免費團體保險保障登記 Free group insurance benefits enrolment

免費團體保險保障登記 Free group insurance protection enrolment

This enrolment is closed. 此登記已完結。

AIA一直致力守護您的健康。即日起至，成功遞交此登記表格，即可獲得由AIA企業業務提供的尊屬免費團體保險保障 (「免費保障」)。成員受保證書將於成功登記後21個工作天內透過財務策劃顧問或AIA提供。

每名人士只可登記免費保障一次(不論任何團體)，並於遞交申請時必須為香港身份證持有人。AIA之財務策劃顧問不可登記免費保障。有關條款及細則，請按此。

AIA strives to safeguard your health. From now till , successful enrolment via this form can enjoy exclusive free group insurance protection offered by AIA Corporate Solutions (“Free Protection”). Member Certificate of Insurance will be provided by Financial Planner or AIA within 21 working days upon successful enrolment.

Each person can only register once for the Free Protection (regardless of the affinity group) and must hold Hong Kong identity card at the time of application. Financial Planner of AIA is not eligible to enroll in Free Protection. For terms and conditions, please click here.

此免費保障只適用於以下團體之會員及其配偶和未婚子女（如適用）This Free Protection is only applicable to the members of the following group and their spouse and unmarried children (if applicable): 此免費保障只適用於以下團體之會員 This Free Protection is only applicable to the members of the following group:

註: 如受保人不符合資格，友邦保留權利終止受保人的保障。
Remarks: AIA reserves the right to terminate the insured’s coverage if the insured does not fulfill the eligibility.

請輸入財務策劃顧問編號
Please enter Financial Planner code:

如有查詢，請與您的專屬財務策劃顧問聯絡 For enquiries, please contact your dedicated Financial Planner:

姓名Name:
財務策劃顧問編號Financial Planner Code:
聯絡電話Contact Number:

請輸入記錄編號
Please enter record number:

會員Member
^*必須填寫，並須與香港身份證上資料相同(手提號碼及電郵地址除外)
Mandatory field, must fill in the information as shown on HKID (except mobile number and email address)

英文姓氏
Last Name in English^*

英文名字
First Name in English^*

中文姓名
Name in Chinese

出生日期
Date of Birth^*

性別
Gender^*

男Male 女Female

香港身份證號碼
HKID card number^*

(e.g. A1234567, 包括括號內之數字或字母include the digit in bracket)

手提號碼
Mobile No^*

(一次性密碼將發送至此號碼 One-time password will be sent to this number)

電郵地址
Email Address^*

為配偶登記 Enrol for spouse

配偶 Spouse

英文姓氏
Last Name in English^*

英文名字
First Name in English^*

中文姓名
Name in Chinese

出生日期
Date of Birth^*

性別
Gender^*

男Male 女Female

香港身份證號碼
HKID card number^*

(e.g. A1234567, 包括括號內之數字或字母include the digit in bracket)

手提號碼
Mobile No

電郵地址
Email Address

為子女登記 Enrol for child

子女 Child 1

英文姓氏
Last Name in English^*

英文名字
First Name in English^*

中文姓名
Name in Chinese

出生日期
Date of Birth^*

性別
Gender^*

男Male 女Female

香港身份證號碼
HKID card number^*

(e.g. A1234567, 包括括號內之數字或字母include the digit in bracket)

子女 Child 2

子女 Child2

英文姓氏
Last Name in English^*

英文名字
First Name in English^*

中文姓名
Name in Chinese

出生日期
Date of Birth^*

性別
Gender^*

男Male 女Female

香港身份證號碼
HKID card number^*

(e.g. A1234567, 包括括號內之數字或字母include the digit in bracket)

子女 Child-3

子女 Child 3

英文姓氏
Last Name in English^*

英文名字
First Name in English^*

中文姓名
Name in Chinese

出生日期
Date of Birth^*

性別
Gender^*

男Male 女Female

香港身份證號碼
HKID card number^*

(e.g. A1234567, 包括括號內之數字或字母include the digit in bracket)

子女 Child 4

子女 Child4

英文姓氏
Last Name in English^*

英文名字
First Name in English^*

中文姓名
Name in Chinese

出生日期
Date of Birth^*

性別
Gender^*

男Male 女Female

香港身份證號碼
HKID card number^*

(e.g. A1234567, 包括括號內之數字或字母include the digit in bracket)

子女 Child-5

子女 Child 5

英文姓氏
Last Name in English^*

英文名字
First Name in English^*

中文姓名
Name in Chinese

出生日期
Date of Birth^*

性別
Gender^*

男Male 女Female

香港身份證號碼
HKID card number^*

(e.g. A1234567, 包括括號內之數字或字母include the digit in bracket)

受益人
Beneficiary^*

受益人Beneficiary

英文姓氏
Last Name in English^*

英文名字
First Name in English^*

中文姓名
Name in Chinese

關係
Relationship ^*

出生日期
Date of Birth^*

性別
Gender^*

男Male 女Female

香港身份證號碼/ 護照號碼
HKID Card No./ Passport No.

除因任何轉讓或任何其他合法行事 / 限制而受到禁止外，會員可保留權利於準受保人在生期間及無須獲得任何受益人或信託人之同意，以友邦保險(國際)有限公司（於百慕達註冊成立之有限公司）(「公司」)的指定表格向我們遞交書面通知，要求:
Unless prohibited by any assignment or any other lawful act / restriction, member hereby reserves the right, during the lifetime of the proposed insured and without the consent of any beneficiary or trustee, by written notice to AIA International Limited (Incorporated in Bermuda with limited liability) (the “Company”) in its prescribed form to:

(a) 更改及撤銷對任何受益人的委任，並以其個人姓名或任何其他姓名取代；及
Change and revoke the appointment of any beneficiary and substitute his / her own name or any other name therefor; and

(b) 委任信託人代受益人接收賠償，以及更換已指派之信託人或撤銷該項指派。
Appoint a trustee to receive the proceeds for the beneficiary, and change or revoke and prior trustee designation or appointment.

對於任何委任或撤銷的有效性以及其後本公司收訖而正待簽發批註更改任何受益人的書面通知，本公司不負任何責任。
The Company is not responsible for the validity of any appointment or revocation and for any subsequent written notice of a change of beneficiary received by it pending the issue of endorsement.

驗證碼
Captcha^*

Refresh

在此網頁中的產品資料並不包含免費保障的完整條款，有關一般條款及不保事項，請參閱條款及細則。您必須在此登記網頁上填報一切有關之事實，否則本公司有權將所繕發之成員受保證書宣告無效。此登記必須在香港特別行政區內進行。此保險產品之保單將會在香港繕發並受香港法律管轄及闡釋。於索償過程中，請提供受保證書上的證書編號及上述團體會員證明副本。本公司非常重視使用本網站人士資料的安全及保密問題。為保護及保障閣下的私隱，本網站採用先進的保安系統，以保障個人私隱。如有疑問或投訴，可按此查閱本公司之聯絡方法。

The product information in this website does not contain the full terms of the Free Protection, for the details of general terms and exclusions, you may refer to the terms and conditions. You have to disclose in this enrolment website ALL material facts, otherwise the Member Certificate of Insurance issued may be void or voidable at the option of the Company. This enrolment must take place in Hong Kong S.A.R. The policy of this insurance product will be issued in Hong Kong and shall be governed by and construed in accordance with the laws of Hong Kong. If you wish to make a claim, please provide the Certificate No. on Member Certificate of Insurance and a copy of proof of the above group membership. The Company takes the security and confidentiality of our user’s information very seriously, in order to safeguard and protect your privacy, this website utilises advanced security techniques to protect individuals' privacy. For enquiries and complaints, please click here to view the contact methods of the Company.

請細閱以下重要事項。Please read the important statements stated below.

聲明DECLARATION

本人現聲明並同意:

(a) 除以書面形式及經本公司發表和批准外，任何其他人士所發表或提供的資料或陳述，本公司毋須負責。
(b) 本人明白任何依據此表格而繕發的成員受保證書是以最高誠信原則為基礎。本人在此登記表格上提供的所有資料均屬真實、完整及正確。本人亦明白本公司相信有關資料均屬真實、完整及正確，並據此作相關的決定，否則任何就該保單提出的索償可能遭拒絕。
(c) 本人已獲提供、瞭解及同意免費保障之條款及細則。本人確認此登記於香港特別行政區內進行及本人確認本人於登記時為上述列明團體之會員。本人亦明白於索償過程中，本人必須提供上述團體會員證明副本。

I hereby declare and agree that:

(a) No information or representation made or given by or to any person shall be binding on the Company unless it is in writing and is presented and provided by the Company.
(b) I understand that any Member Certificate of Insurance issued hereunder is based on the principle of utmost good faith. All information submitted by me in this enrollment form is true, complete and correct. I further understand that the Company, believing them to be such, will rely and act on them, otherwise any claims filed under the policy may be repudiated.
(c) I was provided, understand and agree with the terms and conditions of the Free Protection. I confirm that this enrolment takes place in Hong Kong S.A.R. and I confirm that I am a member of the above-mentioned group at the time of enrollment. I also understand that if I make a claim, I must provide a copy of proof of the above group membership.

個人資料收集及使用PERSONAL DATA COLLECTION AND USE

本表格所收集的個人資料根據「AIA個人資料收集聲明」處理及只會被用作登記本免費保障之用。然而所收集的個人資料未經您明確授權將不會轉移至「AIA個人資料收集聲明」列明以外之第三者機構。您可選擇不向我們提供所需的個人資料，惟這樣會導致閣下不能登記本免費保障。有關「AIA個人資料收集聲明」的詳情，請按此查閱。

All personal information obtained herein is collected for the purpose of enrolling this Free Protection and will be utilised in accordance with the AIA Personal Information Collection Statement ("AIA PIC"). Without your express authorisation, personal information collected will not be transferred to the third parties that are outside of those stated in the AIA PIC. You may choose not to provide the personal information required, but this may result in you not being qualified to enrol in this Free Protection. For the details of the AIA PIC, please click here.

允許財務策劃顧問聯絡CONSENT FOR FINANCIAL PLANNER TO CONTACT

本人同意AIA使用我於此登記表格提供的個人資料予AIA財務策劃顧問聯絡我。

I consent to AIA's use of my personal data provided in this form for AIA financial planner to contact me.

宣傳及市場推廣資料DIRECT PROMOTIONAL AND MARKETING MATERIALS

本人現確定本人已閱讀及明白AIA個人資料收集聲明（「AIA個人資料收集聲明」）。本人同意根據AIA個人資料收集聲明，提供本人的個人資料用作直銷推廣用途。本人確認及同意把本人個人資料轉移至香港境外作直銷推廣用途，並把相關的個人資料轉移至AIA個人資料收集聲明中列明的資料承讓人。

I confirm that I have read and understood the AIA Personal Information Collection Statement (“AIA PIC”). I agree to the provision and use of my personal data for direct marketing purposes in accordance with the AIA PIC. I acknowledge and consent to the transfer of my personal data outside of Hong Kong for direct marketing purposes and to the types of transferees as set out in the AIA PIC.

倘若不同意根據AIA個人資料收集聲明提供、使用及轉移個人資料用作直銷推廣用途，請點選左方。

Please tick the box on the left if you do not agree with the provision, use and transfer of your personal data for direct marketing purposes in accordance with the AIA PIC.

按「下一步」，即代表本人確認已閱讀、瞭解及接受上述所有重要事項。By clicking “Next”, I have read, understood and agreed ALL the above important statements.

一次性密碼已發送至您的手提號碼。
One-time password (OTP) had been sent to your mobile number.

登記完成！您將會收到一封確認電郵。
Enrolment is completed! You will receive a confirmation email soon.

參考編號Reference number:

如有查詢，請與您的專屬財務策劃顧問聯絡For enquiries, please contact your dedicated Financial Planner:

姓名Name:
財務策劃顧問編號Financial Planner Code:
聯絡電話Contact Number:

財務策劃顧問將於稍後與您聯絡。Financial Planner will contact you shortly.