What to do if you feel your insurance claim shouldn’t have been rejected?

Most of us buy insurance for peace of mind knowing that you have protection if something has gone wrong. However, occasionally insurance company refuses to pay your claim.

 

If you feel your claim shouldn’t have been rejected, your first point of call should be lodging a complaint with your insurance company. Alternatively, you could refer your complaint to The Insurance Complaints Bureau which helps resolve claim disputes by way of adjudication.

 

If you are not satisfied with the outcome, you should seek legal redress. Insurance company usually refuses a claim based on various terms, conditions and exclusions in your policy documents. For example, in Wong Chi Man v American International Assurance Co Ltd DCCJ 1873/2005, the plaintiff’s claim for hospitalisation benefits was rejected by AIA for the reason that the plaintiff had taken intermittent home leave and been transferred to a rehabilitation centre prior to his discharge from the hospital. AIA argued that the plaintiff had not been confined in the hospital due to the home leave and transfer, and thus was not entitled to the benefits. In response, AIA offered an ex-gratia settlement of HK$12,000 to the plaintiff. The District Court, however, considered the fact that the plaintiff was charged by the hospital as an in-patient for each day of the hospitalisation period, and that the home leave or the transfer was permitted or even arranged by the hospital, he should be entitled to the benefits. A judgment of HK$126,000 was made against AIA.

 

An insurance dispute lawyer will examine your insurance policy, contact your insurance company, investigate your claim, and advise on whether you may bring a case against the insurance company. Please feel free to contact us at 69776708 for Mr Lam or make an appointment.

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