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Claim Enquiry Form

You are encouraged to contact and negotiate with the financial institution (“FI”) concerned for settling a dispute first. Failing which, you may consider lodging an application for mediation service with the Financial Dispute Resolution Centre (“FDRC”). We will facilitate you to resolve your dispute with the FI by way of “Mediation First, Arbitration Next”. Prior to formal submission of your application, you may fill in this Claim Enquiry Form (“Form”) for our preliminary processing. For enquiries, please call: (852)3199 5199.

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Personal Information

Mandatory fields are marked with an asterisk (*)

Identity *

Title *

Name *

Correspondence Address *

Daytime Phone *

Country code

Phone number

Phone (Other)

Country code

Phone number

Email Address *

Claim Information

Mandatory fields are marked with an asterisk (*)

Name of the FI *

The date on which you first had knowledge of suffering the monetary loss *

Name of the financial product(s) involved *

Amount claimed (HK$) *

Summary of the case/dispute *

Attach supporting document(s)

Have you lodged a written complaint with the FI? *

Has the FI responded to your complaint in writing? *

Have you taken any court action on the dispute? *

Have you lodged a complaint with the Insurance Claims Complaints Bureau (“ICCB”) ? *

Through which channel did you first learn about FDRC? *

Information Collection Statement

Financial Dispute Resolution Centre (“FDRC”)
Personal Information Collection Statement (“PICS”)

The FDRC respects your privacy rights when collecting, storing, using and transferring your personal data, and is committed to ensuring that the processing of all relevant personal data is in compliance with the data protection principles and all relevant provisions of the Personal Data (Privacy) Ordinance, Chapter 486 of the laws of Hong Kong Special Administrative Region (the “Ordinance”). Please read carefully below to learn about the FDRC’s policies and practices on the processing of your personal data. If the FDRC deems it necessary, the relevant policies and practices may be amended or otherwise altered from time to time as appropriate.

1. The Use of Your Personal Data

The provision of your personal data in this Form is voluntary. If you do not provide sufficient information, the FDRC may not be able to provide assistance to you.

Personal data provided by you in this Form will be used by the FDRC solely for the purposes of handling your claim enquiry.

The information in this Form may also be used for the compilation of statistics on enquiries or claims received by the FDRC for research or educational purposes. The outcome of the resulting statistics will not be published in a form that will identify you or disclose your personal data.

2. Disclosure

Please note that the FDRC may transfer your personal data to the related parties who will be contacted by us during the handling of this claim enquiry including the related FI and/or other parties concerned. The personal data collected by the FDRC in the performance of its functions may be disclosed to agencies who are authorised to receive information relating to law enforcement, prosecution and review of decisions.

3. Security

The right to access to your personal data is restricted to the FDRC’s authorised staff and will only be processed in accordance with the relevant provisions of this statement.

4. Access to or Correction of Your Data

In accordance with the Ordinance, you have the right to request access to or correction of your personal data held by the FDRC.

You should make your access request by completing the Data Access Request Form (available at the website and Reception Counter of the FDRC) and submitted to the FDRC’s Data Protection Officer at Room 408-409, 4/F, West Wing, Justice Place, 11 Ice House Street, Central, Hong Kong by post or via email to fdrc@fdrc.org.hk.

5. Retention of Data

The FDRC will not keep your personal data longer than is necessary for the fulfillment of the purposes for which your personal data is or is to be used. The FDRC also may retain any personal data for statistical purposes or destroy such data which is no longer required.

You may browse our website for our Privacy Policy Statement.

I have read, understand and agree with the PICS of the FDRC.

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Please click "SUBMIT" button and wait for a while for our system to process your Form.