Insurance
Insurance

What is Early Claim in Insurance ? Why is it important?

Author Bowtie Team
Updated on 2025-06-12

 

Disclaimer: This article is translated with the assistance of AI.

Ever wondered about Early Claim in insurance? It’s when you file a claim shortly after your policy starts. Rumors swirl about delays or denials – but are they true? The Bowtie team uncovers the facts in this easy read.
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What is an Early Claim?

An Early Claim refers to an “early payout” on your insurance policy, meaning the insured person submits a claim to the insurance company shortly after the policy takes effect. As for what counts as early, there’s no universal definition in the insurance industry or under the law. Generally, it’s considered to be the first 2 years after the policy starts, though we’ve heard some insurers define it as the first 3 years or even 5 years. The truth? Well, that’s probably only known within the insurance companies themselves, as they don’t publicly disclose their “early claim” policies.

Insurance companies tend to handle and approve “early claims” with extra caution. This is mainly to rule out the possibility of the insured having pre-existing conditions at the time of purchase and to ensure there’s nothing suspicious about the claim before approving compensation according to the policy’s terms.

If the insurance company discovers any undeclared medical history or other Investigation , they might suspect the policyholder intentionally withheld information or even bought the policy with a pre-existing condition. In such cases, the insurer has the right to deny the claim or even cancel the policy outright (commonly known as “kicking out” the policy).

Will Early Claim Delay Your Compensation?

Because insurers might investigate “early claims” and request medical records from the Hospital Authority or other healthcare providers, which can take 8 to 12 weeks, some of these claims could take longer to process than usual. That’s different from standard claims, which are often approved and paid out in just a few weeks.

Is Early Claim Always Investigated and Denied?

You might think that since insurers could suspect “early claims” of involving pre-existing conditions or insurance abuse, they always get investigated and rejected. But not necessarily . Insurers will consider factors like the claim’s legitimacy, the evidence provided, and whether there’s any red flags before deciding on a full investigation or final payout.

We’ve already covered the general industry approach to “early claims,” but what about Bowtie? How do we handle them?

At Bowtie, we don’t automatically investigate just because a claim is an “early claim” or a large one. We carefully review each submission, checking if the supporting documents raise any suspicions, inconsistencies, or red flags. If needed, we’ll dig deeper to gather more evidence and clear up any doubts about the insured’s health or the claim’s validity.

Early Claim: Watch Out for the Policy Waiting Period

If there’s solid evidence backing it up, insurers can’t just deny an “early claim.” However, there’s one exception: claims made during the policy’s waiting period , where the policy contract gives them the right to withhold payment.

Take the VHIS Standard plan as an example—while new conditions after purchase don’t have a waiting period, there is a 3-year wait for “pre-existing conditions unknown at the time of purchase” . In the first 3 policy years, payouts are only 0%, 25%, and 50% respectively, with full 100% coverage kicking in from the 4th year.

For Bowtie specifically, here’s how our insurance products handle waiting periods:

Bowtie Insurance Products Policy Waiting Period
Bowtie VHIS Standard First 3 years after policy starts

(Payout ratios increase annually, as mentioned above)

(Applies only to “pre-existing conditions unknown at the time of purchase”)

Bowtie VHIS Flexi

Bowtie Pink

First 90 days after policy starts

(Applies only to “pre-existing conditions unknown at the time of purchase”)

Bowtie Critical Illness First 90 days after policy starts
Bowtie Term Life No waiting period

Bowtie’s Claims Process

You know, an insurance policy is essentially a contract. As long as your claim application is reasonable and doesn’t violate the policy terms, the insurance company is obligated to compensate. So, don’t worry if you need to make an “early claim.” If you’re a Bowtie customer, just prepare the claim form and other required documents, and follow the steps below to submit your application.

Claims Steps
  1. Prepare proof documents (see below)
  2. Log in to your Bowtie account to apply for claims
  3. Answer a few questions about this examination
  4. Submit bank details
  5. Upload required documents
  6. Wait for approval
  7. Receive compensation

Watch the Online Claims Tutorial Video Now

What Documents Do You Need?

You’ll need to prepare the following 3 documents to successfully apply for a claim:

  • Doctor-filled and signed hospitalization claim form
  • Original hospital receipt
  • All pathology reports

Private hospitals usually have claim forms for various insurance companies. Just clearly inform the doctor about your medical insurance, and they’ll have the experience to fill it out. It’s a good idea to prepare a summary of your insurance coverage for the doctor to reference.

How Long Does It Take to Get Compensation After Application?

The time for each claim depends on the complexity of the case. Bowtie’s average processing time is 4.4 working days # ; the compensation amount will be transferred to your specified bank account within 3 working days after successful approval.

  • * As of March 2024, Bowtie’s overall claims cases average processing time is 4.4 working days. Processing time may be affected by the complexity of the actual case, waiting for medical reports, or other supplementary documents.

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*Full coverage shall mean no itemized benefit sub-limits, and applies to designated benefit items only. The benefit payable shall be subject to the remaining deductible (if applicable), annual benefit limit, lifetime benefit limit and other limitations such as reasonable and customary charges, a pre-existing condition, “List of Designated Hospitals in Mainland China” and receiving medical treatment in the United States. For detailed terms and conditions, product risks, and exclusions, please refer to the relevant product website and policy.
^For example, with Bowtie Pink (Ward) and the deductible option HK$80,000, the monthly premium for a 30-year-old non-smoker is HK$197. The premium comparison above is based on similar medical insurance plans with the ward level (data source on 27, July 2023), HK$50,000 to HK$80,000 deductibles, for a 30-year-old non-smoker. Different medical insurance plans have different coverage and benefit limits. For details, please refer to the relevant insurance policy and its terms and conditions.

 

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