Page 110 - Policy Wording - Hollard Business Binder (2020-08-26)

Stated Benefits/Group Personal Accident
2.6.28
2.7
Temporary Partial Disablement Not back at work full time (i.e. mornings only for 3 days a week). The benefit is reduced to 40% of TTD, not exceeding the total number of
weeks under TTD for both TTD and TPD
Medical Expenses:
2.7.1 This should not be more than 10% (ten percent) of the capital benefit or R100 000 (one hundred thousand rand), whichever is the lesser.
2.7.2 Referrals to Hollard:
2.7.2.1 Requests are sometimes received to provide an extension to cover additional medical expenses due to plastic surgery having to be redone following another accident.
2.7.2.2 This is not excluded in terms of the wording but would be subject to the normal medical limit.
2.7.2.3 The problem is that for the second and subsequent applications of such surgery, the task of reconstruction is more difficult and costly and the healing period is somewhat extended resulting in higher medical costs.
2.7.2.4 The overall medical expenses limit should be increased to a suitable figure and the appropriate premium charged on the higher limit.
3. UNDERWRITE THE RISK
3.1 Age limits
3.1.1 Persons between the ages of 15 (fifteen) and 75 (seventy five) years should be covered.
3.1.2 If the Insured Person turns 75 (seventy five) (or more) at renewal, continuation can be considered subject to:
3.2 3.2.1
3.1.2.1 approval by Hollard;
3.1.2.2 medical examination and proof of health by the Insured's GP;
3.1.2.3 an eye test if still driving an insured vehicle;
3.1.2.4 confirmation of no physical defect or infirmity;
3.1.2.5 no medical cover provided.
Information required on the risk:
Stated Benefits
a) Number of persons
b) Wages amount of entire working force
c) Multiple of annual wages/salaries
d) Their respective occupations/occupational categories (depending on whether cover is to operate on a named or unnamed employees basis)
e) Is cover required 24 hours or business hours only?
Group Personal Accident
a) Names with IDs required if the individual is being insured. Do not insure on a blanket basis unless cover is say for all non-executive directors
b) Respective occupations
c) Benefits required
d) Is cover required 24 hours or business hours only?
3.2.2 Avoid insuring on an occupational category basis wherever possible as this makes a claim difficult.
3.2.3 To ensure positive identification of the insured person with the minimum of difficulty in the event of a claim (particularly in the event of Death or Permanent Disability), the full first names and surname as well as the identity number of each named insured person should be shown on the policy schedule. In the rare instances where an insured person is not in possession of a valid identity document, the date of birth of the insured person/s may be recorded as an alternative.
Commercial Underwriting Mandates and Guidelines – Binder – Version 2 2020 109