卓越环球个人医疗保障计划投保书.PDF

Winterthur Insurance (Asia) Ltd, Shanghai Branch Tel:(8621) Fax:(8621) Website: “卓越 ”环球个人医疗保障计划 投保书 I n d i v i d u a l S M A R T C A R E E X C L U S I V E H e a l t h I n s u r a n c e A p p l i c a t i o n F o r m 重要注释Important Notes： 1.在填写本投保申请前，您可以要求业务人员向您提供保险条款。请仔细阅读条款，尤其是除外责任、赔偿限额、免赔额、审阅期、保险责任终止 等黑体字标注的条款内容，并听取业务人员的说明，如对业务人员的说明有不明白或有异议的，请在填写本投保单之前向业务人员进行询问，如未 询问，视同已经对条款内容完全理解并无异议。 Please ask your personal consultant for the insurance clause before fill in this application form. Please carefully read the clause, especially for policy exclusions, annual limit, deductible, free-look period, cancellation/termination of cover, and the others which are all highlighted in bold. You can enquire of your consultant if need any clarification before fill in this application form, otherwise you are deemed to fully understand the clause and have no objection. 2.请如实填写本表内容并确定所填写的内容全部正确无误，根据保险法和相关规定，如您未履行如实告知义务，则可能会导致保险合同被解除或者 本公司不承担相关保险责任。 Under Insurance Law or any subsequent amendment, you are to disclose in the Application form, fully and faithfully, all the f acts which you know or ought to know, otherwise the policy issued may be void. 3.投保人对被保险人应当具有保险利益，否则依据保险法合同无效。 A policyholder shall own the insurable interest in the objects of insurance, otherwise the insurance contract shall be invalid. 4.本投保单为保险合同的重要组成部分。请用蓝色或黑色墨水笔以中文或英文正楷填写，不得涂改，并由投保人、被保险人（或其法定监护人）亲 笔签字。 This application form is an important part of the insurance contract. Please fill in it in Chinese or English block letters with blue or black ink, and shall not alter. There must be handwritten