Claim Form

Administration Form

New Business Related

Outpatient or Dental

SubjectUser TypeDownloadFile SizeRemarks
Tips for Claim Form Selection (Indemnity Products / Managed Care Products)Member 88 KB 
Guide of eClaim SubmissionMember 979.26 KB 

Hospitalization & Surgical

SubjectUser TypeDownloadFile SizeRemarks
Tips for Claim Form Selection (Indemnity Products / Managed Care Products)Member 88 KB 
Hospitalization & Surgical Claim FormMember 914.51 KBFillable Format 

Travel Products

SubjectUser TypeDownloadFile SizeRemarks
Group Travel Insurance Claim FormMember 3 MB 

Life Products

SubjectUser TypeDownloadFile SizeRemarks
Application Form for Death Claim (Claimant's Statement)Member 552 KB 
Group Accident Claim FormMember 723 KB 
Group Total & Permanent Disability Claim FormMember 289 KB 
Long Term Disability Claim FormMember 4 MB 
Critical Illness Claim FormMember 2 MB 

Life or Medical

SubjectUser TypeDownloadFile SizeRemarks
Executive Protect - Health Declaration FormMember 5 MB 
Notice of Termination/TransferPolicyholder 181.42 KB 
Beneficiary(ies) Designation FormMember 961 KB 
Dependent Enrollment FormPolicyholder 372.25 KB 
Member Enrollment FormPolicyholder 211.48 KBFor Managed Care Products 
Group Life Insurance Health Declaration FormMember 554.05 KB 
PowerEasy Health Declaration FormMember 446 KB 
PROMISE Health Declaration FormMember 394 KB 
Group Life Insurance Health Declaration Form - Dependent ApplicationMember 577.04 KB 
Notice of Member Information ChangesMember 221.73 KBFor Managed Care Products 
CEO PRO - Health Declaration FormMember 2 MB 
Notice of Addition & ChangePolicyholder 181.42 KB 

SME Choice

SubjectUser TypeDownloadFile SizeRemarks
SME Choice Enrollment FormPolicyholder 694.47 KB 
Notice of Change - For Group Package PlanPolicyholder 2.12 MB 
Notice of Termination - For Package PlanPolicyholder 2.12 MB 

CEB/CEBPro/CEBProMacau

SubjectUser TypeDownloadFile SizeRemarks
Employee/Dependent Enrollment FormPolicyholder 682.43 KB 
Notice of Termination/TransferPolicyholder 181.42 KB 
Notice of Addition & ChangePolicyholder 181.42 KB 

Group Health Choice (GHC)

SubjectUser TypeDownloadFile SizeRemarks
Employee/Dependent Enrollment FormPolicyholder 682.43 KB 
Notice of Change - For Group Package PlanPolicyholder 2.12 MB 
Notice of Termination - For Package PlanPolicyholder 2.12 MB 

Group Personal Accident (GCA / GPA / GTP / GTS / GPA Choice / SMEasy)

SubjectUser TypeDownloadFile SizeRemarks
Notice of Addition & Change FormPolicyholder 452.36 KB 
Notice of Termination FormPolicyholder 452.36 KB 

CEB Select / CEB Select 2000

SubjectUser TypeDownloadFile SizeRemarks
Employee/Dependent Enrollment FormPolicyholder 682.43 KB 
Notice of Change - For Group Package PlanPolicyholder 2.12 MB 
Notice of Termination - For Package PlanPolicyholder 2.12 MB 

Credit Life Insurance

SubjectUser TypeDownloadFile SizeRemarks
Request for Change of Mailing Address FormMember 128.48 KB 
Request for Insurance TerminationMember 127.19 KB 

Website Application

SubjectUser TypeDownloadFile SizeRemarks
Web User ID / Online Employee Data Submission Service Application FormPolicyholder 386 KB 
On-Line Employee Data Submission Service Application FormPolicyholder 317 KBFor Indemnity Products (not applicable to Package Plan policyholder) 
On-Line Employee Data Submission Service Application FormPolicyholder 287 KBFor Managed Care Products (not applicable to Package Plan policyholder) 
Web User ID Request / Change Form For BrokerBroker 540 KB 

Autopay Service (For Macau Only)

SubjectUser TypeDownloadFile SizeRemarks
Autopay Claims Payment Service Registration FormPolicyholder 378.43 KBOnly available for policies in MOP & MOP accounts at designated banks 

New Business Related

SubjectUser TypeDownloadFile SizeRemarks
Letter of Authorizaton (GP-AML1) (for Hong Kong only) 244.08 KB 
Beneficial Owner Data Form (GP-AML2) (for Hong Kong only) 183.39 KB 
Documentation Required by The AML Guideline (GP-AML-RD) (for Hong Kong only) 351.27 KB 
Example of the Beneficial Owner Data Form (GP-AML2) and the Organization Chart if any shareholder is a Corporate (for Hong Kong only) 227 KB 
Letter of Authorization (GP-M-AML1) (for Macau only) 227.11 KB 
Beneficial Owner Data Form (GP-AML2) (Macau) 184.30 KB 
Documentation Required by The Guidelines on Prevention and Combating Money Laundering and Financing of Terrorism in Insurance (GP-M-AML-RD) (for Macau only) 233.00 KB