FWD case accused of circumventing the law, delaying in paying benefits: Insurance Association waits for recommendation to the Ministry of Health
As reported by Lao Dong Newspaper on September 3, 2025, FWD Life Insurance Company Limited was accused of circumventing the law, delaying the payment of insurance benefits to cancer patients, and reflecting on cases related to the payment of insurance benefits for thyroid cancer patients.
In response to this incident, the Vietnam Insurance Association sent an official dispatch to Lao Dong Newspaper.
According to the Insurance Association, the issue of paying benefits for thyroid cancer patients is not only a unique difficulty for one enterprise, but is affecting the entire life insurance industry.
The main reason pointed out by the Association is that current legal regulations are not unified in determining the severity of thyroid diseases. This leads to confusion in the appraisal and payment decision making process of insurance companies.
The Insurance Association affirms that if businesses handle the lack of facilities, it will create legal risks and at the same time risk causing inequality among customers. Therefore, the Association and its member enterprises have agreed to recommend the Ministry of Health to promptly review and amend Joint Circular No. 28/2013/TTLT-BYT-BLDTBXH. The goal is to have specific, unified instructions and be more suitable for medical practice.
While waiting for consistent guidance from the authorities, the Insurance Association affirmed that businesses are not avoiding responsibility but are being cautious to protect both the rights of participants and the reputation of the market.
"Clear laws" are business risks, not a reason for delaying payments
Discussing this issue with Lao Dong, Dr. Lawyer Dang Van Cuong, Office of Legal Lawyers, Hanoi Bar Association said that the responsibility for market research and service development belongs to insurance companies, not customers.
"Therefore, when an insurance company designs and launches a product, especially serious illness insurance products, they are obliged to carefully study all current legal regulations, from the Law on Insurance Business to related circulars and guiding documents. They must foresee "gray areas" or points that may be controversial in the law to clearly define in their contracts" - Dr.LS. Cuong commented.
According to him, although there is no clause that accurately states the responsibilities of enterprises, this obligation is clearly expressed and is a mandatory requirement inferred from other regulations.
Specifically, Article 21 of the Law on Consumer Protection requires business organizations to provide " accurate and complete" information about the services they do business with.
In the insurance sector, Point b, Clause 2, Article 20 of the Law on Insurance Business stipulates that insurance companies are obliged to: Clearly and fully explain to insurance buyers the insurance benefits, the provisions on excluding insurance liability, rights and obligations of insurance buyers when signing insurance contracts.
To fulfill these obligations, businesses are required to appraise and grasp their products as well as the legal environment before providing them to customers, Thus, in this case, the fault lies entirely with the insurance company for not having carefully researched the market and current laws, leading to the inability to explain overlapping legal regulations.
Dr.LS Cuong compared that selling products and collecting regular fees from customers for many years, then saying that the "law is not clear" is no different from a house builder who starts building a house and then says that the land is weak.
"The risk of lack of clarity of the law is a business risk that businesses must anticipate and take responsibility for, cannot put that burden on customers, especially when they are in a state of serious illness" - Lawyer Cuong commented.
Customers accuse FWD of delaying payment, Ministry of Finance affirms court authority
Mr. Nguyen Q.H, a customer with thyroid cancer, complained to FWD Vietnam for temporarily suspending the settlement of insurance benefits. This happened even though he had concluded a medical examination on the rate of body damage that was eligible for payment.
Mr. H accused FWD of deliberately circumventing the law and seriously violating its obligation to pay on time (expiry date of more than 85 days). The insurance company cited the reason for "unconclusive legal status" for the delay, while the Law on Insurance Business stipulates that businesses must "explain in writing the reason for refusing to pay insurance" (Article 17). The "temporary suspension" is without legal basis.
This delay in payment seriously affected Mr. H's health and finances, so he submitted a petition to the Insurance Management and Supervision Department (Ministry of Finance), requesting FWD to pay and impose a fine.
The Finance Ministry also said it had forwarded the reflection to FWD for the company to resolve. However, the Ministry also stated that if the two sides continue to have disputes related to insurance contracts, the Court is the competent authority to resolve them according to the Civil Procedure Code.
