Claims

Peace of mind

Insurance only matters when you need to make a claim. The TopCover policy has paid in excess of HK$350 million to Members. The Association has processed hundreds of claims over the years, for Income Protection, Critical Illness and Personal Accident benefits, without any disputes arising with the insurers. Many of these Members have been able to return to work, with the help of the Association and the financial support of TopCover.

The earlier you notify the claim, the more we can do to assist and advise you. Please ALWAYS notify your claim to the HKAOA office.

If you have any questions about claims that are not answered on these pages or in the FAQ then please contact us

When should I claim?

The TopCover policy states:

1. The Insurer will not accept liability for any claim, which is not notified in writing to the Insurer within one (1) year of the calendar date of the event giving rise to the claim.

Every claim is different and depends upon the medical condition (accidental injury or illness) and the individual prognosis, and also which of the 3 benefits you are claiming for. We recommend the following NOTIFICATION PROCEDURE to ensure that you comply with the policy and notify your claim to the insurer:

NOTIFY THE INSURER when:

Income Protection Claim.

if you have been sick or injured for 60 days, or as soon as possible if you know or suspect that you may be off work for 150 days

Personal Accident

if you have been off work with an accidental injury for more than 60 days, or as soon as possible if the accident has, or may have, caused a permanent injury. In the event of accidental death, your next of kin or nominee should notify the insurer (Members are recommended to complete a Nomination of Beneficiaries form)

Critical Illness

as soon as possible after the diagnosis of the Critical Illness

FOR ALL CLAIMS:

no later than 1 year from the first day of illness/injury (the first day you could not carry out your flying duties).

How do I notify a potential claim?

Use the TopCover Claim Notification form which can be downloaded here.

Download and complete the PDF file, and email to the insurer and to the HKAOA. If you have an individual policy, confirm that you get a response from the insurer so you know that your claim notification has been received. Once the claim is notified, you may take as long as is necessary to make the claim. The insurer will send you a claim form to guide you through the process.

All Members should always notify and advise the HKAOA office of any potential claim.

The claim process

Income Protection Claims

All claims require Objective Medical Evidence of the illness or injury giving rise to the claim. This is usually straightforward and available from your doctor. It can take some time for a diagnosis and a final prognosis to be established. Do not delay, but provide the medical evidence as it arises so that your claim can be processed and your benefits will be available when you need them.

Benefits are payable when:

1. The Waiting Period is over (150 days), and
2. The Objective Medical Evidence has been received, and
3. Your loss of income is established.

TopCover is Loss of Income insurance. If you are still employed by the company on a reduced salary the policy can ‘top you up’ to a maximum of 100% of your pre-disability income. Therefore you can claim TopCover benefits when still employed.

If the company has terminated you, then you will be eligible to receive your full insured benefit.

If you return to work in the future for another airline/company as a pilot, or in any other regular income-earning role, then your policy will ‘top-up’ those earnings, based upon your original income and the percentage of that income you had insured. See the ‘Proportionate Benefit Formula’ in the policy booklet or wording.

Personal Accident Claims

Personal Accident claims are for serious and permanent injuries, or accidental death. These claims often require the assistance of the next of kin or nominated beneficiary.

Evidence of bodily injury, or death, enables a claim to be paid very quickly. A Nomination Form can speed the release of benefits that may otherwise be held up by probate or other legal requirements.

You can download a Nomination Form here.

Critical Illness Claims

As soon as you have a diagnosis of one of the named Critical Illnesses, submit your claim to the insurer. These claims are normally paid very quickly.

What if need to claim under more than one section?

Simply complete the claim form with the full claim information. The insurer will assess your claim in accordance with the benefit(s) you have selected (for Members with individual policies).