Uni.Asia General Insurance

This is an introductory guide to help you better understand insurance protection against injury or death caused by an accident. It gives you basic information to enable you to make an informed decision when purchasing a personal accident (PA) policy.

What is PA insurance?
PA insurance is an annual policy which provides compensation in the event of injuries, disability or death caused solely by violent, accidental, external and visible events.

PA insurance provides 24-hour worldwide insurance protection.

Scope of PA cover
The scope of cover and scale of benefits differ between insurance companies and you should therefore ensure that you purchase a policy which meets your requirements. The types of coverage normally provided under a PA policy include:

- accidental death
- permanent disablement
- temporary total or partial disablement
- medical expenses
- corrective surgery
- hospitalisation benefits
- funeral expenses

You can either take a PA policy for yourself or a group policy for your family. Sometimes, PA policies are taken by employers for their employees and in such cases, payment of compensation to the employees is at the discretion of the employer. You may not be able to obtain a PA cover if you are involved in certain hazardous occupation. Some PA policies also specify the range of age limits that can be insured.

What are the exclusions?
Death or injury caused by the following events is commonly excluded from the cover:

- war risks
- suicide and insanity
- self inflicted injury
- AIDS
- provoked murder or assault
- childbirth or miscarriage
- hazardous sports
- operating or riding a two-wheel motor vehicle

In addition, a common PA policy also does not cover persons employed under the following professions:

- police/ military and law enforcement officers
- divers
- pilots or crew members
- aircraft testers
- racing drivers
- seamen and sea fishermen
- professional sports person

You are advised to always read carefully and understand your policy exclusions.

Important points to note when buying PA insurance

Scale of benefits
The scale of benefits refers to the amount of compensation payable by the insurance company in the event of injury to or loss of limb, sight or hearing. It determines the proportion of compensation vis-à-vis the loss suffered. For example, the compensation for the loss of an index finger is determined to be 10% of the sum insured, depending on your policy contract. You are advised to note the scale of benefits for death and disablement in your policy which differs between insurance companies.

Beneficiary
You are advised to nominate your beneficiary and ensure that your beneficiary is aware of the PA policy that you have purchased.

Multiple insurances
If you have purchased more than one PA insurance policies, in the event of your demise or disablement, you or your beneficiary, as the case may be, will be compensated under each policy. However, for certain losses such as medical expenses which are compensated on reimbursement basis, you will only be compensated once for the actual loss suffered.

Making a claim against your insurance company

Death claim
A police report and notification to your insurance company should be made as soon as possible. The claim form should be submitted with all supporting documents, such as the death certificate and burial permit. If there is no beneficiary nominated, the dependants of the deceased or the administrator of the deceased’s estate should provide proof of dependency or the letter of administration.

Injury claim
You must give written notice of injury to your insurance company within the time frame stipulated in your policy. You should submit the claim form with all supporting documents such as the medical report and receipts of payment for hospital expenses to your insurer. You will be compensated for benefits under your policy if treatment is obtained or diagnosis is made within the specified time frame from the date of accident.

How to lodge a complaint and the redress avenues available
-	If you have a complaint about the products or services of your insurance company or you are not satisfied with the rejection or offer of settlement of a claim, you should first try to resolve the complaint with the Complaints Unit of the insurance company concerned.
-	If you are still not satisfied with the decision, you can write either to the Customer Service Bureau of Bank Negara Malaysia or the insurance mediator, free of charge. However, the scope of the mediator is limited. Therefore, you need to check with the officer from the Complaints Unit of the insurance company on the proper avenue for dealing with your complaint.
-	Alternatively, you could take your case to court.

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