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(Hong Kong, 28 April 2026) – The Hong Kong Federation of Insurers (HKFI) today announced the findings of the "Determinants of Post-Pandemic Medical Inflation: An Analysis of Private Insurance Claims Data in Hong Kong" study, commissioned by the HKFI and conducted by the Centre for Ageing and Healthcare Management Research of the College of Professional and Continuing Education (PolyU CPCE) at The Hong Kong Polytechnic University (PolyU).

The study, based on data from Hong Kong's private medical insurance market, found a staggering increase of over 60% in overall medical expenditure from 2019 to 2023, representing a double-digit compound annual growth rate. The core driver of this increase was not the unit price of medical services, but a sharp rise of nearly 70% in the claim frequency for inpatient plans, which is directly linked to a surge in day procedures.

This research analysed over ten million inpatient and outpatient claim records, comprehensively comparing the claim frequency, average bill amount per claim, and total medical expenditure before and after the pandemic (2019 vs. 2023). It provides an in-depth analysis of structural changes across demographics, policy types, and medical networks. The findings reflect a worrying upward trend in medical expenditure and premiums in Hong Kong's private medical insurance market. If effective measures are not taken promptly, the long-term affordability and sustainability of the market will face severe challenges.

Surge in Inpatient Claim Frequency Driven by Day Procedures

The study indicates that medical claim expenses in the private market have risen sharply post-pandemic, recording double-digit growth for several consecutive years. If this trend continues, it will severely impact the affordability of premiums for employers and individuals, exert operational pressure on insurance companies, and indirectly strain the public healthcare system.

In contrast, the average bill amount per inpatient claim saw only a modest increase, indicating that the overall expenditure growth was driven by claim frequency, especially for day procedures, rather than by a sharp rise in unit prices.

• Overall Inpatient Claim Frequency: Increased sharply by 68% in four years.

• Small to Medium Claims (approx. HK$5,000 to HK$15,000): Number of cases grew by about 80%.

• Large Claims (over HK$100,000): Number of cases more than doubled.

• Room and Board Claims: The number of claims grew by less than 30%, a stark contrast to the overall inpatient frequency surge, further confirming that the growth primarily came from day procedures rather than traditional hospital stays.

In 2023, the conditions with the highest inpatient claim frequencies were digestive system diseases (e.g. gastritis and duodenitis), viral warts, and viral diseases. Gastro-colonoscopy procedures accounted for a significant portion of claims for digestive system diseases. This suggests the trend is susceptible to consumer and/or provider behaviour. The study also found a substantial increase in the claim frequency for diagnostic tests.

Shift in Outpatient Service Consumption Towards Higher-Cost Services

Although the overall claim frequency for outpatient plans slightly decreased due to a drop in general practitioner (GP) visits, the data shows a clear consumer shift towards higher-cost specialist and therapeutic services.

• General Practitioners: Number of visits decreased by nearly 20%, with an average claim amount of less than HK$400 per visit.

• Chinese Medicine Practitioners: Number of claims grew by about 40%.

• Physiotherapists: Number of claims grew by about 40%.

• Chiropractors: Number of claims grew by nearly 70%.

• High-End Service Fees: The average claim amounts for specialists, chiropractors, and physiotherapists (ranging from HK$600 to over HK$900) were much higher than for GPs.

The study further notes that against the backdrop of an aging population and a rising prevalence of chronic diseases, more people are suffering from conditions that can be effectively managed by physiotherapists and Chinese medicine practitioners, a trend that is unlikely to be reversed.

Policy Design Has Significant Impact: Group Plans and Panel Doctors Effectively Control Costs

The research also compared claim differences across policy types, revealing that group plans and panel doctors are effective in controlling expenses.

• Group vs. Individual Plans: The average inpatient claim amount for group plans was about 40% lower than for individual plans; for outpatient services, it was about 50% lower.

• Panel vs. Non-Panel Doctors: The average inpatient claim amount for using panel providers was over 40% lower than for non-panel providers.

• Voluntary Health Insurance Scheme (VHIS): The average inpatient claim amount was slightly lower than that of non-VHIS individual plans, with a difference of about 10%.

These results remained consistent even after controlling for age differences, suggesting that promoting the use of medical networks and having individual plans adopt certain features of group plans could help control rising medical costs.

Aging Population Exacerbates Expenditure Pressure

The study also found that medical expenses increase significantly with age, and this pressure will intensify as Hong Kong's population continues to age.

• Ageing: Expenses rise sharply with age, with the 75+ age group incurring the highest average bill amount.

• Gender: While females claimed more frequently, males had a higher average inpatient cost.

Prof. Peter Yuen, Dean of PolyU CPCE, stated, "This study clearly indicates that overall health insurance claims increased very substantially after the pandemic. The overall increase amounted to a double-digit increase every year. Such an increase, if it continues at the same rate, will raise serious questions about private health insurance affordability for employers and individuals. Furthermore, among the conditions with the highest claim frequency, we noted a particularly significant increase in cases related to gastro-colonoscopy for digestive system diseases and treatments for viral warts. This growth trend seems to be driven not just by natural changes in the population's health status, but more likely by a shift in citizen behaviour, such as an increased willingness to undergo preventive screenings or elective treatments. This phenomenon warrants in-depth discussion as it pertains to the future use of medical resources."

Ms Selina Lau, Chief Executive of the HKFI, said, "We are grateful to Prof. Yuen and his team for their professional and independent research. The results reveal that the continuous surge in Hong Kong's medical expenses, which leads to higher medical insurance costs, is no longer an issue for the insurance industry alone but a heavy price for society as a whole to pay. We will discuss with the authorities and relevant stakeholders how to address this issue that affects the long-term well-being of Hong Kong. We also call on the public to use their medical insurance prudently, especially in a rapidly aging population, to ensure that medical insurance can truly serve patients in need."

Rising Medical Expenditure Pressure Calls for Multi-Party Collaboration

The study's findings suggest a rather alarming trajectory for healthcare expenditure and related premiums in the private sector. It is imperative that individuals, employers, insurers, healthcare providers, and the Government work together to chart a path forward, ensuring the long-term affordability and sustainability of Hong Kong's private health insurance market.

For details, please refer to the Executive Summary of Research Report and the Presentation Deck.

就最近中東局勢緊張，香港特別行政區保安局(保安局) 2026年2月28日就伊朗和以色列於2025年發出的紅色外遊警示，更新了附加資料，香港保險業聯會（保聯）提供旅遊保險相關資訊如下： 

保障範圍、細則與不保事項

基本上，每份旅遊保單載有「一般除外責任」項目，適用於保單內的全部保障項目。 

然而，每間保險公司發出的旅遊保單中所列明的保障範圍、條款細則及不保事項各有差異，所有實際的理賠個案應以受保人購買的保險及其保單條款作準。 

常見的除外責任

• 旅遊保單中列明的「一般除外責任」，是指保險公司不會賠償由該些除外責任項目引起的損失。

• 常見的除外責任包括但不限於：直接或間接由戰爭、叛亂、敵對行為(不論宣戰與否)或武裝或軍事政變等等引起的情況。

• 如戰爭此等情況，實非商業保險所能承保，故此，因除外責任而引致的損失，將不會受到保障。

• 若機場因戰爭情況而關閉，或旅程因受戰爭影響而延誤，均屬於直接或間接由戰爭因素所致，故旅遊保險一般不會就此作出賠償。⁠

• 旅客應向旅遊服務供應商，如航空公司、酒店等提出取消行程/引致行程延誤的退款申請。

但其他並非由除外責任引起的損失，例如旅客在當地因身體不適需要求醫，只要病因與戰爭或受保障以外的風險無關，旅遊保險仍會按保單條款繼續提供相關的醫療保障。 

外遊警示實施下的縮短/取消行程保障

• 現時部分旅遊保險保單有延伸保障，涵蓋目的地因保安局發出紅色或黑色外遊警示而引致的取消或縮短行程。

• 一般而言，市面上的旅遊保險，黑色警示會涵蓋全部未能退回的行程費用，紅色警示則會涵蓋一半費用。

• ⁠旅客必須先向旅遊服務供應商，如航空公司、酒店等提出取消行程的退款申請，未能退回的餘額可按旅遊保單條款，向保險公司索賠。

• 必須注意：如果受保人在相關外遊警示發出前，已就該次行程購買旅遊保險，方可享有因該警示引致的相關保障。查保安局早於2025年8月18日已向伊朗及以色列發出的紅色外遊警示。旅遊人士如有疑問，宜與保險公司或中介人查詢其保單的保障詳情。

⁠旅遊人士當以自身安全為上，應留意當地情況，並在行程上作出適當安排。值得留意的是：保單條款通常列明，如受保人自行暴露於不必要的危險（意圖拯救他人性命者除外），相關損失將不獲保障。 

以上資料只供參考，詳情請向保險公司或中介人查詢。

The Hong Kong Federation of Insurers (HKFI) welcomes the measures announced by the Financial Secretary in his Budget Speech today (25 February 2026).

We note that a number of the policy initiatives are in line with our advocacy, including attracting enterprises to re-domicile to Hong Kong; developing the non-traditional risk management business and extending the Pilot Insurance‑linked Securities Grant Scheme; stepping up its promotion efforts to attract captive insurance companies to in Hong Kong; promoting the development of international maritime centre and high value-added maritime services; introducing relevant regulation to improve the price transparency of private healthcare services; and encouraging the development of green finance.

We are particularly pleased to note that our proposal to extend the “Enhancing Insurance Industry Talent Training Scheme” has been accepted. The Scheme, now extended until 2029, will play a vital role in nurturing talent and fostering the sustainable development of the insurance sector.

Looking ahead, HKFI will continue to represent the voice of the industry and work closely with the Government to implement various initiatives, fostering the long-term development of the insurance sector in Hong Kong. At the same time, the HKFI will actively align with national strategies to further strengthen Hong Kong’s position as an international financial, maritime and risk management centre.

The Hong Kong Federation of Insurers (HKFI) and its Members, together with the industry today (3 December 2025) announced a donation of HK$9,177,399 to the Government’s “Support Fund for Wang Fuk Court in Tai Po”.

The devastating fire at Wang Fuk Court in Tai Po has claimed over 150 lives, with many more injured or missing. We grieve the loss of these precious lives and extend our deepest condolences to the families affected.

In the wake of such profound tragedy, the insurance industry has turned sorrow into swift action.  In addition to launching a series of facilitative measures to assist victims, the industry has also made significant monetary contributions.  To date, over HK$327M has been donated by insurance companies through their charitable arms, group and parent companies.

While insurance companies have varying levels of financial resources, they share a common commitment to supporting the victims. HKFI has therefore initiated a collective donation drive as every contribution counts in this challenging time.

“This tragedy has united our community in grief, but also in determination to support those in need.  Through our drive, insurance companies and their colleagues have raised over HK$8.6 million for this important cause," said HKFI Chief Executive Ms Selina Lau.  “Alongside HKFI's seed fund and our staff of HK$510,000, we are contributing a total of HK$$9,177,399 to the Government’s “Support Fund for Wang Fuk Court in Tai Po”, as part of our commitment to walk with the community on the road to recovery.”

We would like to extend our sincere gratitude to all HKFI Members and their colleagues, as well as the industry for their generosity and solidarity during this difficult time. Details of their contributions are listed in the annex attached.

[1] Please refer to HKFI’s dedicated webpage for details of the facilitative measures. 

List of Contributions

(Listed by donation amount; if amounts are the same, sorted alphabetically by name of the Donors)

The No.5 alarm fire at Wang Fuk Court in Tai Po yesterday resulted in the deaths of dozens and injuries and missing persons in the hundreds. The Hong Kong Federation of Insurers (HKFI) and the insurance industry extend our deepest condolences to the families of the victims and wish for the swift recovery of the injured and for the missing to reunite with their families. We also thank all the rescue personnel for their efforts!

Many of the victims have insurance coverage. To provide them with appropriate assistance, HKFI member companies have taken immediate actions, including:

•    Setting up a hotline to answer inquiries from victims regarding the scope of policy coverage and specific claims arrangements;

•    Simplifying and expediting the claims process;

•    Providing additional assistance beyond the policy coverage, e.g., offering advance cash allowance for affected home insurance policyholders

•    Rallying agents to offer instant help to their victimized clients;

•    Prioritizing claims from affected policyholders of life, medical, personal accident, household, fire insurance, etc;

•    Waiving death certificate for death claims as far as practicable;

•    Offering premium holiday or extending grace period for premium payment;

•    Waiving / reducing interest for policy loan for a designated period of time.

The above measures aim to ensure that policyholders receive appropriate assistance from insurance companies during this difficult time, alleviating the significant financial and emotional pressures they are facing.

“We are devastated by the tragic fire, and our hearts go out to the victims and their families," said Ms. Selina Lau, Chief Executive of HKFI. "Our member companies are fully equipped to assist victims in their time of need, providing resources and support to help them through this difficult journey towards recovery.”

To assist the victims in understanding their life insurance, home insurance, building insurance, medical insurance, and personal accident insurance coverage, the HKFI has established a special inquiry service. This includes phone and email inquiries.  Important information can also be accessed through the HKFI website.

Inquiry service：

Tel：852 2861 9367 (Office hours: 9am – 12:45pm; 1:45pm – 5:30pm (Monday to Friday), except on public holidays)

Email：Support@hkfi.org.hk

HKFI Website：https://www.hkfi.org.hk/media-release/taipo-fire-incident-insurance-coverage-and-claims-arrangement