Page 108 - Policy Wording - Hollard Business Binder (2020-08-26)

Stated Benefits/Group Personal Accident
1. GENERAL
STATED BENEFITS/GROUP PERSONAL ACCIDENT
1.1 Payment of compensation is made in the event of death or bodily injury being sustained as a result of an external accident. No cover is provided for natural causes.
1.2 Amounts payable in terms of COIDA (Workman's Compensation) will be deducted in respect of Temporary Disability and Medical Expenses.
1.3 This cover does not replace any life cover or conventional medical products including medical aids.
1.4 The sections Stated Benefits and Group Personal Accident are essentially the same, the differences are as follows:
Benefit
Stated Benefits
Group Personal Accident
Compensation
Based on actual earnings:
a) All employees are covered and accumulated wage amount must be ascertained.
b) Will be based on multiple of annual earnings as selected.
Benefit nominated:
a) Named insured persons must be stated in the Schedule with the selected benefit amount.
b) Applies when selected persons are insured (i.e. 5 Engineers).
Insured person
a) All employees included and benefit in accordance of the actual salary.
b) Can be categorized, managers, drivers, etc.
c) All wages payable must be declared and the individual will not be paid more than the actual income.
R7 500 000 R7 500 000
R30 000 000 (based on top 5 earners) R30 000 000 (based on top 5 earners)
Make provision on the bordereaux to cede to Accident & Health the excess layer. If the required benefit exceeds the limit, refer to Hollard.
1.5 Both covers are intended to meet various needs including:
1.5.1 employers (Insured) to provide compensation for employees (of the Insured) and their dependents;
1.5.2 companies (the Insured) requiring cover for the lives of directors or other key personnel to provide compensation for the loss of their services and costs involved in replacing them. Non-executive directors should be covered for business activities of the Insured only, including commuting to and from such activities;
a) Named in the Schedule and specific benefit is payable.
b) TTD benefit is subject to actual earnings but only up to the stated sum insured.
c) Non-executive directors cannot have
24 hour cover. If required, to be referred.
Maximum acceptance
a) Any one life: R2 000 000
b) Temporary Total Disablement (TTD): 104 weeks
c) Weekly benefit: 100% of weekly earnings
d) Medical: R100 000
a) Any one life: R2 000 000
b) Temporary Total Disablement (TTD): 104 weeks
c) Weekly benefit: R3 000
d) Medical: R100 000
Known accumulation
Accumulation limit
1. Total of all wages times period required for Death or PD (1x, 2x or 3x annual earnings; plus
2. total of TTD; plus
3. medical expenses.
1. Total of Death or PD; plus
2. total of TTD; plus
3. medical expenses.
How is the accumulation calculated
Process
Referral
Commercial Underwriting Mandates and Guidelines – Binder – Version 2 2020 107