Author
Bowtie Team
Updated on
2025-05-31
Disclaimer: This article is translated with the assistance of AI.
There are many institutions for handling insurance complaints, but what are their scopes of authority and contact? The Bowtie team has compiled relevant information to help consumers fight for their rights. Read below to check the hotlines for all 8 institutions.
Step 1: Negotiate with the Insurance Company
If you are dissatisfied with how the insurance company or intermediary (such as an agent or broker) handles insurance matters, such as claims or sales practices, you can first negotiate with the insurance company . We recommend submitting a complaint in written form, such as a letter or email, with the following format and content:
- Clearly specify that it is a “complaint” letter or email.
- Note the date of the letter or email.
- Note your name and policy number.
- Explain your complaint and why you believe your claim should not be denied (if applicable).
- Provide evidence supporting your complaint.
- Attach copies of documents provided to the insurance company.
- State the corrective action you hope the insurance company will take.
If you are still dissatisfied with the insurance company’s response after submitting the complaint, you can refer it to other relevant institutions for handling.
Step 2: Seek Assistance from Relevant Organisations
Insurance Authority (Handles Complaints on Conduct of Insurance Companies and Intermediaries)
The Insurance Authority handles conduct complaints against insurance companies and intermediaries, such as unethical sales practices, misrepresentation of policy benefits, providing incorrect advice, failing to explain the cooling-off period to policyholders, not conducting proper financial needs analysis for life policies, mishandling premiums, or other insurance payments. However, note that the Insurance Authority has no authority to adjudicate claims disputes .
To file a complaint, you can download the Complaint Form from the Insurance Authority’s website and submit it after completing it.
Contact details for the Insurance Authority are as follows:
Address: 23rd Floor, Foyer, 625 King’s Road, North Point, Hong Kong
Phone: 3899 9983
Fax: 3753 3812
Email: complaints@ia.org.hk
Website: www.ia.org.hk
Insurance Complaints Bureau (Handles Claims or Monetary Disputes)
The Insurance Complaints Bureau assists individual policyholders or their beneficiaries in resolving insurance disputes with insurance companies, such as when an insurance company denies all or part of a claim on the grounds that it falls outside the coverage under the contract terms, conditions, or exclusions, or cancels the contract due to non-disclosure of material facts or material misrepresentation.
Please note that the complainant must submit a written complaint to the Bureau within 6 months of receiving the insurance company’s final decision. Additionally, the Insurance Complaints Bureau only handles cases where the amount in dispute does not exceed HK$1,200,000 * . For details, refer to the scope of jurisdiction on the Insurance Complaints Bureau’s website.
The Insurance Complaints Bureau only accepts written complaints . Complainants must complete the Complaint Form , detailing the complaint content, and submit it along with copies of the following documents via mail, fax, or email:
- The full policy and policy application form;
- The claims form;
- Medical reports / test reports / quotes or repair receipts / accident police reports;
- Documents from the insurance company providing the final decision.
Contact details for the Insurance Complaints Bureau are as follows:
Address: 29th Floor, Sanax Building, 353 Lockhart Road, Wan Chai, Hong Kong
Phone: 2520 2728
Fax: 2520 1967
Email: icb.enquiry@icb.org.hk
Website: www.icb.org.hk
* If the insured has multiple policies and the reasons for denial are the same or similar, the total claim amount is limited to not exceeding HK$1,200,000; if the claim involves long-term or periodic payments, the total amount for 5 years must not exceed HK$1,200,000.
Hong Kong Monetary Authority (Complaints Against Banks Acting as Licensed Insurance Intermediaries)
For complaints involving banks acting as licensed insurance intermediaries or their representatives, the Insurance Authority will refer the case to the Hong Kong Monetary Authority for handling . If you wish to complain to the Hong Kong Monetary Authority, you need to complete and submit the Complaint Form .
Contact details for the Hong Kong Monetary Authority are as follows:
Address: 55th Floor, Two International Finance Centre, 8 Finance Street, Central, Hong Kong
Phone: 2878 1378
Fax: 2509 3990
Email: bankcomplaints@hkma.gov.hk
Website: www.hkma.gov.hk
Voluntary Health Insurance Scheme Office (For VHIS Policies)
If your complaint involves specific disputes related to VHIS, such as product offerings, features of certified products, or compliance with scheme documents issued by the Food and Health Bureau (e.g., the Code of Practice for Insurers under the Voluntary Health Insurance Scheme), you can submit a complaint to the Voluntary Health Insurance Scheme Office under the Food and Health Bureau .
Contact details for the Voluntary Health Insurance Scheme Office are as follows:
Address: Room 2902, 6 Kwun Tong Road, Kowloon, Hong Kong
Phone: 2529 8900
Fax: 2529 8982
Email: vhis_enquiry@healthbureau.gov.hk
Website: www.vhis.gov.hk
Inland Revenue Department (For Tax Deductions)
Voluntary health insurance and eligible annuity premiums can be used for tax deductions. If you are dissatisfied with how the Inland Revenue Department handles your tax matters, including errors, delays, inappropriate or misleading advice, or poor staff attitude , you can make a complaint to the Complaints Officer .
Contact details for the Inland Revenue Department Complaints Unit are as follows:
Address: 15th Floor, Revenue Tower, 5 Nathan Road, Kowloon, Hong Kong
Phone: 2594 5000 (Complaints Unit)
Fax: 2802 7625 (Complaints Unit)
Email: taxinfo@ird.gov.hk
Website: www.ird.gov.hk
If you disagree with the assessment result , you can submit a written objection stating the reasons within the specified period.
Contact details for the Inland Revenue Department (Objections to Assessment) are as follows:
Address: Ground Floor, Revenue Tower, 5 Nathan Road, Kowloon, Hong Kong
Phone: 187 8022
Fax: 2877 1232
Consumer Council (Mediation for Dispute Resolution)
When handling insurance complaints, the Consumer Council will use mediation to resolve disputes between the complainant and the insurance company . However, note that the Consumer Council is not an enforcement agency and has no power to investigate, adjudicate, or require the insurance company to apologize or discipline staff.
Contact details for the Consumer Council are as follows:
Service Center Address 1: Room 1410, 14th Floor, Kodak House II, 39 Healthy Street East, North Point, Hong Kong
Service Center Address 2: 3 Austin Avenue, Tsim Sha Tsui, Hong Kong
Phone: 2929 2222
Fax: 2856 3611
Email: cc@consumer.org.hk
Website: www.consumer.org.hk
Step 3: Resolve Through Legal Means
Finally, if you are still dissatisfied with the complaint handling results, you may consider making a claim through court proceedings :
- Small Claims Tribunal: Claim amount not exceeding HK$75,000
- District Court: Claim amount above HK$75,000 but not exceeding HK$3,000,000
- High Court: Claim amount exceeding HK$3,000,000
Complainants can also apply for assistance from the Consumer Legal Action Fund. The Fund Management Committee reviews cases according to established criteria to decide whether to accept the assistance application.
Insurance Complaint Examples
The Insurance Complaints Bureau publishes an annual report each year, which shares numerous case studies. The Bowtie team has selected two examples to help readers understand the reasoning and process behind the complaints committee’s decisions.
Medical Insurance Complaint on “Same Illness”
Ms. Fan was admitted to a private hospital due to fever lasting several days, and the insurance company fully compensated for the hospitalization according to the policy terms. About four weeks after discharge, Ms. Fan was hospitalized again due to fever and swelling and pain in both groin areas.
The insurance company considered that Ms. Fan’s second hospitalization was a continuation of the condition from her first hospitalization and thus treated the two hospitalization claims as the same illness.
When determining whether two or more hospitalizations constitute the “same illness,” the complaints committee generally relies on the relevant medical reports and refers to the opinions of the attending physician. Based on the attending physician’s report, Ms. Fan was hospitalized twice within two months due to different infections.
Since fever is a common symptom, the complaints committee found that the existing medical documents were insufficient to prove that the underlying causes of the two hospitalizations were related. The complaints committee believed that the attending physician was more appropriate to comment on Ms. Fan’s physical condition and thus tended to rely on the attending physician’s opinion, agreeing that Ms. Fan’s second hospitalization should be regarded as a separate illness.
Ultimately, the complaints committee ruled in favor of Ms. Fan, requiring the insurance company to handle her hospitalization claims as two separate illnesses.
Medical Insurance Complaint on “Non-Disclosure”
Ms. Lee consulted the public hospital’s family medicine department for multiple uterine fibroids and a liver mass that had persisted for a year in 2021, and was subsequently referred to surgery and gynecology for further follow-up. Five months later, Ms. Wong underwent a full abdominal MRI scan and liver function tests at an imaging center and submitted a claim to the insurance company for the related examination costs.
During the investigation of the claim, the insurance company learned that Ms. Lee had consulted the public hospital’s outpatient department multiple times between 2015 and 2019 for lower back pain, plantar fasciitis, and dry eye syndrome. Since she did not disclose these medical history details when applying for insurance in January 2020, the insurance company rejected the claim on the grounds of non-disclosure of material facts.
Ms. Lee disagreed with the insurance company’s decision, emphasizing that the so-called undisclosed health conditions were minor, and she had fully recovered after using topical medications and eye drops, with no need for follow-up. After receiving Ms. Lee’s case, the complaints bureau referred it back to the insurance company for re-review and submission of a response.
After obtaining further medical documents from the public hospital, the insurance company learned that Ms. Lee had consulted the outpatient department for the above conditions, but all consultations were one-time, and the existing documents did not show that she had continued treatment or follow-ups for these conditions.
Since Ms. Lee’s above medical conditions were minor, the insurance company, upon re-underwriting, agreed to withdraw the original denial of the claim.
Over 90% of Bowtie Customers Are Satisfied With Their Claims
In 2020, the Bowtie customer service team handled over 50,000 inquiry cases , with more than 90% of customers feeling satisfied . Bowtie also has the most Google reviews in the industry, with an average rating as high as 4.6/5 .
Although Bowtie has no intermediaries, it still properly follows up on your cases and provides the most professional customer service. In fact, Bowtie has received positive feedback from many real users .
FAQs
1. What is the average processing time for each case at the Insurance Complaints Bureau?
The average processing time for each complaint case at the Insurance Complaints Bureau is approximately 4 to 6 months.
2. Can I request the Insurance Authority to arrange a meeting with the insurance company or intermediary?
The Insurance Authority does not have the power to compel the insurance company or intermediary to meet with the complainant. However, if the case is appropriate, the Insurance Authority will convey the meeting request, but whether the meeting proceeds and its arrangements will be decided based on the agreement of all relevant parties.
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