Claims Service - Life Insurance

Claims Procedures

Life Insurance

How to submit claims

The Policyowner, Life Insured, Claimant/Beneficiary and the attending physician to complete and sign the appropriate claim forms.
Prepare and collect all required documents.
Submit the completed claim forms together with the supporting documents using one of the following methods:

Through your Insurance Consultant;
Submit in person to any one of the Well Link Life's Wealth Management Centres;
Mail to: Well Link Life Insurance Company Limited, Units 16-18, 11/F., China Merchants Tower, Shun Tak Centre, 168-200 Connaught Road Central, Sheung Wan, Hong Kong.

Upon receipt of your claim application, we will handle and assess immediately.

If you need to get a copy of claim form(s), any enquiries relating to claims or need assistance in submission, you can call our Claims Hotline at +852 2830 7600 during office hours (Monday to Friday from 9am to 6pm, closed on Saturday, Sunday and public holidays), or email to lifeservice@wli.com.hk, or notify us through logging in Well Link Life's online policy management platform so that we can offer our help as quickly as possible.

Service Pledge of Claims Handling

We value our relationship with you. We devote our best efforts to handle all your claims or enquiries and ensure reliable services being provided.

Claim Type - Service Pledge

Accident, Medical and Hospital Claims：Within 3 working days

Major Claims (including Death, Critical Illness and Waiver of Premium Claims)：Within 5 working days

^Note:

^{The above pledges are applicable to cases in which all required documents are received for processing at the time of receiving the claims application.}

Claims Documentation

Required Documents:

Death Claim Form to be completed and signed by Beneficiary/ Claimant
Death Claim – Attending Physician's Report to be completed by the last attending physician of the Life Insured
Death certificate
ID cards of the Life Insured and Beneficiary/ Claimant
Relationship proof between the Life Insured and Beneficiary
Policy document
Other supporting documents:

Copy of the past health or medical records of the insured (such as outpatient record booklet, consultation records, hospitalization records, laboratory reports, etc.)
Doctor / hospital information or patient card copies that the insured had consulted in the past 5 years
Witness statement / police report / newspaper clippings (mainly for traffic accidents or special events)
(If death occurred in Mainland China) Notarial Certificate of Death issued by Mainland's authority and medical death certificate issued by Mainland Hospitals

Points to Note:

Answer all questions clearly on the Death Claim Form. Do not leave any question blank. You can call our Claims Hotline (+852 2830 7600) for a copy of claim form.
Death Claim - Attending Physician's Report to be completed by the attending doctor, with signature and chop at client's own expenses.
Unless otherwise specified, original documents are required.
For any documents not written in English / Chinese, client needs to provide the certified valid translation.
At the time of claim submission, if the beneficiary is under age 18 and the policy has not appointed any trustee, the original "Guardianship Paper" issued by court to the Guardian of the beneficiary has to be submitted.
If there is no designated beneficiary in the policy or the beneficiary stated in policy is "estate" or "legitimate heir", the original "Letter of Administration" issued by Hong Kong Court has to be submitted or the original "Probate" in case a will was made.
Types of information and documents required may be varied on a case by case basis.
We reserve our rights to ask for additional information or documents for assessment of the claim. If we need anything additional from you or other related parties, we will notify your Insurance Consultant or contact you immediately. Since it takes time to obtain the information, the claim assessment process will be prolonged.

Required Documents:

Critical Illness Claim Form to be completed and signed by Life Insured and Policyowner
Critical Illness Claim– Attending Physician's Report to be completed by the attending physician of the Life Insured
ID copies of the Life Insured and Policyowner (if not submitted to us before)
Laboratory and pathological reports
Other supporting documents:

Copy of the past health or medical records of the insured (such as outpatient record booklet, consultation records, hospitalization records, laboratory reports, etc.)
Doctor / hospital information or patient card copies that the insured had consulted in the past 5 years

Points to Note:

Claim form and required documents must be submitted within 90 days after the critical illness was first diagnosed. You can call our Claims Hotline (+852 2830 7600) for a copy of claim form.
Answer all questions clearly on the Critical Illness Claim Form. Do not leave any question blank.
Claim Form - Attending Physician's Report to be completed by the attending doctor, with signature and chop at client's own expenses. Please note that different critical illnesses may require to complete a different Attending Physician's Report.
Unless otherwise specified, original documents are required.
For any documents not written in English / Chinese, client needs to provide the certified valid translation.
If the diagnosis is made in China, all related reports and proof must be issued by the specified hospitals in PRC. For the list of approved China hospitals please refer to "List of Specified Hospitals in PRC".
The definition of each critical illness or early stage critical illness, as well as the relevant exclusions, are listed on the policy provision. No claim is eligible if the diagnosis falls under the exclusions or does not meet the stated definition.
Types of information and documents required may be varied on a case by case basis.
We reserve our rights to ask for additional information or documents for assessment of the claim. If we need anything additional from you or other related parties, we will notify your Insurance Consultant or contact you immediately. Since it takes time to obtain the information, the claim assessment process will be prolonged.

Required Documents:

Waiver of Premium Claim Form – to be completed and signed by Life Insured and Policyowner
Waiver of Premium Claim – Attending Physician's Report to be completed by the attending physician
ID copies of the Life Insured and Policyowner (if not submitted to us before)
Sick leave certificates
Patient card copies
Other supporting documents:

Discharge summary/ Discharge slip copy
Laboratory/ Investigation reports copies
Physiotherapy and occupational therapy progress reports

Points to Note:

Claim form and required documents must be submitted within 6 months after date of disability. You can call our Claims Hotline (+852 2830 7600) for a copy of claim form.
Answer all questions clearly on the Waiver of Premium Claim Form. Do not leave any question blank.
Waiver of Premium Claim - Attending's Physician's Report to be completed by the attending doctor, with signature and chop at client's own expenses.
Unless otherwise specified, original documents are required.
For any documents not written in English / Chinese, client needs to provide the certified valid translation.
There are definitions of disability and exclusions listed on the policy provisions. No claim is eligible if the diagnosis does not meet the definition or falls under the exclusions.
Types of information and documents required may be varied on a case by case basis.
We reserve our rights to ask for additional information or documents for assessment of the claim. If we need anything additional from you or other related parties, we will notify your Insurance Consultant or contact you immediately. Since it takes time to obtain the information, the claim assessment process will be prolonged.

Required Documents:

Hospital or Medical Claim Form to be completed and signed by Life Insured/Insured Person and Policyowner/Policy Holder
Hospital or Medical Claim– Attending Physician's Report to be completed by the attending physician of the Life Insured
ID copies of the Life Insured/Insured Person and Policyowner/Policy Holder (if not submitted to us before)
Receipts - Original (if claiming Well Protect VHIS Series or Surgical Benefit under Well Care Silver Medical Plan) / Copies (if claiming Well Protect 108 Refundable Hospital Income Insurance Plan, or Daily Hospital Income Benefit or Daily Rehabilitation Benefit under Well Care Silver Medical Plan)
Proof issued by attending physician for the necessity and details of the rehabilitation program (if claiming Daily Rehabilitation Benefit under Well Care Silver Medical Plan)
Other supporting documents:

Discharge summary/ Discharge slip copy
Laboratory/ Investigation reports copies
(If hospitalization outside Hong Kong) Outpatient medical record booklet copy and provide detailed reason(s) of seeking treatment outside Hong Kong

Points to Note:

For claiming Well Protect VHIS Series, Well Protect 108 Refundable Hospital Income Insurance Plan or Daily Hospital Income Benefit or Surgical Benefit under Well Care Silver Medical Plan, claim form and required documents must be submitted within 90 days after the Life Insured been discharged from the hospital. For claiming Daily Rehabilitation Benefit under Well Care Silver Medical Plan, claim form and required documents must be submitted within 90 days from the date of completion of the Rehabilitation Program.
Answer all questions clearly on the Hospital or Medical Claim Form. Do not leave any question blank.
Hospital or Medical Claim - Attending Physician's Report to be completed by the attending doctor, with signature and chop at client's own expenses.
You can call our Claims Hotline (+852 2830 7600) for a copy of claim form.
Unless otherwise specified, original documents are required.
For any documents not written in English / Chinese, client needs to provide the certified valid translation.
For claim under Well Care Silver Medical Plan, Life Insured must be confined to hospitals in Hong Kong or specified hospitals in China for eligible claims. For claim under Well Protect 108 Refundable Hospital Income Insurance Plan, if confined in a hospital in places other than Hong Kong or designated areas, the benefit payable and the maximum period will be reduced. Confinement in China must be in specified hospitals. For the list of approved China hospitals please refer to "List of Specified Hospitals in PRC" (Applicable to Well Protect Critical Illness Protection Plan, Well Care Silver Medical Plan and Well Protect 108 Refundable Hospital Income Insurance Plan).
There are definitions and exclusions listed on the policy provisions. No claim is eligible if the diagnosis does not meet the definition or falls under the exclusions.
The Policyowner/Policy Holder may request to provide an estimate on the amount that may be claimed under the provision before the Life Insured/Insured Person receives medical services. The Policyowner/Policy Holder can contact Claims Department directly or via the Insurance Consultant. Upon receiving the request and required information, the Company will inform the Policyowner/Policy Holder directly of the claimable amount estimated in writing within 3 working days. The Company's estimate is for reference only and the actual amount claimable will be subject to the final expenses incurred.
Types of information and documents required may be varied on a case by case basis.
We reserve our rights to ask for additional information or documents for assessment of the claim. If we need anything additional from you or other related parties, we will notify your Insurance Consultant or contact you immediately. Since it takes time to obtain the information, the claim assessment process will be prolonged.

Claims FAQs

No. The proceeds of a death claim are not subject to estate duty as per current regulations in Hong Kong.

The payment is normally made to the beneficiary(ies) of the policy according to the allocation percentage specified, except for the following scenarios:

the beneficiary is under age 18, the proceeds are given to their surviving legal guardian as trustee.
the beneficiary of the policy dies before the Life Insured, the proceeds are paid to the Policyowner.
the policy is collaterally assigned to someone else, we firstly follow the Assignment Deeds and give the assigned amount to the assignee, or the executors / administrators of their estate; any remaining balance goes to the beneficiary.
no beneficiary is designated and the Policyowner is still alive, the proceeds are paid to the Policyowner.
no beneficiary is designated and the Policyowner has passed away, the proceeds go into the policyholder's estate.

You need to complete the related application form with the deceased's personal details. The following documents are also required:

Notarised Certificate of Death
If the death occurred in hospital, you need a medical certificate from that hospital showing the cause of death
If the death did not occur in hospital, you need a death certificate (showing the cause of death) issued by the local police
The Hong Kong or Macau ID card and China re-entry permit or travel document of the deceased (for Hong Kong or Macau resident)
The De-registration of Residence of the deceased (for citizen of mainland China)
Your own Hong Kong or Macau ID card and China re-entry permit or travel document

Under the Births and Deaths Registration Ordinance, a death due to natural causes should be registered within 24 hours. In general, the registered medical practitioner who attended the deceased for the latest illness will sign and issue a Medical Certificate of the Cause of Death (Form 18). Please bring the certificate to the Death Registry for registration of the death. The following documents are required:

Medical Certificate of the Cause of Death (Form 18)
Hong Kong Identity Card or Travel Document of the deceased
Hong Kong Identity Card or Travel Document of the applicant
Applicant are required to provide information on the deceased person's occupation, nationality and marital status
Payment of standard charge of HK$140 per death certificate copy

You may visit the below government website for details of death registry requirement:

http://www.gov.hk/en/residents/immigration/bdmreg/death/deathreg/naturalcause.htm

You need to fill in the following four sections of the claim form:

Information of Deceased Insured and the Incident
Claimant Information
Individual Tax Residence Self-Certification
Declaration and Authorization

If the policy has more than one beneficiary, each needs to complete a separate claim form.

You also need to submit the Death Claim - Attending Physician's Report completed by the deceased's last attending doctor. The cost of the report is borne by the Claimant. There are still other supporting documents to be submitted and please refer to our related Claims Guidelines for details.

In most cases, the claimant must be the beneficiary of the policy.

If the beneficiary is under age 18, their parent or legal guardian can help to file the claim. If there is no beneficiary designated under the policy and the Policyowner is not the Life Insured, the Policyowner can file the claim. If there is no beneficiary designated and the Policyowner is the Life Insured, then the administrator/executor of the deceased Insured's estate can file the claim.

Firstly, the start date of which the symptom or the disease has to be confirmed. Under many circumstances, the symptoms only appear or become significant after a period of time. Therefore, if the symptoms or the medical condition happen within 60 days after your insurance went into effect, it is still not covered. Moreover, the disease does not fulfill the definition of the such critical illness or early stage critical illness, the claim will also be declined. Please refer to the policy provisions for details.

Pre-existing conditions are normally not be covered under the critical illness insurance plan as the already-existing conditions are not the coverage intention of the insurance companies. Therefore, any condition that has started, exists, with signs and symptoms appearing before your insurance went into effect will not be covered under the policy. Please refer to the policy provisions for the definition of the pre-existing conditions.

The benefit payments are paid to the Policyowner. If the Policyowner has passed away, it goes into his/her estate.

Please send us the Claim Form with the supporting documents within 90 days for the Life Insured becoming aware that he/she is suffering from a Critical Illness or Early Stage Critical Illness.

You can give them to us through your insurance consultant, or mail them to us at:

Units 16-18, 11/F., China Merchants Tower, Shun Tak Centre, 168-200 Connaught Road Central, Sheung Wan, Hong Kong

Change of occupation may affect the premium calculated. When there is a change of the job duties or job nature in the occupation, or a change of occupation or engagement in additional occupation, you should notify us in writing immediately, otherwise the benefit may not be payable.

While any premiums are being waived, the payment mode or the basic plan cannot be changed.

Except the waiver is due to the death of the Policyowner under the Payor Benefit, we have the right to request the insured person to be examined by physicians designated by us or to request proof of continuance of the Total Disability. If such proof is not able to be provided, premium will cease to be waived.

As processing time is required for claim assessment, please continue to pay the premium even after the commencement of the disability or claim submission to keep the policy inforce. Once we have approved the claim, we will refund the premium paid on or after the first premium due date following the commencement of total disability back to the Policyowner.

If the insured person suffers from Total Disability, please send us the written notification within 6 months from the date of commencement of the Total Disability. Supporting proof of Total Disability should be submitted within 1 year.

You can give them to us through your insurance consultant, or mail them to us at:

Units 16-18, 11/F., China Merchants Tower, Shun Tak Centre, 168-200 Connaught Road Central, Sheung Wan, Hong Kong

Please send us the Claim Form with the supporting documents within 90 days after the Life Insured was discharged from the hospital.

For Claims relating to Well Care Silver Medical Plan

Pre-existing conditions are normally not be covered under the medical insurance plan as the already-existing conditions are not the coverage intention of the insurance companies. Therefore, any condition that has started, exists, with signs and symptoms appearing before your insurance went into effect will not be covered under the policy. Please refer to the policy provisions for the definition of the pre-existing conditions.

Firstly, the start date of which the symptom or the disease has to be confirmed. Under many circumstances, the symptoms only appear or become significant after a period of time. Therefore, if the symptoms or the medical condition happen within 90 days after your insurance went into effect, it is still not covered. Please refer to the policy provisions for details.

For Well Care Silver Medical Plan, we only accept the hospital confinement or treatment in Hong Kong or specified hospitals in PRC. We will not cover any hospitalization overseas.

There is a 180-days limit per each Policy year for Daily Hospital Income Benefit. The usage will be reset every Policy Year but subject to a combined lifetime limit of 730 days together with the Daily Rehabilitation Benefit.

For Claims relating to Well Protect VHIS Series

We will reimburse the medical expense arises from a pre-existing condition that you were not aware of at the time of application, according to below schedule:

Policy Year - Reimbursement Arrangement

1^st year：No coverage

2^nd year：25% reimbursement

3^rd year：50% reimbursement

4^th year onwards：100% Full coverage

Except psychiatric treatments that are required to be hospitalized in Hong Kong, all other benefits are applicable worldwide.

If the congenital conditions manifested or diagnosed before the Insured Person attained age 8, the resulted expenses incurred for the medical services are not covered.

If you are confined in a type of room that is higher than the entitled ward class of the plan, the following adjustment factors will apply:

Entitled Ward Class in the Plan (Ward)：

Confined Ward Class - Ward Class adjustment factor

Semi-Private Room：50%

Standard Private Room or any room type that is higher than a Standard Private Room：25%

Entitled Ward Class in the Plan (Semi-Private Room)：

Confined Ward Class - Ward Class adjustment factor

Standard Private Room：50%

Any room type that is higher than a Standard Private Room：25%

Entitled Ward Class in the Plan (Standard Private Room)：

Confined Ward Class - Ward Class adjustment factor

Any room type that is higher than a Standard Private Room：50%

The above adjustment factors do not apply when the confinement in a type of room in a Hospital higher than the entitled Ward Class is due to –

(i) unavailability of entitled Ward Class due to ward or room shortage in the hospital of confinement for emergency treatment;

(ii) isolation reasons that require a specific class of accommodation; or

(iii) other reasons not involving your personal preference.

For Claims relating to Well Protect 108 Refundable Hospital Income Insurance Plan

The death benefit amount equals to 150% of the total equivalent annual premiums paid. If there is any indebtedness outstanding, it will be deducted from the death benefit.

Total equivalent annual premiums paid means the accumulated premiums due and paid at the relevant date which is calculated as “annual premium” (i.e. premium payable for annual mode) divided by 12 then multiplied by the corresponding number of months that the premium has been paid. Therefore, the amount calculated for monthly mode will be same as annual mode. Levy or premiums of other benefit items (if any) will be excluded.

Firstly, the start date of which the symptom or the disease has to be confirmed. Under many circumstances, the symptoms only appear or become significant after a period of time. Therefore, if the symptoms or the medical condition happen within 30 days after your insurance went into effect, it is still not covered. Please refer to the policy provisions for details.

Hospital confinement means the admission and confinement of the Life Insured as an in-patient in a hospital upon recommendation of a physician for treatment for a minimum of 6 hours and continuously stay in the hospital prior to discharge. Such confinement must also be medically necessary in order to fulfill the definition.

If the life insured is confined in a hospital in places other than Hong Kong and designated areas (please refer to the policy provisions for details of designated areas), any benefit payable will be reduced to 50% of the relevant benefits; and the maximum period for which the daily hospital income benefit is payable per hospital confinement will be reduced to 90 days. If the life insured is confined in a hospital in Mainland China, the hospital confined must also be listed on the prevailing “List of Specified Hospitals in PRC” maintained by the Company and uploaded onto the website, otherwise, no benefit is payable.