Marine Cargo Insurance Application Form

Marine Cargo Insurance Application Form – For The Members of The Federation of Garment Manufacturers

Single Shipment 單次航運

Applicant Details

Applicant Name 申請人姓名: ( ) Contact No. 聯絡電話:

Email 電郵: Fax No. 傳真號碼:

YOUR DUTY TO DISCLOSE MATERIAL INFORMATION 您的披露責任

Under the law, you have a duty to disclose to the insurer all material information relating to the insurance under consideration and all information you provide must be both complete and accurate. “Material” refers to all information, which a prudent insurer would wish to take into account when considering whether or not to accept the insurance and, if so, upon what terms and at what price. If there are any changes to the information you have supplied to the insurer you must also disclose that as your duty continues up until the insurance has been concluded and “resurrects” in the event of any amendment to the insurance during the period of insurance or any extension or renewal. In the event that there is a breach of the duty of disclosure, the Insurer has the right to avoid the insurance from its commencement. If you are in any doubts as to the ambit of the duty of disclosure or whether a piece of information ought to the disclosed, please contact us.

根據法律的規定，您有責任向保險公司提供有關你正被考慮中的保險的所有重大信息，並且你提供的所有信息必須完整和準確。「重大」在此處是指審慎的保險公司在考慮接受投保與否、如要制定條款和價錢時，所欲取得的所有信息。披露責任將維持至該保險完成議定，並在以下情況下「恢復」：受保期間對保險合約的任何修改，或任何延期或續期。在違反披露責任的情況下，保險公司有權宣告保險合約自始無效。如你對信息披露責任範圍，或應否披露某一信息有任何疑問，不要遲疑請與我們聯絡。

Our Business Principles 我們的經營原則

We shall provide our services to you in accordance with our Business Principles, a copy of which may be obtained from our website at www.lockton-asia.com/Hong-Kong

諾德將根據我們的經營原則提供我們的服務，請瀏覽我們的網頁www.lockton-asia.com/Hong-Kong以獲取經營原則副本。

“Lockton Companies (Hong Kong) Limited (“the Company”) is remunerated for its services by the receipt of commission paid by insurers. Your agreement to proceed with this insurance transaction shall constitute your consent to the receipt of commission by the Company.”

“諾德保險經紀有限公司（「該公司」)藉向保險公司收取的佣金，作為其所提供服務的酬金。閣下同意進行是項保險交易，即構成閣下同意該公司收取佣金。”

Personal Information Collection Statement 收集個人資料聲明

We may collect personal information from you in the course of the provision of our services. It is voluntary for you to provide any information to us. However, your failure to supply information to us may result in Lockton being unable to provide appropriate services including advices to you. In respect of arrangement of your insurance policies, failure to supply information may in some circumstances lead to the insurer refusing to accept your application for insurance or breach of your duty to disclose material facts to your insurer.

我們在提供服務的過程中可能會收集您的個人資料，是否提供屬自願性質，但您未能提供資料有可能導致無法向您提供合適的服務，包括向您提供意見。就保險安排而言，在某些情況下，您未能提供資料可能導致保險公司拒絕承保或違反您對保險公司披露重大事實的責任。

Use of Personal Information: The personal information we collected from you will be used for the following purposes: (1) Offering, providing and marketing our services to you; (2) Evaluating your insurance and/or financial needs, managing your account with us and communication with you; (3) To compile aggregate statistics (including but not limited claims statistics/history) and to monitor insurers performance and customer satisfaction; (4) Conducting market research for statistical or other purposes; (5) Conducting identity and/or credit check and/or enforcing our rights; (6) Purposes specifically provided for in any particular service offered by Lockton; and (7) Other purposes relating to any of the above.

個人資料的使用：我們向您收集的個人資料將被用於以下目的：(1) 向您介紹、提供和推廣我們的服務; (2) 評估你的保險/財務需求，管理您的帳戶以及與您保持聯繫；(3) 編制綜合統計數據（包括但不限於索賠數據/歷史），監督保險公司表現和客戶滿意程度; (4) 為統計或其他目的進行市場研究; (5) 進行身份和/或信貸查核和/或行使我們的權利; (6) 與諾德提供的任何特定服務有關的目的; (7) 與上述任何目的有關的其他目的。

Transfer of Personal Information: Your personal information will be kept confidential but may be provided to: (1) Our affiliates, selected insurance companies and intermediaries for purposes of provision of our services; (2) Agents, contractors or professional advisors of the parties referred to in (1) above; (3) Any parties in connection with claims or potential claims notified by you or made against or otherwise involving you that relate to your insurance policies; (4) Our agents, employees, contractors, professional advisors or any third parties providing services to us in connection with the operation of our business; (5) Credit reference agencies, providers of risk intelligence for the purpose of customer due diligence or anti-money laundering screening; and (6) In event of default, debt collection agencies or legal advisors.

個人資料的轉移：您的個人資料將予以保密，但可能提供予：(1) 為提供我們的服務的目的，我們的關聯方、特定的保險公司和中介機構；(2) 上述(1)項所述的公司、機構的代理、承包商或專業顧問; (3) 與您已經提出或將會提出的索賠或向您提出或任何涉及您的保單的申索有關的任何一方; (4) 我們的代理、員工、承包商、專業顧問和向我們提供與營運相關服務的任何第三方; (5) 就客戶盡職審查或反洗黑錢篩選目的，信貸參考機構、風險情報供應商; (6) 在債務拖欠的情況下，債務追收機構或法律顧問。

Use of Personal Information in Direct Marketing: We intend to use your personal information including your name, contact details, date of birth, transaction behaviour for conducting direct marketing activities in relation to insurance and/or risk consulting/management services, wealth management services and employees’ benefits services offered by us. We also intend to transfer your personal information including your name, contact details, date of birth, transaction pattern and behaviour to our affiliates, insurance companies, providers of medical, employees’ benefits, fitness, wellness, travel, entertainment, food & beverage services, in and outside Hong Kong for sending you promotional materials and conducting direct marketing activities in relation to (re)insurance and/or risk consulting/management services, wealth management services, employees’ benefits services, (re)insurance products, medical, fitness, wellness, travel, entertainment, food & beverage services offered by them.

使用個人資料作直接促銷：我們擬使用您的個人資料包括您的姓名、聯繫方式、出生日期、交易習慣向您開展與以下服務有關的直接促銷活動：保險、風險諮詢/管理、財富管理、僱員福利服務；我們亦擬向我們的關聯方，保險公司，醫療、僱員福利、健身、保健，旅遊，娛樂、食品和飲料服務的提供商轉移你的姓名、聯繫方式、出生日期、交易習慣以就其保險、風險諮詢/管理、財富管理，僱員福利服務，保險產品，醫療、健身、保健、旅遊、娛樂、食品和飲料服務向您開展直接促銷活動。

If you prefer not to receive marketing information, please write to us at 9/F, PCCW Tower, TaiKoo Place, 979 King’s Road, Island East, Hong Kong. We shall without charge to you, ensure that you are not included in future direct marketing activities.

如您不希望收到我們的推廣信息，請致函我們，地址為香港英皇道979號太古坊電訊盈科大廈9樓。我們會在不收取任何費用的情況下確保你不會納入未來的直接促銷活動中。

You have a right under the Personal Data Privacy Ordinance to make a data access or correction request concerning your personal information held by us. We may charge a fee for processing a data access request. You may make such a request by writing to our Data Access Officer at 9/F, PCCW Tower, TaiKoo Place, 979 King’s Road, Island East, Hong Kong and completing a Data Access Request Form specified by the Privacy Commissioner for Personal Data which can be downloaded from www.pcpd.org.hk.

根據「個人資料（私隱）條例」您有權查閱或更正有關您的個人資料。我們可能會就處理您的查閱要求向您收取合理的費用。若您需要提出要求，請填寫個人資料私隱專員指定的查閱資料要求表格（可以在個人資料私隱專員公署網站www.pcpd.org.hk下載）發送至我們的資料查閱主任地址為香港英皇道979號太古坊電訊盈科大廈9樓。

如您不同意我們使用或轉移您的個人資料作直接促銷，請在以下空格加上「」號。

I object to the proposed use or transfer of my personal information in direct marketing. 本人反對使用或轉移本人的個人資料作直接促銷。

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