Hong Kong's new critical illness definitions set a floor, not a higher bar, 10Life analysis finds

HONG KONG, 10 September 2026. The Hong Kong Federation of Insurers' (HKFI) Best Practice on Standardization of Critical Illness Definitions came into effect on 1 September, introducing common Chinese and English definitions for 21 critical illnesses. 10Life, an independent insurance comparison platform in Hong Kong, welcomes the initiative as a step that will make policies easier to compare. A clause by clause analysis of seven leading critical illness policies currently on sale, however, shows that the new definitions represent a minimum standard rather than an improvement in cover, and that on certain conditions they are stricter than what insurers already offer. Because adoption is voluntary, 10Life advises consumers against rushing into a purchase and encourages them to compare the actual policy wording first

The Best Practice covers 16 major critical illnesses and five early stage conditions, and standardises the definition of Activities of Daily Living. According to the HKFI, these 21 conditions account for approximately 90 percent of critical illness claims. Until now, each insurer drafted its own definition of the same disease, making policies difficult to compare side by side. A common text allows consumers to compare policies clause by clause and should reduce disputes at the point of claim. 

Standardised definitions are well established in other markets. The Association of British Insurers first published its Statement of Best Practice for Critical Illness Cover in 1999, has conducted a full review approximately every three years since, renamed the document the Guide to Minimum Standards in 2018, and required insurers to adopt the latest edition by September 2023. The Life Insurance Association of Singapore introduced common definitions in 2003, revised them in 2014 and 2019, and its 2024 framework covering 37 conditions took effect in October 2025. Hong Kong is now following the same path. 

Dennis Lun, Group CEO of 10Life, said: "A common set of definitions gives consumers a shared starting point for comparison and will help reduce disputes over claims. Standardised wording, however, does not make policy terms easier to read, nor does it raise the level of protection. What consumers most want to know is when they will be paid, and how one policy differs from another."

10Life selected five of the most frequently claimed conditions, namely major cancer, severe heart attack, stroke, end stage kidney failure and angioplasty (Percutaneous Transluminal Coronary Angioplasty, PTCA), and compared the HKFI definitions clause by clause against the policy provisions of seven leading critical illness plans from AIA, FWD, AXA, Generali, Manulife, Sun Life and CTF Life. On most of the conditions examined, the sample policies already match or exceed the new standard. On certain conditions, the standard is stricter than prevailing market practice. Two findings stand out. 

Cancer. The HKFI definition requires the diagnosis to be confirmed "by the final post-excision histopathology report". All seven policies require confirmation by a histopathology report, but none stipulates that the report must follow surgical removal of the tumour. Some advanced cancers are not primarily treated by surgery. Stage IV breast cancer, for example, is generally managed with chemotherapy, targeted therapy or hormonal therapy, and is typically diagnosed by needle biopsy. Read literally, such cases may be unable to produce a "post-excision" report. 10Life does not believe this reflects the intent of critical illness insurance and encourages the HKFI to clarify the circumstances in which a histopathology report obtained by needle or endoscopic biopsy will satisfy the definition. 

Angioplasty (PTCA). The HKFI definition requires a stenosis of at least 60 percent in a major coronary artery. All seven policies set the threshold at 50 percent. The HKFI also confines "major coronary artery" to the four principal vessels and excludes their branches; four of the seven policies impose no such restriction. Detailed comparisons for end stage kidney failure, severe heart attack and stroke are set out in Appendices 1 and 2. 

Dennis said: "The new standard codifies existing market practice into a common text. It establishes a floor; it does not raise protection. On certain items, such as the proof of diagnosis for cancer and the stenosis threshold for angioplasty, the standard is in fact more demanding than the market. Compliance with the HKFI standard means only that a policy has met the minimum. It should not be taken as a mark of superior cover."

The Best Practice is issued as voluntary guidance for HKFI member companies and carries no binding force. Each insurer decides whether to adopt it and for which conditions. Among products launched after 1 September, some will use the standardised definitions and others will not, and practice may vary between products from the same insurer. The HKFI has also stated that the definitions are intended to be pricing neutral, with minimal impact on premiums. It follows that adopting the standard is not expected to deliver a material improvement in cover; if it did, premiums could hardly remain unchanged. 

The standard applies in principle only to new products launched on or after 1 September and does not alter existing policies. Where an insurer extends a more favourable definition or claims arrangement to existing customers, policyholders should confirm the scope of that arrangement in the insurer's formal notice.

There is therefore no reason to hurry into an older product before the standard takes hold, since insurers have always been free to offer cover above the minimum. Nor is there reason to seek out products that adopt the standard, since adoption does not signify better cover. The sensible course is to compare, condition by condition, the claim criteria, exclusions and any additional requirements for second or subsequent claims, in light of one's own health, family responsibilities and budget. Policyholders considering a switch should also weigh the risks and costs of fresh underwriting, a new waiting period and surrender of the existing policy. 

Dennis said: "Critical illness insurance is a long term contract, often paid over decades. It should not be decided in haste on account of a single effective date. Whether or not a product adopts the new standard, the policy wording is what counts. 10Life will continue to track the differences between market products and the HKFI definitions to help consumers make well informed choices."

10Life is a one-stop insurance platform offering product research, comparison, application and claims support. Founded by insurance professionals, it helps consumers understand their cover and make informed decisions, and is committed to fair insurance: buy right and be paid in full. 

10Life Financial Limited is an insurance broker company licensed by the Insurance Authority (Licence No. FB1526).

10Life Media Team | press@10life.com

The full comparison data is available on request. Interviews with the Group CEO can be arranged through the media team.

This press release is provided for information and educational purposes only and does not constitute advice to purchase, switch or surrender any insurance policy. Actual cover and claim eligibility are governed by the full terms and any effective endorsements of the relevant policy. The product comparison in this release is a comparison of policy wording and is not a recommendation.

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This table compares only the conditions listed and does not rank products overall. Policy wording as at 4 September 2026.

Where "looser" appears in this release it refers only to the specified condition relative to the HKFI benchmark, not to a higher payout rate, faster payment or broader policy cover.

Condition names differ between policies; this table matches comparable conditions. Claims are assessed under the definition in the relevant policy.

Directly comparable days and percentages are shown first; heart attack conditions, which need to be read in full, are shown separately. Product names are listed in Appendix 4.

Cancer definitions involve cancer type, stage, exclusions and proof of diagnosis. This table separates the conditions and does not generalise from one cancer type to overall cancer cover.

Scope of comparison

The above lists the main dimensions compared and is not a complete list of cancer exclusions. A cancer type not shown is neither confirmed covered nor excluded. General exclusions, waiting periods, territorial and diagnostic requirements outside the definition may also affect eligibility.

Suggested clarification on diagnostic requirements

10Life suggests clarifying whether "post-excision" covers other forms of tissue sampling, and when a needle or endoscopic biopsy report will satisfy the standard. Wording and clinical diagnosis are separate matters; this study does not infer actual claim outcomes from wording alone.

The study compares the HKFI 2026 standard definitions with the wording of the seven individual critical illness products below on five selected conditions. Products were drawn from the whole life critical illness products rated by 10Life. Wording as at 4 September 2026.

The comparison focuses on disease definitions and the thresholds within them. It does not rank premiums, benefit ratios, caps or actual payout rates. Where multiple claims carry different definitions or extra requirements, read the relevant clauses separately.

The HKFI Chinese text is a translation of the English original; the English version prevails. Each product is governed by the language precedence clause in its own policy.

1. Hong Kong Federation of Insurers, Best Practice on Standardization of Critical Illness Definitions and the 2026 standard definitions (published March 2026, effective 1 September 2026)
   https://ci-definitions.hkfi.org.hk/best-practice
2. Hong Kong Federation of Insurers, FAQ on scope and policy arrangements
   https://ci-definitions.hkfi.org.hk/faq
3. Latest policy provisions of the seven products compared (listed above), wording as at 4 September 2026; document names, versions and clause numbers available on request
4. Association of British Insurers, ABI Guide to Minimum Standards for Critical Illness Cover, published 16 September 2022, to be adopted by insurers by 16 September 2023
   https://www.abi.org.uk/globalassets/files/publications/public/protection/abi-guide-to-minimum-standards-for-critical-illness-cover-2022.pdf
5. Association of British Insurers, Statement of Best Practice for Critical Illness Cover, first issued 1999
   https://www.abi.org.uk/globalassets/sitecore/files/documents/publications/public/migrated/life/statement-of-best-practise-for-critical-illness-1999.pdf
6. Life Insurance Association of Singapore, LIA Critical Illness Framework 2024, Part 1, issued 13 May 2025, effective 1 October 2025
   https://www.lia.org.sg/media/4549/lia-ci-framework-2024-part-1-of-4.pdf
7. Life Insurance Association of Singapore, media release, 29 August 2019: records that common definitions were first introduced in 2003 and revised in 2014
   https://www.lia.org.sg/media/2163/media-release.pdf
8. American Cancer Society, Treatment of Stage IV (Metastatic) Breast Cancer: systemic therapies are the main treatment
   https://www.cancer.org/cancer/types/breast-cancer/treatment/treatment-of-breast-cancer-by-stage/treatment-of-stage-iv-advanced-breast-cancer.htm