BENEFITS Personal Accident · BENEFITS 1. Accidental Death and Permanent Disablement &' In the...
5
!"#$% WING LUNG INSURANCE CO. LTD. Personal Accident Insurance Proposal Form !"#$"% PERSONAL INFORMATION COLLECTION STATEMENT=!"#$% The information you provide to us is collected to enable us to carry on insurance business and may be used for the purpose of : – any insurance or related product or service or any alterations, variations, cancellation or renewal of them; – any claim or analysis of it; and may be transferred to: – any related company or any other company carrying on insurance or reinsurance related business or an intermediary or a claims or investigation or other service provider providing services relevant to insurance business or any association or federation of insurance companies that exists or is formed from time to time. – any person/organization to fulfil any of the above purposes and/or for the purpose of data verification within the insurance industry. You have the right to obtain access to and to request correction of any personal information concerning yourself held by Wing Lung Insurance Co. Ltd. Requests for such access can be made to The General Administration Officer of Wing Lung Insurance Co. Ltd. !"#$%&'()!*+,-./%012345 ! !"#$%&'(#)*+#,-'(#)*& !"#$%&' !"!#$%& !"# !"#$%&'()%*+,&'-./0123 !"#$%&'()*!"#$%+,-)./) !"#$%&'()*+,-./01213 !=L=!"#$%&'()*!"+,-./0 !"#$% !"#$%&'()*+,-./01234 !"#$%&'()*+,-.#/01234567
Transcript of BENEFITS Personal Accident · BENEFITS 1. Accidental Death and Permanent Disablement &' In the...
BENEFITS �� !
1. Accidental Death and Permanent Disablement �� !"#$%&'
In the event of Accidental Death or Permanent Disablement occurring within
12 months from the date of bodily injury, a lump sum compensation, in
accordance with the percentage specified in the given Scale of Benefits,
is payable.
�� !"#$%&'()*+,-./0123456789:;<
�� !"#$%&'() *+,
2. Accidental Medical Expenses �� !"#$%
In the event the insured requires medical treatment for injuries resulting from
an accident, the policy pays the actual necessary and reasonable medical,
hospital or surgical expenses incurred, provided such treatment is received
from a legally qualified and registered medical practitioner.
Medical expenses for treatment by a Chinese herbalist or bonesetter are
payable up to HK$1,000 or 10% of the limit covered, whichever amount is
lower, provided the first medical treatment was received from and certified
by a legally qualified and registered medical practitioner.
�� !"#$%&'()*+,-./01234567%89:;
�� !"#$%&'()*�+,-./
�� !"#$ !%&'()*+,-./01023456478
�� !"#$%&'()*+,-./01�23456789:;
�� !"
3. Income Protection* =�� ! *
In the event you are totally disabled as a result of an injury and is unable to
engage in and attend to all duties pertaining to your occupation, profession or
business for more than 7 days, a Benefit at the amount specified is payable
commencing from the 8th day of such period of temporary total disablement.
The maximum period payable for this Benefit is 2 calendar years.
�� !"#$%&'()*+,-./01234567&89:7
�� !"#$"#%&'()$
However, this Benefit will be payable from the first day of your disablement
if you have been confined in a hospital as a registered in-patient receiving
treatment for bodily injury covered by the policy for 2 consecutive days.
�� !"#$%&'()*$+,-./01234560789
If you are self-employed, this Benefit will only be payable for the period that
you are hospitalized resulting from accidental bodily injury. Hospitalization
shall not be less than 12 consecutive hours and the Benefit is payable from
the first day of disablement.
�� !"#$%&'()*+,-./012345),6#789
�� !"#$%&'()*+,-./
G In the event of claim, you have to provide your latest income tax demand
note as proof of income.
G �� !"#$%&'()*+,-./0$12-.345
ACCIDENTAL DEATH AND PERMANENT DISABLEMENT�� !"#$%&'
Scale of Benefits Percentage of Compensation�� !" of the Proposer’s Capital Sum
�� !"#$%&Accidental Death�� ! KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK )
Loss of one or more limbs�� !"#$ KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK )
Loss of both hands, or of all fingers and both thumbs�� !"#$!% KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK )
Total loss of sight of one eye or both eyes�� !�"#$%&'( KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK )
100%Total paralysis�� ! ...................................................................................................... )
Complete and incurable insanity
�� !"#$%&'()*+ KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
Injuries resulting in being permanently bedridden�� !"#$%&' KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK )
Any other injury causing permanent total disablement�� !"#$%&'() KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK )
Loss of sight of eye, except perception of light�� !"#$%&'()* KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 50%
Loss of lens of one eye �� !"#$%&' KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 50%
Loss of four fingers and thumb of one hand =�� !"#$ KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 50%
Loss of four fingers =�� !"#$%" KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 40%
Loss of thumb - both phalanges �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 25%�� ! - one phalanx �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 10%
Loss of index finger - three phalanges =�� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 10%�� ! - two phalanges �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 8%
- one phalanx �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 4%
Loss of middle finger - three phalanges=�� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 6%�� ! - two phalanges �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 4%
- one phalanx =�� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 2%
Loss of ring finger - three phalanges =�� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 5%�� !" - two phalanges �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 4%
- one phalanx �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 2%
Loss of little finger - three phalanges �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 4%�� ! - two phalanges �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 3%
- one phalanx �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 2%
Loss of metacarpals - first or second (additional)�� ! �� !"�� !KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 3%
- third, fourth or fifth (additional)�� !"#$�� !..................................................... 2%
Loss of toes - all =�� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 15%�� ! - great, both phalanges =�� !" KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 5%
- great, one phalanx =�� !" KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 2%- other than great, if more than one toe lost, each�� !"#$%&'�� !"KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 1%
Loss of hearing - both ears =�� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 75%�� ! - one ear �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 15%
Loss of speech �� !"# KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 50%
The complete and irrecoverable loss of use of any member specified above shall be deemed to be lossof such member. In the event of partial loss of any member specified above, a proportionately lowerpercentage of compensation as decided by Wing Lung Insurance Co. Ltd. shall be payable.�� !"#$%&'()*+,-./012345"#$%67/089:�;<=&>�� !"#$%&'()*+,-./012345(678
In the event of Permanent Disablement by physical loss of use not specified above the percentage ofcompensation shall be assessed in proportion to the degree of disability as compared with the casesspecified.�� !"#$%&'()*+,-./01234567891:;<=>?$%@A.B�� !"#$%&'(
The aggregate of all percentages payable in respect of any one accident shall not exceed 100%.�� !"#$%&'()*+,-./0&'%�&1
�� !"#$%
WING LUNG INSURANCE CO. LTD.
Personal AccidentInsurance Proposal Form
�� !"#$"%
PERSONAL INFORMATION COLLECTIONSTATEMENT =�� !"#$%
The information you provide to us is collected to enable us tocarry on insurance business and may be used for the purpose of :
– any insurance or related product or service or any alterations,variations, cancellation or renewal of them;
– any claim or analysis of it; and
may be transferred to:
– any related company or any other company carrying oninsurance or reinsurance related business or an intermediaryor a claims or investigation or other service provider providingservices relevant to insurance business or any association orfederation of insurance companies that exists or is formedfrom time to time.
– any person/organization to fulfil any of the above purposesand/or for the purpose of data verification within the insuranceindustry.
You have the right to obtain access to and to request correctionof any personal information concerning yourself held byWing Lung Insurance Co. Ltd. Requests for such access can bemade to The General Administration Officer of Wing LungInsurance Co. Ltd.
�� !"#$%&'() !*+,-./%012345�
�� !
��� !"#$%&'(#)*+#,-'(#)*&��
�� !� "#$%&'
��� !" !#$%&
�� !"#
��� !"#$%&'()%*+, &'-./0123
�� !"#$%&'()*� !"#$%+,-)./)
�� !"#$%&'( )*+,-./01 213
��� !=L=�� !"#$%&'() *!"+,-./0
�� !"#$%
�� !"#$%&'()*+,- ./01 2��34
�� !"#$%&'()*+,-.#/01234567
��
CLASSIFICATION OF OCCUPATION �� !
Class I ��Professions and occupations involving indoor work mainly of a sedentary(requiring much sitting) nature such as accountants, administrators, architects,auditors, bankers, clergymen, clerks, dentists, indoor sales representatives,lawyers, medical practitioners, secretaries, stockbrokers, surgeons (not veterinary)an teachers.
�� !"#$%&'()*+,-./0123451$5167+��� !"#$%&"�'()'*+�� !"#�� !"
Class II��Professions and occupations involving outdoor or site work or occasional manualwork only when supervising workmen, such as builders (superintending), civilengineers, commercial travellers, decorators (superintending), chauffeurs,foremen, grocers, hairdressers, pharmacists, plumbers (superintending), outdoorsalesmen, surveyors, and tailors.
�� !"#$%&'()*+,#-./012-345'67895�� !"#$%#&'(#)*(#+,(-./01
Class III ��Professions and occupations involving manual work without machinery such asbakers, butchers, carpenters (not using woodworking machinery), electricalengineers, farmers, fishmongers, motor or mechanical engineers, painters, indoorplumbers and veterinary surgeons.
�� !"#$%&'()*+,-)./012345367�� !�� �� !"#$%&$'($)*+ ,!"#$-./$012�� !"#$
Class IV ��Professions and occupations performing extra hazardous work including skilledor semi-skilled workers operating heavy machinery, heavy truck, constructiontrade workers, surface mining, labourers and similar occupations requiring ahigh degree of physical exertion.
�� !"#$%&'()*+,&-./012345367)8-
EXCLUSIONS �� !
War and allied perils, suicide, pregnancy or childbirth, driving or riding in anykind of race, flying as a crew member, professional sports, underwater activitiesinvolving the use of breathing apparatus, intoxication by alcohol, narcotics ordrugs not prescribed by a legally qualified and registered medical practitioner,acquired immune deficiency syndrome (AIDS) or AIDS related complex (ARC),nervous or mental disease, venereal disease, congenital anomalies or deformities,circumcision, infertility, sterilization, heart disease, cancer, rest cure, physicalcheckups and cosmetic or plastic surgery unless to correct an injury coveredunder the Policy.
�� !"#$%&'%()*+,%-.*/0123456789�� !"#$%�&'()*+,-./012%�34�56&78�� !"#$%&'()*+,-.(/0123.4+56.+7�� !"#$%&'�()*+�,-�.-�/0��12�34��� !"#$%&'()*+,-./0.123456789'()��
4. Hospital Cash Allowance �� !"#
In the event the insured is confined in a hospital for treatment of bodily injury,
a daily benefit at the amount specified is payable for such period of
confinement.
The maximum period payable for this benefits is 104 weeks.
�� !"#$%&'()*+,- ./012345 6789:
�� !"#
�� ! NMQ�� !
BENEFITS �� !
1. Accidental Death and Permanent Disablement �� !"#$%&'
In the event of Accidental Death or Permanent Disablement occurring within
12 months from the date of bodily injury, a lump sum compensation, in
accordance with the percentage specified in the given Scale of Benefits,
is payable.
�� !"#$%&'()*+,-./0123456789:;<
�� !"#$%&'() *+,
2. Accidental Medical Expenses �� !"#$%
In the event the insured requires medical treatment for injuries resulting from
an accident, the policy pays the actual necessary and reasonable medical,
hospital or surgical expenses incurred, provided such treatment is received
from a legally qualified and registered medical practitioner.
Medical expenses for treatment by a Chinese herbalist or bonesetter are
payable up to HK$1,000 or 10% of the limit covered, whichever amount is
lower, provided the first medical treatment was received from and certified
by a legally qualified and registered medical practitioner.
�� !"#$%&'()*+,-./01234567%89:;
�� !"#$%&'()*�+,-./
�� !"#$ !%&'()*+,-./01023456478
�� !"#$%&'()*+,-./01�23456789:;
�� !"
3. Income Protection* =�� ! *
In the event you are totally disabled as a result of an injury and is unable to
engage in and attend to all duties pertaining to your occupation, profession or
business for more than 7 days, a Benefit at the amount specified is payable
commencing from the 8th day of such period of temporary total disablement.
The maximum period payable for this Benefit is 2 calendar years.
�� !"#$%&'()*+,-./01234567&89:7
�� !"#$"#%&'()$
However, this Benefit will be payable from the first day of your disablement
if you have been confined in a hospital as a registered in-patient receiving
treatment for bodily injury covered by the policy for 2 consecutive days.
�� !"#$%&'()*$+,-./01234560789
If you are self-employed, this Benefit will only be payable for the period that
you are hospitalized resulting from accidental bodily injury. Hospitalization
shall not be less than 12 consecutive hours and the Benefit is payable from
the first day of disablement.
�� !"#$%&'()*+,-./012345),6#789
�� !"#$%&'()*+,-./
G In the event of claim, you have to provide your latest income tax demand
note as proof of income.
G �� !"#$%&'()*+,-./0$12-.345
ACCIDENTAL DEATH AND PERMANENT DISABLEMENT�� !"#$%&'
Scale of Benefits Percentage of Compensation�� !" of the Proposer’s Capital Sum
�� !"#$%&Accidental Death�� ! KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK )
Loss of one or more limbs�� !"#$ KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK )
Loss of both hands, or of all fingers and both thumbs�� !"#$!% KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK )
Total loss of sight of one eye or both eyes�� !�"#$%&'( KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK )
100%Total paralysis�� ! ...................................................................................................... )
Complete and incurable insanity
�� !"#$%&'()*+ KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
Injuries resulting in being permanently bedridden�� !"#$%&' KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK )
Any other injury causing permanent total disablement�� !"#$%&'() KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK )
Loss of sight of eye, except perception of light�� !"#$%&'()* KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 50%
Loss of lens of one eye �� !"#$%&' KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 50%
Loss of four fingers and thumb of one hand =�� !"#$ KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 50%
Loss of four fingers =�� !"#$%" KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 40%
Loss of thumb - both phalanges �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 25%�� ! - one phalanx �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 10%
Loss of index finger - three phalanges =�� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 10%�� ! - two phalanges �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 8%
- one phalanx �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 4%
Loss of middle finger - three phalanges=�� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 6%�� ! - two phalanges �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 4%
- one phalanx =�� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 2%
Loss of ring finger - three phalanges =�� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 5%�� !" - two phalanges �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 4%
- one phalanx �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 2%
Loss of little finger - three phalanges �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 4%�� ! - two phalanges �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 3%
- one phalanx �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 2%
Loss of metacarpals - first or second (additional)�� ! �� !"�� !KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 3%
- third, fourth or fifth (additional)�� !"#$�� !..................................................... 2%
Loss of toes - all =�� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 15%�� ! - great, both phalanges =�� !" KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 5%
- great, one phalanx =�� !" KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 2%- other than great, if more than one toe lost, each�� !"#$%&'�� !"KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 1%
Loss of hearing - both ears =�� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 75%�� ! - one ear �� KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 15%
Loss of speech �� !"# KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 50%
The complete and irrecoverable loss of use of any member specified above shall be deemed to be lossof such member. In the event of partial loss of any member specified above, a proportionately lowerpercentage of compensation as decided by Wing Lung Insurance Co. Ltd. shall be payable.�� !"#$%&'()*+,-./012345"#$%67/089:�;<=&>�� !"#$%&'()*+,-./012345(678
In the event of Permanent Disablement by physical loss of use not specified above the percentage ofcompensation shall be assessed in proportion to the degree of disability as compared with the casesspecified.�� !"#$%&'()*+,-./01234567891:;<=>?$%@A.B�� !"#$%&'(
The aggregate of all percentages payable in respect of any one accident shall not exceed 100%.�� !"#$%&'()*+,-./0&'%�&1
�� !"#$%
WING LUNG INSURANCE CO. LTD.
Personal AccidentInsurance Proposal Form
�� !"#$"%
PERSONAL INFORMATION COLLECTIONSTATEMENT =�� !"#$%
The information you provide to us is collected to enable us tocarry on insurance business and may be used for the purpose of :
– any insurance or related product or service or any alterations,variations, cancellation or renewal of them;
– any claim or analysis of it; and
may be transferred to:
– any related company or any other company carrying oninsurance or reinsurance related business or an intermediaryor a claims or investigation or other service provider providingservices relevant to insurance business or any association orfederation of insurance companies that exists or is formedfrom time to time.
– any person/organization to fulfil any of the above purposesand/or for the purpose of data verification within the insuranceindustry.
You have the right to obtain access to and to request correctionof any personal information concerning yourself held byWing Lung Insurance Co. Ltd. Requests for such access can bemade to The General Administration Officer of Wing LungInsurance Co. Ltd.
�� !"#$%&'() !*+,-./%012345�
�� !
��� !"#$%&'(#)*+#,-'(#)*&��
�� !� "#$%&'
��� !" !#$%&
�� !"#
��� !"#$%&'()%*+, &'-./0123
�� !"#$%&'()*� !"#$%+,-)./)
�� !"#$%&'( )*+,-./01 213
��� !=L=�� !"#$%&'() *!"+,-./0
�� !"#$%
�� !"#$%&'()*+,- ./01 2��34
�� !"#$%&'()*+,-.#/01234567
��
CLASSIFICATION OF OCCUPATION �� !
Class I ��Professions and occupations involving indoor work mainly of a sedentary(requiring much sitting) nature such as accountants, administrators, architects,auditors, bankers, clergymen, clerks, dentists, indoor sales representatives,lawyers, medical practitioners, secretaries, stockbrokers, surgeons (not veterinary)an teachers.
�� !"#$%&'()*+,-./0123451$5167+��� !"#$%&"�'()'*+�� !"#�� !"
Class II��Professions and occupations involving outdoor or site work or occasional manualwork only when supervising workmen, such as builders (superintending), civilengineers, commercial travellers, decorators (superintending), chauffeurs,foremen, grocers, hairdressers, pharmacists, plumbers (superintending), outdoorsalesmen, surveyors, and tailors.
�� !"#$%&'()*+,#-./012-345'67895�� !"#$%#&'(#)*(#+,(-./01
Class III ��Professions and occupations involving manual work without machinery such asbakers, butchers, carpenters (not using woodworking machinery), electricalengineers, farmers, fishmongers, motor or mechanical engineers, painters, indoorplumbers and veterinary surgeons.
�� !"#$%&'()*+,-)./012345367�� !�� �� !"#$%&$'($)*+ ,!"#$-./$012�� !"#$
Class IV ��Professions and occupations performing extra hazardous work including skilledor semi-skilled workers operating heavy machinery, heavy truck, constructiontrade workers, surface mining, labourers and similar occupations requiring ahigh degree of physical exertion.
�� !"#$%&'()*+,&-./012345367)8-
EXCLUSIONS �� !
War and allied perils, suicide, pregnancy or childbirth, driving or riding in anykind of race, flying as a crew member, professional sports, underwater activitiesinvolving the use of breathing apparatus, intoxication by alcohol, narcotics ordrugs not prescribed by a legally qualified and registered medical practitioner,acquired immune deficiency syndrome (AIDS) or AIDS related complex (ARC),nervous or mental disease, venereal disease, congenital anomalies or deformities,circumcision, infertility, sterilization, heart disease, cancer, rest cure, physicalcheckups and cosmetic or plastic surgery unless to correct an injury coveredunder the Policy.
�� !"#$%&'%()*+,%-.*/0123456789�� !"#$%�&'()*+,-./012%�34�56&78�� !"#$%&'()*+,-.(/0123.4+56.+7�� !"#$%&'�()*+�,-�.-�/0��12�34��� !"#$%&'()*+,-./0.123456789'()��
4. Hospital Cash Allowance �� !"#
In the event the insured is confined in a hospital for treatment of bodily injury,
a daily benefit at the amount specified is payable for such period of
confinement.
The maximum period payable for this benefits is 104 weeks.
�� !"#$%&'()*+,- ./012345 6789:
�� !"#
�� ! NMQ�� !
N.B. : This Proposal Form forms the basis of the Policy. Please give a full answer to each question. A negative answer shall be deemed to begiven if any question on this proposal is not answered.
�� �� !"#$%&'()* +%,-./0123456.78956:;#<=>)�� ��
Office Use �� !
Policy No.=�� !
Agent’s Name �� !
Account No.=�� !
�� !"#$%=WING LUNG INSURANCE CO. LTD.Personal Accident Insurance Proposal Form �� !"#$"%
Please fill in English �� !"#
THE PROPOSER ��
Name��
Relationship with Person to be Insured�� !"#$
Address��
THE PERSON TO BE INSURED ��
Name Sex�� ��
Address��
Tel. No.��
Date of Birth (Age limit: 16-65)�� !"#$%&'NSJSR�
Height Weight�� ��
Period of Insurance From To�� ! � �
Occupation Self-employed? Yes No�� �� !"# � �
Please state nature of your work�� !"#$%&'
Name of Employer�� !
Address of Employer/Employment�� L�� !
Tel. No.��
Annual Income�� !"
PREVIOUS INSURANCE PARTICULARS �� !"#
(a) Do you have any accident, sickness, disability or lifeinsurance existing or applied for in this or any othercompany? If yes, state date, company-type and amount.
�� !"#$%&'()*+%&,-'./0
�� !�"#$%&'()*+,�� �� !
�� !"#$ %&'()*+
(b) Is the weekly indemnity under all policies you have appliedfor less than 80% of your average weekly income?
�� !"#$%&'(�#)*+,-./012
�� !"#$%&'()*+,
(c) Have you ever been declined or accepted on reduced suminsured or other special terms for Life, Accident or SicknessInsurances, or has any Comapny ever cancalled or refusedto renew your Policy or desired to amend the conditions orbenefits? If yes, give details of name of Company, reasonand date.
�� !"#$%&$'()*+,-./0123
�� !"#$%&'(")'�*+�,-./0
�� !"#$%�!"&'�()*!�+,-.
�� !"#$%&'()*+,-./012345
(d) Is there anything hazardous about your occupation orpursuits?
�� !"#$%&'()*+
(e) Have you ever made a claim against any Company duringthe last 5 years for injury or sickness? If “yes”, please givedetails.
�� !"#$%&'()*+,-./01234
�� !"#$%&'()*+,-
(f) Are you now in good health and free from any physicalimpairment, deformity of disease. If “No”, please givedetails.
�� !"#$%&'()*+,-./01234
�� !"#$%&'()
Details:��
Yes No� �
TYPE OF COVER REQUIRED �� !
Amount of Coverage (HK$) Premium (HK$)�� !"#$ �� !"#
Accidental Death &Permanent Disablement
�� !"#$%&'
Accidental Medical Expenses(per accident)
�� !"#$%&'(��)
Income Protection (per year)�� !"#$%
Hospital Cash Allowance(per day)
�� !"#$%&'
CLASS TOTAL�� ! ��
Date �� Proposer’s Signature �� !"
DECLARATION ��
I/We declare and agree
i) that to the best of my/our knowledge and belief the information andanswers given on this form are true and complete in every respect;
ii) that the information and answers given on this form are filled in by me/us or by any other person under my/our full instructions;
iii) that this Proposal and Declaration shall be the basis of and be deemed tobe incorporated in the contract of insurance, including any renewal thereof,between me/us and Wing Lung Insurance Co. Ltd.
�� L�� !"#$%&
i) �� !"#$%&'()*+%,+"-./
ii) �� !"#$%&'() L �� !"#$�% L �� !"#
��
iii) �� !"�# L�� !"#$%&'� ()*$%+,-.
�� !"#$
Minimum Policy Premium: HK$300
�� !"�#$%& PMM�
This brochure is intended only as a general summary. Please refer to the actualpolicy for exact terms and conditions.
�� !"#$%&'()*+$,-./0&123456
�� !"#$%&'()*+,-&./01234&56"780�� !"#$
�� !"#$%�� !"#$%&'()
WING LUNG INSURANCE CO. LTD.(wholly owned subsidiary of WING LUNG BANK LTD.)
���� ! QR�
45 DES VOEUX ROAD CENTRAL, HONG KONG.
��=TEL : (852) 2169 8900 ��=FAX : (852) 2891 8182
��=Agent:
UW/PA043/08-05
MAJOR INSURANCE PRODUCTS �� !"#
^K=�� !"=Commercial Insurance:
�� ! Marine Cargo
�� !"# Employees’ Compensation
�� ! Motor Vehicles
�� Fire and Allied Perils
�� ! Commercial / Industrial All Risks
�� ! Burglary
�� ! Money in Transit
�� !"# Public Liability
�� !"# Professional Indemnity
�� !" Contractors’ All Risks
�� ! Business Package Policy
_K=�� !"=Personal Insurance:
�� ! Family Package
�� Fire and Allied Perils
�� !"# Personal Accident
�� ! Domestic Helper Package
�� ! Medical
�� !"# All Risks - Personal Belongings
�� ! Motor Vehicles
�� ! Pleasure Craft
�� ! Travel
PREMIUM TABLE �� !"#ehA=��
Benefits Class 1 Class 2 Class 3 Class 4�� ! �� �� �� ��
1. Accidental Death &Permanent Disablement 0.092% 0.127% 0.173% 0.265%
�� !"#$%&'
Maximum Sum Insured
�� !" – – – 500,000
– Child below 16 years old
16 �� !"#=–200,000
– Fulltime student over 15 years old
15 �� !"#$% –500,000
2. Accidental Medical Expenses�� !"#
Per Accident �� !
HK$5,000 $138 $161 $207 $317HK$7,500 $173 $207 $265 $414HK$10,000 $202 $242 $311 $472HK$12,500 $230 $282 $357 $541HK$15,000 $259 $317 $403 $604HK$20,000 $317 $386 $495 $736HK$25,000 $374 $460 $587 $869HK$30,000 $432 $529 $679 –Amount in excess of HK$30,000�� HK$30,000 0.92% 1.15% 1.55% –
Maximum Sum Insured�� !"
– 10% of Capital Sum up to 100,000 100,000 50,000 25,000�� ! 10% �� !"#
3. Income Protection�� ! 0.345% 0.518% 0.690% 0.863%
Maximum Sum Insured
�� !"
– 100% of actual annual earnings not exceeding 50% of Capital Sum and up to a maximum of 1,000,000 1,000,000 500,000 250,000
� NMMB�� !"#$%&
�� !"# RMB�� !
Self-Employed Cover only appliesto the period the Insured Personis hospitalized resulting fromaccidental bodily injury and thepremium rate is reduced by 50%
�� !�� !"#$%&'
�� !"#$"%&'(50%
4. Hospital Cash Allowance(per HK$100 per day)
$63 $81 $98 $127�� !"#�� ! ehANMM�� !
Maximum Sum Insured�� !"
– 0.1% of Capital Sum up to $1,000 $1,000 $750 $500(per day)
�� !MKNB�� !"#
�� !
N.B. : This Proposal Form forms the basis of the Policy. Please give a full answer to each question. A negative answer shall be deemed to begiven if any question on this proposal is not answered.
�� �� !"#$%&'()* +%,-./0123456.78956:;#<=>)�� ��
Office Use �� !
Policy No.=�� !
Agent’s Name �� !
Account No.=�� !
�� !"#$%=WING LUNG INSURANCE CO. LTD.Personal Accident Insurance Proposal Form �� !"#$"%
Please fill in English �� !"#
THE PROPOSER ��
Name��
Relationship with Person to be Insured�� !"#$
Address��
THE PERSON TO BE INSURED ��
Name Sex�� ��
Address��
Tel. No.��
Date of Birth (Age limit: 16-65)�� !"#$%&'NSJSR�
Height Weight�� ��
Period of Insurance From To�� ! � �
Occupation Self-employed? Yes No�� �� !"# � �
Please state nature of your work�� !"#$%&'
Name of Employer�� !
Address of Employer/Employment�� L�� !
Tel. No.��
Annual Income�� !"
PREVIOUS INSURANCE PARTICULARS �� !"#
(a) Do you have any accident, sickness, disability or lifeinsurance existing or applied for in this or any othercompany? If yes, state date, company-type and amount.
�� !"#$%&'()*+%&,-'./0
�� !�"#$%&'()*+,�� �� !
�� !"#$ %&'()*+
(b) Is the weekly indemnity under all policies you have appliedfor less than 80% of your average weekly income?
�� !"#$%&'(�#)*+,-./012
�� !"#$%&'()*+,
(c) Have you ever been declined or accepted on reduced suminsured or other special terms for Life, Accident or SicknessInsurances, or has any Comapny ever cancalled or refusedto renew your Policy or desired to amend the conditions orbenefits? If yes, give details of name of Company, reasonand date.
�� !"#$%&$'()*+,-./0123
�� !"#$%&'(")'�*+�,-./0
�� !"#$%�!"&'�()*!�+,-.
�� !"#$%&'()*+,-./012345
(d) Is there anything hazardous about your occupation orpursuits?
�� !"#$%&'()*+
(e) Have you ever made a claim against any Company duringthe last 5 years for injury or sickness? If “yes”, please givedetails.
�� !"#$%&'()*+,-./01234
�� !"#$%&'()*+,-
(f) Are you now in good health and free from any physicalimpairment, deformity of disease. If “No”, please givedetails.
�� !"#$%&'()*+,-./01234
�� !"#$%&'()
Details:��
Yes No� �
TYPE OF COVER REQUIRED �� !
Amount of Coverage (HK$) Premium (HK$)�� !"#$ �� !"#
Accidental Death &Permanent Disablement
�� !"#$%&'
Accidental Medical Expenses(per accident)
�� !"#$%&'(��)
Income Protection (per year)�� !"#$%
Hospital Cash Allowance(per day)
�� !"#$%&'
CLASS TOTAL�� ! ��
Date �� Proposer’s Signature �� !"
DECLARATION ��
I/We declare and agree
i) that to the best of my/our knowledge and belief the information andanswers given on this form are true and complete in every respect;
ii) that the information and answers given on this form are filled in by me/us or by any other person under my/our full instructions;
iii) that this Proposal and Declaration shall be the basis of and be deemed tobe incorporated in the contract of insurance, including any renewal thereof,between me/us and Wing Lung Insurance Co. Ltd.
�� L�� !"#$%&
i) �� !"#$%&'()*+%,+"-./
ii) �� !"#$%&'() L �� !"#$�% L �� !"#
��
iii) �� !"�# L�� !"#$%&'� ()*$%+,-.
�� !"#$
Minimum Policy Premium: HK$300
�� !"�#$%& PMM�
This brochure is intended only as a general summary. Please refer to the actualpolicy for exact terms and conditions.
�� !"#$%&'()*+$,-./0&123456
�� !"#$%&'()*+,-&./01234&56"780�� !"#$
�� !"#$%�� !"#$%&'()
WING LUNG INSURANCE CO. LTD.(wholly owned subsidiary of WING LUNG BANK LTD.)
���� ! QR�
45 DES VOEUX ROAD CENTRAL, HONG KONG.
��=TEL : (852) 2169 8900 ��=FAX : (852) 2891 8182
��=Agent:
UW/PA043/08-05
MAJOR INSURANCE PRODUCTS �� !"#
^K=�� !"=Commercial Insurance:
�� ! Marine Cargo
�� !"# Employees’ Compensation
�� ! Motor Vehicles
�� Fire and Allied Perils
�� ! Commercial / Industrial All Risks
�� ! Burglary
�� ! Money in Transit
�� !"# Public Liability
�� !"# Professional Indemnity
�� !" Contractors’ All Risks
�� ! Business Package Policy
_K=�� !"=Personal Insurance:
�� ! Family Package
�� Fire and Allied Perils
�� !"# Personal Accident
�� ! Domestic Helper Package
�� ! Medical
�� !"# All Risks - Personal Belongings
�� ! Motor Vehicles
�� ! Pleasure Craft
�� ! Travel
PREMIUM TABLE �� !"#ehA=��
Benefits Class 1 Class 2 Class 3 Class 4�� ! �� �� �� ��
1. Accidental Death &Permanent Disablement 0.092% 0.127% 0.173% 0.265%
�� !"#$%&'
Maximum Sum Insured
�� !" – – – 500,000
– Child below 16 years old
16 �� !"#=–200,000
– Fulltime student over 15 years old
15 �� !"#$% –500,000
2. Accidental Medical Expenses�� !"#
Per Accident �� !
HK$5,000 $138 $161 $207 $317HK$7,500 $173 $207 $265 $414HK$10,000 $202 $242 $311 $472HK$12,500 $230 $282 $357 $541HK$15,000 $259 $317 $403 $604HK$20,000 $317 $386 $495 $736HK$25,000 $374 $460 $587 $869HK$30,000 $432 $529 $679 –Amount in excess of HK$30,000�� HK$30,000 0.92% 1.15% 1.55% –
Maximum Sum Insured�� !"
– 10% of Capital Sum up to 100,000 100,000 50,000 25,000�� ! 10% �� !"#
3. Income Protection�� ! 0.345% 0.518% 0.690% 0.863%
Maximum Sum Insured
�� !"
– 100% of actual annual earnings not exceeding 50% of Capital Sum and up to a maximum of 1,000,000 1,000,000 500,000 250,000
� NMMB�� !"#$%&
�� !"# RMB�� !
Self-Employed Cover only appliesto the period the Insured Personis hospitalized resulting fromaccidental bodily injury and thepremium rate is reduced by 50%
�� !�� !"#$%&'
�� !"#$"%&'(50%
4. Hospital Cash Allowance(per HK$100 per day)
$63 $81 $98 $127�� !"#�� ! ehANMM�� !
Maximum Sum Insured�� !"
– 0.1% of Capital Sum up to $1,000 $1,000 $750 $500(per day)
�� !MKNB�� !"#
�� !
N.B. : This Proposal Form forms the basis of the Policy. Please give a full answer to each question. A negative answer shall be deemed to begiven if any question on this proposal is not answered.
�� �� !"#$%&'()* +%,-./0123456.78956:;#<=>)�� ��
Office Use �� !
Policy No.=�� !
Agent’s Name �� !
Account No.=�� !
�� !"#$%=WING LUNG INSURANCE CO. LTD.Personal Accident Insurance Proposal Form �� !"#$"%
Please fill in English �� !"#
THE PROPOSER ��
Name��
Relationship with Person to be Insured�� !"#$
Address��
THE PERSON TO BE INSURED ��
Name Sex�� ��
Address��
Tel. No.��
Date of Birth (Age limit: 16-65)�� !"#$%&'NSJSR�
Height Weight�� ��
Period of Insurance From To�� ! � �
Occupation Self-employed? Yes No�� �� !"# � �
Please state nature of your work�� !"#$%&'
Name of Employer�� !
Address of Employer/Employment�� L�� !
Tel. No.��
Annual Income�� !"
PREVIOUS INSURANCE PARTICULARS �� !"#
(a) Do you have any accident, sickness, disability or lifeinsurance existing or applied for in this or any othercompany? If yes, state date, company-type and amount.
�� !"#$%&'()*+%&,-'./0
�� !�"#$%&'()*+,�� �� !
�� !"#$ %&'()*+
(b) Is the weekly indemnity under all policies you have appliedfor less than 80% of your average weekly income?
�� !"#$%&'(�#)*+,-./012
�� !"#$%&'()*+,
(c) Have you ever been declined or accepted on reduced suminsured or other special terms for Life, Accident or SicknessInsurances, or has any Comapny ever cancalled or refusedto renew your Policy or desired to amend the conditions orbenefits? If yes, give details of name of Company, reasonand date.
�� !"#$%&$'()*+,-./0123
�� !"#$%&'(")'�*+�,-./0
�� !"#$%�!"&'�()*!�+,-.
�� !"#$%&'()*+,-./012345
(d) Is there anything hazardous about your occupation orpursuits?
�� !"#$%&'()*+
(e) Have you ever made a claim against any Company duringthe last 5 years for injury or sickness? If “yes”, please givedetails.
�� !"#$%&'()*+,-./01234
�� !"#$%&'()*+,-
(f) Are you now in good health and free from any physicalimpairment, deformity of disease. If “No”, please givedetails.
�� !"#$%&'()*+,-./01234
�� !"#$%&'()
Details:��
Yes No� �
TYPE OF COVER REQUIRED �� !
Amount of Coverage (HK$) Premium (HK$)�� !"#$ �� !"#
Accidental Death &Permanent Disablement
�� !"#$%&'
Accidental Medical Expenses(per accident)
�� !"#$%&'(��)
Income Protection (per year)�� !"#$%
Hospital Cash Allowance(per day)
�� !"#$%&'
CLASS TOTAL�� ! ��
Date �� Proposer’s Signature �� !"
DECLARATION ��
I/We declare and agree
i) that to the best of my/our knowledge and belief the information andanswers given on this form are true and complete in every respect;
ii) that the information and answers given on this form are filled in by me/us or by any other person under my/our full instructions;
iii) that this Proposal and Declaration shall be the basis of and be deemed tobe incorporated in the contract of insurance, including any renewal thereof,between me/us and Wing Lung Insurance Co. Ltd.
�� L�� !"#$%&
i) �� !"#$%&'()*+%,+"-./
ii) �� !"#$%&'() L �� !"#$�% L �� !"#
��
iii) �� !"�# L�� !"#$%&'� ()*$%+,-.
�� !"#$
Minimum Policy Premium: HK$300
�� !"�#$%& PMM�
This brochure is intended only as a general summary. Please refer to the actualpolicy for exact terms and conditions.
�� !"#$%&'()*+$,-./0&123456
�� !"#$%&'()*+,-&./01234&56"780�� !"#$
�� !"#$%�� !"#$%&'()
WING LUNG INSURANCE CO. LTD.(wholly owned subsidiary of WING LUNG BANK LTD.)
���� ! QR�
45 DES VOEUX ROAD CENTRAL, HONG KONG.
��=TEL : (852) 2169 8900 ��=FAX : (852) 2891 8182
��=Agent:
UW/PA043/08-05
MAJOR INSURANCE PRODUCTS �� !"#
^K=�� !"=Commercial Insurance:
�� ! Marine Cargo
�� !"# Employees’ Compensation
�� ! Motor Vehicles
�� Fire and Allied Perils
�� ! Commercial / Industrial All Risks
�� ! Burglary
�� ! Money in Transit
�� !"# Public Liability
�� !"# Professional Indemnity
�� !" Contractors’ All Risks
�� ! Business Package Policy
_K=�� !"=Personal Insurance:
�� ! Family Package
�� Fire and Allied Perils
�� !"# Personal Accident
�� ! Domestic Helper Package
�� ! Medical
�� !"# All Risks - Personal Belongings
�� ! Motor Vehicles
�� ! Pleasure Craft
�� ! Travel
PREMIUM TABLE �� !"#ehA=��
Benefits Class 1 Class 2 Class 3 Class 4�� ! �� �� �� ��
1. Accidental Death &Permanent Disablement 0.092% 0.127% 0.173% 0.265%
�� !"#$%&'
Maximum Sum Insured
�� !" – – – 500,000
– Child below 16 years old
16 �� !"#=–200,000
– Fulltime student over 15 years old
15 �� !"#$% –500,000
2. Accidental Medical Expenses�� !"#
Per Accident �� !
HK$5,000 $138 $161 $207 $317HK$7,500 $173 $207 $265 $414HK$10,000 $202 $242 $311 $472HK$12,500 $230 $282 $357 $541HK$15,000 $259 $317 $403 $604HK$20,000 $317 $386 $495 $736HK$25,000 $374 $460 $587 $869HK$30,000 $432 $529 $679 –Amount in excess of HK$30,000�� HK$30,000 0.92% 1.15% 1.55% –
Maximum Sum Insured�� !"
– 10% of Capital Sum up to 100,000 100,000 50,000 25,000�� ! 10% �� !"#
3. Income Protection�� ! 0.345% 0.518% 0.690% 0.863%
Maximum Sum Insured
�� !"
– 100% of actual annual earnings not exceeding 50% of Capital Sum and up to a maximum of 1,000,000 1,000,000 500,000 250,000
� NMMB�� !"#$%&
�� !"# RMB�� !
Self-Employed Cover only appliesto the period the Insured Personis hospitalized resulting fromaccidental bodily injury and thepremium rate is reduced by 50%
�� !�� !"#$%&'
�� !"#$"%&'(50%
4. Hospital Cash Allowance(per HK$100 per day)
$63 $81 $98 $127�� !"#�� ! ehANMM�� !
Maximum Sum Insured�� !"
– 0.1% of Capital Sum up to $1,000 $1,000 $750 $500(per day)
�� !MKNB�� !"#
�� !
![WORK INJURY BENEFITS ACT · CAP. 236 Work Injury Benefits [Rev. 2012] [Issue 1] W10 - 4 Section 32. Compensation for permanent disablement of employee in training. 33. Compensation](https://static.fdocuments.net/doc/165x107/5fbc14ba14726a021963eaa6/work-injury-benefits-cap-236-work-injury-benefits-rev-2012-issue-1-w10-4.jpg)
