Date
19 November 2017
Different insurers may write similar policies but they differ in certain gray areas, according to an industry expert. Photo: carehelp.org
Different insurers may write similar policies but they differ in certain gray areas, according to an industry expert. Photo: carehelp.org

Insurance complaints up 13% in 2014

Insurance complaints rose 13 percent in 2014 from the preceding year, mostly involving travel, hospitalization and medical coverage.

More than half of the 603 cases were settled, 10 percent in favor of claimants, am730 reported Tuesday, citing the Insurance Claims Complaints Bureau (ICCB).

Insurance companies won the bulk of the 344 complaints that were decided while 68 claims were mutually resolved between insurers and complainants, the report said. 

ICCB threw out 184 complaints for lack of evidence, or about half of all resolved cases, and upheld decisions in 41 cases.

Chairman Michael Tsui said consumers should check with their insurers whether any medical procedure or high-risk activity they undertake is covered by their policy to avoid disputes in the future.

He cited an example wherein an insurer rejected compensation for a knee injury because the complainant already had been paid in a previous claim.

The panel ruled in favor of the complainant, saying the two claims should have been treated separately being two years apart.

The complainant was awarded HK$71,000 (US$9,155).

In another case, an insurer refused to pay compensation to a 68-year-old man who had to undergo emergency brain surgery during a trip to Australia, saying he had bought travel insurance only and did not disclose any pre-existing medical condition.

ICCB ruled the insurer did not require such disclosure and awarded the complainant HK$310,000.

Charity Au, chairperson of the Life Insurance Council of The Hong Kong Federation of Insurers, said different insurers may write similar policies but they differ in certain gray areas.

She said consumers should compare the terms of different policies before buying insurance.

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EL/AC/RA

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