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Applicant’s health condition declaration
Have you ever applied for life insurance, or health insurance, or COVID - 19 related insurance with other insurance companies?
Have you traveled to COVID - 19 high-risk countries in the past 14 days?
Have you ever been rejected from life or health or a critical illness insurance application; or have been rejected from renewal of insurance, or been added exclusions?
Do you have any sickness that you noticed or identified by a physician related to blood circulation, liver disease, kidney disease, diabetes, epilepsy, AIDS, blood diseases, brain disease, cancer, lung disease, bone and muscle disorder, digestive system disorder, or others.
Tax Deduction Request
Would you like to claim for personal income tax deduction with this health insurance premium?
Would like to get the policy via
Insurance Terms and Conditions
I, the applicant declares that above statements in this application form are true. Should there be any false statement, the agreement will be voidable.
I, the applicant, authorize the company to file, use, and disclose my medical and personal information to the Office of Insurance Commission for the purposes of the Insurance industry supervision.
Under the objectives of insurance application, insurance policy issuance and insurance policy management, including other purposes related to the insurance application, I hereby agree and give my consent to the Company to:
1. To collect, use and disclose my personal data which contain or include sensitive personal data as specified in the agreed purposes.
2. To send and transfer my consent to the medical networking and/or medical practitioners e.g. clinics, hospitals, community healthcare centers, physicians, nurses and/or related persons, to disclose my personal data and the related sensitive personal data. This aims to benefit my insurance application, the insurance underwriting and/or insurance claims, subject to the insurance terms and conditions thereof.
I, therefore, have read and understood all the mentioned details and well acknowledged of the detailed personal data policy as given below, and have had a clear intention with my consent given to the Company for collecting, using, processing and disclosing my personal data for proceeding by the Company as mentioned above.
Tune Insurance Public Company Limited (“Tune”) is aware of our responsibilities to handle your
personal data and protect your personal data with care. We, Tune, would like to inform and explain
the purpose and reasons, how and when we collect and use your information with the following;
Part 1: What personal data do we collect?
Tune will collect, use, process and disclose your personal data below;
1.Your personal data such as name-surname, gender, date of birth, age, nationality, marital
status, address, telephone number, email, identity card number, passport number, work permit
2.Contact details including IP address.
3.Any relevant personal data such as your family members, beneficiary, payee, policy holder,
4.Any contact information between you and Tune, either from telephone, letter, email or
5.Your personal sensitive data such as health data, medical history, religious, genetic,
disability, ethic origin.
6.Your health information such as health/ medical history, medical consultant, medical
record, health questionnaire.
7.Your financial or source of income and any sources from financial need analysis.
8.Your information for performing ‘Know Your Customer’ (KYC) or due diligence.
9.Your payment information related to premium payment or claims payment .
10.Your information from the private agency or government agency or regulator such as the
Office of Insurance Commission, The Anti-Money Laundering Office.
Part 2: What do we use your personal data for?
We will use, collect, process and/or disclose your personal data with the following purpose;
1.To consider an application for an insurance policy, assess and evaluate and underwrite
your application including insurance administration.
2.To provide any information about our products and services.
3.To administer your policy such as policy changes, renewal, policy cancellation or premium
payment or any payment related to your policy.
4.To manage and administer the company’s operation under regulation requirement and
5.To conduct due diligence and know your customer base on underwriting guideline process.
6.To perform internal audit or on-site audit from the regulator.
7.To manage your personal data on our IT system to align with the information security
8.To provide and offer our products and services, marketing campaign and promotions which
may suit you.
9.To comply with the applicable laws and regulations.
10.To deal with your request or inquiries.
11.To handle any complaints, suggestions in relation to your insurance policy or your
Part 3: Who do we share your personal data with?
From the above purpose, we do share your personal data with the following parties;
1.Our service provider and consultant such as third-party administrators, loss adjuster and
claims expert, assistance providers, lawyer, fund manager, IT services.
2.Your families, upon request from you or allowed by you.
4.Our business partners or our agents/brokers for offering our products and services or
provide any assistance to you.
Part 4: How long do we keep your personal data?
We will retain your personal data for as long as is reasonably necessary for the purpose in Part 2
and our record retention policy. In some circumstances we may retain your personal data for longer
periods of time, for instance where we are required to do so in accordance with legal, regulator,
tax or accounting requirements. Where your personal data is no longer required, we will ensure it is
either securely deleted or stored in a way it no longer be used by the business.
Part 5: Your personal sensitive data
We may collect, use, process and disclose your personal sensitive data after we received your
explicit consent except the legislation allows us to use your personal sensitive data without your
consent. We only process your sensitive personal data for the insurance application purpose which
stated in Part 2
Part 6: Your Cookies
Tune may record your actions or history when you visit our website to enhance your experience and
ability to reconnect between Tune and you. You can click ‘Accept Cookies’ to allow us to collect
your consent and cookies.
Part 7: What is your right?
Under Personal Data Protection Act, you have the rights detailed below;
1.Right to Withdraw the Consent
You have the right to withdraw your prior consent except that the withdrawal impacts the
insurance policy administration or claims.
2.Right of Access
You have the right to access and request us to confirm whether we are processing your
personal data or giving you a copy of your personal data.
3.Right to Data Portability
You have right to data portability and request us to provide your personal data to you
in structure commonly used to us or another data controller, but in each case, only
where; the processing is based on your consent or the performance of a contract with you
or the provision or porting would not violate the rights and freedoms of Tune or other
4.Right to Object
You can object to any processing of your personal data which has our legitimate interest
as the legal basis if you believe your fundamental rights and freedom outweigh our
5.Right to Erasure
You can ask Tune to ease your personal data but only where it has been processed
unlawfully or it is no longer needed for the purposes for which it was collected.
6.Right to Restrict Processing
You can ask Tune to restrict your personal data, but only where its accuracy is
contested, to allow us to verify its accuracy or the processing is unlawful, but you do
not want it erased.
7.Right to Rectification
You can ask Tune to rectify inaccurate personal data or may seek to verify the accuracy
of the data before ratifying it.
8.Right to Complaint
You have the right to complain if we have proceeded your data illegally or our data
processor breach the regulations
the Data Protection Officer (‘DPO’),
Tune Insurance at
3199 Maleenon Tower, 14th Floor, Rama IV RD, Khlong Ton, Khlong Toei, Bangkok, 10110