Frequently Asked Questions About Medical Recovery Accident Only Insurance Company Plans
  • What is Medical Recovery Insurance?
    • Medical Recovery Insurance is an insurance protection product that provides cash benefits that are tiered to reflect the recovery time should an employee require a medical procedure as a result of an accident.

      This insurance is designed to provide fixed monetary benefits to your business in relation to those employees who you have declared to us in the event that an employee undergoes a medical procedure following an accident.

      Our plans provide the flexibility to allow cash benefits to be paid to be used to help fund SSP obligations, pay for additional sick pay benefits or to hire temporary staff.
  • What is an Accident?

      A sudden, unexpected event which happens at a certain time and place during the period of cover and which causes bodily injury.

  • What's not covered by Medical Recovery Accident Insurance?
    • Unless otherwise stated in your policy or your Policy Schedule, this insurance does not cover claims related to or in any way caused or contributed to by:

      • Treatment not arising from an accident.
      • Planned treatment(s) which are defined as medical procedure(s) that in the 12 month period prior to an insured person first becoming insured under this policy or at the date that you increased their level of cover:
        • an insured person had a date scheduled for such medical procedure(s) to be carried out; or
        • an insured person was on a NHS waiting list for the medical procedure; or
        • an insured person had been aware of or had been told by their GP or medical specialist that reasonable medical opinion would consider that a medical procedure may be required.
      • Suicide, attempted suicide or intentional self- inflicted injuries.
      • An insured person’s own criminal act.
      • An insured person being under the influence of alcohol or drugs when the accident occurs.
        • war or acts of terrorism
        • An insured person engaging in active war
        • nuclear risks
      • Any medical procedure directly or indirectly arising from or as a consequence of professional sports where a fee is received for training or playing.
      • Accidents occurring outside the UK, Isle of Man, the Channel Islands and the European Economic Community (EEC).
      • Any treatment received more than 12 months after the date of the accident.
  • Who is eligible for cover?

      It is a condition precedent to our liability under this insurance contract that the following matters, in relation to all persons in respect of whom you wish us to provide you with cover under this policy, are true and accurate:

      If any person in respect of whom you wish us to provide you with cover under this policy does not meet the eligibility requirements above we will not provide you with any cover in relation to such person under this policy.

      Please contact the administrator as soon as possible if any person in respect of whom you wish us to provide you with cover under this policy does not meet, or no longer meets, the eligibility requirements, or if you have any queries. Contact details are given on page 4 of the Policy Document

      • All persons are employed by you. This can include any director of your company who is salaried by you.
      • All persons have been declared by you to us via the administrator and are listed in the appendix of insured persons attaching to your Policy Schedule.
      • All persons live in the United Kingdom, Channel Islands or Isle of Man for a minimum of 180 days a year.
      • All persons are aged at least 18.
  • What happens if an insured person requires more than one medical procedure after an accident?
    • Should an insured person require more than one medical procedure at the same time or in succession which is as a result of an accident, then we will only pay for the medical procedure which has the highest benefit.
  • What happens if an insured person's recovery time is longer than expected?
    • Medical Recovery Insurance benefits are graded according to the normal recovery times of operations that in most cases would allow a person to return to light manual work. The benefits will not increase if a person takes longer to recover and will not reduce if they get back to work more quickly than expected.

  • How do I add or remove employees?
    • You can add or remove an employee in respect of whom you wish us to provide cover to you under this policy at any monthly anniversary of your start date by contacting the administrator. Contact details are given on page 4 of our Policy Document.
      Should you increase the level of cover in relation to an employee at your renewal date then we will not cover any planned treatments at the date that the level of cover was increased over and above the previous level of cover purchased for that employee.

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