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Insurance Declaration Form

Insurance Declaration Form Template for Hong Kong

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Key Requirements PROMPT example:

Insurance Declaration Form

"I need a Hong Kong-compliant Insurance Declaration Form for our tech company's new office building opening in March 2025, including provisions for cyber security insurance and coverage for high-value server equipment."

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Document background
An Insurance Declaration Form is a crucial document in the Hong Kong insurance industry, required whenever an individual or organization applies for new insurance coverage or makes significant changes to existing policies. The form must comply with Hong Kong's Insurance Ordinance (Cap. 41) and related regulations, including strict data privacy requirements. It captures comprehensive information about the insurance applicant, including personal details, risk factors, medical history (where applicable), and other relevant information needed for risk assessment. The document serves as a legal record of the applicant's disclosures and forms the basis for the insurance contract. Insurance providers use this information to evaluate risk, determine premium rates, and make underwriting decisions. The form includes mandatory declarations about the truthfulness of information provided and typically requires formal verification through signatures and, in some cases, witness attestation.
Suggested Sections

1. Personal Information: Policyholder's full name, ID/passport number, date of birth, contact details, and address

2. Insurance Coverage Details: Type of insurance, coverage amount, policy period, and premium payment details

3. Risk Disclosure: Statement of material facts and circumstances that could affect the insurance risk

4. Medical History: General health status and medical conditions that are relevant to the insurance application

5. Lifestyle Information: Information about occupation, hobbies, and activities that may affect risk assessment

6. Existing Insurance: Details of other insurance policies held by the applicant

7. Payment Information: Premium payment method, frequency, and bank account details

8. Declaration and Authorization: Standard declarations regarding truth of information provided and authorization for information verification

9. Personal Data Collection Statement: Statement on how personal data will be collected, used, and stored as per PDPO requirements

10. Signature Section: Space for applicant's signature, date, and witness details if required

Optional Sections

1. Beneficiary Nomination: Used for life insurance policies to designate beneficiaries and percentage of benefits

2. Property Details: Required for property insurance to describe the insured property and its characteristics

3. Vehicle Information: Required for motor insurance to detail vehicle specifications and usage

4. Travel Details: Required for travel insurance to specify journey details and coverage requirements

5. Business Information: Required for commercial insurance to detail business operations and risk factors

6. Family Medical History: Required for certain life and health insurance products

7. Supplementary Benefit Selection: Optional riders and additional coverage options available

Suggested Schedules

1. Schedule 1: Detailed Health Questionnaire: Comprehensive medical questionnaire for health-related disclosures

2. Schedule 2: Property Schedule: Detailed list of property and valuables to be insured, including specifications and values

3. Schedule 3: Premium Payment Schedule: Breakdown of premium payments, including installment details if applicable

4. Appendix A: Terms and Definitions: Detailed explanations of technical terms used in the declaration form

5. Appendix B: Privacy Policy: Detailed privacy policy and data protection information

6. Appendix C: Claims Procedures: Information about how to make claims and required documentation

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok³ÉÈË°æ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co
Relevant legal definitions






























Clauses




















Relevant Industries

Insurance

Financial Services

Healthcare

Real Estate

Manufacturing

Retail

Construction

Transportation

Hospitality

Professional Services

Technology

Relevant Teams

Legal

Compliance

Risk Management

Underwriting

Claims Processing

Customer Service

Operations

Sales

Administration

Document Management

Policy Administration

Relevant Roles

Insurance Underwriter

Risk Manager

Compliance Officer

Insurance Agent

Insurance Broker

Claims Manager

Legal Counsel

Corporate Secretary

Chief Risk Officer

Insurance Administrator

Policy Administrator

Customer Service Representative

Business Development Manager

Account Manager

Operations Manager

Industries






Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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