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Please complete the Application in English

Single Trip Travel Insurance Application Form

Type of Trip:
Single Trip Travel
Departure Date:

Departure Date inclusive
Date of Return:

Return Date inclusive
Area:

(Optional)
Destination:

If visit more than one country, please select the last destination.

Purchase of Travel Insurance is not accepted for the city/country which the Government of Hong Kong SAR or any of its authorized entity or organization has announced or issued a Black Color-Coded alert in accordance with the Outbound Travel Alert System.
Plan Selection:
Offer Code:
Applicable to designated customer only #
#Please input Offer Code to enjoy special offer

Note:
  1. The Proposer and Insured Person must be a Hong Kong Permanent Resident holding a valid HKID card.
  2. 'Family Plan' includes the principal insured and his/her spouse, their accompanying children aged 6 months to 16 years old will be covered free of charge. (age means the attained age on departure date).
  3. (a) Child(ren) aged 17 or above, or (b) parents without accompanying child(ren), please submit separate application applying the 'Individual Plan'.
  4. The maximum period of travel covered is 180 days.
  5. Starting from 5 January 2015, all online purchase of travel insurance transactions via our bank's webpage (Including Single Trip Travel and Annual Multi Trips Travel) are not entitled bonus point / cash rebate.

Terms and Conditions © Shanghai Commercial Bank Limited