| Lodging a Complaint | Terms of Reference

Terms of Reference


  1. The complaint is of a monetary nature.

  2. The claim amount/monetary value of the complaints does not exceed HK$1,200,000 * .

  3. The insurer concerned is a Member of the ICB.

  4. The policy concerned is a personal insurance contract.

  5. The complaint is filed by a policyholder, a policy beneficiary, an insured person or a rightful claimant.

  6. The insurer concerned has made its final decision on the claim/dispute.

  7. The complaint is filed with the ICB within six months from the day of notification by the insurer of its final decision.

  8. The complaint in question does not arise from industrial, commercial or third party insurance.

  9. The complaint is not subject to legal proceedings or arbitration.


For Non-claim related complaints:

  1. The non-claim related complaint is not about quality of service or an underwriting decision of an insurer.

  2. The non-claim related complaint is not related to investment performance, level of a fee, premium, charge or interest rate unless the dispute concerns an alleged non-disclosure, misrepresentation, incorrect application, negligence, breach of any legal obligation or duty or maladministration on the part of an insurer.

*  
If an insured holds multiple policies, the aggregate amount of the individual claims involved should not exceed HK$1,200,000 should the causes of the claim rejection be identical or similar. As regards long-tail and periodic claims, the total claim amount, calculated up to a period of five years, should not exceed HK$1,200,000.

 

 

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