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What is Personal Accident Cover?

Life insurance policies pay out, either in a lump sum or a monthly income, following the death of a policyholder. But death isn't the only eventuality that can financially destabilise your family. An accident which leaves you permanently disabled, forcing you out of work, and often requiring medical treatment, care, and the modification of your home, can be equally financially catastrophic.

What is personal accident cover?

You can protect you and your family in case of loss of earnings brought about by serious injury by taking out personal accident insurance. These policies pay out if you suffer serious injury or death as the result of an accident. The Financial Ombudsman, which oversees the insurance industry and advocates on behalf of consumers, defines an accident as "an unforeseen or unexpected and unfortunate occurrence."

It's important to remember that this cover won't be activated if you die or are injured through natural causes, including disease and sickness. You'll need to seek out other cover, such as a critical illness policy, to protect yourself against those scenarios. But for sudden, violent, and unexpected incidents, whether in the workplace or elsewhere, you'll want personal accident cover.

Many life insurance and fully comprehensive car insurance policies will include personal accident cover, but not all will, so read their terms and conditions carefully.

What accidents are covered by personal accident cover?

Personal accident cover benefit kicks in and payouts are delivered if the policyholder dies or is seriously and permanently disabled-including losing, or losing the use of, a limb or sense-in the following circumstances:

  • a workplace accident or injury
  • through violence, such as through a crime
  • in a road traffic accident
  • through slips or spillages
  • amputations, either immediately following the accident or as a result of the accident, within a certain timeframe (for example, 24 months)

Personal accident insurance typically won't cover injuries, disability, and deaths caused under the following circumstances

  • self-inflicted injuries-either caused in a suicide attempt or through recklessness
  • injuries caused by drug use or alcohol intoxication, including road traffic accidents caused when driving under the influence of controlled substances
  • injury due to sickness or disease
  • injuries sustained by professional sportspeople when training or playing
  • injuries sustained while participating in criminal activity
  • injuries sustained in war
  • injuries caused by radiation or other nuclear accident

Examples

To help you understand what eventualities will merit a payout under person accident cover, let's look at two scenarios involving a diabetic policyholder and an amputation. Only one of the following will earn a pay out from a personal accident policy:

  • Scenario 1: A person with diabetes experiences dizziness due to low blood sugar levels while on a ladder and falls, injuring their leg. The leg subsequently needs to be amputated.
  • Scenario 2: A person with diabetes suffers complications that result in the amputation of their leg.

Only in Scenario 1 will a personal accident policy deliver a pay out because only that scenario involved "an unforeseen or unexpected and unfortunate occurrence." The amputation in Scenario 2 can be attributed directly to disease and not to an accident.

Who should obtain personal accident cover?

People who work in high risk environments, such as on building sites, where workplace accidents are common, often obtain personal accident cover.

These insurance policies generally cover injuries sustained anywhere in the world, as long as you are normally resident in the UK, so you might want to take one out before going travelling, as a supplant to travel insurance. However, be aware that accidents sustained during extreme sports are sometimes excluded.

How much does personal accident cover cost? How much does it pay out?

Personal accident cover can be obtained from a little as a few pounds a month, for cover that ranges between £40,000 and £100,000 for a single person. You can also bundle personal accident cover for you and your partner, for premiums that would be less than on two separate politics.

As anyone can be involved in an accident at any age, your premiums for these policies typically don't rise as you grow older, unlike with other insurance policies. You also generally won't have to disclose your medical history or submit to a medical exam, as pre-existing health conditions have little impact on your susceptibility for accident. However, you can age out of policies; they will generally lapse once you've reached your 80s.

Pay outs on personal accident cover are often weighted based on the severity of your injury. For instance, a policy may not pay out if you've only lost 20% of the function of a limb. It may give you 50% of the sum insured, if you're 50% of the function of the limb-or any other percentage equal to the percentage use you've lost, as assessed by a doctor. Above 70% loss and you'll typically receive the full sum insured. The assessment of the loss of senses is conducted similarly.

When you file a claim, you will generally need to submit evidence of your level of impairment from a medical professional.