PA Policy Wording V3

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Transcript of PA Policy Wording V3

  • Zurich Insurance Middle East S.A.L

    Your Policy. Our Promise.

    Personal Accident Insurance

  • Thank you for choosing to purchase your personal accident insurance from Zurich.

    We have 140 years experience of protecting our customers against the unexpected, and we pride ourselves on providing high quality insurance solutions in more than 170 countries.

    Zurich has been serving customers in the Middle East for over 25 years. Our commitment to the region has seen us develop our business in Oman, Kuwait, Lebanon, Bahrain and the UAE.

    As a Zurich customer, youll benefit from being with one of the leading and most secure financial services groups in the world. Our global expertise combined with our regional understanding means that you can be sure you will benefit from products and services tailored to your individual needs.

    We hope you are happy with the your policy and look forward to having the opportunity to be your preferred insurance provider for many years to come.

    Welcome

  • ContentsMaking a claim ........................................................................................................... 5

    Personal accident insurance cover ............................................................................... 6

    Part 1: Definitions ....................................................................................................... 7

    Part 2: Important information ..................................................................................... 9

    Part 3: Benefits and covers ........................................................................................10

    Part 4: General exclusions ..........................................................................................14

    Part 5: General conditions .........................................................................................17

    Part 6: General provisions ..........................................................................................18

    Part 7: Our complaints procedure ..............................................................................24

  • Making a claimPlease notify us within thirty days of any occurrence likely to give rise to a claim.

    If you wish to make a claim, please contact us on:

    800 ZURICH (987 424)

    Alternatively, you can email us at:

    claims.me@zurich.com

  • IndividualBenefit Bronze Silver Gold Platinum

    Accidental Death 100,000 250,000 500,000 1,000,000

    Accidental Death (common carrier) 500,000 1,250,000 2,500,000 5,000,000

    Permanent Partial Disablement 110,000 275,000 550,000 1,100,000

    Permanent Total Disablement 110,000 275,000 550,000 1,100,000

    Individual & SpouseBenefit Bronze Silver Gold Platinum

    Accidental Death 100,000 250,000 500,000 1,000,000

    Accidental Death (common carrier) 500,000 1,250,000 2,500,000 5,000,000

    Permanent Partial Disablement 110,000 275,000 550,000 1,100,000

    Permanent Total Disablement 110,000 275,000 550,000 1,100,000

    FamilyBenefit Bronze Silver Gold Platinum

    Accidental Death 100,000 250,000 500,000 1,000,000

    Accidental Death (common carrier) 500,000 1,250,000 2,500,000 5,000,000

    Permanent Partial Disablement 110,000 275,000 550,000 1,100,000

    Permanent Total Disablement 110,000 275,000 550,000 1,100,000

    Personal accident insurance cover

  • Part 1: Denitions Certain words have specific meanings when they appear in this policy. These meanings are shown below or in the section where they apply. They are printed in bold type. Any other words not appearing in the definition section will follow the English language definition:

    Accident a sudden, unforeseen and unusual specific event that happens unexpectedly caused solely and directly by violent, external and visible means which occur at an identifiable time and place resulting in injury and which is the sole and direct cause of accidental death or disablement.

    Accidental death loss of life due to an accident as determined by a physician/medical practitioner.

    Beneficiary The person or persons nominated by the insured person as stated on the policy schedule, if not mentioned then the beneficiary will be the legal heirs of the insured person.

    Children/child Biological off-springs, legally adopted or fostered children of the insured person who are not in full-time employment, unmarried, not pregnant, without children, primarily dependent on the insured person for support and who are between the ages of three (3) months and eighteen (18) years. Or under twenty three (23) years of age if a full time student

    Close relative Spouse, parent, parent-in-law, grandparent, son or daughter, son or daughter-in-law, brother or sister, brother or sister-in-law, grandchild, legal guardian, children or fianc(e) of the insured person.

    Country of residence Your normal place of residence or dwelling in the United Arab Emirates of which you are a citizen or hold a valid resident status as of the time of the policy issuance.

    Excess The first amount of any claim for which you are responsible to pay for any one event. Or the amount we will subtract from any covered loss that we pay. Or the time period during which any claim will not be paid. If claims are made under two or more covers, for loss or damage caused by the same insured incidence at the same time, excess shall apply for each section as stated in the policy schedule.

    Family The insured person, spouse and unlimited dependent children.

    Injury Bodily injury sustained in an accident directly and independently of all other causes.

    Insurance period The date specified in your policy schedule.

  • Insured person/you/your/yours Each person specified as an eligible person in the policy schedule and for whom the appropriate insurance premium has been paid and accepted for coverage.

    Medical condition The unforeseen and emergent occurrence of symptoms for a disease, illness or injury which, unless treated immediately by a physician, may lead to death or serious impairment of your health.

    Paraplegia Permanent loss of use of both legs and the permanent loss of use of part of or whole of the lower half of the body.

    Permanent total disablement Disablement which for fifty two (52) consecutive weeks immediately following an accident entirely prevents the insured person from attending their usual occupation if employed. Or if not employed, from attending employment of any and every kind. Disablement at the end of that time should be beyond reasonable hope of improvement, total, continuous and permanent.

    Permanent partial disablement Disablement which for fifty two (52) consecutive weeks immediately following an accident prevents the insured person from attending their usual occupation at full physical capacity if employed. Or if not employed, from attending employment of any and every kind at full physical capacity. Partial disablement at the end of that time should be beyond reasonable hope of improvement, total, continuous and permanent.

    Physician/medical practitioner A person other than the Insured person or close relative of the insured person, who is qualified by degree in western medicine and legally authorized in the geographical area of his/her practice to render medical and surgical services.

    Policy schedule All policy documents issued by us outlining information and policy details such as, but not limited to, terms and conditions, premium, covers/benefits and limits, enclosed cover(s), extensions, exclusions and conditions, along with any endorsements issued.

    Pre-existing medical conditions The insured person received medical treatment, diagnosis consultation or prescribed drugs, or medical condition for which the insured person is on a waiting list for hospital in-patient treatment. Or an ongoing or recurring medical condition for which medical advice or treatment was recommended by a medical practitioner within a two (2) year period preceding the original inception of the policy.

    Public common carrier Any mechanically propelled conveyance operated by a company or an individual licensed to carry passengers for hire, including but not

  • limited to aircraft, bus, coach, ferry, hovercraft, hydrofoil, ship, train, tram or underground train.

    Quadriplegia Permanent loss of use of both arms and both legs.

    Spouse A person who has a legitimate marital contract to the insured person as recognized by United Arab Emirates laws between the ages of eighteen (18) years and seventy (70) years.

    Sum insured Maximum amount payable under each cover of the policy schedule as set to be payable by the policys terms and conditions.

    We/us/our/ours Zurich Insurance Middle East S.A.L.

    Part 2: Important information

    Conditions and exclusions

    There are conditions and exclusions which apply to individual sections of the policy and general conditions and exclusions which apply to the whole policy. Please make sure that you read these as well as the cover shown in each section.

    Eligibility

    To be eligible for this insurance:

    You must be a valid resident of the United Arab Emirates; and

    have a valid business, employment or residency visa in the United Arab Emirates;

    Age limit

    You must be between the ages of eighteen (18) years and seventy (70) years at the commencement date of this policy.

    Chosen plan

    There are four (4) available plans to choose from and your policy schedule will show the plan you have chosen.

    You may elect to extend your plan to include your spouse or your family as per the terms, conditions and limits set forth in this policy and provided the