Chapter 2 - Health Insurance Flashcards
(21 cards)
what is personal accident and sickness insurance?
where a sum insured is paid when the insured has an accident of is off work due to sickness
what is the main rating factor for the personal accident element?
the insured occupation
what kind of policy is personal accident and sickness?
benefit policy
what does the accident section of the policy provide?
compensation in the event of accidental death or bodily injury
when are capital sums paid?
in the event of death or certain specified injuries
what is the sickness section normally subject too?
time franchise
what does the sickness section of a standard policy provide?
a weekly benefit up to 104 weeks if the insured is temporarily and totally disabled from their occupation due to sickness or disease
what is time franchise?
if the insured is sick for less than 7 days no payment is made
what does standard cover generally exclude in regards to sickness?
sickness contracted within 21 days of
what does standard death cover usually include?
a capital benefit that start from £20,000 but death must occur within 12 months of the event causing the claim
what is usually paid following total loss of sight in one or both eyes?
a capital sum
what compensation usually follows permanent total disablement?
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
what compensation is usually given for temporary total disablement?
a weekly benefit usually £200 for a maximum of 104 weeks
what is temporary partial disablement?
temporary disablement that prevents the insured person from carrying out a substantial part of business due to accident
what is the traditional figure of temporary partial disablement?
40% of temporary total disablement figure
what is an optional extension under personal accident and sickness insurance?
legal expenses
what are examples of policy limitations on personal accident and sickness?
- geographical location - some policies wont pay if the insured has resided out of the UK for more than 180 days
- age limits
what are some exclusions found on personal accident and sickness policies?
- insured being under the influence of drugs/alcohol
- self inflicted injury
- childbirth or pregnancy
- war risks
what is medical expense insurance?
insurance for those who seek private medical treatment outside the NHS
what does medical expense insurance cover as standard?
- hospital charges
- specialist fees
- additional costs
what do medical expense policies usually exclude?
conditions in which treatment has been provided for in the last 5 years
