更改保单申请表—财务.PDF
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1、INHK005R30 (0818)WPage 頁次 1/12Incorporated in Bermuda with limited liability 於百慕達註冊成立之有限公司Hong Kong SAR Office:18/F, Tower 1, HSBC Centre, 1 Sham Mong Road, Kowloon, Hong Kong香港特別行政區地址:香港九龍深旺道1號滙豐中心1座18樓HSBCFTXPolicy Number* 保單號碼*1 1 1 1 1 1 1 1 12 2 2 2 2 2 2 2 23 3 3 3 3 3 3 3 34 4 4 4 4 4 4 4 45
2、5 5 5 5 5 5 5 56 6 6 6 6 6 6 6 67 7 7 7 7 7 7 7 78 8 8 8 8 8 8 8 89 9 9 9 9 9 9 9 90 0 0 0 0 0 0 0 0ePolicy servicing _ You can now make online submission via HSBC Personal Internet Banking for transfer of funds (investment choices), change in premium allocation, policy value withdrawal and change o
3、f payment, giving you the convenience of 24/7 access for shorter turnaround time. Please visit .hk/1/2/hk/insurance for more details._cj _ 閣下可透過滙豐個人網上理財以更快捷及全天候24小時方式,隨時處理轉調基金(投資選擇)、更改保費分配、提取保單金額及更改繳付保費指示。詳情請瀏覽.hk/1/2/chinese/hk/insurance。applicable to some plans only. 只適用於相關保險。Request for Policy Ch
4、ange Financial a _ Plan Name計劃名稱Name of Policyholder in English(Surname first)保單持有人英文姓名(先填寫姓氏)# ID Type ULEP: Goal Access Universal Life Plan (Education) (駿富教育萬用壽險計劃); WGIP: HSBC Wealth Goal Insurance Plan(滙溢保險計劃);FGIP: HSBC Family Goal Insurance Plan(滙盛人生保險計劃)6. If the payments are paid in currenci
5、es other than the policy currencies/currency of levy cap i.e. HKD as provided by the Insurance Authority, the payments would be subject to change according to the prevailing exchange rate of policy currencies/HKD to payment currencies to be determined by the Company from time to time. Likewise any p
6、ayments settled in currencies other than the policy currencies/currency of levy cap i.e. HKD, the payments would be subject to the change according to the prevailing exchange rate of policy currencies/HKD to payment currencies to be determined by the Company from time to time. The fluctuation in exc
7、hange rates may have impact on the amount of payments including but not limited to premium payments, levy payments and benefit payments. By choosing the plans denominated in currencies other than local currency, you are subject to the exchange rate risks. Exchange rate fluctuates from time to time.
8、You may suffer a loss of your benefit values and the subsequent premium payments and/or levy payments (if any) may be higher than your initial premium payment as a result of the exchange rate fluctuations. 如繳付款項貨幣有別於保單貨幣或保險業監管局訂定徵費上限的貨幣(即港幣),該款項可能會受本公司不時釐定的保單貨幣港幣對繳付款項貨幣的匯率而改變。同樣,如任何款項的貨幣不是以保單貨幣或保險業監
9、管局訂定徵費上限的貨幣(即港幣)支付,該款項將會受本公司不時釐定的保單貨幣對支付貨幣港幣的匯率而改變。匯率之波動會對款額構成影響,包括但不限於以繳付保費,保費徵費及利益支付款項。選擇非本地貨幣結算的保單,閣下須承受匯率風險。匯率會不時波動,閣下可能因匯率之波動而損失部分的利益價值及繳交往後保費及或保費徵費(如有)可能會比繳交首次保費及保費徵費金額為高。7. The Bank has explained the product features to you including potential liquidity, time horizon, any currency implication
10、s, fees except for reduction of Sum Insured/Protection Amount and deletion of supplementary benefits. Please visit an HSBC branch to conduct the “Financial Planning Report/Financial Needs Analysis” and submit it together with this form.)基本計劃附加保障_ -XJX_ ._d 5 3aY KZ Kg i._H # J _fKWi._H # J _( S t_f_
11、a. New Sum Insured/Protection Amount is subject to maximum and minimum requirements.新保額保障額不得超越保障計劃之最高及最低限制。b. Not applicable to Major Illness Benefit (to age 65).不適用於嚴重疾病保障(至65歲)。Increase in Protection Amount is only applicable to supplementary benefits attached to SPP/SPL/LIVP/RIVP policies. Additi
12、on of Major Illness Benefit (Advance Payment) for ULPP only allows within premium payment period for regular premium policy. This request is not applicable to single premium policy. 增加保障額只適用於儲全保卓滙投資壽險計劃投資儲全保退休儲全保之附加保障。駿富保障萬用壽險計劃增加嚴重疾病保障(預支保額)只適用於定期保費的保單。此申請不適用於躉繳保費的保單。For HSBC Comprehensive Critical
13、 Illness Protection Plan, addition of supplementary benefits and increase of sum insured after policy issuance is not allowed.於保單生效後,增加附加保障和增加保額並不適用於滙安健危疾保障計劃。Addition of Female Benefit will result in simultaneous addition of Major Illness Benefit if the latter was not attached to the policy.如嚴重疾病保障
14、未曾附加於保單上,於附加女性保障時,嚴重疾病保障會自動附加於保單。c. Deletion of Major Illness Benefit will be accompanied by deletion of Female Benefit applied/added on or after Nov 2001 if such is attached to the policy.刪除嚴重疾病保障會自動刪除2001年11月以後簽發或附加於保單之女性保障。* For reduction of sum insured, the cash value/surrender value (if applica
15、ble)/special bonus (if applicable) and death benefit/critical illness benefit (if applicable) of the policy will be reduced accordingly. A full review of your existing policy is/are recommended before you make this decision. For ULPP and ULEP, addition/reduction of sum insured is allowed after the f
16、irst policy anniversary for single premium policy and after the 5th policy anniversary for regular premium policy. The addition/reduction of sum insured is subject to minimum and maximum amounts determined by us from time to time. Reduction of sum insured is subject to surrender charge (if any). Sur
17、render charge applies during the first 10 policy years for ULPP and 8 policy years for ULEP. The maximum surrender charge is up to 45% (ULPP)/55% (ULEP) for regular premium policy and 11% (ULPP)/12% (ULEP) for single premium policy of the account value on the date we receive the request times the pe
18、rcentage of reduction of sum insured. Please refer to the policy terms for the relevant details. 若減少投保額,保單的現金價值退保價值(如適用)特別獎賞(如適用)及身故死亡賠償嚴重疾病保障(如適用)將會相應調低。故我們建議閣下於提出此申請前作出全面之復審。駿富保障萬用壽險計劃及駿富教育萬用壽險計劃躉繳的保單可於首保單年度後增加減少保額,定期保費的保單可於第5個保單年度後增加減少保額。增加減少保額的最低及最高款額將由本公司不時訂定。減少保額須繳付退保費用(如適用)。退保費用分別適用於首十個保單年度(駿
19、富保障萬用壽險計劃)首八個保單年度(駿富教育萬用壽險計劃),定期保費保單的退保費用最高達當收到要求時戶口價值的45%(駿富保障萬用壽險計劃)55%(駿富教育萬用壽險計劃)乘以減少投保額的百分比及躉繳保費保單的退保費用最高達當收到要求時戶口價值的11%(駿富保障萬用壽險計劃)12%(駿富教育萬用壽險計劃)乘以減少投保額的百分比。閣下可查閱保單條款以得到相關的詳細資料。If “Standing Instruction” has been set up for premium payment arrangement, please be reminded that you should comple
20、te and return the “Standing Instruction Request form” to The Hongkong and Shanghai Banking Corporation Limited for the amendment/cancellation of the said arrangement. Normally, it takes 5 business days to processing such request.若上述保單已設立常行指示以繳付保費,請注意,閣下需填妥並交回常行指示申請表予香港上海滙豐銀行有限公司,以修改或取消有關常行指示的安排。有關安排
21、,一般需時5個工作天方可生效。 Not applicable to WIPP.不適用於財富投資人壽計劃。 Not applicable to Corporate customer. Under the addition of the Payors Benefit and the Payor is not the Policyholder, Nationalities 2 and 3 are optional. Otherwise, please state all your current Nationality(ies) if you have any revision. In additi
22、on, nationality proof is required if the change of nationality applied by non-permanent Hong Kong resident.不適用於公司客戶。如申請付款人供款保障及付款人並非保單持有人,國籍2及3為非必要填寫資料。否則,如修正任何國籍資料,請填寫閣下現在的所有國籍。此外,如非香港永久居民申請修正國籍資料,請附上國籍證明。Change Sum Insured/Protection Amounta Add Reduce New Amount更改保額保障額a 增加 減少 新保額Basic Plan * 基本計劃
23、Yearly Renewable Term Benefit N/A 續年定期壽險保障Term Protection Benefit N/A 定期壽險保障Addition of Amount Deletion of Deletion of Joint Life InsuredSupplementary SupplementaryBenefitsbBenefitsc增加附加保障b保額 取消附加保障c取消聯名受保人+Addition of Payors Benefit 申請付款人供款保障Relationship to Life Insured: Father Mother Other與受保人之關係:
24、 父親 母親 其他 +Addition of Joint Life Insured (applicable for MPP only) 申請增加聯名受保人(只適用於樂安居供樓保障計劃)Applicant Status: Home Loan Existing Home Guarantor申請人身份: Applicant Loan Customer 擔保人樓宇貸款申請人 現有樓宇貸款客戶 +Please complete item (i) to (viii), Part II and Part III. 請填寫以下(i)至(viii)項,第二及第三部分。(i) Mr 先生 Mrs 太太 Miss
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