Exclusions differ from one insurer to another, and checking them is part of our work before we recommend a policy to you.
A fall in the building leads to a broken arm and three weeks off work. A policy with a daily benefit pays the agreed amount for every day you are unable to work, and if a permanent restriction of movement remains after treatment, permanent disability is assessed on top of that. Medical documentation from day one is what decides the payout, and we help you with the claim.
The injury happens at the weekend, on a private trip. Policies with cover 24 hours a day pay out no matter where and when the accident happened, while cheaper versions cover only time at the workplace and the journey to work. The difference in premium between those two versions is often smaller than people expect.
The insurer uses its own table and sets a lower disability percentage than the client expected. The percentage is not a free assessment but a specific entry in a table that forms part of the policy terms, so it pays to know in advance how that table is written. We compare the tables before the policy is signed and help with the correspondence when the finding is disputed.
The examples are illustrative and show how the cover works in practice.
An accident is a sudden event that acts from the outside, independently of the will of the insured person, and causes bodily injury, disability or death. Typical examples are a fall, a road accident, being struck by an object, a burn or an electric shock. Medical conditions that arise internally, such as a heart attack or a stroke, are as a rule not treated as accidents.
Accident insurance pays money because of the consequences of an injury, meaning a sum for disability, a daily benefit or a hospital benefit. Voluntary health insurance pays for examinations and treatment in private facilities, illness included. The two go together rather than replace each other, because accident cover does not pay for illness and health cover does not pay a sum for disability.
The insurer sets the percentage of permanent disability using the table that forms part of the policy terms and applies that percentage to the agreed sum. The assessment is only made once the condition has stabilised, usually after treatment and rehabilitation are finished. That is why the amount for the same injury differs between insurers, because their tables differ too.
It depends on what has been agreed. The standard version with most insurers is cover 24 hours a day, in all places and abroad, but there are also cheaper policies limited to working hours and the journey to work. For travel, keep in mind that accident insurance pays a benefit, while the cost of treatment abroad is covered by travel insurance.
The claim goes to the insurer together with medical documentation, the report from the first examination and the discharge letter if there was hospital treatment. The most common mistake is not reporting the injury to a doctor straight away, which leaves no evidence of how it happened. We tell you exactly what to attach and follow the file through to a decision.
Send us a short enquiry. We collect offers from every insurer that covers this risk and explain the differences before you sign anything.
