Emergency Anti-mask Law - Impact on Life Insurance, Health Insurance, Accident Insurance and Critical Illness Insurance Coverage? (Chinese Article)

Estimated reading time 4 minutes

10Life Team

25 Oct 2019
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10Life Team

25 Oct 2019

Estimated reading time 4 minutes

修訂《逃犯條例》引致香港大規模示威,更觸發多宗警民衝突,武力流血事件屢見不鮮。為了「止暴制亂」,特區政府引用《緊急法》推出《禁蒙面法》,網上流傳《禁蒙面法》會令保單失效。無疑,實施《禁蒙面法》令以前不犯法的事(蒙面)變成犯法,而某些保險產品不保參與非法行為時發生的損失,但是,《禁蒙面法》本身並沒有影響保單的效力。歸根到底,受保人要留意自己是否參與非法活動,政府或保險公司對於衝突事件的定性,再了解這些事情有否令保險產品的保障被削減、甚至失效。

在設計保險產品時,保險公司會考慮風險因素,不少旅遊保險、醫療保險會將「戰爭」、「恐怖襲擊」、「暴動」等列為不保事項,因為這些情況可能帶來難以預計的大量死傷,導致極大額的索償。有人以為,保險不保所有因「非法活動」導致的損失,事實上我們不能一概而論,再者,某人是否犯法亦應由法庭審理。大家要知道,不同保險種類的條款都不相同,保障範圍有異,本文將以自願醫保、人壽、危疾、及意外保險加以說明。

自願醫保是醫療保險,保障受保人的住院及部分日間手術的醫療開支。自願醫保的不保事項條款中,並沒有提及過「遊行」、「示威」、「暴動」、「恐怖襲擊」等,但就有明確指明,不會賠償因「參與非法活動」而產生的醫療費用。「參與」及「非法」是兩個重要的用字,在香港,遊行示威是合法。按條款字面理解,如果受保人參與合法示威時受傷入院,保險公司理應賠償醫療開支。

不過,如果遊行示威變得踩界,例如遊行路線或時間超越不反對通知書所批准的、活動沒獲發不反對通知書但市民照樣前往參與、警察表明集會遊行人士正「參與非法集結」、或政府為活動作出「暴動」定性後,受保人繼續參與活動而衍生的醫療開支,保險公司就有機會拒絕賠償。

至於受保人只是經過活動現場而受傷,並非參與其中,即使該遊行示威屬於非法,由於他並不是「參與」活動,按字面理解,保險公司仍需賠償有關的住院醫療開支。

可是,如果情況演變成「奪權」、「政變」、「戰爭」等,那麼,無論是否參與者、或是路人甲,保險公司都可按不保事項而拒賠。

人壽保險主要作身故賠償,爭議空間較少。實際上,一般人壽保險的不保事項是﹕若受保人於投保後一年內自殺,保險公司只會退還已繳保費,不作賠償。

一般危疾保險的不保事項有﹕投保後12個月內自殺、等候期內出現徵狀的疾病、及自致的傷害等。危疾保險的保障可適用於,衝突中導致失明、失聰、斷肢、心臟病等嚴重疾病,只要符合該疾病的定義,保險公司理應賠償。

意外保險旨在保障因「意外」所致的醫療開支及傷殘。若不是「不能預料及非自願之事故」,很難獲得賠償。於和平合法的示威中,參加者或途人受傷,或者,市民出街在無先兆下遇到衝突而受傷,意外保險應賠償損失。但假如現場出現武力衝突、警方沒有對活動發不反對通知書,受保人在明知有危險的情況下仍前往該處,不論是否路過或參與活動而導致受傷或殘疾,有些保險公司可能認為不是意料之外,就有機會拒賠。

部分意外保險的條款列明不保事項,舉例,友邦保險自選人身意外保險2就不保「抵觸或企圖抵觸法律的行為,或拒捕」,如果原來合法的公眾活動被定性為非法,而受保人繼續參與活動,保險公司就有機會以此拒賠。

以下是多數保險產品對衝突情況的保障。讀者需留意,保險公司仍有機會自行詮釋保單條款內的字眼,因此要決定某指定保單在某特定情況下,會否賠償,最終或需視乎保險公司的決定。


在這段風雨飄搖的日子,一幕一幕觸目驚心的畫面,身為香港人,無不痛心。身於大時代,彷彿有作為,又好似微不足道,但由心出發,多點關心身邊的家人朋友,珍惜生命。筆者相信人性本善,守住良心,漫漫長路,繼續走,始終會走到出路。 

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Jack, Ng Wai Lap

黃維立

AXA Unit Manager

4.6
3978
610

Nik, Leung Tsz Kei

梁芷萁

10Life Financial Manager, Insurance Specialist

4.8
1173
274

Winnie, Ng Wai King

吳惠琼

FTLife Agency Manager

4.8
1849
309

Even, Shum Miu Chu

岑妙珠

恆泰 高級理財顧問

4.6
1345
250

Philip, Lee Hon Lun

李漢麟

YF Life Branch Manager

4.4
1644
262

Tony, Yeung Chun Fung

楊俊鋒

FWD Life Wealth Planner

4.7
1763
308

Mabel, Siu Sin Wan

蕭善尹

FTLife Wealth Management Director

5
1058
313

Edward, Lam Wing Chuen

林永泉

Convoy Senior Wealth Management Advisor

4.6
1557
263

Noble, Suen Chit Yuen

孫哲遠

AIA Associate Director, Wealth Management and Protection

4.4
1114
249

Liu Lai Ting

廖麗婷

FWD Senior Branch Manager

4.8
1408
211

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