MSIG’s policy of actively encouraging our claims experts to give comfort and reassurance to our customers, especially those who have a particular problem, is paying dividends. The results speak for themselves. Increasingly, we’ve been getting compliments from appreciative customers, sometimes even when their claims have been rejected for reasons they didn’t at first understand.

A recent example is Ms. Sung, one of our travel insurance customers who was full of praise for our claims team. Despite the fact that her claim was only partially settled, she was very impressed by our timely advice and wholehearted support throughout the claims settlement process.

When Ms. Sung was in the UK for 2 weeks over Easter, she unfortunately mislaid her handbag while sightseeing, resulting in the loss of her mobile phone and £400 in cash. Ms. Sung reported the incident to the local police and submitted a claim with us immediately upon her return to Hong Kong.

Raymond, our claims adviser assigned to Ms. Sung's case, quickly determined that with Ms. Sung’s travel policy, her mobile phone was listed under General Exclusions and, as such, only the missing cash was covered.

His past experience has taught Raymond that every claimant likes to know the details of how their case will be settled. He therefore ensured that Ms. Sung was kept closely informed of her claim status from the outset starting with the case receipt acknowledgement, followed by the proposed claim offer and finally, the acknowledgement of acceptance. Raymond did this using mobile SMS and phone calls.

As a result, Ms. Sung accepted the claim offer without query and her claim was settled and paid within one week. Even though Ms. Sung was unable to get full payment for her claimed losses, she was impressed by the organised, timely and responsible way in which her claim was handled as well as by Raymond’s sincere and caring attitude.

Shortly after settlement, we received a very complimentary letter from Ms. Sung, who also promised to recommend MSIG’s products and services to her friends.

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iTravel Plus (Single Trip)
iTravel Plus (Annual)

While traveling in the UK in July 2016, Ms. Lam accidently slipped on the floor of her hotel bathroom and injured her spine causing her to be unable to move.

Because Ms. Lam had taken out MSIG travel insurance, she immediately called the 24-hour worldwide travel assistance hotline to request emergency assistance in helping her return to Hong Kong for further treatment. Ms. Lam’s attending doctor advised that she was not yet medically fit enough to be evacuated back to Hong Kong. As a consequence, she was hospitalised in the UK and returned to Hong Kong on a business class flight arranged by MSIG’s emergency assistance service on 20th August 2016.

After returning to Hong Kong, an operation was scheduled for 5th January 2017. Ms. Lam was now beginning to worry that the time between her accident in July 2016 and her operation on 5th January 2017 had already exceeded the 3-month follow-up medical expenses insurance period. Ms. Lam then contacted MSIG’s claims department to request an extension to her follow-up medical treatment period.

On learning the difficulties surrounding Ms. Lam’s particular situation, we specially agreed to extend her follow-up medical treatment period for three weeks.

Ms. Lam later wrote to us expressing her gratitude not only for our speedy turn-around time in dealing with her medical expenses recovery (which greatly alleviated her financial burden), but also for our professional advice and empathetic consideration taken from a customer's perspective.

Ms. Lam, who has been a loyal MSIG customer since 1990, also took the opportunity to thank us again for the peace of mind she’s enjoyed over the years.

Learn more about our insurance plans:
iTravel Plus (Single Trip)
iTravel Plus (Annual)

With a customer-focused attitude at the heart of our corporate values, MSIG bases the grounds for claims compensation on the underwriting intention rather than the literal meaning of policy wording to ensure customers enjoy the full protection of their cover.

As one of the leading general insurers in the market, MSIG's assessments are highly sought after by industry bodies as a second opinion. What follows is a clear demonstration of how we consider insurance cover from a customer's perspective, using a travel claim rejected by another insurer as an example.

Mr. Cho joined a cruise land tour in Singapore during which he fell and fractured his right ankle. He received initial medical treatment at the medical centre on his cruise ship during which a walking boot was fitted to prevent further injury. When he was transferred back to Hong Kong, he underwent an operation followed by hospital recuperative care.

In due course, Mr. Cho submitted his medical expenses claim to his travel insurer. However, expenses related to the use of a walking boot were declined on the grounds that "devices such as wheelchairs and crutches that were not used during hospital confinement" would be excluded from the policy.

The ICCB referred this case to us for our advice. The walking boot is traditionally regarded as a brace, but in Mr. Cho's case, we believe the walking boot was used to prevent additional short-term injury pending his repatriation for an operation at a Hong Kong hospital. Additionally, as the accident occurred during a cruise, Mr. Cho could not have been quickly transferred to a Hong Kong hospital. Preventing the injury from getting worse was essential. In cases of this nature, the walking boot's purpose of usage is different from the original underwriting intention to exclude any medical devices for prolonged use.

Having taken everything into consideration, we concluded that compensation for the expense of the walking boot was appropriate in this claim adjustment.

Learn more about our insurance plans:
iTravel Plus (Single Trip)
iTravel Plus (Annual)

Nowadays, many companies would like to hire part-time employees for a more flexible workforce. However, employers may neglect the importance of taking out an insurance policy for their part-time employees.

It is compulsory for the employer to take out a valid insurance policy to cover the liabilities, both under the Employees' Compensation Ordinance (ECO) and common law, for both the full-time and part-time employees who suffer from any injury at work.

The potential liability of an employer towards a part-time employee in an employees' compensation claim can be much higher than one expects.

S11 of ECO :  "Method of calculating earning", (for the purpose of calculating employees' compensation)

(7) Where the employee had entered into concurrent contracts of service with 2 or more employers under which he worked at one time for one such employer and at another time for another such employer, his monthly earnings shall be computed as if his earnings under all such contracts were earnings in the employment of the employer for whom he was working at the time of the accident;

Provided that the earnings of the employee under the concurrent contract shall be taken into account only so far as the employee is incapacitated from performing the concurrent contract; ......

In other words, if your part-time employee works for more than one company concurrently and he/she suffers injury arising out of and in the course of employment with you, causing him/her to be incapacitated from performing jobs under the concurrent contract, you are liable to pay employees' compensation calculated on the basis of not just the part-time salary that you offered but also on the total earnings of all his/her full-time or part-time jobs so far under concurrent contracts. Please note that S11 (7) does not apply to full-time employees. 

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Employees’ Compensation
Group Personal Protector

Scenario:
An employer required all his workers to sign a form stating that once the worker is discovered to be engaging in other gainful employment during his/her sick leave period due to injury from work, the employer would not be liable for his/her compensation for the period he/she worked. The worker must also fully refund to the employer all payments he/she had already received. The employer's liability under the Employees' Compensation Ordinance (ECO) in relation to the accident would be fully discharged.

Question:
Did the employer have the right to require the worker to sign such a form and would the agreement be considered valid?

Answer:
The intention behind the form has violated the Employees' Compensation Ordinance. According to the ECO, Chapter 282, Section 10 - Compensation in case of temporary incapacity:

(1) "Where temporary incapacity whether total or partial results from the injury, the compensation shall be periodical payments ... Such periodical payments shall be, or shall be at the rate proportionate to, a monthly payment of four-fifths of the difference between the monthly earnings which the employee was earning at the time of the accident and the monthly earnings which he is earning, or is capable of earning, in some suitable employment or business during the period of temporary incapacity after the accident..."

In other words, if the injured worker cannot work at all during the sick leave period, the employer needs to pay four-fifths of the worker's earnings at the time of the accident.

Even if the employer discovered that a worker had been engaging in other gainful employment during his/her sick leave period, the employer will still be liable for employees' compensation, provided the worker still suffered a loss of earnings according to the above ECO provision. 

Therefore, the employer cannot require the worker to sign such a form and the agreement mentioned in the above case is not valid. Any term which purports to extinguish or reduce any right, benefit or protection conferred upon an employee by the Ordinance has no legal effect.

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Employees’ Compensation
Group Personal Protector

With the increasing publicity on occupational diseases, more and more people are concerned if their cases would be defined as occupational diseases and if they are covered under employees' compensation. In this issue, we would like to share some tips on this topic.

Under the Employees' Compensation Ordinance Cap. 282 Sec. 32 ("the Ordinance"), if any employee suffers incapacity or dies as a result of a prescribed compensatory occupational disease "and is due to the nature of any employment in which the employee was employed at any time within the prescribed period immediately preceding such incapacity or death, whether under one or more employers", the employee shall be entitled to compensation under this Ordinance.

Are all occupational diseases covered under Employees' Compensation Ordinance?

The answer is "No". This is why there are many claims disputes over occupational diseases. Unlike injuries which are easier to detect physically, diseases need to be proved as compensable occupational diseases. It is clearly stated in the Second Schedule of the Ordinance that only 48 specified diseases under 4 categories, caused by physical agents, biological agents, chemical agents or miscellaneous agents are covered under the Ordinance. In the case that an employee is suffering from a disease that is not specified in the Ordinance, it would take more time and effort to prove to the court that the disease falls with the meaning of "a personal injury arising out of and in the course of the employment".

We advise customers to refer to the Ordinance to check if you are able to claim employees' compensation for suffering from occupational diseases. If you fail to claim from the ECO, do find out if you are able to claim from your employer's medical scheme or your own medical insurance plan.

Learn more about our insurance plans:
Employees’ Compensation
Group Personal Protector

Scenario:
Mr. Wong is the merchandising manager of a garment trading company. When he was walking from his home to the MTR station to catch his flight to Milan for a business trip, he fell and broke his leg. 

Question:        
Is Mr. Wong covered by the employees' compensation?

Answer:        
According to the Employees’ Compensation Ordinance (ECO) Chapter 282 Section 5(4) (g):
 
"an accident to an employee shall be deemed to arise out of and in the course of his employment if it happens to the employee while he is, with the express or implied permission of his employer, travelling by any means of transport for the purposes of and in connection with his employment between Hong Kong and any place outside Hong Kong or between any place outside Hong Kong and any other such place."
                                    
As Mr. Wong sustained his injury while he was on the way to catch his transportation for a business trip, he was not travelling by any means of transport at the material time of accident. Therefore, in Mr. Wong's case, according to the ECO, such accident shall not be deemed to arise out of and in the course of employment and Mr. Wong's injury did not fall within the ambit of the ECO.

Employees' compensation covers only employer's liability at law to pay compensation to the injured employee, but not all accidents fall within the coverage of ECO. Therefore, as a responsible company, you can take out group medical or personal accident insurance as one of the employees' benefits.

Learn more about our insurance plans:
Employees’ Compensation
Group Personal Protector