Page 112 - Hollard Private Portfolio - Version 3.5

110 Hollard Private Portfolio – Version 3.5 – 7 May 2024
Personal accident
Psychiatric conditions
We do not cover death, disability or bodily injury that was caused by stress, stress-related symptoms, psychosis, neurosis,
or diagnosed psychiatric or nervous disorders.
Trade and economic sanctions
If an insured person is subject to trade and economic sanctions, we cannot provide cover if it means we would not
comply with such trade or economic sanctions.
Claiming under this cover section
The conditions set out in the section Claiming under this policy in the Understanding your policy section do not apply
to the Personal accident cover section.
How to claim
○ Tell us of the death, disability or bodily injury in writing within four months from the date of the accident.
○ Send us the evidence and other documents we ask for within the reasonable time that we will give you. We
typically need the following, but we may ask for more depending on the details of the claim:
– A certified copy of the insured person’s identity document.
– An original signed claim form.
– A certified copy of the insured person’s death certificate (if applicable).
– Post-mortem reports (if applicable).
– A copy of the police report (if applicable).
– Medical reports and clinical evidence (if applicable).
– Proof of hospitalisation (admission and discharge forms).
– Blood alcohol results (if applicable).
If the steps above are not followed, or if you do not send us the information, we ask for within the time we
give you, we may reject the claim.
We may ask for medical examinations
○ For a permanent disability benefit claim, the insured person must undergo medical examinations when we ask
them to, as often as required. We will pay the cost of the medical examinations.
How we may limit the amounts we pay
○ If an insured person sustains more than one kind of bodily injury in the same accident, we will not pay more
than 100% of the limit as shown in your policy schedule.
○ If we pay a benefit for the loss of a limb, we will not also pay the benefit for part of that limb.
For example: If we pay for the loss of a hand, we will not also pay the percentages shown for the loss of fingers.
○ If an insured person becomes permanently disabled and then dies because of their injuries, we will either pay
100% of the Permanent disability benefit, or the full Death benefit. We will not pay for both benefits.
○ Death benefits for children are restricted to the amounts shown in your policy schedule.
If we approve the claim
If we approve the claim, we will pay the benefits as follows:
○ We will pay the permanent disability benefit to the insured person.
○ We will pay the death benefit to the insured person's estate.
○ If the insured person is your child, we will pay the death and permanent disability benefit to you.
○ We will pay the amount under the Hospital benefit and Trauma counselling benefit to the insured person. We
will not pay any costs directly to a service provider.