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Terms of Reference
- The complaint is claim-related.
- The claim amount does not exceed HK$800,000*.
- The insurer concerned is a Bureau Member.
- The policy concerned is a personal insurance policy.
- The complaint is filed by a policyholder/beneficiary/rightful claimant.
- The policyholder must be a resident in Hong Kong .
- The insurer concerned has made its final decision on the claim.
- The complaint is filed with the Bureau within six months from the day of notification by the insurer of its final decision.
- The dispute in question does not arise from industrial, commercial or third party insurance.
- The claim is not subject to legal proceedings or arbitration.
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If an insured holds multiple policies, the aggregate amount of the individual claims involved should not exceed HK$800,000 should the causes of claims are 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$800,000. |
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