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 I am a Hong Kong resident, and 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 have read and agreed to be bound by the terms and conditions of the Contract of this Scheme and 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 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.
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:
processing, assessing and determining any Applications for insurance products and services;
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;
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;
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;
provision and design of products and services of the Company;
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;
communication with you or the Member in relation to any of the purposes set out in this Statement;
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
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:
the Company’s group companies (“Group Company”);
any insurance intermediaries authorised by you and the Company;
any re-insurance companies authorized by the Company;
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);
any actual or proposed assignee, transferee, participant or sub-participant of all or a substantial part of the Company’s rights or business;
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:
Insurance, medical, healthcare, financial and related services and products;
rewards, benefits, referral, member activities, loyalty or privileges programmes and related services and products; and
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:
to check whether the Company holds personal information relating to you or the Member and to access such personal information;
to require the Company to correct any personal information relating to you or the Member which is inaccurate;
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
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.
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