Chapter 2 - Health Insurance Flashcards

1
Q

what is personal accident and sickness insurance?

A

where a sum insured is paid when the insured has an accident of is off work due to sickness

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2
Q

what is the main rating factor for the personal accident element?

A

the insured occupation

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3
Q

what kind of policy is personal accident and sickness?

A

benefit policy

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4
Q

what does the accident section of the policy provide?

A

compensation in the event of accidental death or bodily injury

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5
Q

when are capital sums paid?

A

in the event of death or certain specified injuries

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6
Q

what is the sickness section normally subject too?

A

time franchise

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6
Q

what does the sickness section of a standard policy provide?

A

a weekly benefit up to 104 weeks if the insured is temporarily and totally disabled from their occupation due to sickness or disease

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7
Q

what is time franchise?

A

if the insured is sick for less than 7 days no payment is made

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8
Q

what does standard cover generally exclude in regards to sickness?

A

sickness contracted within 21 days of

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9
Q

what does standard death cover usually include?

A

a capital benefit that start from £20,000 but death must occur within 12 months of the event causing the claim

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10
Q

what is usually paid following total loss of sight in one or both eyes?

A

a capital sum

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11
Q

what compensation usually follows permanent total disablement?

A

usually a capital sum - but it may not be payed for 12-24 months after the accident as it takes time to determine whether the disablement is both permanent and total

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12
Q

what compensation is usually given for temporary total disablement?

A

a weekly benefit usually £200 for a maximum of 104 weeks

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13
Q

what is temporary partial disablement?

A

temporary disablement that prevents the insured person from carrying out a substantial part of business due to accident

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14
Q

what is the traditional figure of temporary partial disablement?

A

40% of temporary total disablement figure

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15
Q

what is an optional extension under personal accident and sickness insurance?

A

legal expenses

16
Q

what are examples of policy limitations on personal accident and sickness?

A
  1. geographical location - some policies wont pay if the insured has resided out of the UK for more than 180 days
  2. age limits
17
Q

what are some exclusions found on personal accident and sickness policies?

A
  1. insured being under the influence of drugs/alcohol
  2. self inflicted injury
  3. childbirth or pregnancy
  4. war risks
18
Q

what is medical expense insurance?

A

insurance for those who seek private medical treatment outside the NHS

19
Q

what does medical expense insurance cover as standard?

A
  1. hospital charges
  2. specialist fees
  3. additional costs
20
Q

what do medical expense policies usually exclude?

A

conditions in which treatment has been provided for in the last 5 years