Hollard - Easy Personal Accident
Transcript of Hollard - Easy Personal Accident
| Personal accident
easy
Helpline number: 0860 123 EASY (0860 123 3279)
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Cover section: Personal accident
Hollard – Easy – Personal accident cover section – 20170908
Index
1. DefinitionsthatapplytoyourPersonalaccidentsection 2
2. Whatwecover 3
3. Conditionsforcover 3
4. Mainbenefits 4
5. Additionalbenefits 5
6. Specificexclusions–whatwedonotcover 7
7. Claimingforthepersonalaccidentbenefits 8
8. Whencoverforaninsuredends 9
9. Servicebenefits 10
10. Optionalbenefits 11
Helpline number: 0860 123 EASY (0860 123 3279) Helpline number: 0860 123 EASY (0860 123 3279)
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Cover section: Personal accident
Hollard – Easy – Personal accident cover section – 20170908
Cover section: Personal accident
YourPersonal accident section explains the types of benefits that are available to you. Youmust read this sectiontogetherwiththegeneraltermsandconditionsandyourpolicyschedule.
ThiscoversectionincludesGeneral personal accident andEn route personal accidentbenefits.Pleasereadyourpolicyscheduletoseewhichbenefitsapplytoyou.
1. Definitions that apply to your Personal accident section
ThefollowingdefinitionsareusedinthePersonal accident sectionofthispolicy.
Insureds IfyouchoseGeneral personal accident, Insuredswillmean:
− You,yourpartnerandyourchildrenassetoutinthepolicyschedule.
IfyouchoseEn route personal accident, Insuredswillmean:
− Thedriverofthecarandthepassengers.Wewillonlycoverthenumberofoccupantsthatthecarislicensedtocarry,uptoamaximumoftenoccupants,includingthedriver.
− Theriderofamotorbikeandonepassenger.
Ifyouchosebothbenefits,Insuredswillmeanalloftheabove.
Partner Apersonwhoisthepermanentlifepartner(whetherinaheterosexualorhomosexualpartnership)orspouseorcivilunionpartnerofapolicyholder inaccordancewith:
− theMarriageAct,68of1961;
− theRecognitionofCustomaryMarriagesAct,68of1997;
− theCivilUnionAct,17of2006;or
− thetenetsofanyAsiaticreligion.
Apermanentlifepartnerisapartnerwhoyoulivewithforlongerthan12months.
AmaximumofonepartnerwillbecoveredforbenefitsundertheGeneral personal accidentsectionofthispolicyatanyonetime.
Child Willmeananunmarried,financiallydependentchildofthepolicyholderwhohasnotyetattainedtheageof18,andwillinclude:
− abiologicalchild,aposthumouschild,astepchild,agrandchild;and
− alegallyfosteredchildandanadoptedchild.
While thepolicyholder is eligible for coverunder this policy, the agemay (at ourdiscretion),beextendedtoachildwhohasreachedage24,inrespectof:
− an unmarried child who is a full time student at a registered educationalinstitution.Beingafulltimestudentmeansthechildmustattendlecturesandthecoursemustbeatleast12monthsinduration.Afulltimestudentdoesnotincludestudiesviacorrespondence;and
− anunmarried,financiallydependentchildofthepolicyholderwhoismentallydisabledorpermanently,totallyphysicallydisabled,whilethepolicyholder iseligibleforcoverunderthispolicy.
Amaximum of six children will be covered under theGeneral personal accident sectionofthispolicyduringtheentireperiodofthepolicyholder’scoverunderthispolicy.
Helpline number: 0860 123 EASY (0860 123 3279)
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Cover section: Personal accident
Hollard – Easy – Personal accident cover section – 20170908
Accident An incident the insured could not foresee, that happens unexpectedly andunintentionallyatanidentifiabletimeandplace,andresultsindeathorbodily injury.
Bodily injury Physicalinjurytoaperson’sbodycausedbyviolent,accidental,externalandvisiblemeans.Thisincludesstarvation,thirst,exposuretotheelementsandhijacking.
2. What we cover
YoucouldchooseGeneral personal accidentorEn route personal accidentbenefits,orboth.Dependingonyourchoice,certainbenefitsorservicessetoutinthePersonal accidentsectionofthispolicywillnotapplytoyou.
2.1 If you chose the General personal accident benefit
a. Main benefits. Wewillcovertheinsuredsforallthemainbenefits.
b. Additional benefits. Wewillcovertheinsuredsforalltheadditionalbenefits.
c. Service benefits.YouhaveaccesstotheTrauma and HIV assistance helpline.
d. Optional benefit. Youmaychoosetobecoveredfortheoptionalbenefit.
2.2 If you chose the En route personal accident benefit
a. Main benefits. Wewillcovertheinsuredsforallthemainbenefits.
b. Additional benefits. Wewillcovertheinsuredsforonlythefollowingadditionalbenefits:
− Medicalexpenses
− Traumacounselling
c. Service benefits. Noservicebenefitsareavailable.
d. Optional benefit.Nooptionalbenefitisavailable.
2.3 If you chose both benefits
Ifyouchosebothbenefits,theinsuredswillbecoveredunderbothbenefits,unlesswesaydifferently.
Forexample:Ifaninsureddies,wewillpaythedeathbenefitamountundertheGeneral personal accident section,plusthedeathbenefitamountundertheEn route personal accident section.
3. Conditions for cover
a. ConditionsspecifictoGeneral personal accidentbenefits:
− Wecovertheinsuredsanywhereintheworld,butyourpermanenthomemustbewithinthebordersofSouthAfrica.
− Anaccidentreferstoanykindofaccidentincludingacarormotorbike accident.
b. ConditionsspecifictoEn route personal accident benefits:
− Yourcaroryourmotorbikemustbeinsuredwithusunderthispolicy.
− Wecovertheinsuredsforaccidentsthatinvolvesyourcaroryourmotorbike,withinthecountriessetoutinthecarormotorbikesectionofthispolicy.
− Anaccident refersonly toanaccidentwithacarormotorbike that is insuredwithusunder thispolicy.
c. Aninsuredmustbe6monthsorolder,butnotolderthan80yearsatthedateofanaccident.
d. Anaccidentmusthappenduringtheperiod of insurance.
e. Death,totalandpermanentdisabilityorpartialdisabilitymusthappenwithin12monthsofthedateoftheaccident.
f. Intheeventofaclaimaninsuredmustundergoamedicalexaminationifweaskhimto.Wewillpaythecostoftheexamination.
g. Youmust tell usof anyphysical illnessordisability that youknowof at anytimeduring theperiod of insurance.
Helpline number: 0860 123 EASY (0860 123 3279) Helpline number: 0860 123 EASY (0860 123 3279)
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Cover section: Personal accident
Hollard – Easy – Personal accident cover section – 20170908
4. Main benefits
Wecovertheinsuredsfordeathorpermanentdisabilitythatarecauseddirectlybyanaccident.
4.1 Death benefit
Ifan insureddiesbecauseofanaccidentduring theperiod of insurance,wewillpay100%of thesum insured.
4.2 Permanent disability benefit
Ifaninsuredsuffersapermanentdisability,wewillpayapercentageofthesum insuredassetoutbelow.
− Ifaninsuredsuffersmorethanonekindofdisability,thetotalbenefitpayablewillnotexceed100%ofthesum insuredperincident.
− Wewillonlypayonebenefitperlimb.Forexample,ifwepayabenefitforlosinganarm,wewillnotpaythebenefitforlossofthehandandfingersaswell.
Disability Percentageof sum insured
Totalandpermanentlossoffunction,orthephysicalseparationofbotharmsorbothlegs
100%
Totalandpermanentlossoffunction,orthephysicalseparationofonearmand oneleg
100%
Totalandpermanentlossoffunction,orthephysicalseparationofonearmor oneleg
50%
Totalandpermanent lossof function,orthephysicalseparationofonehandandonefoot
100%
Totalandpermanentlossoffunction,orthephysicalseparationofonehand 75%
Totalandpermanentlossoffunction,orthephysicalseparationofonefoot 50%
Lossoffingers:
− fourfingersononehand 70%
− thumb 30%
− anyfingerotherthanthumb 5%
Lossoftoes:
− alltoesononefoot 30%
− greattoe 10%
− anyothertoe 2%
Completeandirreversiblelossofhearing:
− inbothears 100%
− inoneear 25%
Completeandirreversiblelossofsight:
− inbotheyes 100%
− inoneeye 50%
Lossofspeech 100%
Totalandincurableparalysisorbeingpermanentlybedridden 100%
Totalandpermanentlossofintellectualcapacity. 100%
Helpline number: 0860 123 EASY (0860 123 3279)
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Cover section: Personal accident
Hollard – Easy – Personal accident cover section – 20170908
4.3 Disappearance
Ifaninsureddisappearsduringtheperiod of insurance,wewillassumetheinsured’sdeathandwillpaythedeathbenefitassetoutabove.Thefollowingconditionsapplytothisbenefit:
− Theinsured’sdisappearancemustbebecauseofanaccidentwhichcausedbodily injurythatcouldhaveresultedindeath.
− Wewillassumetheinsured’sdeath,ifinouropinionareasonableamountoftimehaspassed. − Wewillnotconsideraclaimforthedisappearancebenefitbefore12monthsafterthedateofthe
disappearance. − Ifwehavepaidthedisappearancebenefitandtheinsuredislaterfoundtobealive,youmustpay
backthedeathbenefitamountthatwehavepaid.
4.4 Terrorism
Wewillalsocoverthedeathordisabilityofaninsuredbecauseofactsofterrorism.Wewillpaythedeathordisabilitybenefitsassetoutabove.
Actsofterrorismmeans:
− Theuseofthreat,violenceorforceforpolitical,religious,personalorideologicalreasons. − Thismayormaynotincludeanactthatisharmfultohumanlife. − Itcouldbecommittedbyanypersonorgroupofpersons,actingalone,onbehalfoforwithany
organisationorgovernment. − Itincludesanyactcommittedwiththeintentiontoinfluenceanygovernmentorinspirefearinthe
public.
4.5 Limitation of benefits
Wemayincreasethemaximumamountsfromtimetotime,orwhenlegislationchanges.Ifwelimittheclaimamounttothemaximumsbelow,wewillrefundthepremiumswereceivedforanycoverwedidnotprovide.
− Ifaninsuredbecomesdisabledandthendiesbecauseofthesameaccident,wewillpaythehigherofthedeathordisabilitysum insured.
− Ifaninsurediscoveredundermorethanonepersonalaccidentpolicyissuedbyus,weonlypayabenefitunder thepolicywith thehighestbenefitamount.Wewill refundthepremiums thatwereceivedundertheotherpolicyfortheclaimthatwedonotpay.
− Benefitsforchildrenaresubjecttoamaximumamountasallowedbylaw.Thetotalamountthatwewillpayonallpoliciesissuedbyusissubjectto:
• R10000(tenthousandRand)ifthechildisyoungerthan6years;and• R30000(thirtythousandRand)ifthechildis6yearsorolder,butyoungerthan14years.
5. Additional benefits
Wewillautomaticallycoveraninsuredforthefollowingadditionalbenefitsuptothelimitssetoutinthepolicyschedule.
5.1 Medical expenses
Ifaninsuredsustainsbodily injurybecauseofanaccident,which(directlyorindirectly,andindependentlyofanyothercause)requiresmedicalorsurgicaltreatment,wewillpayforthemedicalexpenses.
Medicalexpensesarethenecessarycostsandexpensesformedicaltreatmentincluding:
− surgical,dental,hospital,nursingandprescribedremedialexpenses; − artificialaidsandprostheses;or − doctors’fees.
Wewillnotpaymedicalexpensestoaserviceproviderunderanycircumstances.
IfyouarecoveredforboththeGeneral personal accident andEn route personal accident benefits,wewillonlypayforthemedicalexpensesonce.
Helpline number: 0860 123 EASY (0860 123 3279) Helpline number: 0860 123 EASY (0860 123 3279)
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Cover section: Personal accident
Hollard – Easy – Personal accident cover section – 20170908
5.2 Trauma counselling
Wewillpaythecostofprofessionalcounsellingtohelptheinsuredcopewithtraumaifheisthevictimofanactofviolenceoratraumaticaccident.
− Anactofviolenceincludesanassault,robbery,rapeorarmedcarhijack.
− Youmustreporttheactofviolencetothepoliceandgiveusthecasenumber.
− Thisbenefitincludescounsellingfortheinsured’s immediate familymemberswhowereexposedtothesameactofviolenceortraumaticaccident.
− Wewillnotpayifyouarecoveredunderanotherpolicyforasimilarbenefit.
− IfyouarecoveredforboththeGeneral personal accidentandEn route personal accident benefits,wewillonlypayforthetraumacounsellingcostsonce.
5.3 Life support machinery
Ifaninsuredsustainsbodily injurybecauseofanaccident,wewillpaythecostoflifesupportmachineryorequipmentneeded.
5.4 Mobility cover
Wewillpaythecostofaprosthesis,oramanualorelectricwheelchairifaninsuredis:
− permanentlyandphysicallydisabled;
− becauseofabodily injurycausedbyanaccident;
− whichresultsintheneedforawheelchairoranyotherapplianceforfreedomofmovement.
Wewillnotpayifyouarecoveredunderanotherpolicyforasimilarbenefit.Wemustadmitadisabilityclaimunderthispolicy.
5.5 Rehabilitation costs
Wewillpaythecostsofarehabilitationprogramme,exceptforthecostscoveredbytheinsured’smedicalaid.Thebenefitappliesif:
− weadmitavaliddisabilityclaimunderthiscoversection;and
− inouropinionthe insured’sdisabilitypreventshimfromperformingthematerialandsubstantialdutiesofhisoccupationatthetimeoftheaccident.
Rehabilitation programmes are re-skilling, re-training or medical treatment programmes to help theinsuredbecomeabletoperformthedutiesof:
− hisownoccupation;or
− any occupation forwhich the insured has, or can reasonably be trained to have, the necessaryknowledge,skillsorabilitytoreturntowork.
5.6 Search and rescue
Ifaninsuredsustainsbodily injurybecauseofanaccident, wewillpaythereasonablesearchandrescuecosts.
− Thisbenefitincludesfreeingandbringingtheinsuredtoaplaceofsafety,ortopreventbodily injury.
− Iftheinsuredisfoundincircumstanceswhichareunlikelytohaveresultedinbodily injury,wemayaskyoutopaybackanybenefitpaidbyus.
5.7 Emergency transportation costs
Ifaninsuredsustainsbodily injurybecauseofanaccident,wewillpaythecostsandexpensesnecessaryforemergencytransportationofaninjuredinsuredtotheclosestmedicalfacility.
Iftheclosestmedicalfacilitycannotprovidethetreatmentrequired,wewillpaythecosttotransporttheinsuredtoadifferentmedicalfacility.
Helpline number: 0860 123 EASY (0860 123 3279)
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Cover section: Personal accident
Hollard – Easy – Personal accident cover section – 20170908
Aqualifiedmedicaldoctor,orifnotavailable,thehighestqualifiedmedicalpractitionermustconfirmthatemergencytransportationtoadifferentmedicalfacilityisnecessarybecause:
− thelocalmedicalfacilitiesareinadequateforthetreatmentoftheinsured’sinjury;and − transportingtheinsuredtoadifferentmedicalfacilitywillhelptheinsuredtorecoverfaster.
5.8 Return of an injured person
Ifaninsuredsustainsbodily injurybecauseofanaccident,wewillpaythereasonableandnecessarycoststo return an insured from thehospital tohis normal placeof residence in SouthAfrica. The followingconditionsapplytothisbenefit:
− Youmustaskusforourpermissionbeforeyouarrangeforthereturnofaninsured. − The insured’s injury must be of such a serious nature that it prevents him to return home
unaccompanied. − Wewillnotpayanybenefitifthedistancefromthehospitaltothenormalplaceofresidenceisless
than100km.
5.9 Return of a body
Ifweadmitavaliddeathclaimunderthiscoversection,wewillpaythereasonableandnecessarycoststoreturnthebodyofadeceasedinsuredfromtheplaceofdeathtotheplaceofburialinSouthAfrica.Wewillnotpayanybenefitifthedistancefromtheplaceofdeathtotheplaceofburialislessthan100km.
6. Specific exclusions – what we do not cover
TheexclusionssetoutintheGeneral exclusions sectiondonotapplytothebenefitspayableunderyour Personal accident section.Wewillnotpayaclaimforanyofthefollowing:
6.1 Trade and economic sanctions
Wecannotprovideanycoverifthatmeanswewouldnotcomplywithtradeoreconomicsanctions.Ifwefindoutthataninsuredissubjecttosuchsanctions,wewillcancelyourpolicyfromthepolicy start date orthedatethattheinsuredbecomessubjecttosanctions.Wewillrefundanypremiumspaidbyyouandwillnotpayanyclaims.
6.2 Not because of an accident
Wewillnotpayaclaimfordeathordisabilitythatisdirectlyorindirectlyrelatedtophysicaldisabilityorillness.
6.3 Pre-existing conditions
Wewillnotpayaclaimfordeathordisabilitythatwascausedbyanillness,medicalcondition,disabilityorinjurythatexistedatanytimebeforethecover start date.
6.4 Mental conditions
Wewillnotpayaclaimfordeathordisabilitythatwascausedbyinsanity,neurosisordiagnosedmentalornervousdisorders.
6.5 Insured’s actions cause death or disability
Wewillnotpayaclaim if the insured’sdeathordisability isdirectlyor indirectlycausedbyanyof thefollowing:
a. Criminal activities
Criminalactivitymeanstheinsuredis:
− underinvestigationforcommittingacrime; − beingprosecutedforcommittingacrime;or − convictedbyaCourtofLawforhavingcommittedacrime. − Wewilldelayourclaimsdecisionuntilthefinalisationoftheinvestigation,orthecriminal
trial.Youmustgiveusproofoftheoutcomeoftheinvestigationorthecriminaltrial.
Helpline number: 0860 123 EASY (0860 123 3279) Helpline number: 0860 123 EASY (0860 123 3279)
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Cover section: Personal accident
Hollard – Easy – Personal accident cover section – 20170908
b. Military or police activities
Theinsuredisinactiveservicewiththedefenceforce,policeservicesorcorrectionalservices.
c. Warlike activities
Nuclear,biologicalandchemicalwarfareorsabotage.
Theinsuredactivelytakingpartin:
− anywar,invasion,rebellion,revolution,uprising,riot,civilcommotion,strike,ortheseizingofpower;or
− labourdisturbance,includingariot,commotionorotherformofpublicdisorderintheworkplace.
d. Irresponsible actions
Theinsured:
− deliberately or negligently exposes himself to the risks and events that led to the claim,exceptwheretheinsuredattemptstosaveahumanlife;
− attemptsorcommitssuicideordeliberatelyinflictsinjuryonhimself;
− refusestoseekandfollowreasonablemedicaladviceortreatment;
− driveswhenoverthelegalalcohollimit;
− takesillegaldrugsorpoison;or
− isunderthe influenceofmedication,unlessthemedicationwasprescribedbyaqualifiedmedicalpractitionerandtakeninthecorrectdosage.
e. Dangerous activities
Theinsured:
− participatesinsportcompetitivelyorasaprofessionalorforfinancialreward;or
− participatesinanykindofracing,speedtestsordurationtests;or
− isinvolvedinaviation,gliding,micro-lighting,parachutingortravellingbyairexceptasafee-payingpassengerinafullylicencedaircraft.
7. Claiming for the personal accident benefits
TheconditionssetoutinthesectionClaiming under this policy donotapplytothebenefitspayableunderyour Personal accident section.
7.1 How to claim
Ifthereisaclaimforabenefitpayableunderthiscoversection,thepersonclaimingthebenefitfortheinsuredmust:
a. Tell us of the death, disability or bodily injury in writing within six monthsfromthedateoftheaccident.Wewilltellhimwhatevidenceandotherdocumentsweneedtoprocesstheclaim.
b. Send us the evidence and other documents we ask for within 30 daysfromthedatethatweaskforit.Wetypicallyneedthefollowing,butwemayaskformoredependingonthedetailsofyourclaim:
− anoriginalsignedclaimform
− anoriginalcertifiedcopyoftheinsured’sdeathcertificate
− anoriginalcertifiedcopyoftheinsured’sidentitydocument
− proofofbankingdetails
− ifapplicable,acopyoftherelevantPolicereport
− medicalreportsandclinicalevidence
− proofofmedicalexpenses(invoicesandproofofpayment)
Helpline number: 0860 123 EASY (0860 123 3279)
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Cover section: Personal accident
Hollard – Easy – Personal accident cover section – 20170908
c. Ifthestepsabovearenotfollowed,orthepersondoesnotsendustheinformationweaskforwithinthetimegivenabove,hewilllosetherighttoclaim.
7.2 Undergo medical examinations or treatment
Foradisabilitybenefitclaim,theinsuredmustundergomedicalexaminationsortreatmentwhenweaskhimto,asoftenasrequired.Wewillpaythecostofthemedicalexaminationsortreatment.
7.3 If your claim is valid
Ifweassessyourclaimasvalid,wewillpaythebenefitsassetoutbelow:
− Wewillpaythepermanentdisabilitybenefittotheinsured.
− Wewillpaythedeathbenefittotheinsured’sestate.
− Iftheinsuredisyourchild,wewillpaythedeathandpermanentdisabilitybenefittoyou.
− Wewillpaythemedicalexpensesandthecostoftraumacounsellingtotheinsured.Wewillnotpayanycostsdirectlytoaserviceprovider.
7.4 Our responsibility ends after we have paid a claim
Oncewehavepaidaclaim,wehavemetourresponsibilitiestoyouintermsofthispolicy.Wewillnotberesponsibleforanyothercostsrelatingtothatclaim.
7.5 We will not pay any interest
Anyamountduebyuswillnotattractanyinterest.
7.6 If you do not agree with our claims decision
a. Complain to Hollard
Ifwedonotacceptaclaimorifyoudon’tagreewiththeamountoftheclaim,youmayaskustoreviewourdecisionwithin90daysofthedatethatyoureceivedournotice.
b. Complain to the Ombudsman
YoumayalsosendyourcomplainttotheOmbudsmanforShort-termInsuranceatanytime.PleasecontacttheOmbudsmanonthecontactdetailssetoutintheQuick reference guide.
c. Take legal action
Youmaytakelegalactionagainstuswithin270daysofthedatethatyoureceivedournotice.Totakelegalaction,summonsmustbeservedonus.Ifthisisnotdoneintime,youwillloseyourrighttoclaimandwewillnolongerberesponsibleforthatclaim.
YoumayalsochoosetotakelegalactionagainstuswithoutfirstaskingustoreviewourclaimdecisionorcontactingtheOmbudsmanforShort-termInsurance.IfyoutakelegalactionagainstusbeforecontactingtheOmbudsman,youcanonlyapproachtheOmbudsmanforassistanceafteryouhavewithdrawnthesummonsagainstus.
8. When cover for an insured ends
Coverforaninsuredendswhenanyofthefollowinghappens:
a. premiumsforthepersonalaccidentbenefitsarenotpaid;
b. theinsuredreachestheageof80yearsold;
c. wepayaclaimfor100%ofthedisabilitybenefit;or
d. theinsureddies.
Helpline number: 0860 123 EASY (0860 123 3279) Helpline number: 0860 123 EASY (0860 123 3279)
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Cover section: Personal accident
Hollard – Easy – Personal accident cover section – 20170908
9. Service benefits
9.1 Trauma and HIV assistance helpline
This servicegivesyouaccess toa24houremergencyassistancehelpline tohelpyouwithany traumasituation.YouhavetocallourHelplinenumbersetoutintheQuick reference guide.
− Professionalnursesprovidethisemergencyassistanceservice.
− Thisserviceisavailable24hoursadayfor365daysayear.
− WewillonlyprovidetheseserviceswithinthebordersofSouthAfrica.
− Aninsuredcancallthehelplineintheeventofthefollowingtraumaticevents:
• Traumaticaccident
• Actofviolence,includinganassault,robbery,rapeorarmedcarhijack.
a. Trauma assistance helpline
− Wewillarrangeforemergencymedicalassistanceiftheinsuredsustainsbodily injury.
− Wewillarrangeforpsychologicalcounsellingatapublicorprivatetraumacounsellingcentreiftheinsuredisthevictimoftraumaorassault.
− We will also arrange for emergency medical transport to the closest, most appropriatemedicalfacility.Wewillnotarrangeforanyinter-hospitaltransfers.
− Wewillrefertheinsuredtopsychiatristsforpsychiatricconsultationsifneeded.
− Wewill pay back the costs you have to pay up to the limits that apply to the followingAdditional benefitssetoutabove:Medical expenses, Trauma counsellingandEmergency transportation costs.
b. HIV assistance helpline
− TheHIV-protectionservicegivestheinsuredaccesstodiagnosis,hospitalcare,treatmentandcounsellingintheeventofsuspectedHIVinfection.
− HIVinfectioncanbesuspectedbecauseofrapeoraccidentalexposure,forexampleneedleprickwithacontaminatedneedle.
− Theserviceincludes24-hours-a-day,365-days-a-yeartelephonicaccesstoanHIVcounsellingcentreforinformation,adviceandsupport,aswellascounsellingforpost-traumaticstressdisorder.
Wewillpayforbloodtests
− WewillpayforthreeHIVbloodtestsperincident.Thefirstbloodtestwillbedoneimmediatelyaftertheincident.
− IftheinsuredtestsHIVpositivenofurthertestsarecovered.
− IftheinsuredtestsHIVnegative,thesecondtestwillbesixweeksaftertheincidentandthethirdtestwillbethreemonthsaftertheincident.
IftheinsuredtestsHIVnegative
IftheinsuredtestsHIVnegativeimmediatelyaftertheincident,andthetreatingdoctorprescribesandadvisesit,wewillpayforthefollowingcosts:
− A30-daystarterpackofantiretroviralmedication.Wecannotpayforthismedicationiftheinsuredcallslaterthan72hoursafteraccidentalHIVexposure.Thisisbecauseantiretroviralmedicationisonlyeffectivewithin72hoursofaccidentalHIVexposure.TheinsuredmustcallourHelpline assoonaspossibleafterexposure.
− Aseven-daycourseofSTI(SexuallyTransmittedInfections)medication.
− A‘morning-afterpill’topreventpregnancyinthecaseofrape.
− RegistrationforanHIV-managementprogramme.
Helpline number: 0860 123 EASY (0860 123 3279)
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Hollard – Easy – Personal accident cover section – 20170908
IftheinsuredtestsHIVpositive
IftheinsuredtestsHIVpositiveimmediatelyaftertheincident,theinsuredwillhaveaccesstothefollowing:
− Aseven-daycourseofSTI(SexuallyTransmittedInfections)medication.
− A‘morning-afterpill’topreventpregnancyinthecaseofrape.
− Threeconsultationsperincidentwithageneralpractitioner,trauma-trainednurseortraumacounsellor.
c. How to call for assistance
AninsuredmustcallourHelpline andgivedetailsofthecircumstances,immediatedangersandhiscondition.Thenurseswillarrangeforthenecessaryassistance,beitthepoliceorthenearestlocalemergencyassistanceservices.Thenurseswillmonitorthemedicalconditionofthe insured,andshouldthesituationdevelopintoamedicalemergency,thenurseswill:
− Arrangeforemergencymedicalevacuation,eitherbyroadorairambulance.
− Arrangefortheinsuredtobetransportedtoahospitalwithemergencyfacilitiesclosesttothesceneoftheincident.
− Monitortheinsured’stransportationandcondition.
10. Optional benefit
Thisisnotanautomaticbenefit.Youmustchoosetobecoveredforthisbenefitandpaytheextrapremium.
10.1 Rental car excess cover
Wewillpayyoubacktheinsuranceexcessyouhavetopaytoacarrentalcompanyifyouhaveanaccident witharentalcar.
− Youmustgiveusproofoftheamountyoupaid.
− Wewillonlypayuptoamaximumofthelimitsetoutinthepolicyschedule.