extent that trade or economic sanctions or other similar laws or
regulations prohibit the coverage provided by this insurance.
Limits of Liability and Deductibles: This Policy is subject to the Aggregate Limit of Liability and Deductibles stated in
the Schedule.
Other Insurance: If a covered loss under this Policy is insured under any other valid policy, prior or current, then this
Policy shall cover such loss, subject to its limitations, exclusions, conditions, provisions and other terms, only to the
extent that the amount of such loss is in excess of the amount of payment from such other insurance, whether such
other insurance is stated to be primary, contributory, excess, contingent or otherwise.
Physical Examinations and Autopsy: The Company, at its expense, has the right to have the Insured Person examined
as often as reasonably necessary while a claim is pending. It may also have an autopsy made unless prohibited by law.
Refunds: There will be no refund of premium to the Insured Person/Policyholder once coverage under any Insuring
Clause of this Policy has become operative.
Reinstatement of Policy: When this Policy terminates by reason of non-payment of premium, any subsequent
acceptance of a premium shall constitute reinstatement of the Policy by the Company, and shall only cover loss
resulting from Accidental Bodily Injury sustained or Sickness commencing after the date of such reinstatement.
Renewal: This Policy may be renewed with the consent of the Company by payment of the premium in advance at the
rate specified by the Company at time of renewal.
Rights of Recovery: In the event that authorisation of payment and/or payment is made by the Company or on its
behalf by its authorised representatives, including emergency assistance provider, the Company reserves the right to
recover against the Insured Person the full sum which has been paid, or for which the Company is liable, to a Medical
Facility to which the Insured Person has been admitted, less the Company’s liability under the terms of the Policy.
Subrogation: In the event of any payment made under this Policy, the Company shall be subrogated to all the Insured
Person’s rights of recovery and indemnity against any person or organisation and the Insured Person shall execute and
GBT Wording-1013 Section C – Policy Wording: Page 10 of 12
deliver instruments and papers and do whatever else is necessary to secure such rights. The Insured Person shall take
no action to prejudice such rights.
Territory: Worldwide.
PART IV: EXCLUSIONS
GENERAL EXCLUSIONS APPLICABLE TO ALL INSURING CLAUSES -
This Policy does not cover loss arising out of:
1. Pre-existing, congenital or hereditary conditions. A pre-existing condition, meaning prior Sickness or Accidental
Bodily Injury contracted or sustained by an Insured Person, or Immediate Family Member of the Insured Person, or
for which medical treatment or advice has been given or the symptoms of which would cause a reasonably prudent
person to seek diagnosis, care or treatment within twelve (12) months prior to the commencement of a Covered
Trip. For the purpose of Insuring Clauses 3A and 3B, Sickness or Accidental Bodily Injury should occur within a 30
days period before the commencement of the Covered Trip.
2. Travelling abroad contrary to the advice of a Physician, or for the purpose of obtaining medical treatment or
services.
3. Suicide, attempted suicide or intentional self-infliction of bodily injury.
4. Abortion, miscarriage, pregnancy or resulting childbirth.
5. Dental care (unless resulting from Accidental Bodily Injury to sound and natural teeth).
6. Mental or nervous disorders, insanity.
7. War (whether declared or not), invasion, act of foreign enemies, civil war, revolution, rebellion, insurrection, military
force or coup, or from the Insured Person performing duties as a member of armed forces or police.
8. Participation in professional sports events (unless approved by the Company).
9. Prohibition or regulation by any government, or customs detention.
10. Damages relating to the unlawful, wilful, malicious acts of the Insured Person.
11. The Insured Person not taking reasonable efforts to safeguard his/her property or to avoid injury or minimise any
claim under this Policy.
12. Actions of the Insured Person while under the influence of alcohol or drugs to the extent of legal impairment.
13. Riding in any aircraft except as a passenger in a properly licensed aircraft flown by a qualified pilot.
14. The Insured Person’s actions in the course of committing a felony or while under arrest by authorities because of
commission of a felony.
15. Nuclear weapons, radiation, or radioactivity from any nuclear fuel or nuclear waste arising from the combustion of
nuclear fuel and/or any self sustaining process of nuclear fission.
16. AIDS or AIDS Related Complex, any Accidental Bodily Injury or Sickness commencing at the time of or subsequent
to a sero-positive test for HIV or related disease, or any other sexually transmitted diseases.
17. The Insured Person engaging in manual labour or hazardous work including but not limited to offshore drilling,
mineral extraction, handling of explosives, construction work, stunt works and aerial photography.
EXCLUSIONS APPLICABLE TO INSURING CLAUSE 1A: PERSONAL ACCIDENT -
This Policy does not cover loss arising out of Accident occurring during or as a direct or indirect result of any surgery
except when such surgery was necessary to treat or restore function after an Accidental Bodily Injury covered by this
policy.
EXCLUSIONS APPLICABLE TO INSURING CLAUSE 2A: PERSONAL BAGGAGE -
The following causes or property are excluded from coverage under this Policy:
1. Animals, motors/motor vehicles/motorcycles or their accessories, boats or any other conveyances, household
effects, drugs, foodstuffs, antiques, computer parts/software/accessories, artificial teeth or limbs, securities, tickets,
valuable papers other than travel documents or data recorded on disks, tapes, cards or other equipment.
2. Loss or damage caused by wear and tear, gradual deterioration, workmanship or vermin.
3. Loss of or damage to hired or leased equipment.
4. Loss of business goods or samples.
5. Loss of unattended baggage sent in advance, souvenirs, or articles mailed or shipped separately.
6. Loss of or damage to the Insured Person’s personal property or baggage left unattended in any vehicle or
conveyance, or in any public place or arising out of the Insured Person’s failure to take due care and precautions
for the safeguard and security of such property.
EXCLUSIONS APPLICABLE TO INSURING CLAUSES 3A AND 3B: TRIP CANCELLATION AND TRIP CURTAILMENT-
This Policy does not cover loss arising out of:
1. Government regulation, control or action, bankruptcy, liquidation or default of Travel Provider(s).
2. Public Common Carrier caused cancellations.
GBT Wording-1013 Section C – Policy Wording: Page 11 of 12
3. Changes in plans, financial circumstances and any business or contractual obligations of the Insured Person, or an
Immediate Family Member of the Insured Person.
4. Any event or circumstance which occurs prior to the Covered Trip.
EXCLUSIONS APPLICABLE TO INSURING CLAUSE 5: PERSONAL LIABILITY -
This Policy does not cover loss arising out of:
1. Bodily Injury to any person who is a relative of the Insured Person or who is in the Insured Person’s custody or
control, or damage to property which belongs to the Insured Person or which is in the Insured Person’s custody or
control.
2. Damages relating to any liability assumed under a contract.
3. The ownership, possession, lease or rental of any vehicles, aircraft, firearms or animals.
4. The undertaking of any trade or profession.
5. Any criminal acts or proceedings.
PART V: HOW TO MAKE A CLAIM
Any occurrence or loss which may give rise to a claim should be reported in writing immediately but in any event NOT
LATER THAN 30 DAYS AFTER THE INCIDENT TO:
Federal Insurance Company, Hong Kong Branch
(The address of the Company is stated in the Schedule.)
Telephone No. (852) 2861 3668 Fax No. (852) 2865 7778
Claim Form: Claim Form is available for download at www.chubb.com/international/hk/
Proof of Loss: Written Proof of Loss must be given to the Company within 30 days after the date of such loss including
original copies of all relevant documentation. The Policyholder or Insured Person shall notify the Company promptly of
the reason and possible time frame for submission when such Proof of Loss is delayed. Failure to give written Proof of
Loss within 180 days will invalidate the claim.
Time of Payment of Claims: Benefits payable under this Policy will be paid within 30 days of receipt of a completed
Proof of Loss.
24 Hours Worldwide Emergency Hotline Service
For any emergency assistance service, simply call (852) 3122 8800 and quote your Policy No. in effect.
Personal Information Collection Statement
What do we use personal data for
We, Federal Insurance Company Hong Kong Branch, may use the personal data which you provide to us in a
proposal form for insurance or in any other documents relating to an insurance policy or claim of whatsoever
nature made under an insurance policy issued by us, and the modifications, variations or cancellation of any
such information, for the following purposes:
x processing and evaluating your application and any future application you make;
x administering your insurance policy and providing services in relation to your insurance policy;
x investigation, processing and paying claims under your insurance policy;
x to contact you regarding your enquiries or relating to the collection of insurance premium or payment
discrepancies or any other matters relating to your insurance policy or a claim under it;
x for identification and verification purposes;
x for our own internal records;
x to commence or defend any legal proceedings made by or against us, our directors, officers, employees,
subcontractors, agents, affiliates and/or subsidiaries;
x to provide you with relevant marketing (for details on direct marketing, please see below);
x for other ancillary purposes which are directly related to the above purposes;
x complying with applicable laws, regulations or any industry codes or guidelines.
Direct Marketing
With your consent, we may also use your name, contact details and policy details to contact you with direct marketing
communications regarding financial and insurance products by postal mail, email, telephone or SMS.
GBT Wording-1013 Section C – Policy Wording: Page 12 of 12
With your consent, we may also provide your name, contact details and policy details to our related companies (as that
term is defined in the Companies Ordinance), who may send you direct marketing communications regarding financial
and insurance products by postal mail, email, telephone or SMS.
If you do not wish us to use your personal data in direct marketing as described above, you may exercise your opt-out
right by notifying us. You may write to the Operations Services Manager at the address provided below, or provide the
Company with your opt-out choice in the relevant application form (if applicable).
To whom do we disclose personal data
We may disclose your personal data for the above purposes to the following:
x third party agents, contractors and advisors who provide administrative, communications, computer, payment,
security or other services which assist us to carry out the above purposes (including medical service providers,
emergency assistance service providers, telemarketers, mailing houses, IT service providers and data processors);
x our personnel, agents and affiliates in order to provide you with the products or services you request;
x in the event of a claim, loss adjudicators, claims investigators and medical advisers;
x our related companies (as that term is defined in the Companies Ordinance);
x any reinsurers, brokers or agents for the purposes of underwriting or administering your policy;
x any person in connection with claims made by or against or otherwise involving you in respect of any products or
services provided by us;
x any of our service providers insofar as required to enable us to provide the services you have requested;
x our legal and professional advisors;
x in the event of default, the Small Claims Tribunal, debt collectors and recovery agents;
x the Hong Kong Federation of Insurers (or similar association of insurance companies) and its members;
x the Insurance Claims Complaints Bureau and similar industry bodies;
x government agencies and authorities as required or permitted by law.
The personal data you provide to us may be transferred to our company’s parent, subsidiary or affiliate in Hong Kong or
other jurisdictions having privacy laws which are substantially similar to, or serve the same purposes as, the PDPO.
You acknowledge this and agree and consent to the transfer to and storage of your information in these jurisdictions.
We may preserve or disclose personal data when required by law or court order, or as requested by other government
or law enforcement authorities, or in the good faith belief that such preservation or disclosure is otherwise necessary or
advisable including and without limitation to protect the rights, properties or personal safety of, or commence or defend
any claims, demands or legal proceedings by or against us, our directors, officers, employees, subcontractors, agents,
affiliates and/or subsidiaries. We shall not be liable to you or to any third party as a result of such preservation or
disclosure of personal data for any of these purposes.
We may also use and disclose your personal data otherwise with your consent.
It is mandatory to provide all of the personal data requested on the proposal form for insurance or such documents
relating to an insurance policy or claim, as enclosed with this Statement. Failure to provide all the personal data
requested on this form or such documents may mean we are unable to process your application.
Accessing and correcting your personal data
You may seek access to or request correction of any personal data we hold about you by contacting:
Operations Services Manager Federal Insurance Company, Hong Kong Branch 2401 Harcourt House, 39 Gloucester Road, Wanchai, Hong Kong.
For more information about how we use your personal information, please visit our website:
http://www.chubb.com/international/hk/ to see our privacy policy.
Trav
el In
sura
nce A
pplic
atio
n Fo
rm fo
r A
IESE
C H
ong
Kon
g In
sure
d Pe
rson
Arra
nged
by
Mar
sh (H
ong
Kon
g) L
imite
d U
nder
writ
ten
by F
eder
al In
sura
nce
Co.
Priv
acy
Unl
ess t
he P
olic
yhol
der o
r Ins
ured
Per
son
tells
Mar
sh n
ot to
, Mar
sh m
ay
disc
lose
the
info
rmat
ion
the
Polic
yhol
der o
r Ins
ured
Per
son
prov
ides
to M
arsh
, to
oth
er o
rgan
izat
ions
whe
re M
arsh
bel
ieve
s it i
s nec
essa
ry to
ass
ist M
arsh
and
th
e ot
her o
rgan
izat
ions
in p
rovi
ding
the
serv
ices
. Rec
ipie
nts w
ill ty
pica
lly b
e in
sure
rs, r
eins
urer
s, ot
her i
nsur
ance
inte
rmed
iarie
s, he
alth
wor
kers
, in
vest
igat
ors,
law
yers
, los
s adj
uste
rs a
nd M
arsh
rela
ted
com
pani
es th
roug
hout
th
e w
orld
D
estin
atio
n W
orld
wid
e to
Wor
ldw
ide
Im
port
ant N
otes
In
sure
d Pe
rson
Pe
riod
of I
nsur
ance
D
isclo
sure
to In
sure
rs F
or a
n in
sure
r to
deci
de to
take
a ri
sk a
nd th
en to
mak
e an
info
rmed
ass
essm
ent o
f the
risk
it fa
ces u
nder
a c
ontra
ct o
f ins
uran
ce, a
ll re
leva
nt m
atte
rs m
ust b
e di
sclo
sed
in th
e ut
mos
t goo
d fa
ith to
it. T
he d
uty
to
mak
e fu
ll an
d fra
nk d
isclo
sure
rests
upo
n th
e pa
rty se
ekin
g in
sura
nce
cove
r and
no
t upo
n th
e br
oker
who
act
s on
that
par
ty’s
beh
alf.
Surn
ame
Giv
en N
ame
From
dep
artu
re d
ate
to th
e en
d of
trip
Prem
ium
for e
ach
trip
(Eac
h In
sure
d Pe
rson
)
*
Plea
se ti
ck th
e ap
prop
riate
one
1.
Com
mun
ity P
roje
cts
_
__ C
ateg
ory
A1
– H
KD
450.
00 (u
p to
8 w
eeks
)
___
Cat
egor
y A
2 –
HK
D55
0.00
(up
to 1
0 w
eeks
)
___
Cat
egor
y A
3 –
HK
D65
0.00
(up
to 1
2 w
eeks
) 2.
Wor
king
Abo
ard
Inte
rnsh
ip
_
__ C
ateg
ory
B1 –
HK
D1,
450.
00 (u
p to
7 m
onth
s)
_
__ C
ateg
ory
B2 –
HK
D1,
850.
00 (u
p to
12
mon
ths)
A
s sta
ted
on H
ong
Kon
g ID
Car
d Y
our
Dut
y of
Disc
losu
re B
efor
e yo
u en
ter i
nto
a co
ntra
ct o
f gen
eral
insu
ranc
e w
ith a
n in
sure
r, yo
u ha
ve a
dut
y to
disc
lose
to th
e in
sure
r eve
ry m
atte
r tha
t you
kn
ow, o
r cou
ld re
ason
ably
be
expe
cted
to k
now
is re
leva
nt to
the
insu
rer’s
de
cisi
on w
heth
er to
acc
ept t
he ri
sk o
f the
insu
ranc
e an
d, if
so, o
n w
hat t
erm
s. Y
our h
ave
the s
ame
duty
to d
isclo
se th
ose
mat
ters
to th
e in
sure
r bef
ore
you
rene
w, e
xten
d, v
ary
or re
inst
ate
a co
ntra
ct o
f gen
eral
insu
ranc
e.
You
r dut
y ho
wev
er d
oes n
ot re
quire
disc
losu
re o
f mat
ter;
•
that
dim
inish
es th
e ris
k to
be
unde
rtake
n by
the
insu
rer;
•
that
is o
f com
mon
kno
wle
dge:
•
th
at y
our i
nsur
er k
now
s, or
in th
e or
dina
ry c
ours
e of
his
bus
ines
s,
ough
t to
know
; •
as
to w
hich
com
plia
nce
with
you
r dut
y is
wai
ved
by th
e in
sure
r
H
KID
No.
/ Pas
spor
t No.
:
E-
mai
l Add
ress
:
C
over
age
24 h
ours
wor
ldw
ide
cove
ring
the
Insu
red
Pers
on a
gain
st A
ccid
enta
l Dea
th, B
odily
Inju
ry a
nd a
ny c
over
age
spec
ified
he
reun
der w
hile
on
the
trip
of th
e Po
licyh
olde
r out
side
the
terr
itory
of H
ong
Kon
g
Rem
arks
: Th
e ag
e lim
it of
Par
ticip
ants
is b
etw
een
sixte
en (1
6) a
nd e
ight
y (8
0)
Non
-disc
losu
re I
f you
fail
to c
ompl
y w
ith y
our D
uty
of D
iscl
osur
e, th
e in
sure
r m
ay b
e en
title
d to
redu
ce h
is lia
bilit
y un
der t
he c
ontra
ct in
resp
ect o
f a c
laim
or
may
can
cel t
he c
ontra
ct. I
f you
r non
-disc
losu
re is
frau
dule
nt, t
he in
sure
r may
al
so h
ave
the
optio
n of
avo
idin
g th
e co
ntra
ct fr
om it
s beg
inni
ng.
Trip
Can
cella
tion/
Cur
tailm
ent C
laus
e :
- Cov
er U
nexp
ecte
d ou
tbre
ak o
f stri
ke, r
iot,
civi
l com
mot
ion
or
n
atur
al c
atas
troph
e - E
xclu
de O
utbo
und
Trav
el A
lert
Paym
ent M
etho
d
Ch
eque
or C
ash
paya
ble
to A
IESE
C H
ong
Kon
g Li
mite
d on
or b
efor
e (d
eadl
ine)
.
Si
gnat
ure
of In
sure
d Pe
rson
Dat
e
For e
nqui
ry o
f ins
uran
ce c
over
age,
ple
ase
cont
act
M
s Dily
s Li
Fo
r O
ffice
Use
Dec
lara
tion
It is
und
erst
ood
and
agre
ed th
at a
ll an
swer
s to
all q
uesti
ons a
re to
the
best
know
ledg
e an
d be
lief c
ompl
ete
and
true.
Alth
ough
the
sign
ing
of th
is pr
opos
al d
oes n
ot b
ind
to e
ffect
insu
ranc
e, I
agre
e th
at a
ll an
swer
s to
such
qu
estio
ns, t
oget
her w
ith th
is a
gree
men
t, sh
all f
orm
the
basis
of a
ny p
olic
y iss
ued
here
unde
r; th
at n
o in
sura
nce
will
be
effe
cted
unt
il th
e po
licy
is
issue
d.
M
arsh
(Hon
g K
ong)
Lim
ited
EP
ID:
Emai
l : d
ilys.k
w.li
@m
arsh
.com
or
TN
ID:
Tel :
852
230
1 72
10 F
ax: 8
52 3
009
4159
w
ww
.mar
sh.c
om