Critical-illness insurers stall on large claims, with no third-party arbitration

A string of Hong Kong cases shows that people who buy high-end medical insurance, pay premiums for years and have a good claims record can suddenly find that, the moment a large claim arises (such as a cancer recurrence or a long hospital stay), the insurer stalls indefinitely on the grounds that the case is 'under review', paying out nothing and giving no reason for refusal — leaving patients in financial crisis as medical bills keep mounting. People report that such situations are not isolated incidents but a common industry tactic, with insurers starting to stall or refuse to continue paying out by various means once cumulative claims reach a certain level.

Hong Kong lacks any effective third-party insurance-complaints body or fast arbitration mechanism, so consumers have nowhere to turn when they urgently need a payout, and the market also lacks a professional claims service able to represent consumers and pressure insurers.