� Comprehensive Protection for you and yourmotor car

(Photography by Josiah Leung)

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Product FeaturesThird Party Legal Liabilities InsuranceTo protect you and/or insured driver against legal liability for causing• Third Party’s death and/or bodily injury• Third Party’s property damagearising out of the use of your motor car.

Comprehensive InsuranceIn addition to third party legal liabilities insurance, to provide protection againstaccidental loss of or damage to your motor car and/or its accessories or spareparts resulting from any causes, such as fire, collision, theft, and other accidentallosses.

Free Additional Protections(Applicable to Comprehensive Insurance only)

New for Old Vehicle Replacement ProtectionIf you suffer a total loss of your motor car which is less than 12 months old byreason of a theft or an accident, settlement will be based on the value of a newvehicle of the same make and model, without deducting any depreciation.

Windscreens/Windows Damage ProtectionIn the event of accidental damage to windscreen or windows of your motor carbut without damage to other parts of the motor car in the same accident, we willpay for the replacement cost up to HK$5,000 without deduction of excess/NCD.

Personal Accident ProtectionIf you or the insured driver whist driving the insured motor car sustains bodilyinjury as a result of a traffic accident, we will provide additional benefit up toHK$100,000 for death or loss of limbs or loss of sights.

No Claim Discount ProtectionNo matter how many claims you make, if the total claims amount within a policyyear is less than HK$60,000 or 15% of the sum insured of the insured motor car(whichever is the lower), your NCD shall be protected and remains unchangedfor the immediately subsequent renewal of the policy.

Claim Recovery ServiceIf an accident caused by a liable third party, we will undertake to pursue arecovery on your behalf against the liable third party. If the process is successful,we will refund to you the portion of claim excess paid.

Rental of Replacement Car ProtectionIn case, your motor car sustains a partial loss due to a traffic accident resulting inimmobilization and the repairing time is over 48 consecutive hours, we will payfor your cost of rental of replacement car from a car rental company necessarilyand reasonably incurred during the loss of the use of your motor car. Themaximum limit is HK$300 for each complete day after the first 48 hours andHK$3,000 per policy year.

Clothing and Wearing Apparels ProtectionIf the clothing and wearing apparels of the driver or passenger in the insuredmotor car are damaged during a traffic accident, we will pay for the replacementcosts of damaged clothing and wearing apparels up to HK$2,000 per policy year.

Accidental Medical Expenses ProtectionWe will pay up to HK$10,000 per event for the necessary and reasonablemedical expenses if the Insured or insured driver or passengers of the insuredmotor car sustains bodily injury due to a traffic accident.

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Private Car Insurance PlanIn accordance with the Hong Kong Motor VehiclesInsurance (Third Party Risks) Ordinance (Chapter 272), allcar owners are compulsory to arrange third party riskinsurance for use of their vehicles on a road.

This plan not only offers you compulsory third party legalliabilities insurance to suit your needs, but also thecomprehensive insurance for your motor car with manyextra value-added benefits. With our insurance protection,you can experience a more carefree and enjoyable drivingthan ever.

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About Asia InsuranceAsia Insurance Company Limited, a leading insurerwith HK$2 billions paid-up capital offering a comprehen-sive range of insurance products since 1959, is a member ofAsia Financial Holding Limited which is listed. Reflectingthe company’s excellent capital position and goodunderwriting performance, Standard & Poor’s has assignedAsia Insurance an “A” Insurer Financial Strength rating since2007.

(Photography by Josiah Leung)

IMPORTANT NOTICE:If there is any conflict between the English version and the Chinese version ofthis document, the English version shall prevail.

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Product FeaturesThird Party Legal Liabilities InsuranceTo protect you and/or insured driver against legal liability for causing• Third Party’s death and/or bodily injury• Third Party’s property damagearising out of the use of your motor car.

Comprehensive InsuranceIn addition to third party legal liabilities insurance, to provide protection againstaccidental loss of or damage to your motor car and/or its accessories or spareparts resulting from any causes, such as fire, collision, theft, and other accidentallosses.

Free Additional Protections(Applicable to Comprehensive Insurance only)

New for Old Vehicle Replacement ProtectionIf you suffer a total loss of your motor car which is less than 12 months old byreason of a theft or an accident, settlement will be based on the value of a newvehicle of the same make and model, without deducting any depreciation.

Windscreens/Windows Damage ProtectionIn the event of accidental damage to windscreen or windows of your motor carbut without damage to other parts of the motor car in the same accident, we willpay for the replacement cost up to HK$5,000 without deduction of excess/NCD.

Personal Accident ProtectionIf you or the insured driver whist driving the insured motor car sustains bodilyinjury as a result of a traffic accident, we will provide additional benefit up toHK$100,000 for death or loss of limbs or loss of sights.

No Claim Discount ProtectionNo matter how many claims you make, if the total claims amount within a policyyear is less than HK$60,000 or 15% of the sum insured of the insured motor car(whichever is the lower), your NCD shall be protected and remains unchangedfor the immediately subsequent renewal of the policy.

Claim Recovery ServiceIf an accident caused by a liable third party, we will undertake to pursue arecovery on your behalf against the liable third party. If the process is successful,we will refund to you the portion of claim excess paid.

Rental of Replacement Car ProtectionIn case, your motor car sustains a partial loss due to a traffic accident resulting inimmobilization and the repairing time is over 48 consecutive hours, we will payfor your cost of rental of replacement car from a car rental company necessarilyand reasonably incurred during the loss of the use of your motor car. Themaximum limit is HK$300 for each complete day after the first 48 hours andHK$3,000 per policy year.

Clothing and Wearing Apparels ProtectionIf the clothing and wearing apparels of the driver or passenger in the insuredmotor car are damaged during a traffic accident, we will pay for the replacementcosts of damaged clothing and wearing apparels up to HK$2,000 per policy year.

Accidental Medical Expenses ProtectionWe will pay up to HK$10,000 per event for the necessary and reasonablemedical expenses if the Insured or insured driver or passengers of the insuredmotor car sustains bodily injury due to a traffic accident.

Private Car Insurance Proposal Form �� !"#!$Head Office: 16/F Worldwide House, 19 Des Voeux Road Central, Hong Kong. �=�=�� !"#$%&'()*+,&-. Tel: +852 3606 9933 Fax: +852 2810 0225Business Centre: 8/F 118 Connaught Road West, Sheung Wan, Hong Kong. �� !"#$%&'()* 118� 8� Tel: +852 3606 9933 Fax: +852 2810 0218Email: mailbox@afh.hk Website: http://www.asiainsurance.hk

Please complete the form in block capitals and tick ❏✓ the appropriate boxes. �� !"#$%&'()*+,-.$/❏✓ �

(MPC 3000/052010)

PARTICULARS OF DRIVERS WHO WILL REGULARLY DRIVE THE MOTOR CAR �� !"#$%&'()*Full Name of Driver Nominated as Named Driver? Relationship with Proposer Occupation Age No. of Years of Driving�� !" �� !"#$%&'()\ �� !"# �� �� �� !"#

Proposer ❏Yes ❏No As above As above As above�� � � �� �� ��

❏Yes ❏No� �

❏Yes ❏No� �

PLEASE ANSWER ALL THE FOLLOWING QUESTIONS : �� !"#$=W(1) Has the Motor Car been modified in any way from manufacturer’s standard specifications? ❏ Yes ❏No�� !"#$%&'()*+,-,./0,1234\ � �

(2) Have you or any person who to your knowledge may drive the Motor Car been involved in any traffic accident during the last 3 years? ❏ Yes ❏No�� !"#$%&'()*+,-./0123456789:;\ � �

(3) Have you or any person who to your knowledge may drive the Motor Car been convicted of any of the following driving offences during the last 3 years: ❏ Yes ❏Nospeeding, careless driving, dangerous driving or driving whilst under the influence of alcohol? � ��� !"#$%&'()*+,-./0123456789-.:;<=-.:>?-.'�@ABC&-.\

(4) In respect of Motor Insurance, have you or any person who to your knowledge may drive the Motor Car been declined such application, or been ❏ Yes ❏Norefused renewal, or been terminated such insurance, or been imposed terms on your/his/her policy by any insurance company? � ��� !"#$%&'()*+,-./0� 12345)*!"6789:!;89<!;=>?@AB!"(CDEFBGHIJK!LM\

(5) Do you or does any person who to your knowledge may drive the Motor Car suffer from defective vision or hearing or from any physical or mental infirmity? ❏ Yes ❏No�� !"#$%&'()*+,-#./0123!"456789 :;1<=\ � �

If the answer to any of the above question is “Yes”, please supply details. �� !"#$%&'()*+,-$./0123

Important Notices �� !(1) Failure to supply true answers to this Proposal Form or inform the Company of all material

information about your insurance proposal may render the insurance policy invalid. If you haveany doubt about what you should disclose, do not hesitate to check with the Company or yourinsurance agent/broker.

(2) Please attach copy of valid Vehicle Registration Document of the Motor Car and documentaryevidence of present Motor Insurance “No Claim Discount”.

(3) The Private Car Insurance will not be effective unless this Proposal has been formally accepted bythe Company.

(4) Any personal information collected by the Company may be used, stored or disclosed to anyindividual or organization to evaluate this application, or provide subsequent services. Requestsfor personal data access or correction may be addressed to Data Protection Officer of theCompany.

(5) This brochure is not a policy of insurance. Please refer to the policy document for full details ofterms, conditions and exceptions.

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Declaration ��I/We desire to insure with Asia Insurance Company Limited (“the Company”) in respect of the MotorCar as detailed herein and hereby declare that:(1) the Motor Car is in good condition;(2) the Motor Car will not be driven by any person who to my/our knowledge does not hold a full

valid driving licence or has been disqualified from holding such driving licence;(3) the particulars given in this Proposal Form are true and nothing materially affecting the insurance

risk has been concealed by me/us;(4) if any particulars or answers in this Proposal Form are not in my/our hand-writing, the person or

persons filling in such particulars and answers shall be deemed to be my/our agent for thatpurpose;

(5) I/We hereby agree that this Proposal and Declaration shall be incorporated in and taken as thebasis of the proposed contract between me/us and the Company; and

(6) I/We agree to accept a policy in the Company’s usual insurance policy form for this class ofinsurance.

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DETAILS OF PRESENT MOTOR INSURANCE “NO CLAIM DISCOUNT” (NCD)�� !"#$%&'()*Ek`aF=�� !"#$

Name of Insurer �� !"# Present Policy Number �� !"#

Registration Mark NCD (%) Transfer the NCD to the Motor Car proposed�� !"# �� !"#$EBF here? �� k`a�� !"#$%&'\

❏ Yes ❏No� �

Proposer’s Signature �� !"

Date ��

Authorized Agent �� !

For Office Use Only �� !Account No. Cover Note No. Policy No.

PARTICULARS OF MOTOR CAR TO BE INSURED �� !"#$Registration Mark Vehicle Make/Model Year of Manufacture Cylinder Capacity (c.c.) Seating Capacity (excl. driver)�� !"# �� !"L�� �� ! �� !=EÅKÅKF �� !"#=E�� !F

Chassis Number �� !"# Engine Number �� ! No. of Door Type of Body�� ! �� !

Est. Value of the Motor Car including Accessories Please declare non factory-fitted accessories Anti-Theft Alarm System Use of the Motor Car �� !"#$(Sum Insured) with value over HK$5,000 (Model/Value)�� !"#$%&'E�� !"# $F �� !"#$%&'()*+,-./01 �� !=E��L��F��=HK$

Type of Transmission �� !=E��F Hire Purchase Owner (if any)

❏ Automatic ��=E�� F �� !"#=E�� F

❏ Manual ��=E��F Usual parking place of the Motor Car

❏ Automatic & Manual �� !"#!$% !=E�� !F �� !"#$%&

❏ For social domestic and pleasure purposes �� !

❏ For business professional use or for use by employees �� !

❏ Others, please specify �� !"#$%&

PARTICULAR OF PROPOSER �� !"Full Name of the Proposer ❏ Mr �� Age No. of Years of Driving�� !" ❏ Ms �� �� �� !"#

Proposer’s Business/Position Mobile Phone No. �� !�� !"#$L��

Home Address �� ! Home Tel. �� !

Business Address �� ! Office Tel. �� !

Operative Insurance Cover Required ❏ Third Party Legal Liabilities �� !"#$ Is insurance cover (damage to the Motor Car only) required for driving in Guangdong ❏ Yes ��� ! ❏ Comprehensive �� ! Province? �� !"#$�=�� !"=���=E�� !"#$%&'%(F=\ ❏ No �Period of Insurance From to�� ! � �