HK Insurance Claims Complaints Panel reports rise in complaints, payouts

Highest single case award reaches HK$820,000

HK Insurance Claims Complaints Panel reports rise in complaints, payouts

Insurance News

By Roxanne Libatique

The Insurance Claims Complaints Panel, the adjudication body under Hong Kong’s Insurance Complaints Bureau (ICB), handled a larger volume of complaint work in 2025, with more cases ending in compensation for policyholders. Data released on April 14, 2026, show that the ICB received 857 complaint cases in 2025, about 32.7% more than in 2024. Of these, 447 claim-related complaints were closed during the year. In 124 of those cases, insurers paid a total of HK$13.6 million in claim compensation to complainants.

Hospitalization/medical and travel insurance policies were the most frequently cited products in the claim disputes brought to the bureau. Michael F S Tsui, MH, chairman of the Complaints Panel, said only a portion of disputes required a formal adjudication. “The Complaints Panel ruled in favour of the complainants in 11 cases and upheld the insurers’ decisions in 45 cases. The highest single case award amounted to around HK$820,000,” he said.

Panel remit, composition, and process

The ICB functions as a dispute resolution body for personal insurance contracts between consumers and member insurers. It is chaired by independent chairman Dr Pamela Chan Wong Shui, BBS, JP. Its board comprises eight other directors, split between four non-industry members and four industry representatives. Consumers can use the bureau’s free mechanism to pursue resolution of disputes arising from personal insurance policies. Within this structure, the Complaints Panel is appointed by the ICB to adjudicate claim complaints between insurers and policyholders or their beneficiaries. Its decisions are binding on all ICB member insurers.

Policyholders who disagree with a ruling are not required to accept it as a final outcome. They retain the right to pursue legal action, and their legal rights are not affected by the panel’s decisions. As a result, the panel operates as an alternative dispute resolution channel running alongside, rather than replacing, the court system. The panel has five members, most of whom are drawn from outside the insurance industry. Members serve on a voluntary basis. Tsui chairs the panel in his capacity as a barrister-at-law. The other members are

  • Barrister-at-law Astina S T Au, nominated by the Consumer Council
  • Fanny W M Fung, representing the General Insurance Council of the Hong Kong Federation of Insurers
  • Orchis T L Li, representing the Life Insurance Council of the same federation
  • Karen C K Tam, nominated by the Hong Kong Institute of Certified Public Accountants

IA complaint trends track similar increase

The rise in complaints recorded by the ICB mirrors patterns reported by the Insurance Authority (IA) in its Conduct In Focus report for 2025, released on March 30, 2026. According to the IA, the authority received 1,173 complaints in 2025, up 19.9% from 978 in 2024. The year-on-year increase was sharper in the first half of 2025, when complaints were about 33% higher than the same period a year earlier, before moderating to an increase of around 20% for the full year.

Over a longer timeframe, the 2025 tally is close to the 1,163 complaints recorded in 2019 and remains 21% below the 1,494 cases lodged in 2020. The IA also compared these figures with market growth. It reported that total gross premiums in the first three quarters of 2025 reached HK$637 billion, exceeding the full-year 2019 figure of HK$567 billion. On case handling, the authority said it closed 85% of complaints received in the first half of 2025 within six months, compared with its service pledge to close at least 80% within that period.

Conduct, disclosure, and operations dominate complaint themes

The IA’s complaint statistics indicate that issues remain concentrated in a small number of categories. The authority reported that “Conduct” accounted for 26% of cases, “Representation of Information” for 19%, and “Business or Operations” for 25%. Complaints relating to “Conduct” and “Representation of Information,” which together made up 45% of the total, were mainly linked to intermediaries’ pre-contract sales practices and post-sale servicing. The Conduct In Focus report also discussed a series of regulatory topics affecting insurers and intermediaries. These included new commission-spreading rules for participating policies, clarified expectations for agent managers’ accountability, early-stage attrition among intermediaries, mixed public feedback on intermediary services, and enforcement actions against broker companies over anti-money laundering and counter-terrorist financing controls.

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