Personal Accident Insurance
Asked on 25 May 2020
I mean injuries during exercise sometimes when you don't realise it, so proving it will be hard right haha. Oh, and also if there's anything else I should be aware of, please let me know, thanks!
Nigel Tan, Senior Financial Planner (AFC) at Great Eastern Life
Answered on 25 May 2020
The criteria for accidents include
Yes it is difficult to prove so thats why theres usually a limit on how much you can claim based on your PA reimbursement.
Basically you pay for physio upfront and seek reimbursement or claims from the insurer through your agent. The claims form is mostly based on personal declaration basis so its quite difficult to the injury was not due to an accident.
Required documents would be:
1) Original receipt for your physio claims
2) Completed claims forms which has your declaration and description of injury
What you should be aware of - No drugs, alcohol, breaking the law during the accident
Different insurers may have different terms and conditions, as well as process on claims. Generally, we need to fill up an accident claim form.
In detail, we will describe the incident, e.g. accident date, how did the accident happened, etc. Thereafter, the Claims department will assess your claim based on the submitted information.
If you are unsure on the scope of coverage or how to make a claim, then it is best to work with an experienced consultant who is able to give you responsible advicve. This will save you the trouble of having to read the entire policy contract, as well as time taken to complete your own claim form.
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Usually personal accident claims (small injuries) only cover the medical part in the form of reimbursement. No additional cash will be paid to you. Which means that the possibility of 'fraud' for accidents is low since it doesnt benefit you. (Getting yourself injured to make a claim on the medical fees only doesnt make sense)
As for larger accident that causes permanent damage to your limbs, usually there will be police reports and witnesses to support your claim.
The keyword here is "accidental". The claim success will be dependent on the description of accidental injury, and the extent of the injury expenses incurred. The insurer has the right to request for medical documents from the medical institution you visit, as well as a second medical opinion if required for reimbursements of expenses.