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Personal accident
Key terms to understand
Accident
Bodily injury Child
Medical practitioner Insured persons
Partner
An incident an insured person could not foresee, that happens unexpectedly and unintentionally at an identifiable time and place, and results in death or bodily injury. This includes motor vehicle accidents and hijackings
Physical injury to an insured person’s body caused by accidental, external and visible means. This includes injury caused by starvation, thirst and exposure to the elements
An unmarried, financially dependent child of the policyholder who has not yet attained the age of 18. While the policyholder is eligible for cover under this policy, the age may (at our discretion) be extended to a child who has reached age 24, in respect of:
○ an unmarried child who is a full-time student at a registered educational institution. Being a full-time student means the child must attend lectures and the course must be at least 12 months in duration. A full-time student does not include studies via correspondence
○ an unmarried, financially dependent child of the policyholder who is mentally disabled or permanently, totally physically disabled.
A person who is legally licensed and qualified to practise medicine and surgery as required by the laws of the Republic of South Africa. This person may not be the policyholder, an insured person or any member of their family
You, your partner, your children or members of your immediate family, who permanently live with you and who are financially dependent on you. An insured person also includes people employed by you at your home, such as cleaning staff, nannies, au pairs, drivers and gardeners. Insured persons must be set out and named in your policy schedule
A person who is your permanent life partner who you have lived with for longer than 12 months at the time of the accident, your spouse or civil union partner
Paying out after a claim
How much we pay
We pay out the exact amount of cover that you chose when you signed up for this policy, so any claim is settled simply by referring to the Schedule of compensation below:
Schedule of compensation
○ death −
○ medical benefit −
○ disability −
Who do we pay
sum insured stated in the Schedule sum insured stated in the Schedule as stated in the disability table
We pay you, or any person or beneficiary named in the Schedule. In the event of your death, payment is made to your legal representatives, your estate or the person you have nominated in the policy as your beneficiary.
Age limit
You can claim only if you are older than six months and younger than 80 years of age. No pay-outs will be made for anyone outside of this age limit, even if the claim is a valid one.
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