Chubb Life Insurance Product Enquiry Form, Hong Kong

Alternatively you can contact our Premier Customer Service Center:

Address	35/F, Chubb Tower, Windsor House, 311 Gloucester Road Causeway Bay, Hong Kong
Office Hours	Monday - Friday 9:00am - 6:00pm Saturday 9:00am - 12:30pm
Hotline	+852 2894 9833
Fax	+852 2577 0866
Email	Enquiries.HKLife@chubb.com

First Name

Surname

Contact Number

Enquiry / Comments

All personal information obtained herein is collected for the purpose of enabling us to contact you and utilized in accordance with the Chubb Hong Kong's Personal Information Collection Statement (“Chubb PICS”). Without your express authorization, personal information collected will not be transferred to third parties outside of those stated in the Chubb PICS. You may choose not to provide the personal information required, but this may result in us being unable to contact you.

Please confirm you have read and agreed the Personal Information Collection Statement.

I agree to the use of my personal data for the above purposes in accordance with the Chubb Life Personal Information Collection Statement .