1. | The information and particulars provided on this application are accurate, true and complete and are given to the best of my knowledge and belief. I have not withheld any material information and accept that this application and declaration shall form the basis of the contract between Blue Cross (Asia-Pacific) Insurance Limited (the “Company”) and me. I hereby acknowledge that failure to supply true and accurate answers to this application or inform the Company of all material information about my application may render the Company unable to accept or process this application or the insurance policy void. |
2. | The insurance coverage applied for shall only take effect when this application has been accepted by and the required premium has been paid to the Company. |
3. | I understand and agree that the Company shall not be deemed to provide cover (including not to pay any claim or provide any benefit), when the provision of such cover would expose the Company to any, or any risk of, sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union, United Kingdom, United States of America or any jurisdiction applicable to the Company. |
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I, HEREBY DECLARE AND AGREE THAT:


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About Blue Cross
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Tel : (852) 2839 6333(852) 2839 6333 Email : cs@bluecross.com.hk Fax : (852) 2263 7517 Customer Service Hours
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9:00am - 5:30pmClosed on Saturday, Sunday and Public Holidays Address
54/F Hopewell Centre, 183 Queen's Road East, Wan Chai, Hong Kong -
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