(852) 3427 3847
service@gf-inf.com
荃灣灰窑角街24-32 號 美德大廈8樓I室
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荃灣灰窑角街24-32 號 美德大廈8樓I室
(852) 3427 3847
service@gf-inf.com
Financial Needs Analysis Form
Section 1: Personal Details
(
*
optional field)
第一部分: 基本資料
(
*
選擇性填上)
Policyowner Personal Particulars
投保人個人資料
English Name (英文名稱):
Chinese Name (中文名稱):
Title (稱謂):
Select Title
Mr. 先生
Miss 小姐
Date of Birth (出生日期):
Nationality (國籍):
Smoker Status (吸煙者狀態):
Select Status
Non-smoker 非吸煙者
Smoker 吸煙者
Identity Card No. (身份證號碼):
ID Document Type (證件類型):
Select Document Type
HKID 香港身份證
PRC ID 中國大陸身份證
Passport 護照
Other 其他
Other ID Document Type (其他證件類型):
Country of Birth (出生地點):
Country of Tax Residence (稅務居住地):
Mobile Tel. No. (手提電話號碼):
Home Tel. No. (住宅電話號碼):
Office Tel. No. (辦公室電話號碼):
Email Address (電郵地址):
Marital Status (婚姻狀況):
Select Marital Status
Single 未婚
Married 已婚
Divorced 離婚
Widowed 喪偶
Residential Address (住宅地址):
Correspondence Address (通訊地址):
Education Level (教育程度):
Select Education Level
Primary Level or below 小學或以下程度
Secondary 中學
Non-degree Tertiary 非學位高等教育
University Degree or above 大學學位或以上
Employment Status (就業狀況):
Select Employment Status
Full-time employed 全職工作
Part-time employed 兼職工作
Self-Employed 自僱
Unemployed 沒有就業
Position (職位):
Industry (行業):
Policyowner Family Situation
投保人家庭狀況
Number of Dependents (需要供養人數目):
Policyowner Intended Retirement Age
投保人預期退休年齡
Retirement Age (退休年齡):
Select Retirement Age
65 years old 歲
Others 其他
Retired 已退休
Other Retirement Age (其他退休年齡):
Insured Personal Particulars
受保人個人資料
English Name (英文名稱):
Chinese Name (中文名稱):
Title (稱謂):
Select Title
Mr. 先生
Miss 小姐
Date of Birth (出生日期):
Nationality (國籍):
Smoker Status (吸煙者狀態):
Select Status
Non-smoker 非吸煙者
Smoker 吸煙者
Position (職位):
Relationship with Policyowner (與投保人關係):
Insured Existing Coverage
受保人已有保障
Insured Existing Coverage 受保人已有保障
Sum Insured 總保額 (HKD 港幣)
Life Insurance 人壽保險
Critical Illness Insurance 危疾保險
Accidental Insurance 意外保險
Medical Insurance 醫療保險 (Type 種類)
Other Existing Coverage 其他現有保障 (Please specify details 請註明詳情)
Financial Information
財務資料
Estimated Monthly Surplus / (Deficit)
估計每月剩餘/ (超支)
Estimated Monthly Surplus / (Deficit) 估計每月剩餘 / (超支)
Amount 金額 (HKD 港幣)
(A) Average Monthly Incomes of past 2 years 過去 2 年的平均每月收入
Salary / Commission / Bonus 薪金 / 佣金 / 花紅
Rental Income 租金收入
Other Incomes 其他收入
Total Average Monthly Incomes 每月總平均收入(A)
(B) Average Monthly Expenses of past 2 years 過去 2 年的平均每月支出
Personal & Household Expenses 個人及家庭開支
Mortgages / Loans Repayment 按揭 / 借貸還款
Insurance 保險
Other Expenses 其他支出
Total Average Monthly Expenses 每月總平均支出(B)
Estimated Disposal Monthly Income 估計每月可動用收入 (A) – (B)
Assets 資產
Amount 金額 (HKD 港幣)
(C) Liquid Assets 流動資產
Cash & Deposit 現金及存款
Current Investment / 投資 (e.g., Listed Equities or Bonds 例如：上市股票或債券)
Other Liquid Assets 其他流動資產
Total Liquid Assets 流動資產總額 (C)
(D) Short Term Liabilities 短期負債
Personal or card loan / bank overdraft, etc 個人貸款或信用卡貸款 / 銀行透支等
Insurance Policies existing premium financing 保險政策現有保費融資
Total Short Term Liabilities 短期負債總額 (D)
Estimated Net Liquid Assets 估計淨流動資產 (C) - (D)
(E) Non-Liquid Assets 非流動資產
Properties 物業
Other Non-Liquid Assets 其他非流動資產 (e.g., Company Shares 例如：公司股份)
Total Non-Liquid Assets 非流動資產總額 (E)
(F) Long Term Liabilities 長期負債
Mortgage Loans 抵押貸款
Personal / Credit Card Loans 個人/信用卡貸款
Other Liabilities 其他負債
Total Liabilities 負債總額 (F)
Estimated Net Non-Liquid Assets 估計淨非流動資產 (E) – (F)
Section 2: Financial Needs Analysis
第二部分: 財務需要分析
1. What are your objectives for seeking to purchase an insurance product? (tick one or more)
A. Financial protection against adversities (e.g. death, accident, disability etc.)
為應付不時之需提供財務保障（如身故、意外、殘疾等）
B. Preparation for health care needs (e.g. critical illness, hospitalization etc.)
為應付醫療保健需要（如危疾、住院等）
C. Providing regular income in the future (e.g. retirement income etc.)
為未來提供定期的收入 (例如: 退休收入等)
D. Saving up for the future (e.g. child education, retirement etc.)
為未來需要作儲蓄（如兒童教育、退休等）
E. Investment
投資
F. Others (please specify)
其他（請註明）
2. If "Investment" (answer E) is chosen as one of the objectives in Q1 above, to meet your "Investment" objective, how would you prefer to manage different investment options/investment choices, if available, under the insurance product? (tick one)
如在上述問題中選擇「投資」(答案 E) 作為目標之一，為實現上述「投資」的目標，閣下希望如何管理保險產品項下的不同投資選項／投資選擇（如有）？（勾選一項）
I want to make my own decisions (without any professional advice to be provided by the authorized insurer and/or licensed insurance intermediaries) to choose and manage different investment options/investment choices, if available, under an insurance product, and I am willing to do it throughout the entire duration of the target benefit/protection period of an insurance product
本人願意按個人決定（毋須獲授權保險人及／或持牌保險中介人提供任何專業意見的情況）選擇及管理保險產品項下的不同投資選項／投 資選擇（如有），並且願意在保險產品的目標利益／保障期的整個期間作出此決定。
I want to make my own decisions (with professional advice to be provided by the authorized insurer and/or licensed insurance intermediaries) to choose and manage different investment options/investment choices, if available, under an insurance product, and I am willing to do it throughout the entire duration of the target benefit/protection period of an insurance product
本人願意按個人決定（經獲授權保險人及／或持牌保險中介人提供專業意見的情況）選擇及管理保險產品項下的不同投資選項／投資選擇如有），並且願意在保險產品的目標利益／保障期的整個期間作出此決定。
I do not want to choose or manage different investment options/investment choices, if available, under an insurance product
本人不願意選擇或管理保險產品項下的不同投資選項／投資選擇（如有）。
3. If you are considering critical illness and/or medical insurance product(s) to meet your objectives in Q1 above, what type(s) of the following critical illness and/or medical insurance product(s) will you consider to purchase? (Please choose one or more)
如閣下有意考慮以危疾及/或醫療保險產品迎合閣下上述問題1的目標，閣下會考慮投保以下哪種類型的危疾及/或醫療保險產品? (可選擇一項或多項)
A. Product providing income subsidy during hospital confinement (Please also complete 'Medical Insurance Needs Assessment')
住院期間的現金津貼的產品 (並請完成'醫療保險需要分析')
B. Product reimburse medical expense for hospital confinement (Please also complete 'Medical Insurance Needs Assessment')
實報實銷住院期間醫療費用的產品 (並請完成'醫療保險需要分析')
C. Product paying a pre-defined amount of living benefit upon confirming specific conditions or undergoing certain treatments
在確認指定情況或接受特定治療後，支付預定的生存賠償金額的產品
D. Otherss, Please specify 其他，請說明 :
4. What is your target benefit/protection period/expected timeframe for meeting the target amount for insurance policy? (tick one)
閣下的保單目標利益／保障期／實現目標金額的預期時間為？（勾選一項）
A. < 1 year 少於 1 年
B. 1-5 years 1-5 年
C. 6-10 years 6-10 年
D. 11-15 years 11-15 年
E. 16-20 years 16-20 年
F. > 20 years 超過 20 年
G. Whole of life 終身
5. Upon the existing insurance protection plan owned, what is your target extra benefit/protection/saving amount? (can choose more than one)
除閣下現時擁有的保險計劃之外，閣下想增加的保險金額/儲蓄金額是？(可選擇多於一項)
Life Protection 人壽保障
Critical Illness Protection 危疾保障
Regular Income 定期收入 (every year start from 每年開始由
age / after year 年歲 / 年期後)
Saving 儲蓄 (on 到
age / years 年歲 / 年期)
Others 其他 (
)
Others 其他 (
)
6. Your ability and willingness to pay insurance premiums:
閣下繳付保費的能力及意願：
(a) What maximum percentage of your monthly disposable income (i.e. after deducting all expenditures) from all sources (including income from liquid assets) would you be able and willing to use to pay for the insurance premium (including your existing insurance policy(ies)) throughout the entire term of the insurance policy?
在整個保單期內，閣下能夠及願意繳付的保費（包括閣下現有的其他保單）佔透過所有收入來源（包括流動資產收入）獲得的每月可動用收入（即經扣除開支）的最高比率為？
(Remark : Disposal Monthly Income = Average Monthly Income - Average Monthly Expenditure)
(註：每月可動用收入 = 每月平均收入 – 每月平均開支)
If it is over 50%, please explain the reason 如果比例超過百分之50，請解釋或註明原因
(b) What maximum percentage of net liquid assets (i.e. after deducting all short term liabilities and exisitng insurance policies premium financing, if any) would you be able and willing to use to pay for the insurance premium (including your existing insurance policy(ies)) throughout the entire term of the insurance policy?
在整個保單期內，閣下能夠及願意繳付的保費（包括閣下現有的其他保單）佔閣下現有的淨流動資產（包括扣除所有短期負債及現有保單貸款(如有)）的最高比率為？
(Remark : Net Liquid Assets = Liquid Assets - Short Term Liabilities)
(註：淨流動資產 = 流動資產 – 短期負債)
If it is over 50%, please explain the reason 如果比例超過百分之50，請解釋或註明原因
7. How long are you able and willing to pay for an insurance policy?
閣下能夠及願意繳付保單多長時間？
Basic Plan 基本計劃 Years not exceed 年期不超過 :
year(s)年
Whole of life 終身
A single pyt of not more than 一次性付款不超過
Rider Plan, if any 附加保障(如有)
year(s)年
Whole of life 終身
8. If the installment period is beyond the Intended Retirement Age, please specific the affordable for continuous payment
如供款年期超過預期退休年齡，請說明可以持續供款的原因
The premium can be paid by the retirement saving according to the actual need during retirement.
保費會根據退休時的實際需要，由退休儲蓄金支付。
Others 其他
9. Will you intend to use 'Premium Financing' to arrange the policy?
閣下是否打算運用'保費融資'安排此保單？
Yes 是
No 否
If yes, please complete the premium financing arrangement analysis form (attached sheet)
如答案是'有'，請填上保費融資安排分析(另頁)。
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