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Accident insurance

Accident insurance

Travelers and tourists are subsequently exposed to unpredicted situations associated with various risk levels abroad. Most of these situations may not be fully covered alone by the de facto medical Insurance, which is a criterion for a successful overseas trip. Hence, your insurance plan can be enhanced by including an accident insurance options.

An Accident Insurance is a non-medical option which provides compensation for the occurrence of accidents, which directly results in the death or dismemberment of critical body parts or permanent disablement of an insured, upon the inclusion of the aforementioned non-medical option by the insured.

The Accident Insurance takes care of the expenses associated with unforeseen and risky events, which are influenced by accidents, provided these events are covered in your insurance policy.

Why you should apply for an accident Insurance

It is not mandatory, but it is also better to apply for an Accident Insurance due to the following reasons:

  • Accidents can occur at any location and time when it is not financially feasible to pay for hospital bills.
  • The regular Medical insurance plan may not provide enough coverage alone.
  • Expenses from accidents may be covered by the regular medical insurance, but it will not pay compensation for an eventual permanent discomforts.
  • An inclusion of the accident insurance will provide compensation in cases of layoff as a result of total disablement caused by an accident.

What is an Accident?

An Accident is an unpredictable event that has the probability of occurring without the intention of the insured. Accidents are characterized by sudden, external and violent bodily impacts, resulting in sustenance of severe injuries.

What cases are covered by Accident insurance?

Depending on the contract binding you and your insurer, the Accident insurance will cover expenses arising from certain accidental cases, provided you include the accident insurance as one of the non-medical options in your insurance policy document.

In summary, your Accident insurance should provide coverage in the following cases listed below:

  • Death caused by Accident, and not by a previously existing illness.
  • Loss of Limbs
    Usually involves the physical separation of the limbs from the body or total and irrecoverable loss of use of either a hand above the wrist or foot above the ankle. The insurance Company shall be responsible for providing the stipulated percentage of the insured sum.
  • Loss of Extremity
    In the event of a total physical and permanent separation or total and irrecoverable loss of use of fingers, ears, nose or genital, the insurer will pay the stipulated percentage of the insured sum as a compensation.
  • Loss of sight
    If the total or irrevocable loss of sight is confirmed by an optician, and approved by the insurance company, the insurer will pay the specified percentage of the insured sum in the case of the loss of an eye, or double of the specified percentage of the insured sum in the case of permanent loss of both eyes, as a result of a physical accident.
  • Accidents associated with consequential permanent disablement
    The insurance company shall pay the stipulated percentage of the insured sum, provided:
    • The insured is unable to carry out normal business activities for the period of 12 calendar months.
    • The issue is documented and certified by two approved and qualified medical practitioners, who confirm that the insured’s condition is beyond improvement at the end of the documented period. And even, if the insured have no business or occupation, the insurance shall provide coverage, as long the disabilities continuously confines the aforementioned individual to the house and prevents such individual from attending normal activities.

Note:
The insured must be receiving medical treatment and comply with the physicians advise and instructions.

For more details concerning these cases and others not mentioned in this section, please consult your insurance policy or insurer’s customer care.

What cases are not covered by accident Insurance?

Your Accident insurance may not cover some exceptional cases, and they are not limited to those presented in this article. Hence it is strongly advisable, that you read your policy or consult the assistance of your insurer’s customer care for more information about any confusion pertinent to your insurance policy.

Your Insurance Company shall not be held responsible for expenses incurred as a result of:

  • Illnesses or pre-existing health disorder, even if the said illness is aggravated as a result of an accident.
  • Any accident caused by illness.
  • Unforeseen illness subsequently contracted.
  • Any Consequence of health treatment not necessitated by an accident covered by the insurance.
  • Death caused by suicide or self-inflicted harm.
  • Accident caused by intake of excess alcohol or drug abuse.

What are the limits to compensation of accidents?

  • If the insured is not an adult, compensation shall not exceed a certain sum in case of death.
  • If the insured is elderly, a certain percentage of the insured sum will be paid as compensation in the cases of death or disability.

The compensation for reasonable expenses or loss is determined by circumstances which you experience and your insurance Company. Different insurers have several methods of estimating the compensation for accidents covered in the insurance policy.

What should be done in cases of accidents?

When you experience an accident, and you are strong and conscious of your environment, do the following:

  • Inform your insurer through its customer care.
  • Introduce yourself with the names on your insurance policy document.
  • Explain your situation.
  • Pay attention to the instructions of your insurer’s customer agent.
  • Receive treatment from qualified and approved physicians in hospitals that are within your insurer’s network.

Who will receive compensation in cases of death?

Unless your insurer has received a written and authenticated instruction, the insurance sum shall be paid to the following individuals:

  • Immediate family members of the insured.
  • Insured’s wife.
  • Children of the insured.

In the absence of the individuals listed above, the insured’s cohabitee shall receive the insured sum. Provided he/she has been registered at the same address as the insured for a significant amount of time in years. And in absence of the cohabitee, the insured sum shall be inherited by the insured’s beneficiaries.

Note:
If an initial percentage of the insured sum was paid as a compensation in event of disablement due to accident. In case of subsequent death resulting from the same accident, the amount payable will be calculated as the amount by which the death benefit exceeds the previous payment.

Summary

  • Accident insurance serves as a supplement to the medical insurance plan, and it is designed to provide compensation for permanent losses caused by accidents.
  • An Accident is an unpredictable event that has the probability of occurring without the intention of the insured.
  • Accident insurance will not cover pre-existing illness, accident as a result of drugs and alcohol, suicide or intentional harm of one’s self.
  • Always inform your insurer’s customer care about your involvement in an accident, provided you are able to do so.
  • In cases of death, your immediate family members, spouse, children, cohabitee or listed beneficiaries in that order, will receive the stipulated amount as compensation. An exception to the aforementioned individuals will only be applicable when your insurer has received a written and authenticated instruction.
  • Consult your insurer for more details about any arising doubt. Proper mastery of your insurance policy will enable you to inquire about issues in the right manner.