| Adjudication for Claim-related Complaints | Processing of Claim-related Complaints Flow Chart

Processing of Claim-related Complaints Flow Chart

  1. Any Claim-related Complaint received by the ICB shall be screened by the Case Manager who must first be satisfied that there is some substance in the Complaint, and that the Complaint falls within the Terms of Reference of the ICB. 

  2. The ICB shall refer the Claim-related Complaint to the Member for a reply. Unless the Member settles the Complaint, or the Complaint is determined to be groundless at this stage, the ICB shall pass the Complaint to three Honorary Secretaries for their opinions in accordance with the rules, practice and procedures regarding the handling of Complaints determined by the Complaints Panel and Article 89 of the Articles of Association of the ICB. 

  3. Following receipt of the advisory reports from the Honorary Secretaries in relation to any Complaint, the ICB shall refer any recommendation for settlement to the Member for reconsideration. Unless the Member settles the Complaint at this stage, the ICB shall pass the Complaint together with the advisory reports of the Honorary Secretaries to the Complaints Panel for final determination. 

  4. Following any meeting or hearing of a Complaint, the Complaints Panel may upon resolution by the members of the Complaints Panel facilitate the satisfactory settlement or withdrawal of the Complaint by making an Award against the Member against whom the Complaint is made, or making a recommendation, or dismissing the Complaint.


Claim-related Complaints Handling Flow Chart
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