Mr. Wong had been working in a printing company for the past 6 years. He decided to resign from his job. Just a week before he left, he sustained a waist injury whilst at work controlling a printing machine. He reported this accident to the employer immediately. Mr. Wong consulted a doctor for his injury and he was granted 2 weeks of sick leave. 
 
Later on, Mr. Wong submitted the relevant sick leave certificate to his employer and requested his employer to pay him the 2-week sick leave payments as employee’s compensation. His employer only paid the first week's compensation but refused to pay for the second week’s as Mr. Wong had already left the company by then. 

According to the Employees’ Compensation Ordinance (“ECO”), an employer is liable to pay compensation in respect of injuries sustained by his employees as a result of a work accident. The injured employee is entitled to receive sick leave payments (i.e. periodical payment) during the period of temporary incapacity (sick leave) up to 24 months. The employer’s liability to pay sick leave payments will continue even though the injured employee has left the employer’s employment. In this case, Mr. Wong’s employer is liable to pay Mr. Wong’s 2-week sick leave payments and any of his future entitlement as stipulated in the ECO. 
 
The above case demonstrates a misunderstanding that “termination of employment relationship” would put an end to the liability of employers to pay employees' compensation. In fact, the employer is still liable to pay the ex-employee periodical payments for further sick leave granted to him and other compensation including medical expenses and permanent incapacity etc, irrespective of whether the employment relationship still exists. 

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Employees’ Compensation
Group Personal Protector

According to the Employees’ Compensation Ordinance, an employer is liable to pay compensation in respect of injuries sustained by his employees as a result of an accident arising out of and in the course of employment. An employer must be in possession of a valid insurance policy to cover his liabilities both under the Employees’ Compensation Ordinance and common law for work injuries for all employees. 

If the employer does not take out insurance cover for all his business operations and/or for all employees’ occupation categories, can they still enjoy corresponding cover? 

Mr. Ng is running a transportation business. His company is also engaged in frozen meat trading. One of Mr. Ng’s employees was injured when he was working as a “machine operator” undertaking meat cutting work. 

The injured employee claimed employees’ compensation from his employer. Mr. Ng then lodged the claim under the employees’ compensation insurance policy. However, the insurer declined to indemnify Mr. Ng’s company. Why did the insurer reject this claim? 

The insurance company rejected Mr. Ng’s claim on the grounds that Mr. Ng only declared the “Business/Trade” of his company as "Transportation”, and did not declare the employee’s occupation category of “machine operator” when taking out employees' compensation insurance cover. The meat cutting work being engaged in by the injured employee at the time of accident was for Mr. Ng’s food trading business, which is irrelevant to the insured business of “Transportation” as specified in the policy schedule. 

In addition, “machine operator” did not fall within any of the categories of employees insured under Mr. Ng’s policy. The insurance company was of the opinion that the injured employee was not covered by the policy. However, being the employer, Mr. Ng’s company is still liable to compensate the injured employee according to the Employees’ Compensation Ordinance. 

There is always a risk that employees may be accidentally injured while at work. Employees’ compensation insurance provides cover against accidents to employees during the course of their employment, protecting the employer’s business from the financial burden generated from the compensation and ensuring the company complies with all legal requirements. To enjoy this protection, employers are advised to declare all material facts including, all usual trade and business, number of employees, job nature and occupation categories of employees, total earnings, etc., allowing the insurance company to assess the risk exposure and premium level. This will also prevent disputes and arguments when accidents occur. 

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Employees’ Compensation
Group Personal Protector

A few years ago, a Hong Kong tourist who travelled to Thailand alone nearly drowned in the hotel swimming pool and was subsequently rushed to a local hospital for emergency treatment. Since the tourist had not bought any travel insurance, and all flights during the Lunar New Year were full, she was forced to remain in the local hospital. The patient was eventually joined by her family and flown back to Hong Kong for medical treatment. In addition to the delay, she had to pay the medical and hospitalisation fees of over HK$100,000.

Of course, nobody wants to encounter a serious accident in a foreign and unfamiliar country where an emergency could cause extreme anxiety. But one must take precautions as accidents do happen. The best solution is to make sure you are well protected while abroad with travel insurance. The 24-hour Worldwide Travel Assistance Service in a travel insurance plan ensures that you can receive emergency assistance around the clock wherever you may be. Let’s illustrate this with a simple example.

Before their 15-day tour in Vietnam, Miss Leung and her mother purchased travel insurance. On the third day of the tour, her mother slipped in the hotel bathroom and was knocked unconscious. She was immediately transferred to a local hospital for treatment. Miss Leung was worried about the quality of the local medical system and felt it was vital to send her mother back to Hong Kong for further treatment.

Under these circumstances, Miss Leung would be able to immediately report the incident to the 24-hour Worldwide Travel Assistance Service line to arrange for medical evacuation for her mother. As soon as a local doctor certifies that a patient should be transported elsewhere for treatment, the 24-hour Worldwide Travel Assistance Service will provide the most suitable transportation available depending on the severity of the patient’s injury. The insurance company will also settle the fees incurred directly with the third parties up to the maximum cover limit of the plan, allowing Miss Leung to focus on her mother without having to concern herself with additional burdens.

In addition, before finalising the departure plan for Miss Leung’s mother, the insurance company will arrange for immediate family members to fly to Vietnam to care for the injured. The insurance company will assume responsibility for all transportation and accommodation costs, again, within the limit of the plan.

With the 24-hour Worldwide Travel Assistance Service, travellers can rest easy and enjoy their vacation knowing that they are protected by comprehensive coverage. However, policy holders should take note of the following points:

1. Do not arrange any medical service without prior approval from the insurance company who reserves all rights for approval.
2. The insurance company will not cover the evacuation or treatment fee which is the result of any pre-existing medical conditions.

Further to the second point; if the insured acknowledges in advance any pre-existing disease and/or is receiving long-term treatment for conditions (such as heart disease, diabetes, and hypertension) and requires first aid and/or medical evacuation during the trip due to this, the insurance company would not be responsible for any related costs.

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iTravel Plus (Single Trip)
iTravel Plus (Annual)

Scenario:
Ms. Chan is a regular customer of a restaurant which has a bar area. She has alleged that she injured her ankle when she tried to sit on a bar stool after returning from the washroom at around 1am. While attempting to sit down, she slipped and fell when placing her foot on the footrest of the bar stool. Ms. Chan did not complain to the staff at the scene at the time, but after about a month, she complained to the restaurant owner that she had injured her ankle in the bar area a month earlier and that she intended to make a claim.

Question:
Will Ms. Chan's claim from the restaurant owner be successful?

Answer:
If Ms. Chan had raised a complaint about the slippery conditions that caused her to fall and injure her ankle immediately after the accident happened, and also provided details and evidence of the slippery substance and/or witnesses to her allegation of the condition of the bar floor, as well as and if all these evidences revealed that the restaurant owner knew the risks of the dangerous conditions that existed in the restaurant but was failed to correct them and give sufficient warning to his/her customers, it is most probable that Ms. Chan could have proved liability against the restaurant owner. as it was the restaurant owner's negligence lead directly to her injury and he or his insurance company would be liable when she made a claim.

Unfortunately, Ms. Chan did not complain about the slippery conditions immediately after her accident. In addition to her late complaint and the lack of independent witness(es) to support her allegation, as well as her consumption of alcohol, it is difficult to prove the cause(s) of the accident and who should bear the liability.

Accidents do happen. Although you may be entitled to compensation for your injuries, this may not be the case if your evidence and proof are not enough to support your claim. Therefore, it is important to have sufficient insurance protection, such as medical or personal accident insurance. Even if the property owner or occupier is not liable for a claim concerning your injury, you can still enjoy the benefits provided by your own medical or personal accident insurance. If you are property owners or occupiers, you are strongly advised to take out public liability insurance to cover your legal liability towards the general public. 

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Public Liability

The ferry tragedy that happened on 1 October 2012 took away 39 lives, and resulted in a total of 7 families losing their loved ones. While the whole community continues to express its deepest condolences to the families of the victims, this tragedy yet again brought the subject of personal accident protection sharply into focus.

Accidents do happen very unexpectedly and in their immediate aftermath, the victim’s family members often find it difficult to settle back into some semblance of normality, sometimes aggravated by practical issues such as financial support.

With tragedies such as this recent ferry disaster, it often takes years to complete the investigation and subsequent legal processes before liability claims can be settled. Therefore, reliable and long-term financial support coupled with an immediate lump sum compensation will help in relieving the victims' families' financial pressure.

Personal Accident protection aims to provide comprehensive coverage to the insured against bodily injury directly caused by an accident. Lump sum compensation can ease the financial pressure of losing the ability to work. Additionally, customers can also choose the optional medical expenses section so that medical expenses incurred as a result of the accident can be reimbursed.

At the same time, some personal accident protection plans will offer temporary disablement cover as another optional cover. This pays a weekly benefit for up to 104 weeks, leaving the insured worry-free during the recovery period.

With all this in mind, when choosing a suitable Personal Accident protection plan for the future, you are advised to base your requirements on your current financial burdens, economic status and medical benefits so that your protection is maximised over the long term.

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Personal Protector 3.0

According to the amended Section 28 of the Building Management Ordinance (Cap. 344), starting from 1st January 2011, all owners’ corporations must procure and keep in force a policy of third party risks insurance in relation to the common parts of the building and the property of the corporation. The minimum insured amount of each policy is HK$10 million for third party bodily injury or death per event. 

Customers who have already procured third party risks insurance should make sure that they are fully compliant with the Ordinance and adequately insured. By doing so, it helps to alleviate the financial burden on the owners’ corporations and individual apartment landlords because if someone is injured or dies in an accident in the common areas of the building, the compensation can be huge.

However, although it is a statutory provision, similar to other insurance, any liability arising from illegal parts of the building or unauthorised building work is excluded from the insurance: 

“(d) any liability arising out of a breach of any duty imposed by law in relation to:

1. any building within the meaning of the Buildings Ordinance (Cap. 123) erected in contravention of that ordinance; or
2. any building work or street work carried out in contravention of the Buildings Ordinance (Cap.123).

except in respect of all “designated exempted work” (as prescribed in the Building (Minor Works) Regulation) that has fulfilled the requirements of Section 39C(2), (3) and (4) of the Buildings Ordinance (Cap. 123).....”

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Public Liability

Scenario:
Mr. Shek, an insured driver, was driving along a road and was approaching a bus stop. Suddenly, a child who intended to catch the bus dashed out from the opposite side of the road towards the rear of the bus. Unable to stop the car in time, Mr. Shek knocked the child down and also crashed into the bus. The child was admitted to the hospital. The bus and the insured car were damaged. Mr. Shek took a post-accident breathalyzer test and the result exceeded the prescribed limit. Though he was not charged for any driving offence, he was convicted of drunk driving. The injured child and the bus company demanded compensation.

In this scenario, should Mr. Shek bear all the responsibilities or should the insurance company settle the claims for a) the injured child; b) third party property damage (i.e. the bus); and c) Mr. Shek's own car damage?

Answer:
As Mr. Shek was convicted of drunk driving, under the policy exclusions, it would not be the insurance company, but Mr. Shek to bear all liabilities arising out of the accident. However, the accident involved third party bodily injury. Under the Insurers' Concerned Principle of The Domestic Agreement issued by the Motor Insurers' Bureau of Hong Kong (MIB), the insurance company would run a risk of being liable for not properly defending the bodily injury claim.

Therefore, the insurance company would take over the conduct of proceedings on a "without prejudice" basis for the insured. In this way, the insurer could properly handle any possible proceedings with the assistance of the insured. After the third party bodily injury claim was settled by the insurer, the compensation made to the third party would be recovered from Mr. Shek, who was also liable for the bus damage claim. The insurer was also not liable for Mr. Shek's own damage.

As long as the accident is caused by the insured driver's negligence, he or she is still held liable for third party bodily injury regardless of the insurance cover. Even worse, the insured's own bodily injury and property damage as well as the third party's property damage will not be covered by the insurer. Therefore, it is important to always practise safe driving. 

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Private Motor Car