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The Tokio Marine and Fire Insurance Co. (HK) Ltd.

Agents Portal

Agents Portal

Claim Procedures

IMPORTANT NOTE
The guidelines mentioned below are for general reference only. The final interpretation of any specific provision or its applicability is subject to the provisions of the relevant insurance policy under cover.

EMPLOYEES' COMPENSATION INSURANCE

INSURED TO DO
  1. In the event of an employee sustaining work-related bodily injury or death by accident or occupational disease, complete the prescribed form below and send them to the Labour Department in the following manners:
      Resulting in Notice Period Form
    Work Injury Period of Incapacity not exceeding 3 days Within 14 days Form 2B
    Period of Incapacity exceeding 3 days Within 14 days Form 2
    Death Within 7 days
    Occupational Disease Incapacity Within 14 days Form 2A
    Death Within 7 days
    Work Injury
    Resulting in Notice Period Form
    Period of Incapacity not exceeding 3 days Within 14 days Form 2B
    Period of Incapacity exceeding 3 days Within 14 days Form 2
    Death Within 7 days
    Occupational Disease
    Resulting in Notice Period Form
    Incapacity Within 14 days Form 2A
    Death Within 7 days
  2. Send us a copy of the completed Form 2 or Form 2A or Form 2B as a claim notice at the same time.
  3. In the event of any occurrence which may give rise to a claim, notify us immediately in writing with full particulars.
  4. Inform us in writing when you become aware of any intention of prosecution or any impending prosecution inquest or fatal inquiry in connection with any such occurrence. Every letter, claim, writ summons and process shall be notified or forwarded to us immediately on receipt.
  5. You, being the employer are required to pay periodical payments on normal pay days to the employee at the rate of four-fifths (4/5) of salary for the period of temporary incapacity (sick leave) certified by a registered medical practitioner or a registered dentist.
  6. You are also obliged to pay medical expenses for medical treatments provided by a registered medical practitioner or dentist in respect of your employee's work injury. You shall reimburse the medical expenses to your employee within 21 days upon request.
  7. You are required to pay compensation as assessed on Certificate of Compensation Assessment "Form 5" or Certificate of Review of Compensation Assessment "Form 6" within 21 days from its issuance. Otherwise you may have to pay surcharge to the employee. (Please refer to the reverse side of Form 5 or Form 6 for details.)
  8. If you receive any correspondence from the employee's solicitor or third party, inform us immediately and do not answer it without our consent.
  9. You are obliged to urge the injured worker to approach the Labour Department for sick leave clearance once he/she has resumed duty.
  10. In case of any uncertainty, make enquiry to us or to the Labour Department before taking any action.
DOCUMENTS REQUIRED
  1. Copy of the following:
    • A completed set of Form 2 or Form 2A or Form 2B
    • Accident Report (if any);
  2. Original of the following:
    • Relevant Certificate(s) of Compensation Assessment issued from the Labour Department (i.e. Form 5, Form 6, Form 7 or Form 9);
    • All Sick Leave Certificate(s) issued by a Registered Medical Practitioner(s);
    • Medical Expenses Receipt(s) issued by a Registered Medical Practitioner(s); and
    • Receipt acknowledged and duly signed by the injured employee in respect of the employees' compensation settlement

GOLFER (HOLE-IN-ONE)

INSURED TO DO
  1. Inform us of any occurrence or notice received which may produce a claim immediately
DOCUMENTS REQUIRED
  1. A completed Golfer Insurance Hole-in-One Claim Form (original)
  2. A copy of the Hole-In-One Certificate, issued by the golf club
  3. All original official receipt for the actual expenses incurred for the celebration
  4. Any additional information and document as and when required by us or adjuster other than the above

GROUP PERSONAL ACCIDENT / PERSONAL ACCIDENT

INSURED TO DO
  1. Inform us of any occurrence which may produce a claim immediately
  2. Cooperate and assist the adjuster when called upon
DOCUMENTS REQUIRED
  1. A completed Personal Accident Claim Form (original)
  2. All original medical receipts
  3. All sick leave certificates, if applicable
  4. Documents issued by doctor/clinic/hospital, if applicable
  5. Any additional information and document as and when required by us or adjuster other than the above

LIABILITY INSURANCE

INSURED TO DO
  1. Inform us of any occurrence or notice received which may produce a claim immediately
  2. Do not admit liability or make settlement with any third party
  3. Record particulars and nature of any bodily injury involved (if any)
  4. Take photos of the accident scene and damaged property
  5. Record contact details of all other parties involved (if any)
  6. If you receive any email, letter or legal documents from any third party who is seeking for any compensation, please pass it to us immediately
  7. Cooperate and assist the adjuster when called upon
DOCUMENTS REQUIRED
  1. A completed General Liability Claim Form (original)
  2. All documents received from any third party
  3. A detailed list of the damaged/lost property
  4. Police Statement and a signed Letter of Consent if police is involved
  5. Photos taken at accident scene and damaged property
  6. Any additional information and document as and when required by us or adjuster other than the above

MARINE CARGO

INSURED TO DO
  1. Instruct carrier/forwarder to issue irregularity report and/or put your own remark on the delivery receipt when the loss/damage happened under their custody
  2. Give a notice to hold carrier/forwarder/responsible parties liable
  3. Notify our office/overseas office immediately when loss/damage is found
  4. Provide relevant shipping documents and photos (i.e. Policy no, Transport document, Invoice & Packing list)
  5. Take all necessary steps to mitigate loss/damage. In case packing must be removed to avoid further loss/damage, retain all the packing materials and take photos showing the packing and cargo condition during unpacking.
  6. Render assistance to surveyor if survey is arranged
  7. Instruct carrier/forwarder to report to police for the loss of vehicle accident, theft, hijacking, etc.
DOCUMENTS REQUIRED
General
  1. A completed signed and stamped claim note (original)
  2. An original policy
  3. Invoice & Packing List
  4. Front and reverse side of Bill of Lading/Airway Bill/Truck Receipt/Delivery Order
  5. A damage notice issued from carrier/forwarder/port authority to inform the loss/damage
  6. A copy of claim notice sent to carrier/forwarder/responsible parties and also their replies
  7. Survey report and fee note (if applicable)
Additional documents may be requested (if applicable) but not limited to
  1. A completed statement of fact (original)
  2. Power of Attorney (original)
  3. Letter of Indemnity (original)
  4. Cargo manifest (i.e.內地海關及香港海關陸路進出境清單)
  5. Inspection/Technical/QC report
  6. Repair fee quotation/receipt
  7. Police report
  8. Loading and discharging tally report/vanning and devanning report
  9. Equipment Interchange Receipt for FCL cargo (in/out at POD and POL)
  10. An initial and final written confirmation issued by carriers/forwarder in relation to cargo shortage
  11. Salvage quotation
  12. Any additional document/information which would assist our claim consideration

MOTOR INSURANCE

MOTOR INSURANCE - Own Damage
INSURED TO DO
  1. Inform us of any occurrence or notice received which may produce a claim immediately
  2. Report to police immediately for traffic accident or theft of insured vehicle
  3. Take photos of the damaged parts, accident scene, road condition and all involved vehicles
  4. Record particulars and nature of any bodily injury involved (if any)
  5. Record contact details of all other parties involved (if any)
  6. Cooperate and assist the surveyor/adjuster when called upon
DOCUMENTS REQUIRED
  1. A completed Motor Vehicle Claim Form (original)
  2. Repair quotation for the insured vehicle
  3. Police Statement and a signed Letter of Consent if police is involved
  4. A copy of the Vehicle Registration Document for the insured vehicle (both sides)
  5. A copy of the driver's HKID and Driving Licence
  6. Screening Breath Test result, if applicable
  7. Photos &/or Car Cam Footage taken at accident scene and all involved vehicles
  8. Any additional information and document as and when required by us or adjuster other than the above
MOTOR INSURANCE - Windscreen Damage
INSURED TO DO
  1. Arrange the insured vehicle to the windscreen repairer
  2. Take photos of the windscreen with insured’s vehicle registration number before and after the repair
  3. Report to police immediately if the damage of windscreen is caused by third party
DOCUMENTS REQUIRED
  1. A completed Motor Windscreen Damage Claim Form (original)
  2. Repair/Replacement payment invoice/receipt (original)
  3. Photos showing the windscreen before and after the repair
  4. A copy of the Vehicle Registration Document for the insured vehicle (both sides)
MOTOR INSURANCE - Third Party Liability
INSURED TO DO
  1. Inform us of any occurrence or notice received which may produce a claim immediately
  2. Do not admit liability or make settlement with any third party
  3. Report to police immediately for traffic accident
  4. Take photos of the damaged parts, accident scene, road condition and all involved vehicles
  5. Obtain information of the third party, if possible
  6. Record particulars and nature of any bodily injury involved (if any)
  7. Record contact details of all other parties involved (if any)
  8. If you receive any email, letter or legal documents from any third party who is seeking for any compensation, please pass it to us immediately
  9. Cooperate and assist the surveyor/adjuster when called upon
DOCUMENTS REQUIRED
  1. A completed Motor Vehicle Claim Form (original)
  2. All documents received from any third party
  3. Police Statement and a signed Letter of Consent if police is involved
  4. A copy of the Vehicle Registration Document for the insured vehicle (both sides)
  5. A copy of the driver's HKID and Driving Licence
  6. Screening Breath Test result, if applicable
  7. Photos &/or Car Cam footage taken at accident scene and all involved vehicles
  8. Information of the third party, if applicable
  9. Any additional information and document as and when required by us or adjuster other than the above

OVERSEAS TRAVEL ACCIDENT INSURANCE   (Policy issued in Hong Kong)

INSURED TO DO
  1. Seek medical treatment from "Registered Medical Practitioner" when medical condition is necessary.
  2. For (i) inpatient or hospitalization claims; or (ii) the medical expenses incurred has exceeded HK$3,000, request the Registered Medical Practitioner to complete the "Attending Physician's Statement" on the Overseas Travel Accident Insurance Claim Form.
  3. Complete the Overseas Travel Accident Insurance Claim Form by the insured person (if there is any other Insurance in force, please state the name of the insurance company and policy number) and submit together with related documents within 30 days from the date of consultation/accident.
DOCUMENTS REQUIRED
  1. A completed Overseas Travel Accident Insurance Claim Form with the "Attending Physician's Statement" duly completed on the claim form (original)
  2. All original medical receipts, including but not limited to Hospital Statement, Attending Physician's Bill(s) stating the following:
    • Name of patient
    • Name of hospital/clinic
    • Name of Attending Physician, signature and stamp
    • Date of consultation
    • Diagnosis
    • Date of admission to hospital, where applicable
    • Date of accident, where applicable
    • Details of accident, where applicable
    • Itemized breakdown of charges
    • Issue date of receipt
    • For diagnostic imaging and laboratory tests, please submit the latest referral letter stating the diagnosis and reason for referral.
  3. Any additional information and document other than above as and when required by us or adjusters.

OVERSEAS TRAVEL INSURANCE   (Policy issued in Japan)

INSURED TO DO
  1. Seek medical treatment from Doctor of Medicine when medical condition is necessary.
  2. For (i) inpatient or hospitalization claims; or (ii) the medical expenses incurred has exceeded JPY300,000, request the Doctor of Medicine to complete the "Attending Physician's Statement" on the Overseas Travel Insurance Claim Form.
  3. Complete the Overseas Travel Insurance Claim Form by the insured person (if there is any other Insurance in force, please state the name of the insurance company and policy number) and submit together with related documents within 30 days from the date of consultation/accident.
DOCUMENTS REQUIRED
  1. A completed Overseas Travel Insurance Claim Form with the "Attending Physician's Statement" duly completed on the claim form (original)
  2. All original medical receipts, including but not limited to Hospital Statement, Doctor of Medicine's Bill(s) stating the following:
    • Name of patient
    • Name of hospital/clinic
    • Name of Doctor of Medicine, signature and stamp
    • Date of consultation
    • Diagnosis
    • Date of admission to hospital, where applicable
    • Date of accident, where applicable
    • Details of accident, where applicable
    • Itemized breakdown of charges
    • Issue date of receipt
    • For diagnostic imaging and laboratory tests, please submit the latest referral letter by Doctor of Medicine stating the diagnosis and reason for referral.
  3. Any additional information and document other than above as and when required by us or adjusters.

PLEASURE CRAFT INSURANCE

PLEASURE CRAFT INSURANCE - Own Damage
INSURED TO DO
  1. In the event of an accident, complete the prescribed form i.e. Report of Marine Incident (Form No. M.O. 822) as required by Hong Kong Marine Department ("HKMD") and send it to the Marine Accident Investigation Section of HKMD as soon as possible within 24 hours after the accident
  2. Send us a copy of the completed Report of Marine Incident as a notice at the same time and provide us your insurance policy number
  3. Take photos showing the extent of damage of the vessel
  4. Take all necessary steps to safeguard or recover the insured Vessel, avoid or minimize any loss, damage or expense to the insured Vessel or Craft
  5. Render assistance to surveyor if survey is arranged
  6. DO NOT dispose any damaged materials and repair the damaged vessel without our prior consent/seeking our comment
  7. In case vessel damage due to vessel collision, please preserve all rights against third parties and do not release third parties from liability
  8. Do not accept any compensation/offer from liable party, if any, without our prior consent
  9. In the event of a salvage payment arising under the policy, please seek our consent before signing any salvage agreement
DOCUMENTS REQUIRED
  1. Report of Marine Incident
  2. Certificate of Ownership
  3. Operating Licence
  4. Pleasure Vessel Operator Certificate of Competency
  5. Photos of the damage condition of vessel
  6. Maintenance record of the vessel
  7. Repair quotation
  8. Survey report and fee note (if applicable)
  9. Police report, if applicable
  10. Salvage quotation, if applicable
  11. Any additional document/information which would assist our claim consideration
PLEASURE CRAFT INSURANCE - Third Party Liability
INSURED TO DO
  1. In the event of an accident, complete the prescribed form i.e. Report of Marine Incident (Form No. M.O. 822) as required by Hong Kong Marine Department ("HKMD") and send it to the Marine Accident Investigation Section of HKMD as soon as possible within 24 hours after the accident
  2. Send us a copy of the completed Report of Marine Incident as a notice at the same time and provide us your insurance policy number
  3. Take photos of the accident scene and damaged property / opponent vessel, if applicable
  4. Record particulars and nature of any bodily injury involved (if any)
  5. Record contact details of all other parties involved (if any)
  6. Do NOT admit liability or make settlement with any third party
  7. If you receive any email, letter or legal documents from any third party who is seeking for any compensation, please pass it to us immediately
  8. Cooperate and assist the adjuster when called upon
DOCUMENTS REQUIRED
  1. Report of Marine Incident
  2. Certificate of Ownership
  3. Operating Licence
  4. Pleasure Vessel Operator Certificate of Competency
  5. Maintenance record of the vessel
  6. All documents received from any third party
  7. A details list of the damaged/lost property
  8. Photos of the accident scene and damaged property / opponent vessel, if applicable
  9. Police statement and a signed Letter of Consent if police is involved
  10. Salvage quotation, if applicable
  11. Any additional document/information which would assist our claim consideration
Download Claim Forms (SOURCE: HONG KONG MARINE DEPARTMENT)

PROPERTY INSURANCE

INSURED TO DO
  1. Inform us of any occurrence or notice received which may produce a claim immediately
  2. Take all practical steps to mitigate the loss/damage
  3. Report to police immediately in case of theft, burglary and/or malicious damage
  4. Take photos of the accident scene and damaged property
  5. Do not dispose of the damaged property
  6. Cooperate and assist the adjuster when called upon
DOCUMENTS REQUIRED
  1. A completed General Property Claim Form (original)
  2. A detailed list of claims for the damaged/lost property
  3. Repair/replacement quotation and purchase receipt for the damaged/lost property
  4. Police Statement and a signed Letter of Consent if police is involved
  5. Photos taken at accident scene and damaged property
  6. Any additional information and document as and when required by us or adjuster other than the above

MISC INSURANCE

DOMESTIC HELPER - Employer's Liability (Employees' Compensation)
INSURED TO DO
  1. Please refer to the procedures of Employees' Compensation Claim
DOMESTIC HELPER - Medical Claim
INSURED TO DO
Clinical/Dental Expenses:
  1. Submit a completed set of the Domestic Helper Insurance Claim Form to us together with original of official medical receipt bearing the following details within 90 days:
    • Name of Helper
    • Date of Treatment
    • Diagnosis
    • Attending physician's signature with stamp
    • Date of Issue
    • Itemized Breakdown of Charges
Hospitalization Expenses
  1. Notify us in writing with particulars such as Policy Number, Name of Policyholder together with the following documents within 90 days:
    • A completed full set of "Hospitalization & Surgical Claim Form" (original):
      • Insured Helper fills in Part I
      • Attending physician fills in Part II
    • Original official medical receipt(s) including but not limited to Hospital Statement, Attending Physician Bill(s), Receipt of Supplies Purchase (if applicable), etc. stating the treatment date, patient's name, diagnosis and breakdown of charges
    • Other supporting documents (e.g. medical reports, claim statements from other insurance companies)
DOMESTIC HELPER - Non-Medical Claim
INSURED TO DO
  1. Inform us of any occurrence or notice received which may produce a claim immediately.
  2. Submit a completed set of the Domestic Helper Insurance Claim Form to us together with the relevant supporting documents and proof of loss
  3. Copy of Police Statement and Police Report no. if police is involved