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Bupa Carepro online purchase (single enrolment)

Bupa Carepro online purchase (single enrolment)

Buy online now to enjoy 10% first year subscription discount. Online enrolment for Bupa CarePro is applicable for:

1. Single enrolment

2. Annual payment only

3. Payment by Visa or MasterCard or AlipayHK

1. Select benefits

Please provide the following information and select the benefit level.

Date of birth

Gender

male female

Select benefit level

Ward HK$

Semi - Private HK$

Private HK$

Dental Benefit

Plan A HK$

Plan B HK$

Add optional benefits

Suppl. Major Medical HK$

Clinical benefit HK$

Hospital Cash HK$

Full cover HK$

Maternity benefit HK$

Annual subscription and levy

Original Subscription

HK$ 0.00

10% online discount on subscription

- HK$ 0.00

Subscription Levy (0.06)%

HK$ 0.00

Contract effective date

01 Apr 2019

About Levy Collection

1Select benefits
2Personal details
3Health declaration
4Payment

Annual subscription and levy

HK$ 0.00

2. Personal details

Please provide the following information to proceed.

Surname

Given name

HKID card no.

Date of birth

Height

inches

Weight

lbs

Mobile

e-mail

I want to receive Policy document by:

e-Services by post only

Smoker

Yes No

Address

Block / Building / Site / Estate

Street No. & Street Name

Sub-District, e.g. Po Lam or Tai Wai

District, e.g. Tseung Kwan O or Sha tin

Bank account for claim reimbursement

The applicant is defaulted to receive the reimbursement. Please contact Bupa Health Management Consultant for other arrangement

Account holder

Bank name

Bank account

3. Health declaration

You do not need to tell us about your history of common cold or flu or upper respiratory tract infections. Female proposed Member does not need to tell us about your history of childbirth.If you do not provide us with information required in the health declaration, we may terminate your cover or it may stop us from paying your claims.

In the last 3 years, have you (or the proposed member) had:

a) consultation or medical investigations (eg scans or blood tests) for any medical condition(s) or symptoms which have continued for 2 weeks or more and/or occurred more than once during the period;

b) consultation or medical investigations as a result of abnormal findings from medical investigations; or

c) consultation by a specialist for two times or more for the same medical condition(s)?

Yes No

In the last 5 years, have you (or the proposed member) ever taken / been advised to take any medication prescribed by a doctor regularly for a continuous period of longer than 1 month?

Yes No

In the last 7 years, have you been admitted to hospital, had an operation or a procedure?

Yes No

In the last 6 months, have you had any undiagnosed symptoms, or currently undergoing medical investigations or awaiting results for the said symptoms?

Yes No

Have you had a history of cancer, heart condition, stroke or joint replacement; or are there any medical devices (eg shunts for draining fluids from the brain, pins and plates for fixation of broken bones) currently in your body?

Yes No

Declaration and authorisation

You have provided the information required for this Application. Upon checking the box below and submitting this online application, you confirm that you have read and understood the Declaration and Authorisation and agree to be bound by the same.

I apply as a Member of Bupa CarePro Health Insurance Scheme. I have read and understood the Declaration and Authorisation and agree to be bound by the same. I confirm that the credit card or AlipayHK account used to make payment under this Contract is either held by myself or other relationship acceptable by Bupa*. I further acknowledge that any Subscription refund made under this Contract shall be payable to the Subscriber only.

*Applicable to spouse, parents or children of the Subscriber.

I solemnly declare I am NOT US permanent resident**. I acknowledge that Bupa may terminate the cover with immediate effect if the law of the country in which I am located, or my country of residence or nationality, including but not limited to USA and Japan, or any other law which applies to Bupa or the Contract, prohibits the provision of healthcare cover by Bupa to local nationals, residents or citizens. Equivalently, I understand that I am obliged to immediately notify Bupa in writing if I become a permanent resident of USA during the Contract Year.

**"Permanent resident" means a person who is resident in a country and who is a national of that State or who is permitted to reside and work permanently in that State in accordance with applicable law. The United States, including the United States and Puerto Rico free state.

Personal Information Collection Statement

I have read and understood the Personal Information Collection Statement .

I consent to Bupa using my personal data, including my name, contact details, gender, health and family status, to send me marketing communications (including by email, SMS or instant messenger) as described in the Personal Information Collection Statement, including in relation to insurance (such as subscription discount), wellness, rewards, loyalty or privileges programmes and related products and services. I understand that I have the right to request Bupa to cease using my personal data for direct marketing purposes by emailing customercare@bupa.com.hk or calling the Bupa Customer Care helpdesk on 2517 5333.

Declaration and Aurthorisation

I apply as a Member of Bupa CarePro Health Insurance Scheme (“Scheme”) and I acknowledge that Benefit is not payable under this Scheme being applied for any costs of treatment arising from any existing illnesses, injuries or other conditions presented before the Coverage Commencement Date unless complete details are fully disclosed by me in this Application and accepted by Bupa (Asia) Limited (“Bupa”).

I declare that, to the best of my knowledge and belief, the statements contained in this Application are true and complete.

I acknowledge that Bupa reserves the right to ask for submission of more details of health status or medical reports of me at my own cost.

I also authorise any medical practitioner, hospital, clinic, by whom or where I have been observed or treated or any insurance company or organisation that has any records or health information concerning me for any reason, to give full particulars thereof including prior medical history to Bupa. A copy of this authorisation shall be considered as effective and valid as the original..

I agree to be bound by the terms and conditions of the Contract of this Scheme, which I understand are available on request and will be provided to me if this application is approved. I agree that this Health Declaration and the answers given in this Application shall be the basis of the Contract between me and Bupa. I understand that I have the right to cancel this Contract within 21 days from the Coverage Commencement Date and that if I do not cancel the Contract within that period, all information in this Application is deemed to be final.

I acknowledge that Bupa has discretion to appoint Registered Medical Practitioners, Hospitals, Qualified Nurses, cancer centres, day-case centres, diabetic centres, wellness centres and other service providers to provide health and care services, credit facilities for eligible medical expenses and to do all things and acts incidental to such appointment for the Member. I acknowledge and agree that such appointment shall be made on such terms and conditions as Bupa shall think fit at its absolute discretion. Bupa shall not be liable for any claim whatsoever which may be made against any such service provider appointed by Bupa by the Member.

e-Services

You can access our e-Services through myBupa , our online and mobile platform, to view and download some of your policy-related documents. To access these e-documents*, you are required to register for a myBupa account and provide an email address where you will receive email notifications when a document is ready for you to access from your myBupa account. You will no longer receive hard copy of these documents by post.

*Please refer to myBupa for the latest list of e-documents available on myBupa. This list is subject to change.

Personal Information Collection Statement

Bupa (Asia) Limited (the “Company”)

Personal Information Collection Statement (“Statement”) relating to the Personal Data (Privacy) Ordinance (the “Ordinance”)

In compliance with the Ordinance, the Company would like to inform you of the following: 1. From time to time, it is necessary for you, or the Member, to supply the Company with certain personal information when you apply for insurance or financial products and services from the Company, or when you apply to make changes to your policy, or when you renew a policy;
Failure to supply personal information requested by the Company may result in the Company being unable to process your Application and/or provide products, services and other related services to you, or the Member;
During the course of your relationship with the Company, further personal information relating to you, or the Member, may also be collected in the ordinary course of our business, for example, when you lodge insurance claims with the Company.
Personal information relating to you, or the Member, may be used for the following purposes:
1. processing, assessing and determining any Applications for insurance products and services;
2. offering and providing products and services to you, or the Member, and processing requests made by you, or the Member, from time to time, including but not limited to requests for addition, alteration, deletion, maintenance, management and operation of insurance benefits or insured Members;
3. any purposes in connection with any claims made by or against or otherwise involving you, or the Member, in respect of any products and/or services provided by the Company including, without limitation, making, defending, analyzing, investigating, processing, assessing, determining or responding to such claims;
4. performing any functions and activities related to the products and/or services provided by the Company including, without limitation, audit, reporting, market research, general servicing, maintenance of online and other services, identity verification, data matching, research and statistical analysis, and reinsurance arrangements;
5. provision and design of products and services of the Company;
6. exercising the Company’s rights in connection with provision of insurance products and services to you, or the Member, from time to time, for example, to determine any amount of indebtedness from you, and collecting and recovering owing from you or any person who has provided any security or undertaking for your liabilities;
7. communication with you or the Member in relation to any of the purposes set out in this Statement;
8. enabling an actual or proposed assignee, transferee, participant or sub-participant of all or a substantial part of the Company’s rights or business to evaluate the transaction intended to be the subject of the assignment, transfer, participation or sub-participation; and
9. making disclosure to satisfy the requirements of any laws, rules and regulations, codes of practice, guidance notes or guidelines binding on the Company.
Personal information collected or held by the Company relating to you, or the Member, will be kept confidential but the Company may provide such personal information inside or outside the Hong Kong Special Administrative Region, for the purposes specified in paragraph (4) and (6) to the following classes of transferees:
1. the Company’s group companies (“Group Company”);
2. any insurance intermediaries authorised by you and the Company;
3. any re-insurance companies authorized by the Company;
4. any agent, contractor or third party service providers who provide administrative, telecommunications, computer, payment, data processing or storage, printing, research or other services to the Company in connection with the operation of business (including without limitation insurers, banks, lawyers, accountants, claims investigators, debt collection agencies, data processing companies, research agencies and professional advisors);
5. any actual or proposed assignee, transferee, participant or sub-participant of all or a substantial part of the Company’s rights or business;
6. any person to whom the Company is under an obligation to make disclosure under the requirements of any law, rules, regulations, codes of practice or guidelines binding on the Company including, without limitation, any applicable regulators, governmental bodies, industry recognized bodies, credit reference agencies, the Courts, and where otherwise required by law.
Only with your consent or with your indication of no objection, the Company may use your, or the Member’s personal information collected from time to time, including name, contact details, gender, health and family status, to provide you, or the Member with marketing communications relating to the following of the Company, Group Company, or co-brand partner or business partner of the Company, including:
1. Insurance, medical, healthcare, financial and related services and products;
2. rewards, benefits, referral, member activities, loyalty or privileges programmes and related services and products; and
3. donations and contributions for charitable and/or non-profit making purposes; The Company will not disclose personal information relating to you, or the Member to third parties for marketing purposes without your consent.
Under and in accordance with the terms of the Ordinance, you have the following rights:
1. to check whether the Company holds personal information relating to you or the Member and to access such personal information;
2. to require the Company to correct any personal information relating to you or the Member which is inaccurate;
3. to ascertain our policies and practices in relation to personal data and to be informed of the kind of personal data held by the Company, and
4. to request the Company to cease using your personal information for direct marketing purposes. Requests can be made in writing to the Company’s Data Protection Officer at the following address:
  Data Protection Officer
  
  18/F, Berkshire House 25 Westlands Road,
  
  Quarry Bay, Hong Kong
In accordance with the terms of the Ordinance, the Company has the right to charge a reasonable fee for the processing of any personal information access or correction request.
For any enquiries about this Statement, please do not hesitate to contact our Customer Care helpdesk at 2517 5333.
Nothing in this Statement shall limit the rights of customers under the Ordinance.
In case of discrepancies between the English and Chinese versions of this Statement, the English version shall prevail.

We have updated your quotation according to the information you provided. Please review and proceed.

Error found during form submission. Please re-try or contact our staff via Email.

Your payment has been cancelled. Please try again or contact our sales agent 2517 5860.

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Bupa Carepro online purchase (single enrolment)

1. Select benefits

Select benefit level

Dental Benefit

Add optional benefits

Annual subscription and levy

2. Personal details

3. Health declaration

Declaration and authorisation

Personal Information Collection Statement

Medical insurance

Customer care

Health & wellness

About Bupa

Keep in touch

About myBupa

Key functions include:

How to choose the right insurance

Hospital & surgical

Critical illness

Hospital cash

Civil servant

Customers with group medical insurance

How to choose the right insurance

To discuss your healthcare needs call us on 2517 5860

Claims

Forms

Useful information

For customer support, call us on 2517 5333 (for individuals) / 2517 5388 (for group)

Online health assessment

Health information

Programme & support

About myBupa

Key functions include:

Bupa Carepro online purchase (single enrolment)

1. Select benefits

Select benefit level

Dental Benefit

Add optional benefits

Annual subscription and levy

2. Personal details

3. Health declaration

Declaration and authorisation

Personal Information Collection Statement

Customer care

Health & wellness

About Bupa

Keep in touch