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  • BC-2.9 BC-2.9 Claims

    • BC-2.9.1

      In addition to the requirements under Paragraph BC-2.9.2, where licensees' insurance activities include the handling of claims, they must:

      (a) Respond promptly when claims are first notified, and provide customers with an explanation about how the claim will be handled and any actions required of the customer;
      (b) Provide reasonable guidance to customers in pursuing their claim;
      (c) Consider and handle claims fairly and promptly, and keep the customer informed of progress;
      (d) Inform customers in writing, with an explanation, if the licensee is unable to deal with all or any part of the claim; and
      (e) Forward settlement of claims without undue delay, once settlement has been agreed.
      Amended: April 2016
      Amended: October 2007
      January 2007

    • BC-2.9.2

      Where an insurance firm deals with medical insurance and handles all the claim processing activities directly, i.e. without using a TPA:

      (a) It must process and settle all medical claims with policyholders within 15 calendar days from the receipt of all necessary documents; and
      (b) It must process and settle claims from healthcare service providers within 30 calendar days from the receipt of all necessary documents from the healthcare service providers.
      April 2016

    • BC-2.9.3

      Insurance firms must comply with Paragraph BC-2.9.2 by 30th September 2016 at the latest.

      April 2016