Personal Accident

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Personal Accident Insurance

A major accident can suddenly disrupt your entire life. Why let your financial situation take a beating? It’s better to stay protected with personal accident insurance.

Personal Accident Insurance is a policy to cover individuals and groups from the physical injuries and financial loss. It covers among other things death, Permanent Disability, Temporary Total Disablement, accidental medical expenses, funeral expenses, hospital cash, artificial appliances. This type of cover is a hybrid of two products, life insurance and medical insurance as it caters for bodily injuries and also covers pure financial indemnity to the insured in form of death and disability benefits. Insurance premiums for PA insurance policies have duration of one year and insurance premiums are paid annually.

Personal Accident (PA) insurance may be taken as a standalone cover or as an optional rider on other more commonly known insurance products. For example, a PA cover may be taken with a life insurance/savings product, providing financial compensation to the insured in case of the eventual risk. A PA cover is also commonly bundled on comprehensive motor insurance policies and medical insurance policies, where it covers members of the insured’s family in case they are travelling in the insured vehicle in the event of a road accident.

Personal Accident Insurance is similar to the Work Injury Benefits Act (WIBA) which is a statutory insurance provided by employers to all employees in Kenya. The main difference is that it WIBA only covers employees during official working hours and duties while a PA covers the insured at all times. To remove this duplication between the two products, a newer product WIBA+ has been introduced which offers employees all round protection in and out of the office similar to a PA cover.

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Personal Accident Insurance Features

PA Insurance provides financial support to you and your family in the event you suffer an accidental injury, accidental disability, or die from an unforeseen accident. PA coverage varies from life insurance in two forms:

PA Insurance directly covers death resulting from accidents, not from natural causes, or medical conditions. But life insurance covers all the three types of death. A personal accident cover does not provide investment compensation in addition to death benefits. An annual policy is renewable every twelve months.

A PA cover does not refund cash where clients pay up for several years with accident-free incidences. But some companies offer bonuses ranging 5-10% for loyal customers with no claims over a stretched period. Group PA covers come in handy for industries such as security, transportation, construction and manufacturing workers. The Insurance Act, 2007, mandates employers to have all laborers’ carrying out risky tasks insured under the Workmen’s’ Compensation Act (WIBA), which is an enhanced personal accident policy for technical employees. Click here to get a WIBA quotation for your employees.

Scope of Accident Insurance Coverage

PA Insurance covers various incidents with compensation payouts based on the degree of the accident. You can find the rate tables used by insurers to compute beneficiary payments in the proposal forms or a personalized company brochure.

1. Accidental Death

Policy contract runs for a maximum 12 months. In this case, accidental death benefits fall within the limited period, after which, if no death occurred, you might renew your policy for an extended further 12 months. In other words, the contract expires every year, and you may replace it immediately to continue enjoying coverage benefits. All claims are paid out to your nominated next of kin.

Here’s how an insurer determines accidental death benefits:

Approved: If the insured accidentally broke their limbs while carrying a heavy load up a flight of stairs, but catch a severe fever while hospitalized and die from it, a claim payment should be made because it was the accident that led to their illness.

Not Approved: If the insured had a medical condition that makes them faint occasionally causing a few bruises or a fatal death as a result; the beneficiaries will not receive a death claim benefit because it was the illness that caused the accident that led to the insured’s death.

2. Permanent Total Disability (PTD)

If you become permanently disabled out of an accident, a lump sum payment is made. However, a time limit of 6 months applies to determine total permanent disability before the disbursement is paid out.

Total disability prevents you from engaging in any work. Some insurers pay partial lump sum while others give you the option of a one-off payment.

Examples of Permanent Total Disabilities:

  • Loss of sight in both eyes
  • Loss of speech and hearing
  • Loss of both limbs; Hands and feet
  • Loss of any combination of one foot /one arm or sight in one eye

3. Temporary Permanent Disability (TPD)

Insurers pay benefits in the event of partial loss of one limb. The amount received is a percentage of the sum you’re insured for. A weekly benefit is paid in case of accidental injury to the insured since they cannot go back to work immediately. Benefits payouts vary between 100 -104 weeks. (Two years).

4. Medical Expenses

Your personal accident policy also caters to a percentage of your medical bills incurred during your hospitalization. Insurers reimburse the insured for any medical costs incurred because of an accident. The medical refund covers hospitalization, surgery, and medical prescriptions. The maximum amount payable varies with insurers and coverage limits of your policy contract.

5. Daily Hospital Cash

PA policies pay out daily hospital cash as an additional benefit. This benefit gives a fixed daily payment, e.g. (Ksh.250 a day) up to a certain number of days (60 days per year) for hospitalization care. To qualify, you must be confined to a hospital bed out of accident related injuries.

To Get a Personal Accident Insurance policy Contact us today to fill a PA proposal form or for further consultation.

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