PERSONAL ACCIDENT INSURANCE
Capital Benefits
What does this section cover?
This section provides cover for the Insured Events as set out in the table below where these events occur during the Period of Insurance when the Insured is participating as set out above.
What are the benefits payable?
$150,000 maximum for Death and other benefits as detailed in the list of Insured Events below: Subject to the following age limit restrictions:
- Insured Person aged 16 to 85 years
- $150,000 maximum
- Insured Persons aged 16 years and under
- $20,000 maximum
| Insured Events | % of Max Capital Sum payable |
||
|---|---|---|---|
| 1. | Death | 100% subject to a maximum of $10,000 for insured persons without dependent children | |
| 2. | Permanent Total Disablement | 100% subject to a maximum of 5 times annual pre-disability earnings | |
| 3. | Permanent Disability not otherwise provided | The percentage we determine as being consistent with the compensation provided in this table but not exceeding 75% | |
| 4. | Permanent paraplegia | 250% | |
| 5. | Permanent quadriplegia | 250% | |
| 6. | Permanent unsound mind to the extent of legal incapacity | 100% | |
| 7. | Permanent and incurable paralysis of limbs | 100% | |
| 8. | Permanent total loss of the entire sight of one or both eyes | 100% | |
| 9. | Permanent total loss of hearing in both ears | 100% | |
| 10. | Permanent total loss of use of both hands | 100% | |
| 11. | Permanent total loss of use of both arms | 100% | |
| 12. | Permanent total loss of use of both feet | 100% | |
| 13. | Permanent total loss of use of both legs | 100% | |
| 14. | Permanent total loss of use of one hand and one foot | 100% | |
| 15. | Permanent total loss of use of one hand and one arm | 100% | |
| 16. | Permanent total loss of lens in one eye | 50% | |
| 17. | Permanent total loss of the hearing in one ear | 50% | |
| 18. | Permanent total loss of the use of one foot or one leg | 50% | |
| 19. | Permanent total loss of the use of four fingers and thumb of either hand | 75% | |
| 20. | Permanent total loss of the use of four fingers of either hand | 40% | |
| 21. | Permanent total loss of the use of one thumb, both joints | 30% | |
| 22. | Permanent total loss of the use of one thumb, one joint | 15% | |
| 23. | Permanent total loss of the use of a finger, three joints | 10% | |
| 24. | Permanent total loss of the use of a finger, two joints | 8% | |
| 25. | Permanent total loss of the use of a finger, one joint | 5% | |
| 26. | Permanent total loss of the use of all the toes of one foot | 15% | |
| 27. | Permanent total loss of the use of great toe, both joints | 5% | |
| 28. | Permanent total loss of the use of great toe, one joint | 3% | |
| 29. | Permanent total loss of the use of other toe (each toe) | 1% | |
| 30. | Third degree burns and/or resultant disfigurement which covers more than 40% of the entire body | 50% | |
| 31. | Broken Bones | a) Neck or Spine | $3,000 |
| b) Hip, Pelvis | $2,000 | ||
| c) Skull, Shoulder blade | $1,000 | ||
| d) Collar bone, upper leg | $750 | ||
| e) Upper arm, knee cap, forearm, elbow | $500 | ||
| f) Lower leg, jaw, wrist, cheek, ankle, hand, foot | $200 | ||
| g) Vertebrae, ribs | $200 | ||
| h) Finger, thumb, toes | $150 | ||
Any permanent total disability or permanent total loss of use of any body part not shown above will be compensated at a percentage of $50,000 as determined at the sole discretion of the Underwriter. Such determination will not be inconsistent with the benefits provided under the events listed above. Any benefit payable in the Schedule above is limited to 20% of the amount if the injury occurs whilst the Insured Person is travelling to or from an activity insured under the policy. |
|||
What the Insurer Will Not Pay
The Insurer will not pay for any claim under this section if the claim arises directly or indirectly out of any of the following:
- Any injury, medical condition, infirmity or weakness known to the insured person or which would have been known to a reasonable person in the circumstances to have existed prior to the commencement of this Policy;
- Illness;
- Any injury where you are entitled to receive a benefit from any statutory transport accident scheme or statutory workers compensation scheme.
Capital Benefits – Conditions
- Any payable condition claimed under capital benefits must occur within 12 months of the date of injury.
- Any capital benefit payable will be reduced by any amount of any other capital benefit the Insurer have paid or are liable to pay in connection with the same injury.
- Any capital benefit payable under this section will be reduced by any amounts paid under the disappearance capital benefit.
- All further cover for you ceases if you become entitled to a capital benefit of more than 75% of the capital sum insured.
- The maximum amount payable for any one event involving more than one insured person is the aggregate limit of liability shown on the Policy Schedule. If this amount is not enough to pay all claims in full, the Insurer will reduce each insured person's benefit proportionately.
Other Capital Benefits
Other capital benefits for Funeral Expenses and Disappearance may also be payable. Please refer to the Policy Wording for Details.
This is a summary of cover only and does not purport to contain all policy terms, conditions and exclusions. Please refer to the policy wording and PDS for full details.
Please note that in some cases the cover available is broader than the cover outlined in the Standard Policy Wording and PDS. Please contact JLT Sport for further details.
