Fire Online Insurance Application

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Fire Insurance Online Application Form
火險網上申請書

This online application form is for residential building only.
For commercial and industrial building, please complete the download form and send it to us by fax at 2827 0622 or by email to cs-shkpi@shkp.com for underwriting approval. Upon receipt of your completed form, our customer services staff will contact you soon.
此網上投保書只適用於住宅樓宇。
凡商業及工業樓宇，請填寫下載申請書並以傳真(傳真號碼: 2827 0622) 或電郵(cs-shkpi@shkp.com) 方式交回本公司批核承保。收到閣下的申請書後，本公司客戶服務職員將盡快與閣下聯絡。

Use of Personal Data Circular 個人資料使用通告
Please click here to read 請按此詳閱

I have read and agreed with the Circular to Customers relating to the Personal Data (Privacy) Ordinance - Use of Personal Data. 我已閱讀並同意新鴻基地產保險有限公司就個人資料(私隱)條例致客戶有關個人資料的通告。

Please complete the form in English. Shaded input fields must be completed. 請用英文完成表格。陰影部份必須填上。

Part I Insured's Personal Information 投保人個人資料
Title 稱謂
Surname 姓
Given Name 名
Correspondence Address 通訊地址		Room 單位 Floor 層 Block 座 Building/Estate Name 大廈/ 屋苑名稱 Street No.and Name 街道號數及名稱 District 地區 Territory 區域
Email 電郵地址
Contact Telephone No. 聯絡電話		Mobile 手提 Home 住宅 Office 辦公室 Fax No 傳真
Insured's SHKP Club Membership No. (if applicable)* 投保人新地會會員編號 (如適用)*		Ordinary Member 普通會員 Star Member 星級會員

Part II Insurance Particulars 投保事項
Name of Property Owner(s) 業主名稱
Insured Property Address(for Residential Only) 投保物業地址(只限住宅)		Same as above 同上 Yes 是 No 答 (if not, please fill in below) 如答否，請填寫以下有關資料
Room 單位/ Floor 層/ Block 座		Room 單位 Floor 層 Block 座
Building/ Estate Name 大廈/ 屋苑名稱
Street No. & Name 街道號數及名稱
District 地區
Territory 區域
Mortgagee 按揭銀行
Mortgagee's Address 按揭銀行地址
Mortgage Loan Number 按揭貸款編號

1) What is the building category of the Insured Property? 投保物業屬於那種樓宇類別?		Government Public Housing Estate 政府公共屋邨 Private Residential Development/Building 私人屋苑/樓宇 Home Ownership Scheme 居者有其屋計劃之屋苑

2) Is the age of the building over 25 years? 樓宇樓齡是否超過二十五年?		Yes 是No 否

3) Is the Insured Property a house/ Semi-detached House/ Village House? 投保物業是否獨立屋/ 半獨立屋/ 村屋 ?		Yes 是No 否

4) Is the Insured Property located on ground level? 投保物業是否位於地面層?		Yes 是No 否

5) Have you made any claims on Fire Insurance and the like within the past 3 years? 閣下是否於過去三年內就火災保險或類似保險申請索償?		Yes 是No 否

6) Have you ever been declined for any new application, renewal or imposed special terms and conditions on Fire Insurance? 閣下是否曾經被拒絕接受投保同類之火災保險或於續保時需附加任何特別條件?		Yes 是No 否

Part III Sum Insured & Coverage 保額及承保範圍
Sum Insured 保額 (HK$)**
Annual Premium 全年保費 (HK$)***
Levy 徵費 (HK$)
Premium plus Levy 保費及徵費 (HK$)
Covering 投保項目		On the building including landlord's fixtures and fittings but excluding foundations and drains. 樓宇結構包括發展商之裝修，但地基及渠道除外
Insured Perils 受保風險		Fire; Aircraft dropped; Earthquake; Explosion; Riot & Strike; Malicious Damage; Overflowing of Water Tanks; Typhoon; Windstorm & Flooding; Bursting Pipes; Landslide & Subsidence. 火災、飛機撞毀、地震、爆炸、暴動及罷工、惡意破壞、水箱滿溢、颱風、風暴及水浸、水喉及水管爆裂、山泥傾瀉及下陷

Period of Insurance 投保日期 (dd/mm/yyyy)		12 months from 12個月由 (dd/mm/yyyy) 開始


* SHKP Club member should be the Insured. 新地會員必須為投保者本人。 Reinstatement cost of the building or mortgaged loan amount required by the Bank. 樓宇建築之重建費或銀行指定之按揭金額。 * The minimum premium of the policy is HK$400.This sum is non-refundable even if the policy is subsequently cancelled. 本保單最低收費為 HK$400。倘若投保人於保單屆滿前退保，此保費將不獲退還。