The number of complaints received by the insurance industry's self-regulator climbed almost a fifth last year but the watchdog said it just reflected the fact that more people were buying insurance.
There was no indication that more companies were using unscrupulous sales tactics, the Insurance Claims Complaints Bureau said yesterday.
"As the number of people who buy insurance increases, it is natural for the number of complaints to go up as well," the chairman of the bureau's complaints panel, Michael Tsui Fuk-sun said.
Of 479 complaints received last year - up 18 per cent over 2011 - 278 have been closed with only 5 per cent of complainants winning their cases.
Among those who won was a woman who was refused cover for heart treatment in hospital 10 months after buying her policy even though she had disclosed the pre-existing condition and been issued a policy without an exclusion. The panel ruled that the insurer should honour the HK$21,000 claim.
Those who lost included a man who was stopped and searched for drugs in London by two men claiming to be police and later found his wallet with £400 (HK$4,724) missing. The panel ruled that as there was no violence it was not robbery and backed the insurer's rejection of the claim on this ground.
In another case, a man said he twisted his right knee during a trip to Taiwan but he only went to the doctor on the sixth day after he returned to Hong Kong.
The complaint panel upheld the insurance company's decision that there was not enough evidence to show the injury happened in Taiwan, since the man did not visit the doctor as soon as he returned.
Of the other closed cases, 19 per cent were mutually settled between the insurers and the complainants after intervention by the regulator, 49 per cent lacked prima facie evidence, 13 per cent were withdrawn and the panel backed the insurers in 14 per cent of the cases. Almost half the complaints were about medical insurance and just over a fifth were over travel policies.
One-third overall concerned policy terms where the parties argued over whether certain items were covered.
Meanwhile, Tsui said the families of those killed in the Egyptian hot balloon tragedy had not complained to the regulator.