• Death Benefit Claim Form (to be completed by claimant)
• Complete Self-Certification Form (to be completed by beneficiary):

For individual, please complete:

   - Self-Certification Form – Individual

For Entity, please complete:

   - Self-Certification Form – Entity

   - Self-Certification Form – Controlling Person

Basic Documents

1. Original Death Certificate#
2. If policy has been in effect less than 2 years, please submit Death Benefit Claim Form (Attending Physician's Statement) completed by deceased's last attending doctor at claimant's own cost
3. Original/Certified Copy of Identity Proof/Passport of the insured and the beneficiary(ies)
4. Relationship proof copy between the insured and the beneficiary(ies) (e.g. birth certificate copy, household register copy or marriage certificate copy)

Additional Documents May Be Required

• If the death benefit is payable to estate

   - Original Letter of Administration by High Court# or

   - Original Grant of Probate by High Court (if the deceased has left a will)#

• If any of the beneficiary is under age 18

   - Legal Guardianship Paper of the minor beneficiary

• If death is caused by Accident

   - Witness Statement

   - Newspaper Clipping

   - Police Report

   - Autopsy Report

   - Coroner's Report

• If death occurs in Mainland

   - Original Notarial Certificate of Death (certified by the Notary Public Office)#

   - Cancellation of Residence of the deceased (if the deceased is a Mainland citizen)

   - Proof of Hong Kong ID Card Cancellation (if the deceased is Hong Kong ID Card Holder)

• If death occurs overseas (i.e. outside Hong Kong and Mainland)

   - Proof of Hong Kong ID Cancellation (for Hong Kong ID Card Holder)

   - If the proof or report is not in Chinese or English, please provide an official Chinese or English translation

You may submit the claim via your insurance intermediary or pass it to us in person or by mail to :

China Pacific Life Insurance (H.K.) Company Limited
Room 1802, 18/F, Lee Garden One, 33 Hysan Avenue, Causeway Bay, Hong Kong

If your have any questions or difficulties during the claim process, you can:

Email us: wecare@cpiclife.com.hk
(Hong Kong) Customer Service Hotline: (852) 3169 5500 br (Mainland) Customer Service Hotline: 95500

Our dedicated Customer Service Ambassador will be there to help.

Important notes:
#We shall return the original documents to you after verification.
We reserve the right to request for further information or waive a required document.

• Complete Critical Illness Benefit Claim Form (to be completed by claimant); and
• Select the relevant Critical Illness Questionnaire for completion by the attending doctor (at claimant's own cost)

   - Cancer Questionnaire

   - Heart Attack Questionnaire

   - Stroke Questionnaire

   - For other Critical Illness Questionnaires, please contact our Customer Service Hotline at (852) 3169 5500 or 95500

Basic Documents

• Identity proof copy or Passport copy of the Policy Owner and the Insured (if no precedent record with our company)
• All relevant laboratory/medical reports including pathological report and coronary angiogram (if any)

Additional Documents May Be Required

• If the Critical Illness is diagnosed in Mainland

   - Diagnosis proof from Designated hospitals of the Company and Hospitals which are officially classified as Grade III public hospitals by the People's Republic
of China

• If the Critical Illness is diagnosed outside Hong Kong and Mainland

   - If the medical document or report is not in Chinese or English, please provide an official Chinese or English translation

You may submit the claim via your insurance intermediary or pass it to us in person or by mail to :

China Pacific Life Insurance (H.K.) Company Limited
Room 1802, 18/F, Lee Garden One, 33 Hysan Avenue, Causeway Bay, Hong Kong

If you have any questions or difficulties during the claim process, you can:

Email us: wecare@cpiclife.com.hk
Call us: (852) 3169 5500 or 95500

Our dedicated Customer Experience Ambassador will be there to help Please note that we reserve the right to ask for additional information deemed necessary.