Personal Accidents
Personal accidents are defined as serious physical injury due to an accident resulting from an obviously severe and sudden external factor that causes the death of the insured or any disability resulting directly from this accident.
• The accident must not be expected or preplanned by the insured.
• The accident must be caused by reasons outside the body.
• The accident must be severe.
• The accident must be obvious and visible.
• The accident must be the proximate cause of the death or the disability of the insured and no other factors interrupt that chain of events.
Insurance of personal accidents covers the following:
• Death
The case of death can be proven and must happen within three months of the accident in order to avoid the interference of any factors unrelated to the accident which can increase the injury. In the case of death, the amount of insurance is paid to the beneficiary named in the policy, or to the legal inheritors if the beneficiary is not mentioned in the policy. These are the same standards for paying the other benefits mentioned in the policy.
• Permanent Total Disability
This means that if the permanent disability prevents the insured from performing any work and this is confirmed within a period of three months of the accident, then the insured receives a compensation of 100% of the insured amount as stated in the policy. The cases of permanent disability are:
• Permanent blindness in both eyes
• Loss of two limbs (two arms, two legs, or one arm and one leg)
• Permanent blindness in one eye and loss of a limb
• Permanent Partial Disability
This means that if the permanent total disability resulted from losing a limb or an eye under the condition that this happens within three months of the accident, then the insured receives 50% of the total insurance amount stated in the policy. Some of the permanent partial disabilities are:
• Permanent blindness in one eye
• Loss of one limb (one arm or one leg at or above the wrist or the ankle)
• Permanent deafness in both ears
• Loss of a finger or a toe
• Temporary Total or Partial Disability
Sometimes, the injury does not cause permanent total disability to the insured, and the insured can perform part of his regular duties for a specific period, but then the injury increases gradually to result in a total disability to perform work at all. In contrast, sometimes, the injury causes a total disability to the insured, but then this disability gradually disappears until the insured becomes able to continue performing duties.
Medical expenses
Most personal accident policies do not cover medical expenses following an accident. However, coverage for these expenses can be offered for a limited cover but are subject to the payment of additional premium to be agreed upon between the parties
