What is considered an “accident”? How is accident insurance different from medical insurance? Bowtie is here to answer some of the public's most common questions about accident insurance.
Definition on Accident Insurance
Accident insurance protects against injuries caused by accidents and pays out in the form of either a lump-sum amount, reimbursements for medical expenses or weekly compensation.
Difference between Accident & Medical Insurance
The main difference between accident insurance and medical insurance is the cause for compensation. If an injury is caused by natural illness such as cancer and requires medical treatment, or a medical examination such as gastroscopy for diagnosis, then medical insurance will cover the expenses. However, accident insurance will not.
*subject to coverage of outpatient, Chinese medicine and bone-setting treatments
Note: The above is for reference only. Specific criteria for compensation is subject to the policy clauses.
5 Important notes for Accident Insurance
- Age & Occupation may affect coverage
Most insurance companies set an age limit for accident insurance, accepting applicants only between 18 to 60 years of age. Some insurers have broadened the age limit to 15 to 70 years of age.
Some have no age limits but offer different coverage and benefits based on the insured’s age. Therefore, elders and children should pay close attention to the detailed terms.
Since accident insurance doesn’t cover illnesses, the underwriting process is simpler. Sometimes, health information from the insured is not even required. However, insurers would approve or reject the application based on applicant’s occupation because certain occupations are at high risk of accidents.
Most insurers have a list of “uninsured occupations” which include professional drivers, construction workers, high-altitude workers, athletes, and jockeys. Government forces may be uninsured in some cases as well.
- Hospital expenses may be excluded
Generally, accident insurance can be divided into three categories:
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$ / X ︰Small amount of compensation or no compensation
$$$︰Large amount of compensation
$︰Small amount of compensation
According to market data, most companies offer “all-in-one” accident insurance which includes a lump-sum payment for death benefit as well as basic bone-setting and physiotherapy treatments. Some insurers offer $100 only per day and do not cover outpatient treatments.
As for hospitalization, some insurers offer daily allowance between $400 to $2,000. Accident insurance with medical protection will cover medical fees such as examination or surgery on a reimbursement basis.
Some companies offer lump-sum payment for death or serious injuries only and do not cover expenses for hospitalization, bone-setting or outpatient treatments.
All in all, we believe “medical protection” is a major consideration when purchasing accident insurance, as long-term treatment or rehabilitation and care are needed for most injuries from accidents while the probability of death or disability is relatively low.
Accidents may be excluded as well
Not all accident insurance covers international regions. Some insurers specify a list of covered geographic areas such as Europe or Southeast Asia. However, not all insurers publish this in the policy terms and conditions, so it is important to double check before insuring.Common excluded items
In addition to illnesses, the most common exclusions are suicide, illegal activities, wars, riots and military service, etc. And apart from commercial flights, most accident insurance does not cover air travel such as private planes.Calculation of Accident Insurance
Different insurance companies use different pricing methods for premiums. Some insurers set the premiums based on age groups. For example, there is a set premium for ages 10 to 17 and another for ages 18 to 40.
Some insurers price premiums based on the coverage. More coverage means higher premiums. And there are some insurers that consider all factors before providing a quote, including the insured’s age, occupation and associated risks.
Any Accident Insurance in Bowtie?
Bowtie Touch-Wood covers treatment due to injury or accident. Compensation is Payable for the actual expenses for medically necessary treatments which are incurred within 12 month of the date of the Accident.
Eligible medical treatments include:
- Physiotherapy, chiropractic and Chinese bone-setting treatments (as Outpatient)
- Outpatient treatments; and
- Inpatient treatments and Day Case Procedures, with benefit categories similar to hospital indemnity insurance plans
Learn more about Bowtie accident insurance here: https://www.bowtie.com.hk/en/insurance/accidental