Page 120 - Hollard Business Branch Policy Wording

Group Personal Accident
OPTIONAL EXTENSIONS (if stated in the Schedule to be included) Accident Expert assistance
The Company will provide the Insured with the Accident Expert assistance provided by Roadcover in respect of assistance with claims under the Compensa on for Occupa onal Injuries and Diseases Act (COIDA) or claims under the Road Accident Fund (RAF), as set out in the Annexure ‘1’ to the Policy Schedule.
Provision of these services will be subject to the assistance services standard terms condi ons provisions and procedures as described in the Annexure “1” a ached to the Policy Schedule.
The following addi onal provisos are applicable in respect of the above men oned Accident Expert assistance:
1. The injured person has to be an Insured Person in terms of this Sec on and be employed by the Insured.
2. Any costs incurred by an injured Insured Person, being approached by an outside party without the wri en consent of Roadcover will not be covered.
3. The injured employee is at all mes free to get outside second opinions but the cost of these will not be covered unless approved in wri ng by Roadcover.
4. The injured employee is not obliged to use these assistance services and may seek alterna ve assistance in the event of which the Company will not be liable for any incurred costs.
5. The Accident Expert Assistance services are only available for Accident, injury or incident that occurs in the Republic of South Africa.
6. At the me of the Accident, injury or incident the Insured and the Insured Person must comply with the legal and regulatory ma ers required by the Acts governing the Compensa on Commissioner in terms of COIDA and/or the RAF.
7. The Accident Expert Services provided by Roadcover does not guarantee performance from or by the Compensa on Commissioner (COIDA) and/ or the RAF.
Hospitalisa on
If, during the period of insurance, an Insured Person is admi ed to hospital as an in-pa ent as a result of Accidental Bodily Injury, the Company will pay the amount re ected in the Schedule per day for a period of hospitalisa on up to 90 (ninety) days or the number of days re ected in the Schedule, whichever is the highest;
PROVIDED THAT:
1. the Company will not be liable for the rst 24 (twenty four) hours of each and every period of hospitalisa on;
2. successive periods of hospitalisa on, due to the same or related causes, will be regarded as one accident.
HIV accidental exposure
If an Insured Person becomes infected with Human Immunode ciency Virus "HIV" as a result of an accidental bodily exposure arising from and in the course of his employment, the Company will pay to the Insured, on behalf of the Insured Person or his/her estate, the amount stated in the Schedule.
For the purposes of this Op onal Extension an Insured Person does not become infected with "HIV" within the meaning of this Insurance unless;
1. within a period of 24 (twenty four) hours, following the accidental exposure, the Insured Person makes an o cial report of such exposure to the nominated responsible person within the Insured’s organisa on, who in turn within 72 (seventy two) hours must provide wri en no ce to the Company of such accidental exposure; and
2. within 72 (seventy two) hours of such exposure, the Insured Person undertakes a test performed by a registered medical prac oner in accordance with laboratory and clinical criteria represen ng good clinical prac ce at that date which demonstrates that the Insured Person does not have Human Immunode ciency Virus; and
3. within a period of 3 (three) calendar months from the date of the accidental exposure and during his life me the Insured Person is rst diagnosed by a registered medical prac oner as being "HIV" posi ve, the diagnosis being made in accordance with laboratory and clinical criteria represen ng good clinical prac ce at that date.
Hollard Business Policy – Branch – Version 1 2018 Page | 119