Chapter 2: Health Insurance Flashcards
What does Personal Accident and Sickness Insurance cover?
A sum will be paid out in the event of an accident or if the insured is off work due to sickness.
What type of insurance is a health policy?
Benefit policy.
What does accident insurance cover?
Will pay a benefit in the event of accidental bodily injury or death.
How do insurers define ‘accidental’?
- Must be fortuitous
- Must have an identifiable cause
- Death must be caused by bodily injury independent of any other cause
How long will a benefit be paid out for under a health policy?
104 weeks.
What does a sickness policy cover?
Provides a benefit for up to 104 weeks if the insured is unable to work.
What is a ‘franchise’ in terms of sickness cover?
A time delay before the benefits are paid out. E.g. the insured must be unable to work for more than 7 days.
What are the limitations to a personal accident and sickness policy?
- Geographical limits
- Age limits.
Give some exclusions to a personal accident and sickness policy.
- Alcohol or drug consumption
- Self-inflicted injury
- Physical defects existing prior to the injury
- Childbirth
- War risks
- Sickness occurring within 21 days of cover start
What is medical expenses insurance?
Cover for private medical costs.
What does medical expenses insurance cover?
- Hospital charges
- Specialist fees
- Additional costs
