Health Insurance Flashcards
What type of policies are health Insurance described as?
Benefit policies
What cover is provided by the accident section of a standard personal accident and sickness policy?
Compensation in the event of accidental death or bodily injury.
How long does the usual accident policy provide a weekly benefit for?
Capital sums (i.e. lump sums) are paid in the event of death or certain specified injuries. The policy usually provides a weekly benefit of up to 104 weeks or compensation if the insured is temporarily totally disabled due to an accident.
How long does the usual sickness policy provide a weekly benefit for?
The sickness section of a standard personal accident and sickness policy provides a weekly benefit of up to 104 weeks if the insured is temporarily and totally disabled from engaging in their usual occupation due to sickness or disease.
How long is the period of time that is generally excluded at the commencement of a sickness policy?
Cover generally excludes sickness contracted within the first 21 days of the commencement of the policy period.
Name 5 of the personal accident and sickness policy benefits
Death Total loss of (sight in) one or both eyes Total loss of one or both limbs Permanent total disablement Permanent partial disablement Temporary total disablement Temporary partial disablement Medical expenses Payment of benefits
What are the policy limitations to personal accident and sickness policies?
Geographical limits - cover for accidents is usually worldwide, whereas sickness cover is generally restricted to the UK, Europe, USA, Canada, Australia and New Zealand. Sickness cover may be extended beyond these limits, subject to an additional premium.
Age limits - Specified age ranges apply most common being 16–70 years in respect of accident cover and 16–60 years in respect of sickness cover. However, once it has accepted a risk, an insurer will often extend these limits for existing policyholders.
Name 4 of the exclusions on personal accident and sickness policies.
The insured being under the influence of, or being affected by, alcohol or drugs, unless under medical supervision;
Self-inflicted injury or disease;
Physical defects or infirmity which existed prior to an accident;
The insured engaging in certain sports and pastimes, although some insurers will cover them for an additional premium, e.g. aviation (other than air travel in a fully licensed passenger-carrying aircraft as a passenger), motor cycling, polo, racing on horseback or on wheels, winter sports or mountaineering involving the use of ropes or guides;
Childbirth, pregnancy, venereal disease or AIDS;
War risks; and
Sickness occurring within 21 days of the commencement of sickness cover.
What is the standard cover under a medical expenses policy
Hospital charges - These include costs such as theatre fees, surgical dressings and consultations.
Specialist fees - These include surgeons’ and anaesthetists’ fees.
Additional costs - These include ambulance fees and nursing fees.
