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Individual Life & Group Claims Arrangement Form (Hong Kong) Mobile App

File an Individual Life and Group Claims Arrangement using this digital app instead of a pen and paper form. Captures Individual Life Policy Information, Group Policy Information, and where the claim documents should be transferred after the assessment.

  • Lendlease
  • The Cooperative
  • PG&E
  • oxy
  • Red Bull
  • Mirvac

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Take a peek inside the Individual Life & Group Claims Arrangement Form (Hong Kong) Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico integer

    Policy Number

  • Ico textbox

    Name of Proposed Insured/Insured

  • Ico textbox

    I.

  • Ico integer

    Area Code

  • Ico textbox

    Agency/Broker Name

  • Ico textbox

    Agent/Broker Code

  • Ico statictext

    Operations Team:

  • Ico textbox

    Agent/Broker’s Name

  • Ico integer

    Agent/Broker’s Tel.

  • Ico textbox

    Name of Employer / Group

  • Ico integer

    Group Policy No.

  • Ico textbox

    Name of Insured Employee / Member

  • Ico textbox

    Certificate No.

  • Ico statictext

    Relationship with Insured Employee / Member:

  • Ico checkbox

    Spouse

  • Ico checkbox

    Children

  • Ico checkbox

    Others, please specify:

  • Ico textbox

    Others

  • Ico statictext

    Please transfer the claim documents to the following department upon the completion of the claim ...

  • Ico checkbox

    Life Operations - Claims Department

  • Ico checkbox

    Corporate Solutions Department

  • Ico statictext

    Documents Attached:

  • Ico checkbox

    Claim Form

  • Ico checkbox

    Receipts

  • Ico decimal

    Total Amount:

  • Ico checkbox

    Settlement Breakdown / Worksheet / Shortfall

  • Ico checkbox

    Medical Report

  • Ico checkbox

    Laboratory Test Reports

  • ...and More!

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