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Microchip Submission

  1. Statement Pursuant to Section 25(5) of the Insurance Act. You are to disclose on this Proposal Form fully and faithfully all the facts which you know or ought to know, otherwise the policy issued hereunder may be voided.
  2. Please contact our Customer Service Officers at our Contact Centre Hotline: 6461 6222 from Mondays to Fridays, 9.00am to 5.00pm or email to [email protected] should you require further assistance.


Declaration

  1. I am aware of and agree to abide by the policy terms, conditions and exclusions and confirm that the information given in this application/form is true, accurate and complete.
  2. I acknowledge and agree that CIMB Bank Berhad, Singapore Branch (“CIMB”) and Sompo Insurance Singapore Pte. Ltd. (“Sompo”) may collect, use, disclose and/or process my personal data in accordance with the Personal Data Protection Act 2012 for the purposes and uses described in CIMB’s Terms and Conditions Governing Personal Data Protection Act (PDPA) 2012 (“PDPA T&C”) and Sompo’s Privacy Policy (including the provision of protection, services related to this insurance policy, screening activities in accordance with legal/regulatory obligations/risk management procedures). This may include disclosure to CIMB and Sompo’s business partners, intermediaries, third party service providers and industry associations. CIMB’s PDPA T&C can be found at www.cimbbank.com.sg. Sompo’s Privacy Policy can be found at www.sompo.com.sg.
  3. I consent to receive marketing, advertising and promotional information about products and services that CIMB, Sompo and/or their respective affiliates, business partners and related corporations may be offering and which CIMB or Sompo believes may be of interest or benefit to me by way of postal mail, electronic transmission to my email address(es) provided to CIMB and/or Sompo, and/or voice/phone call or SMS/MMS (text messages) to my telephone number(s) provided to CIMB and/or Sompo.
    4. Note: Regardless that you do not agree to the above, please note that CIMB and Sompo reserve the right to send a specified fax message (as defined in The Personal Data Protection (Exemption from Section 43) Order 2013) (the “Exemption Order”) and/or a specified text message (as defined in the Exemption Order) (i.e. a marketing fax message or a marketing text message) to your Singapore telephone number, if there is an ongoing relationship between CIMB or Sompo and you and the purpose of the message is related to the subject of the ongoing relationship, pursuant to the requirements and conditions of the Exemption Order.
  4. I understand that I can withdraw, manage my consent to receive marketing, advertising and promotional information from CIMB at www.cimbbank.com.sg and/or from Sompo at www.sompo.com.sg, specifically, if I no longer wish to receive marketing, advertising and promotional information from CIMB, I may withdraw my consent by filling up the following form at www.cimbbank.com.sg/content/dam/cimbsingapore/personal/accounts/forms/form-pdpacustomer-withdrawal.pdf or by calling CIMB At-Your-Service Hotline. And if I no longer wish to receive marketing, advertising and promotional information from Sompo, I may withdraw my consent by filling up the following form at www.sompo.com.sg/marketingconsent.
    5. For the avoidance of doubt, any withdrawal of consent must be made from CIMB and Sompo separately. Withdrawal of consent from CIMB shall not be deemed to apply to Sompo and vice versa.

I agree to the declaration


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