Tips on buying insurance
Choosing an insurance product
You should carefully examine your insurance needs and budget to choose an insurance product that suits you in terms of coverage, sum insured, and premium and risk level. An insurance policy is a contract between you and the insurer. You should be aware of your duties (e.g. accurate disclosure of material facts) and rights (e.g. making claims and cancelling during the cooling-off period) under the contract. Read the publication titled Tips on buying insurance and consult your insurer or insurance intermediary if you have any questions.
Changes in the stages of your life affect your risk exposure and responsibilities. To choose a policy that suits your needs, you should, in general, identify your protection needs and objectives according to your current life stage. You can use the assessment tool on this website to find out whether your existing insurance coverage is adequate for your circumstances and forecast your insurance needs for the next 50 years.
No. Insurance is a risk transfer tool, whereby you transfer part of your risks associated with an accident or illness, for example, to an insurer to reduce your potential financial burden should things go wrong. Therefore, you should not focus on comparing claims payments with premiums paid. Instead, consider whether you could afford the expenses that you will incur if you do experience an unexpected accident or illness, and evaluate whether your existing coverage suits your protection needs.
No. Everyone has their own path on their life journey with their own circumstances and financial situation, so everyone has different insurance needs. Furthermore, some insurance products, like medical insurance, work on a reimbursement basis. You cannot claim more than the amount actually paid even if you are covered by a number of insurance policies or a policy with a huge sum insured. And the more policies you have and the higher the amount insured, the higher the premiums you will have to pay. Be sure you do not end up with financial problems because of taking out too many policies. Before choosing an insurance product that suits you in terms of coverage, sum insured, premium level and risk level, identify your protection needs according to your current life stage by making reference to one of the following sections:
Childhood and adolescence
Young adulthood
Mature adulthood
Raising a family
Pre-retirement
Childhood and adolescence
Young adulthood
Mature adulthood
Raising a family
Pre-retirement
Applying for insurance
It depends. You can buy insurance for a person only if there are “insurable interests” in your relationship. Insurable interests exist if you would have a provable financial loss if the covered events happened to the insured person. To prevent moral hazard, insurable interest is often related to relationships by law, blood or possession. In other words, you can buy insurance only on behalf of a family member or spouse.
Your health condition and history are crucial factors in underwriting. You must actively and honestly disclose all critical information to the insurer. The insurer can then reasonably assess the risk based on the disclosed information. The insurer may reject claims on the ground of non-disclosure or misrepresentation of material facts if you have failed to disclose this kind of information. To clearly specify the information that needs to be disclosed, the industry issued a document titled Best Practice on Standardizing Underwriting Questionnaire for Individual Indemnity Hospital Insurance Plans. Insurers are encouraged to adopt a standardised underwriting questionnaire. For details, visit the Hong Kong Federation of Insurers’ website.
Medical examinations are often used as an underwriting tool for life insurance with a huge sum insured, critical illness or medical insurance. However, not all insurers require every insured individual to undergo a medical examination. They will make the request based on the conditions and circumstances of the applicant. But whether or not you are required to undergo a medical examination, you are still obliged to disclose your health condition and history actively and honestly. The insurer can then reasonably assess the risk based on the disclosed information.
No. Some insurance policies use the term ‘guaranteed renewal’, which means the insurer guarantees policy renewal regardless of the health condition and claims record of the insured person, according to the policy terms. But guaranteed renewal does not mean the terms and conditions of the renewed policy will remain unchanged. The insurer has the right to adjust the premium level depending on the age of the insured person, inflation and other factors. If a product is no longer available in the market, the insurer will not accept a renewal for the product concerned. You should evaluate whether you have to adjust your insurance portfolio once the policy term ends according to your latest personal circumstances.
You should first recognize which insurance products allow online self-service. Insurance products that can be purchased online without going through an insurance intermediary involve mainly short-term contracts, which are simple and have a high protection element, such as travel insurance, home insurance and term life insurance. If you are interested in insurance products with long-term contracts, investment elements and complex structures, such as investment-linked assurance scheme (ILAS) products, you must meet with an insurance intermediary and undergo a financial needs analysis before you can be insured. Some insurers have launched virtual onboarding services via video conference in a pilot run to conduct non-face-to-face sales. Insurance intermediaries can conduct video conferences with policyholders to analyse their financial needs and complete the entire application process. To choose among the two different sales platforms, learn more about the differences between the two and assess your understanding of the desired product and your expectations of after-sales service, etc. For details, refer to the Insurance Digital Onboarding page on the Insurance Authority website.
As no insurance intermediary will be assigned to follow up your application and possible claim payments, you should first assess your personal needs and financial capability on your own, learn more about the policy terms and after-sales service offered by different insurers, and answer the online underwriting questions carefully. If anything is unclear, immediately call the customer service hotline or consult the customer service officer through live chat. Avoid making any decisions in a rush. You should also pay attention to cybersecurity to make sure your personal data is secure and avoid entering a fraudulent website. For details, refer to the Insurance Digital Onboarding page on the Insurance Authority website.
Making claims
In general, you are required to submit the following documents for a death claim:
- Death claim form filled in by the applicant and the attending doctor;
- Original death certificate;
- Copy of the deceased person’s ID card;
- Copy of beneficiary’s ID card, or birth certificate if they are below 18 years old;
- Relationship proof between the deceased and the beneficiary, e.g. marriage certificate and birth certificate;
- For an accidental or unnatural death, a traffic accident report, post-mortem report, coroner’s report or newspaper clippings are required as necessary; and
- For death outside Hong Kong, proof of deregistration of ID card issued by the Immigration Department is required.
Yes. The deadline is normally a specified date from the date the insured event occurred (e.g. death, accident or treatment). For example, the time limit for lodging a medical claim is normally within 30 to 90 days from the date of treatment or discharge from hospital, subject to the relevant clauses on claims application of the policy. You should submit the application forms with the relevant supporting documents to the insurers within the time limit. Insurers have the right to reject your claim if it is submitted after the deadline.
“Reasonable and customary charges” is one of the principles insurers follow when handling medical claims. In general, insurers refer to relevant information from private hospitals and healthcare facilities, as well as medical report and claims statistics, when determining the amount of a claim payment. In other words, if the claimable amount exceeds a “reasonable and customary charge”, the insurer may not offer full reimbursement of the covered items. The insured person will have to pay the shortfall. For more information about making medical insurance claims, refer to a leaflet titled Understanding Medical Insurance – Tips on making claims.
Insurance intermediary services
Insurers will normally arrange for their customer service department or another insurance agent to look after your policy. Some insurers may allow their clients to choose any other agent who is working there. Contact your insurers to ask about the arrangements and get the contact information of your new insurance agent.
Insurance agents can receive payment of premiums only when they are authorized to do so by their appointing insurers and must handle the payment of premium in strict conformity with the requirements set by the insurer. However, to protect your interests, you are recommended to use the official methods specified by the insurer to pay the premium directly to the insurer. If you are going to pay the premium via your insurance agent, DO NOT pay cash or remit a premium to the agent’s personal account. Pay it by a crossed cheque payable to the insurer.
First, check the licence status of the insurance intermediary. The status of all registered intermediaries can be found in the Register of Licensed Insurance Intermediaries on the Insurance Authority (IA)’s website. Second, ask the insurance intermediaries about their scope of service and remuneration and consider if the products they are selling suit your personal needs. Lodge a complaint with the IA about any suspected misconduct or mis-selling practices of intermediaries. To learn more about how to deal with insurance intermediaries, refer to the leaflet titled Understanding the role of insurance intermediaries and policyholders’ interests.
Mainland China visitors buying Hong Kong insurance products
Yes. The entire sales process of an insurance policy issued by a Hong Kong insurer must take place in Hong Kong. You must sign all the relevant documents in person in Hong Kong. Sales activities in the Mainland are not covered by Hong Kong regulations and may breach the relevant laws and regulations in the Mainland. If some part of the solicitation took place in the Mainland, this may have an adverse impact on the effectiveness of your insurance policy and the investigation process related to any disputes arising in the future. To protect your interests, keep a proper record of your travel to Hong Kong and the information obtained during the sales process.
Be suspicious of persons purporting to be licensed insurance intermediaries from Hong Kong who solicit you in the Mainland to buy insurance from a Hong Kong insurer whilst in the Mainland. Such solicitation includes holding product briefing sessions in the Mainland and recommending Hong Kong insurance products in the Mainland through instant messaging applications or social media platforms. Licensed insurance intermediaries in Hong Kong are not allowed to solicit insurance business in the Mainland. They may breach the relevant laws and regulations in the Mainland if they do so.
Only Hong Kong licensed insurance intermediaries can sell Hong Kong insurance products, and the entire sales process must take place in Hong Kong. If you are dealing with a third party who is not a licensed insurance intermediary in Hong Kong, it means that the person is not regulated, and this will affect your protection. The qualification of any unlicensed person is in doubt. They may be unable to provide professional and accurate advice on the insurance policy. You could find yourself a victim of mis-selling. Check the licence status of any persons who approached you in the Register of Licensed Insurance Intermediaries on the Insurance Authority's website before accepting their services.
No. Apart from the bonuses or discounts specified in the policy, any direct or indirect rebates offered by the insurance intermediaries, including rebates offered by any third party, may breach the relevant regulations. The fitness and properness of the insurance intermediaries or unlicensed persons offering rebates are in doubt. Offering these rebates may violate the guidelines issued by the Insurance Authority and will not be recognized by the insurer. Check the licence status of the persons approaching you in the Register of Licensed Insurance Intermediaries on the Insurance Authority's website before accepting their services.
You should refer to the product fact sheets and policy surrender documents (if applicable) to learn about the product features, such as the policy coverage, exchange rate risk, rates of return for guaranteed and non-guaranteed benefits, and fees and charges incurred from early surrender or withdrawal of policy benefits. Read carefully the Important Facts Statement for Mainland Policyholder (IFS-MP) to learn about the risks of buying insurance in Hong Kong. An insurance policy is a contract between you and the insurer. Be aware of your duties (e.g. accurate disclosure of material facts) and rights (e.g. making claims and cancelling policies during the cooling-off period) under the contract. If you have any questions about the policy terms or find any discrepancies between the terms and the explanations by the intermediary, consult the insurer directly for clarification.
If you are planning to buy a Hong Kong medical insurance product, be aware that there might be a list of designated hospitals in the Mainland for hospitalization and treatment. Expenses incurred in other medical institutions may not be covered. For claims for medical expenses incurred in the Mainland, it normally takes longer to check the relevant medical records from Mainland medical institutions. Before taking out a policy, pay attention to the claims procedures and requirements, such as the time limit for lodging a claim, required documents, exclusions and definition of “medically necessary”. To avoid disputes about claims, disclose your medical history before taking out the policy and keep proper records of the relevant documents.
Insurance intermediaries can receive payment of premiums only if they are authorized to do so by their appointing insurers, and they must handle the premium payment in strict conformity with the requirements set by the insurer. However, to protect your interests, you should use the official methods specified by the insurer to pay the premium directly to the insurer. If you choose to pay the premium via your insurance intermediary, pay the premium with a crossed cheque payable to the insurer. DO NOT pay cash or remit premiums to the intermediary’s personal bank account. If you do, it will be difficult to prove that the amount you paid to the intermediary is the premium payment.
If you are planning to borrow funds from a financial institution to pay the premium of a new insurance policy, and in doing so, assign all or part of the rights under the proposed policy as collateral to the financial institution, which is known as ‘premium financing’, be sure that you understand the potential risks of this funding arrangement. Premium financing involves the use of leveraged borrowing to purchase an insurance policy. As the borrower, you may suffer a financial loss from the various potential risks and have your rights under the policy affected, as the policy is pledged to the financial institution. Visit the Decoding Premium Financing webpage on the Insurance Authority’s website to study the pros and cons of using premium financing.
The Insurance Authority (IA) is the statutory body that regulates and supervises the Hong Kong insurance industry. It may handle complaints regarding the conduct of authorized insurers and licensed insurance intermediaries in the insurance market in Hong Kong. “Conduct” broadly covers matters such as sales and marketing practices in relation to insurance policies, the negotiation or arrangement of insurance policies, the giving of advice and making of recommendations on insurance policies, and the handling of premiums or other insurance monies on behalf of policyholders. To file a complaint about matters related to the conduct of an insurer or insurance intermediary with the IA, you should download the Complaint Form on the IA’s website and send the completed form to the IA’s sub-office in North Point by post, fax or email.
However, the IA is not empowered to handle disputes about claims. For a complaint of a monetary nature for a claim amount not exceeding HK$1,200,000, please submit it to the Insurance Complaints Bureau (ICB). Visit the ICB’s website for details.
For any questions about your rights and obligations of a policy holder, please contact the Insurance Authority.
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The IA reserves the right to modify the above policies or information from time to time as appropriate.Last Revision Date: 29 August 2022|Copyright © 2022 Insurance Authority. All rights reserved.