Authorization and Consent of Third Party Intermediary

I hereby give my consent, authorize, and acknowledge by my signature below that I have read and agree to all of the terms and conditions.

A )Third Party Intermediary

Name of Authorized Third Party Intermediary:
B )Release and Share of Information

The proposer understand, acknowledge, and agree to share the following information between Sun Flower Insurance Brokers Limited (hereinafter referred as “Sun Flower”) and the Third Party Intermediary (hereinafter referred as “TPI”) In consideration of the mutual covenants and conditions herein, to induce the parties hereto to provide certain information to each other and for other good and valuable consideration,

  • )All correspondence(s) including Insurance Quotation and Placing, Application Form & all relevant documents, Policy Document(s), Claims Documents, Personal &/or Company Data(s).
  • )All relevant documents and information of current policies, renewal notices, claims documents, Personal &/or Company Data(s), etc.
Sun Flower Insurance Brokers Limited is committed to ensuring the privacy and security of the personal data it holds. We aim to meet this commitment by implementing the principles and requirements of the Personal Data (Privacy) Ordinance of the HKSAR. By voluntarily choosing to provide your personal information to us, you are permitting Sun Flower Insurance Brokers Limited to store, maintain, process and use this information in accordance with this statement, for purposes such as sending information in regard to our products and services, events, promotions and other activities which may be of interest to you. It is entirely voluntary for you to provide your personal information. However, failure to do so may result in our inability to process your requests fully and to provide facilities and services. Personal data supplied to Sun Flower Insurance Brokers Limited will be kept confidential and are accessible only to staff providing services to you. We will also take all reasonably practicable steps to erase your personal data that are no longer required for the purposes for which the data were originally collected. You are entitled to request access to and correction of your personal information, and to review the privacy policy of Sun Flower Insurance Brokers Limited by contacting us.
C )Declaration before arrangement of insurance policy

The proposer understands, acknowledge, and agree in addition to complying with the policies, procedures or requirements relating to third party intermediaries that any licensed insurance broker company has in place, before Sun Flower arrange an insurance policy for you, Sun Flower has the responsibility to information you that:

  • )the broker will be responsible for arranging the insurance policy and, for this purpose, the client should only deal directly with the broker (i.e. the client should not deal with the TPI for arranging the insurance policy);
  • )The TPI does not represent the broker and should have no involvement in the arrangement of the insurance policy;
  • )the broker disclaims all liability for any advice in relation to the insurance policy given to the client by the referrer; and
  • )premium for the insurance policy should be paid directly either to the broker or the insurer concerned (and not to the TPI)
D )Remuneration:

The Proposer acknowledge and understand that Sun Flower and other entities within the Sun Flower Group may earn and retain remuneration in connection with insurance which we place for you.  

  • )Where Sun Flower is remunerated by commission, the following provision shall apply in respect of insurance transactions undertaken pursuant to these Terms of Business. 
  • )Sun Flower is remunerated for its services by the receipt of commission paid by insurers. Your agreement to proceed with this insurance transaction shall constitute your consent to the receipt of commission by Sun Flower.   
  • )Remuneration to Sun Flower may include commissions paid by insurers based upon factors such as premium volume, underwriting profitability, administrative expense reimbursements and/or fees.  
  • )Sun Flower may also charge you fees for placing the insurance for you. Any such fees will be contained in the quotation slip provided to you in respect of the relevant placement.   
  • )If you have any queries or require further details in relation to any aspect of our remuneration, please contact your Sun Flower Technical Representative at any time.
E )No Sun Flower Third Party Liability:

The proposer understands, acknowledge, and agree if, at the proposer request, an intermediary that is not affiliated with Sun Flower is also used in any way in arranging any insurance you agree as follows: 

  • )Sun Flower has no liability for any failure or refusal by that intermediary to disclose any remuneration; 
  • )Sun Flower has no liability for any act, error or omission by that intermediary or its directors or officers; and 
  • )remuneration earned by that intermediary is separate from and in addition to remuneration earned by any Sun Flower entity.  
This letter of authorization is valid with immediate effect unless instructed otherwise.

The Proposer (Insured / Policyholder) Authorized Signature
(With Company Chop if applicable)

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Date ( dd / mm / yyyy )

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