These days in Hong Kong, there are many people taking out personal accident insurance. “Temporary Disablement benefit” is one of the optional covers available under personal accident insurance. It provides weekly benefit within a specific period of time for an insured person who is not able to engage in or attend to his/her usual employment or occupation.

“Temporary Disablement benefit” is designed for full-time permanent employees. If the insured person unfortunately gets injured and is not able to work, the insurance company will compensate the insured person with a weekly benefit based on the injured person’s medical certificate and sick leave proof provided by the employer.

As self-employed people and part-time employees may not be able to provide the sick leave proof normally obtained from employers, “Temporary Disablement benefit” may not be suitable for them. Instead, they can take out hospital cash insurance as an alternative which provides a cash benefit when they are confined in hospital for treatment of sickness or bodily injury. They only need to provide the invoices for in-patient medical treatment in order to file a claim.

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Personal Protector 3.0

Mr. Leung and his family have just moved into their newly-bought apartment without doing any renovation work as most of it was already done by the developer. Being the occupant of the apartment, he took out home contents insurance Home Protector in the interim to protect his property. Unfortunately, a no.8 typhoon damaged his windows and caused water damage to his wardrobe. As a result, he had to replace the damaged windows and the entire wardrobe.

Mr. Leung prepared all the required documents and lodged a claim with his insurance company. After assessment, Mr. Leung's insurance company reimbursed him for the cost of a new wardrobe, but declined the claim for repairing the damaged windows.

Why was Mr. Leung's claim for the expense of repairing the damaged windows rejected?

Items such as walls, windows, ceilings, floors and doors are usually regarded as a part of the building structure and should be covered by building insurance (sometimes called fire insurance). As Mr. Leung had only taken out home contents insurance, the damaged windows did not fall within the contents insured under the policy. However, if Mr. Leung had renovated the windows, his insurance company would have treated them as Household Improvements, which are covered by home contents insurance Home Protector.

If customers have not renovated their homes, to achieve maximum protection, they should consider taking out building cover in addition to home contents insurance.

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Mr. Leung has been employed as a jazz teacher in a dance school for over three years. As his reputation increased, he decided to start his own business, creating a dance team that performs in clubs, bars, outdoor venues etc. Three weeks ago, he fell off the stage accidently which rendered him incapable of walking in the short term. He then filed a claim for weekly cash benefit for temporary disablement under his Personal Accident insurance with his insurance company. However, the insurance company declined his claim due to the change in the nature of his occupation from employee to self-employed. The insurance company stated that Mr. Leung’s current occupation was different from that which their records showed. He should have informed his insurance company when he stopped being a full-time dancing teacher and became a self-employed performer. In this case, since temporary disablement benefit is not applicable to the self-employed, Mr. Leung was not entitled to any compensation from his insurance company.

As it is very difficult to prove the attendance record of a self-employed person, the temporary disablement section which pays weekly benefit is not applicable to the self-employed person.

Occupation is a crucial factor in personal accident insurance. As insurance companies use the occupation of the insured person to assess risk exposure and to calculate the premium, it is vital that the insured person should inform his insurance company of any updates, especially a change in occupation during the insured period, in order to ensure adequate protection and prevent rejected claims due to unreported changes.

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Personal Protector 3.0

Mr. Chan bought a new apartment in November and took out home contents insurance. At the same time, his home contents policy for his current residence expired a month earlier. Knowing he was moving out of his current residence soon, he did not renew his old policy.

He hired a van and asked some friends to help him with the removal. Unfortunately, his vase and mirror were broken during the course of transit. He filed a claim with his insurance company immediately. However, Mr. Chan did not receive any compensation from his insurance company because his new home insurance did not cover this type of removal.

Why did his insurance company not cover Mr. Chan’s damage arising from this removal?

As home contents insurance only covers property in the course of removal by professional removers, Mr. Chan’s removal completed with the help of his friends was excluded. Furthermore, Mr. Chan’s removal should have been covered under a Household Removal extension under the home contents policy of his current home instead of under the policy of his new apartment. Unfortunately however, Mr. Chan’s former home contents policy had not been renewed before the removal.

For household removal, customers are advised to hire professional removers to ensure better handling of their property. It is also important to make sure the policy has an extension of Household Removal to cover property removed from their home to the new residence before carrying out the removal.

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Home Protector
FamilySurance Plus 4.0
Mortgage Fire
HelperSurance 4.0

Many insured persons may not be aware of the duty of the loss adjuster. In fact, the appointment of a loss adjuster is a common practice in claims procedure. Loss adjusters are the experts in assessing the extent of damage and the potential third party claims. They are responsible for providing suggestions on mitigation of loss, procedures on submission of claims and advice on policy coverage, as well as dealing with third party claims arising from the incident. Below is an example demonstrating the role of a loss adjuster:

Mr. Chan took out home contents insurance for his newly bought second-hand premises in Tai Po. A few months ago, a flush water supply pipe to the cistern in the bathroom of his premises burst. The flush water inundated the entire premises and caused serious damage to home appliances, furniture and the flooring and skirting.

Mr. Chan cleared up the water immediately and tried to prevent the water from flooding the premises even more. In the meantime, he filed a claim to his insurance company and a loss adjuster was appointed to carry out a site inspection in his premises.

After investigation, the loss adjuster confirmed that the bursting of the water pipe was due to normal wear and tear of the pipe. The adjuster report stated that the resultant water damage to Mr. Chan’s home contents and building improvements (flooring and skirting) should be covered by the Home Protector insurance policy. However, as the replacement of the water pipe was excluded as specified in the policy, the cost of replacement was not covered. Finally, the insurance company made settlement based on the adjuster report.

To smoothen the claims procedure, the insured person should cooperate with the loss adjuster by providing all information and assistance required by the insurance company.

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Home Protector
FamilySurance Plus 4.0
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HelperSurance 4.0

The insurance compensation issue of the Manila hostage tragedy raised awareness about personal accident benefits in travel insurance amongst the general public. Criticism spread widely when the insurance company declined the claims of an injured whose lower jaw, left thumb and right index finger were shattered by bullets. The insurance company declared that current travel insurance does not cover such injury under the short-scaled personal accident benefits.

At that time, the tragedy sparked an outcry about the difference between permanent disablement benefit in short-scaled cover in travel insurance and the long-scaled cover in personal accident insurance. The incident clearly highlighted that the general public is not familiar enough with personal accident protection – essential cover for you and your loved ones.

Put simply, personal accident insurance can be divided into 3 major benefits, namely, permanent disablement, temporary disablement and medical expenses. Permanent disablement is the major cover factor of personal accident insurance. Compensation for permanent disablement will be paid to the insured according to the long-scaled benefit as specified in the policy if a specific body part of the insured person is proved to be permanently disabled according to a qualified doctor. Compared to short-scaled cover, long-scaled cover provides wider coverage to the insured. If the injured in the tragedy had separately taken out personal accident insurance, their injuries in the tragedy would have been covered, instead of getting only cash relief.

Accidents can happen at any time. Personal accident insurance shelters you from unfortunate possibilities, gives you added protection and relieves your financial burden.

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Personal Protector 3.0

During the rainy season, Hong Kong’s weather is quite unstable with typhoons and rainstorms which often cause a lot of damage and disruption. Last year, a window was blown out from its frame and sent crashing into the window of the opposite flat before shattering on the ground below. Fortunately, no one was injured in this accident.

Does home contents insurance provide cover for window frames being damaged by typhoons?

Firstly, it has to be determined whether the window frame is an original fixture or the insured’s own improvement and the coverage of the policy. Home Protector insurance policy covers household improvement under home contents section. Household improvement refers to improvements and betterments to walls, windows, ceilings, floors or doors, which then cease to be the property’s original fixtures as purchased. Therefore, if the insured has made improvements to the original window frames, he/ she should make a claim under his/her home contents insurance.

By contrast, if there is no improvement or betterment made to the window frames, they will be regarded as part of the building structure and will only be covered by the building section which is an optional cover to a Home Protector insurance policy.

Customers are advised to consider taking out a home contents insurance with a building section as the optional cover in order to enjoy comprehensive coverage.

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Home Protector
FamilySurance Plus 4.0
Mortgage Fire
HelperSurance 4.0

Mrs. Chau hurt her lower back as a result of sneezing and went to see a bonesetter. Mrs. Chau has a personal accident insurance policy covering medical expenses of bonesetter for treatment of Accidental Bodily Injury. She submitted a claim for medical expenses as she thought her injury due to sneezing was an accident.
 
However, her insurance company rejected her claim as Mrs. Chau’s injury did not meet the definition of Accidental Bodily Injury. Mrs. Chau was surprised by this and wanted to know why.
 
Insurance policies define “Accidental Bodily Injury” as bodily injury caused solely and directly from accidental external violent and visible means as evidenced by visible bruise or wound on body, and which are independent of any other cause and not by sickness, disease or gradual physical or mental wear and tear.
 
In Mrs. Chau’s case, the back sprain was caused by sneezing which came about neither as a result of accidental external violent and visible means nor was it evidenced by visible wounds on her body that could indicate that the condition was caused by “Bodily Injury” and not by sickness such as Spinal Degeneration. Hence, her insurance company was unable to compensate her for her claim for Accidental Medical Expenses. 

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Personal Protector 3.0

Many housing estate windows were damaged when Typhoon Vicente passed close to Hong Kong in 2012. Generally speaking, most home insurance policies cover any loss caused by a typhoon. However, if the damage comes about as a result of lack of maintenance or through gradual deterioration, will it still be covered by home insurance policy?

During the night that Typhoon Vicente affected Hong Kong, Ms. Lai discovered water seepage at the base of the walls inside her bedroom which, in turn, caused water damage to the timber skirting and her bed. Ms. Lai subsequently lodged a claim with her insurance company as her premises were already protected by home and building insurance. After assessment, Ms. Lai’s insurer reimbursed her for the cost of a new bed, new timber skirting as well as the cost of repainting the affected areas of her bedroom walls.

However, Ms. Lai’s insurer declined her claim for the repair of concrete walls, rusted steel bars and waterproofing work. Why was Ms. Lai’s claim for the expense of maintenance work rejected?

This part of Ms. Lai’s claim was declined because the underlying cause of the problem occurred in external walls in which no easily visible or obvious damage caused by the typhoon was identified. Her insurer concluded that the water had seeped through a crack which had come about through natural wear and tear.

As wear and tear is excluded by the majority of home insurance policies, Ms. Lai’s claim for repair and maintenance work was rejected. Apart from the extent of the cover provided by the insurance policy, customers should also understand the excluded items to avoid dispute.

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Home Protector
FamilySurance Plus 4.0
Mortgage Fire
HelperSurance 4.0

It has always been MSIG’s belief that our protection should primarily be built upon the interest of our customers. A recent case fully demonstrates our philosophy.

Mr Cheung accidentally dropped his watch into water. After checking his Home Protector insurance policy, he discovered that he had to pay $1,000 excess if the damage was caused by water. He decided to call us for more information about the water damage excess.

As the watch was damaged by water, a layman would naturally think that he has to pay the water damage excess according to the policy. The original intention of imposing a water damage excess was to limit excessive losses that serious incidents such as typhoons and flooding might bring to the insurer. Technically speaking, some insurers may apply the water damage excess to Mr Cheung’s claim. Knowing the underwriting intention of water damage excess, we chose not to in order to act fairly and responsibly to our customers.

There are lots of home contents insurance policies in the market and different insurers have different business philosophies and interpretations of policy wordings. At MSIG we always strive to provide insurance products that bring true protection to our customers.

Learn more about our insurance plans:
Home Protector
FamilySurance Plus 4.0
Mortgage Fire
HelperSurance 4.0