What is Personal Accident and Sickness Insurance?

What is Personal Accident and Sickness Insurance? Thumbnail Image

Personal Accident and Sickness insurance provides a weekly benefit as a portion of the insured person’s income if they are unable to work due to a covered event arising from a bodily injury or sickness.

Weekly benefits are normally limited to a maximum of 85% of the insured person’s average weekly wage or the selected sum insured, whichever is the lesser.

Policy Features

Depending on your needs, most policies allow you to tailor cover by customising a range of features which will ultimately determine your level of cover and the premiums you will pay. When purchasing cover it is essential to understand these features to ensure the product is right for you.

  • Accident only cover: Accident only cover only pays weekly benefits when injuries resulting from an accident event prevent the insured person from returning to work.
  • Accident and Sickness cover: In addition to accident cover, an Accident and Sickness product also provides cover when sickness prevents the insured person from returning to work.
  • Capital Benefits: A ‘capital benefit’ is a lump sum paid to you in the event you suffer a permanent injury or accidental death.
  • The waiting period: The waiting period (also referred to as ‘Excess period’ or ‘deferred period’) is the time period you would have to be off work before the policy would start to pay a benefit. As a general rule, the longer the waiting period the lower the premiums.
  • Benefit Period: This is the maximum period of time that you could potentially receive a benefit for each individual claim. Typically a shorter benefit period will result in lower premiums.
  • Scope of Cover: The option to select when cover applies. The broader the cover, the higher the premium. Potential cover options include: 24/7 cover including at work, 24/7 reduced by any workers compensation entitlement or simply outside business hours only.

How are Premiums Calculated?

Insurers consider a range of rateable factors when calculating insurance premiums for Personal Accident and Sickness Insurance. Such factors include:

  1. Age – Unfortunately older we are, the longer we take to recover from injury and the more likely we are to suffer from sickness.
  2. Occupation – Office workers have lower ratings as they can continue to work with some injuries e.g. a broken ankle. Whereas a scaffolder would not be able to return to work at all with the same injury.
  3. The weekly Sum Insured (benefit) selected.
  4. The Level of Cover desired – Is the cover for Accident and Sickness or Accident only? Does the insured want Capital Benefits?
  5. The Benefit Period
  6. The Waiting period

What is generally NOT covered by Personal Accident and Sickness Insurance?

As a rule of thumb*, most insurers do not extend cover to injury or sickness which occurs as a result of:

  • Pre-existing condition/s
  • Pregnancy and childbirth
  • Acts which are Intentional, criminal or otherwise deliberately caused by you
  • Being under the Influence of alcohol or drugs
  • Participating in professional sports
  • Acts of war and terrorism

What Now?

Need cover to protect your income today? Cerberos can offer comprehensive Personal Accident and Sickness cover which you can bind, purchase and receive full policy documentation online within minutes. Customise your level of cover by choosing from a range of policy options to tailor your cover to suit your lifestyle. Choose to pay in full or via monthly instalments. Get started today!

If you have any further questions or you would like assistance in assessing your Personal Accident and Sickness insurance needs please be sure to contact one of our insurance experts.

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