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Understanding Your Participating Policy

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Individual insurance claims procedure

At Manulife, we provide a fast and simple individual insurance claims process along with the proper safeguards to meet your urgent needs, so you can enjoy outstanding protection as well as peace of mind.

Individual Insurance Claims Report 2021

Ways to make your claim

1. Try our eClaims service

Applicable for single hospitalization receipt not exceeding HKD3,000

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2. For receipt above HKD3,000:

Download and complete Claim Form

Collect claim-related documents

Submit Claim Form and documents within 90 days of discharge from hospital

Upon receipt of all required documents¹, we will assess claims and may approve within 14 working days²

Receive claim settlement

¹The required documents include all the following basic document requirements and additional document requirements (if applicable). Manulife may also require customers to further submit (or obtained by the company) other medical reports or any related documents related to the claim assessment for evaluation.

²Manulife’s Claims Department follows the principles of “Medically Necessary” and “Reasonable and Customary” and the general practice of the local insurance industry when assessing and approving claims.

Claim-related documents

Basic requirements³

Fully completed Medical Insurance - Hospitalization & Surgical Claim Form (C13)
• Part I - completed and signed by Insured / Policyowner
• Part II - completed, signed and stamped by Attending Physician (Doctor) / Surgeon
Original hospital receipts
Original statement of charges / accounts
Copy of HKID Card or passport of both Policyowner and Insured (if you have not provided the relevant document(s) to us before or the document(s) in our record is / are no longer valid or do(es) not comply with the current regulatory requirements)
Full set copy of medical documents from hospital, including copy of laboratory, diagnostic, imaging & histopathology report and discharge summary
Breakdown of charges of laboratory, investigation tests, medication, meal and medical package (if applicable)

Additional requirements (if applicable)

Original receipts with diagnosis proof (for pre- / post-hospitalization outpatient / day case surgery outpatient benefit)

Copy of payment advice and original / certified true copies of receipts from other insurer(s) (if claims paid by other insurer(s))

Copy of daily hospitalization record and Home Visit Permit (if hospitalized in Mainland China hospitals)

Copy of student identity card (if claiming for a dependent of the insured who is a student aged 18 to 25)

Copy of police report / traffic accident report / police statement (if traffic accident involved)

Copy of discharge summary / slip or sick leave certificate with diagnosis (if hospitalized in a Hong Kong government hospital)
Fully completed Wart/Benign Skin Lesion Surgery Claim - Supplementary Form (C_ENQ02) (if applicable) and related medical documents:

- All consultation records from treatment center, related to this wart surgery

- Operation record with details note including operation duration, operating medication, body part performed and numbers of warts treated

- Pre- and post-surgery clinical photos, subject to the sensitivity of the body location where the treatment was performed, signed by patient

- Pathology report (if surgical curettage was done)

- Itemized breakdown of charges with details of specific procedure performed, medication prescribed, laboratory test and any other medical and/ or non- medical services rendered

³ Manulife reserves the right to request for original documents or other supplementary documents / information if deemed necessary.

VHIS Claimable Amount Estimate / Preliminary Assessment

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Cashless Day Surgery eService

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Medical Insurance - Hospitalization & Surgical Claim Form (C13)

Wart/Benign Skin Lesion Surgery Claim - Supplementary Form (C_ENQ02)

OGD/Colonoscopy Day Surgery or Hospital Admission Consultation Form

Claims procedure

Download and complete Claim Form

Collect claim-related documents

Submit Claim Form and documents within 30 days after the date of accident

Claims assessment and approval by Manulife Claims Department

Receive claim settlement

Claim-related documents

Basic requirements

Fully completed Claim Form for Accident (C12)
• Part I - completed and signed by insured / policyowner
• Part II - completed, signed and stamped by Attending Physician (Doctor)
Copy of Sick Leave Certificate(s) with Diagnosis (for disablement claims)
Original Medical receipt(s) with diagnosis proof (for medical reimbursement claims)
Copy of HKID Card or passport of both Policyowner and Insured (if you have not provided the relevant document(s) to us before or the document(s) in our record is / are no longer valid or do(es) not comply with the current regulatory requirements)

Additional requirements (if applicable)

Diagnostic / Laboratory Reports (if diagnostic / laboratory test done)

Referral Letter from Attending Physician (Doctor) (if attended by Specialist / Physiotherapist / Occupational Therapist)

Copy of Police Report / Traffic Accident Report / Police Statement (if involved in a Traffic Accident)

Copy of compensation breakdown from other insurer(s)(if claim paid by other insurer(s))

Physiotherapy / Occupational Therapy Report (if Physiotherapy / Occupational Therapy done)

Original Statement of Charges / Account and Original hospital receipts (if hospitalized)

Claim Form for Accident (C12)

Claims procedure

Download and complete Claim Form

Collect claim-related documents

Submit Claim Form and documents within 30 days of:
i) the first diagnosis date of the Major Disease or the Gender Specific Illness or the Juvenile Disease;
OR
ii) the date of an Angioplasty Procedure

Claims assessment and approval by Manulife Claims Department

Receive claim settlement

Claim-related documents

Fully completed claim form for major disease / female benefit
• Page 1 & 2 - completed and signed by claimant / policyowner
• Attending Physician's Statement - completed, signed and stamped by Attending Physician (Doctor)
Copies of all histopathology reports, laboratory reports, X-rays results, reports of CT Scan and other imaging studies, blood test results and / or other relevant proof / medical evidence
Copy of HKID Card or passport of both Policyowner and Insured (if you have not provided the relevant document(s) to us before or the document(s) in our record is / are no longer valid or do(es) not comply with the current regulatory requirements)

Claim Form for Major Disease - Kidney Failure

Claim Form for Major Disease - Myocardial Infarction

Claim Form for Major Disease - Cancer

Claim Form for Major Disease - Stroke

Claim Form for Major Disease - Heart Valve Surgery / Less Invasive Treatments of Heart Valve Disease

Please log in to our customer website to download other claim forms.

Claims procedure

Download and complete Claim Form

Collect claim-related documents

Submit Claim Form and documents no later than 12 months after the commencement of Total Disability

Claims assessment and approval by Manulife Claims Department

Receive claim settlement

Claim-related documents

Basic requirements

Fully completed Claimant's Statement of Disability (C03) for disability in first 24 months OR Claimant's Statement of Continued Disability (C04) for continuous claims for disability after 24 months
• Page 1 & 2 - completed and signed by claimant / policyowner
• Attending Physician's Statement - completed, signed and stamped by Attending Physician (Doctor)

Copy of Sick Leave Certificate(s) with Diagnosis

Copy of HKID Card or passport of both Policyowner and Insured (if you have not provided the relevant document(s) to us before or the document(s) in our record is / are no longer valid or do(es) not comply with the current regulatory requirements

Additional requirements (if applicable)

Income proof (e.g. tax return for the past 12 months prior to disability)

Proof of occupation (e.g. Employment Letter)

Employer's confirmation

Certificate of Employees' Compensation Assessment (Form 5 or 7)

Claimant's Statement of Disability (C03)

We understand the passing of a loved one is a very difficult time for those left behind. We have made the claim procedures for the death benefit as simple as possible, so you can focus on the things that most require your attention.

Claim procedures

Download and complete Form C01 "Proof of Death (Claimant's Statement)"

Collect related documents (As outlined in Claim-related documents section below)

Submit Form C01 “Proof of Death (Claimant’s Statement )” and related documents

Claim assessment and approval by Manulife

Receive claim settlement

Claim-related documents

Basic requirements

Fully completed Form C01 “Proof of Death (Claimant’s Statement )”
Certified true copy of Death Certificate*
Copy of beneficiary’s HKID card/ Passport
Copies of policyowner and life insured’s HKID card/ Passport
Copy of beneficiary’s proof of relationship with the deceased life insured such as birth certificate or marriage certificate (if the beneficiary’s HKID card number / Passport number was not provided by the policyowner on either the policy’s application and/or Beneficiary Designation Form)
Original policy contract, or complete “Declaration of Loss of Policy” section on Form C01 “Proof of Death (Claimant’s Statement )” if applicable except in the event of an eContract or policy with more than 1 life insured.

Additional requirements

If the life insured passes away within 2 years of:

The date of policy issue; or
The date of last reinstatement; or
The effective date of:
- An increase of the face amount; or
- An increase of the rider amount; or
- An additional of rider benefit;

whichever date is later,

Then please prepare submit the following additional documents:

Form C02 "Proof of Death" Physician’s Statement
Medical Report (if requested by Manulife )

Accidental or Unnatural Death

Police Report
Coroner’s Report
Post-mortem Report
Newspaper Clippings

Death in Mainland China

Certified true copy of Notarial Death Certificate*
Certified true copy of Hong Kong Identity Card Cancellation Certificate*
Pathological Diagnosis Certificate
Copy of Mainland Travel Permit for Hong Kong and Macau Residents
Cremation papers
Certificate of Import of Human Remains (if any)

Claims submission

By Mail

Hong Kong

Claims Department

Individual Financial Products

Manulife (International) Limited

22/F, Manulife Financial Centre,

223-231 Wai Yip Street, Kwun Tong, Kowloon, HK

Macau

Individual Financial Products

Manulife (International) Limited

Macau Administration Office, Avenida De Almeida Ribeiro No. 61, Circle Square, 14 andar A, Macau

In Person

Hong Kong Customer Service Centre

21/F, Tower A, Manulife Financial Centre,

223-231 Wai Yip Street,

Kwun Tong, Kowloon, HK

Macau Customer Service Centre

Macau Administration Office, Avenida De Almeida Ribeiro No. 61, Circle Square, 14 andar A, Macau

After making a claim, policyowner may log in to Manulife customer website, and check the claim status or view past claim records (up to 5 years) under “Claims > Individual claim history” section.

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