Exclusions and Limitations - Personal Accident Plan

We are not providing you with advice on whether the personal accident insurance policy is suitable for you, therefore, you need to decide, if the policy is right for you. As with any type of insurance there are important features that you need to be aware of.

There are some situations that you are not covered for and some limitations on what will be paid out. This is a summary of the main exclusions and limitations of your policy. Full details are shown in sections A, D and E of the Certificate of Insurance which can be downloaded here.

Limits on the amount you will recieve

  • The maximum amount we will pay for Disability Benefits is £250,000.
  • If you die within 90 days of an accident only the Death and Hospitalisation Benefits are paid.
  • Accidents that result in serious total disability are paid once per person covered by the policy. For example, the higher benefit for loss of sight in both eyes is paid once per person, but the lower benefit of loss of sight in one eye is paid twice per person. Please refer to the Policy Summary for full details.
  • Accidents that result in less serious disability (Items 9-16 on the Benefits of Cover) are paid more than once per person covered by the policy up to a limit of £100,000 for adults and £10,000 for children. Once the limit has been reached, cover will stop for that person.
  • Cover for Permanent Total Disability is not provided for those under the age of 16 or over 65.
  • The Hospitalisation Benefit is reduced by half for those over 65.
  • Children's Hospitalisation Benefit and Disability Benefit is 10% of the adult amount and the Death Benefit is £7,500.
  • The Hospitalisation Benefit is only payable after the fourth day of being admitted to hospital.
  • If you are admitted to hospital again for the same accident, the Hospitalisation Benefit will only be paid if this is within 90 days of your original admittance.
  • The Out of Country Hospitalisation Benefit is not paid in all countries. We exclude most countries that might be currently considered dangerous, such as Afghanistan, Iraq, Iran, Israel and others such as, India, China and Russia.

Benefits are paid in addition to any other insurance you may have and are free of personal tax (under current law). It is prudent to review any existing insurance you may have to see if it will be affected.

Pre-existing medical conditions

  • If you have a pre-existing medical condition and an accident makes your condition worse we will assess whether your condition was a factor when you make a claim. This may result in the amount payable being reduced proportionally.

When you are not covered

If the accident is a result of the following, we will not provide any cover:

  • for self inflicted injuries
  • whilst working in the Armed Forces (including the Territorial Army)
  • whilst flying as a Pilot or Cabin Crew
  • whilst under the influence of non-prescribed drugs or excessive alcohol
  • whilst participating in some risky leisure activities e.g. rock climbing, potholing and parachuting
  • whilst competing in any race other than on foot or whilst swimming
image

Have a query?
Call the Accident
Help Line on
Telephone Freephone

0808 178 8915

Monday - Friday
8am - 8pm

Calls may be recorded
for training and
monitoring purposes