Your Personal Accident (PA) policy may have different categories of coverage. Here are the more common ones. If your policy cover these, you will be able to make a claim in the event of an injury due to accident.
Medical Reimbursement (due to Accident)
- Outpatient consultation, scans and X-rays, physiotherapy (referral letter required) and medication, are some of the the claimable medical expenses.
- TCM and Chiropractor may also be claimable but usually with a lower sub-limit.
- Mobility Aids that are prescribed due to the injury may be claimable as well.
- Should surgery or hospitalization be required, if you have an integrated shield plan or other hospital plans, you can also claim from your PA policy, subject to the limits from this policy. This will allow you to claim for the co-payment that you have to pay from the integrated shield policy.
- Medical Reimbursement benefit is on a reimbursement basis, and you will only be able to claim from one policy at a time, up to the total bill paid.
Coverage due to Sickness / Infectious Disease
- Some personal accident policies cover for certain sickness as well. Some of it includes Dengue Fever, Zika, HFMD and Food Poisoning.
- The coverage for this is usually on medical reimbursement with lower sub-limit of the medical expense, or some covers a daily hospital cash, in the event of a hospitalization.
Daily Hospital Cash
- For hospitalization due to an accident, in additional to the medical reimbursement, if your policy has a daily hospital cash benefit, you will be able to claim for this as well.
Fracture & Burn
- This is usually an additional lump sum payout, in % of the location of the fracture, or area and degree of burn, up to the claim benefit limit.
Temporary Total Disablement (Weekly)
- Some accident policies covers for weekly benefit in the event of a temporary total disablement.
- Should the injury prevents you from engaging in your usual occupation or business activity, you will be able to make a claim from this benefit.
Death / Permanent Disablement
- This is a lump sum benefit that is payable in the event of death or permanent disablement that occurs within 365 days of the accident.