AonProtect. Personal Accident and Travel Insurance. Policy. Arranged By Maven Underwriters

Transcription

1 AonProtect Personal Accident and Travel Insurance Policy Arranged By Maven Underwriters Maven Underwriters is part of AUM Europe. AUM Europe is a trading name of Aon Limited which is authorised and regulated by the Financial Services Authority in respect of insurance mediation activities only Maven AonProtect policy wording V.1

2 AonProtect Personal Accident and Travel Insurance Page Agreement to Contract...3 General Definitions...4 General Conditions...7 General Exclusions...10 AonProtect Assistance...11 Section A Personal Accident Death Permanent Total Disablement Permanent Disabling Injuries Temporary Total Disablement Temporary Partial Disablement...18 Accident Medical Expenses...18 Rehabilitation Case Management...18 Section A Personal Accident - Extensions...19 Chauffeur expenses...19 Coma Benefit...19 Compassionate travel...19 Corporate Event Attendees...20 Corporate Reputation Protection...20 Dependent Child Benefit...21 Dependent Adult Benefit...21 Domestic Service Expenses...21 Funeral Expenses...21 Home Adaptation/Relocation Expenses...21 Hospital Confinement Benefit...21 Hospital Visiting Expenses...22 Loss of or Damage to Personal Belongings from Assault...22 Paraplegia...22 Partners and/or Children of Directors...22 Partners and/or Children of Employees...22 Permanent Disfigurement...23 Post Traumatic Stress Disorder - Terrorism...23 Quadriplegia...23 Quality of Life Improvement Advice...23 Retraining Expenses...23 Return Home Expenses...24 Simultaneous death of Insured Person and Partner...24 Urgent Expenses following death...24 Visitors...24 Work Experience...24 Section B - Travel Disruption...28 Travel Delay Hijack Kidnap, Ransom and Extortion Legal Expenses Medical and other travel expenses...36 Medical Expenses...36 Hospital Confinement benefit outside the United Kingdom...36 Supplementary Travel and Accommodation Expenses...36 Emergency Repatriation Expenses...37 On-going treatment in the United Kingdom...37 Search and Rescue Expenses Money...39 Financial Card Misuse...39 Emergency Replacement of Passport, Visa, Travel Documents or Driving Licence Personal Belongings and Business Equipment...41 Personal Belongings Delay...41 Page 1

3 Loss or Delay of Home Keys or Car Keys...41 Business Equipment Personal Liability Personal Security Specialist Expenses Political and Natural Disaster Evacuation Rental Vehicle Excess...49 Important Information...50 Financial Service Authority...50 Complaints Procedures...50 Data Protection...50 Financial Services Compensation Scheme...51 Page 2

4 Agreement to Contract Maven Underwriters is part of AUM Europe. AUM Europe is a trading name of Aon Limited which is authorised and regulated by the Financial Services Authority in respect of insurance mediation activities only This Maven Underwriters branded AonProtect Policy is underwritten by the following Insurers ( Insurers ) who have authorised ACE European Group Limited as the lead Insurer to act on their behalf. Insurers Lead Insurer: ACE European Group Limited Main Business: General Insurance. Registered in England No Head Office: ACE Building, 100 Leadenhall Street, London, EC3A 3BP. Authorised and regulated by the Financial Services Authority (FSA). Registration Number: FRN Co- Insurer: AIG UK Limited Main Business: General Insurance. Registered in England No Head Office: AIG Building, 58 Fenchurch Street, London, EC3M 4AB. Authorised and regulated by the Financial Services Authority (FSA). Registration Number: Subscription 65.0% 35.0% Full details can be found on the Financial Services Authority s register by visiting: or by contacting the FSA on The Insurers obligations under this Agreement are several and not joint and are limited solely by the extent of their subscriptions as shown above. The subscribing Insurers are not responsible for the subscription of any co-subscribing Insurer who for any reason does not satisfy all or part of its obligations. The Policyholder (as specified in the Policy Schedule) and the Insurers agree that: 1. The Policyholder will pay the Premium as agreed. 2. The Insurers will subject to the terms, Conditions and Exclusions of this Policy, provide the Insurance in the manner and to the extent set out in this Policy. All information supplied to Insurers by the Policyholder shall be incorporated into and be the basis of this Policy. 3. This Policy, Policy Schedule, Schedule of Benefits and endorsements, if any, shall be read together as one contract and any word or expression to which specific meaning has been attached shall, unless the context otherwise requires, bear such meaning wherever it may appear. For and on behalf of Insurers Page 3

5 General Definitions Accident - A sudden, violent, external and identifiable event that happens by chance and could not have been expected. The word accidental shall be construed accordingly. If an Insured Person suffers Bodily Injury as a result of unavoidable exposure to severe weather conditions Insurers will consider it as having been caused by an Accident. Accommodation - Accommodation of a standard up to but not exceeding that in which the Insured Person was or would have been staying during the course of the Journey. Additional Insured Person - Any person or category of persons shown as being Additional Insured Persons in Schedule of Benefits - Travel. AonProtect Assistance - the telephone advice, information and counselling services and/or the travel assistance and emergency medical and repatriation services and/or the security information, advice or assistance services arranged by Insurers. Associated Company - A company or organisation of the Policyholder whose name has been advised to and accepted by Insurers (subject to the General Condition providing automatic cover for new acquisitions in certain circumstances). Bodily Injury - Injury which is caused solely by Accidental means and which independently of illness or any other cause results in the Insured Person s death or disablement within twenty-four calendar months from the date of the Accident. Business - The business of the Policyholder as described in the Schedule. Business Partner - An individual who has entered into a legal contract with one or more people to manage the Business of the Policyholder and to share in the responsibilities, resources, profits and liabilities of such Business. Child/Children - The children, stepchildren and legally adopted children for whom an Insured Person or their Partner is the Parent or Legal Guardian. To be covered by this Policy, the Child/Children must: 1. not be married; and 2. be under 18 years of age or under 25 years of age if in Full Time Education Corporate Event - Any Business related event arranged by or on behalf of the Policyholder in order to promote their Business. Country of Domicile - The country in which the Insured Person is habitually resident during the Period of Insurance. Where the Insured Person is not domiciled in the United Kingdom and where the context permits, the term United Kingdom shall be construed as meaning the Insured Person s Country of Domicile. Director - Any person holding the position of director with the Policyholder but excluding nonexecutive directors of the Policyholder unless otherwise agreed in writing with Insurers. Dependent Child - A Child who is dependent on the Insured Person or the Insured Person s Partner. Effective Time - The time during a Period of Insurance when an Insured Person is covered as detailed in the Schedule of Benefits. Employee(s) - Any person(s) under a contract of service or apprenticeship with the Policyholder. Excess - The first amount of a claim, expressed as a monetary amount or a percentage of the loss, which the Policyholder must bear. Page 4

6 Full Time Education - A programme of learning provided by a recognised educational body, which leads to a qualification by examination or assessment which is either: full-time study; or a mixture of study and work experience as long as at least two thirds of the total time for the course is spent on study. GBP - Pounds sterling. Hijack - The unlawful seizure or wrongful taking control of an aircraft or other conveyance in which the Insured Person is travelling. Hospital - Any establishment which is registered or licensed as a medical or surgical hospital in the country in which it is located and where the Insured Person is under the constant supervision of a Qualified Medical Practitioner. Hospital Confinement - Admission to a Hospital as an In-patient as a result of Bodily Injury or illness for a continuous period of 24 hours or more on the advice of and under the constant supervision of a Qualified Medical Practitioner. Incidental Holiday - Any holiday taken in conjunction with a Journey made primarily for Business purposes. In-patient - An Insured Person who has gone through the full admission procedure and for whom a clinical case record has been opened and whose admission is necessary for the medical care and treatment of Bodily Injury or illness and not merely for any form of nursing, convalescence, rehabilitation, rest or extended care. Insured Person - Any person or category of persons shown as being insured in the Schedule of Benefits. Journey - Any trip covered by this insurance which commences during the Period of Insurance and does not exceed 12 months duration. Cover will start from the time of leaving home or normal place of Business (whichever is left first) and continue until arrival back at home or normal place of Business (whichever is reached last). Trips exceeding 12 months duration must be notified to and accepted by Insurers and the Secondee Endorsement applied to the Policy. Kidnap - The illegal abduction and holding hostage of an Insured Person for the purpose of demanding payment of money or the performance of some other action as a condition of release. Parent or Legal Guardian - Any person with parental responsibility or a legal guardian in accordance with the Children Act 1989 and any statutory amendment modification or re-enactment of it. Partner - An Insured Person's spouse or civil partner, registered pursuant to the Civil Partnership Act, or someone of either sex with whom an Insured Person is living as though they are their spouse or civil partner at the time of the occurrence that is the subject of a claim under this Policy. Period of Insurance - The period between and inclusive of the dates shown From: and To: in the Policy Schedule commencing at hours on the earliest date shown and expiring at midnight on the latest date shown. Both dates refer to local standard time at the address of the Policyholder as shown in the Policy Schedule. Policyholder - The person, firm, company or organisation named as the Policyholder in the Policy Schedule. Premium - The amount shown on the Policy Schedule in respect of the specified Period of Insurance or any amount that subsequently becomes due as a result of alteration, adjustment or renewal of the Policy. Premium Tax all taxes and other para fiscal charges relevant to Insurance Business and payable by the Insurers. Page 5

7 Qualified Medical Practitioner - A doctor or specialist who is registered or licensed to practice medicine under the laws of the country in which they practice other than: an Insured Person a Partner of the Insured Person a member of the immediate family of the Policyholder or of an Insured Person an Employee or Director of the Policyholder. Specific Definitions Specific Conditions and Specific Exclusions - Those definitions, conditions and exclusions, more particularly stated in the Sections or sub-sections to which they specifically apply. United Kingdom - England, Scotland, Wales and Northern Ireland (excluding the Isle of Man and the Channel Islands). Where the Insured Person is not domiciled in the United Kingdom and where the context permits, the term United Kingdom shall be construed as meaning the Insured Person s Country of Domicile. War - armed conflict between nations, invasion, act of foreign enemy, civil war, military or usurped power. PLEASE NOTE that Specific Definitions relating to individual Sections or sub-sections of this Policy are located and contained in the appropriate Sections or sub-sections. Page 6

8 General Conditions Adjustable Policies Where it has been agreed to base the Premium on estimated values and subsequently to adjust the Premium in the light of actual values 1) The Policyholder shall declare to Insurers the agreed necessary information without unreasonable delay and in any event within six months of the end of the period being adjusted or at such other date or within such other time limit as may be agreed. 2) Insurers will adjust the Premium in accordance with the terms agreed and the Policyholder will pay to Insurers any Premium that may be due or Insurers will return to the Policyholder such Premium as may be due. Arbitration If any difference arises as to the amount to be paid under this Policy (liability being otherwise admitted) such difference shall be referred to an arbitrator to be appointed by the parties in accordance with the relevant statutory provisions. Where any difference is to be referred to arbitration in accordance with this Condition the making of an award shall be a condition precedent to any right of action against Insurers. Assignment Other than as provided under the General Condition entitled Payment of Benefits, the benefits under this Policy may not be assigned by the Policyholder. Insurers shall not be bound to accept or be affected by any notice or any trust, charge, lien, purported assignment or other dealing with or relating to this Policy. Automatic cover for acquisitions and new subsidiaries If during the Period of Insurance the Policyholder acquires or creates any subsidiary or Associated Company either directly or through one of its own subsidiaries, cover under this Policy automatically extends to include such subsidiary or Associated Company from the date of its acquisition or creation, provided that the revised underwriting information does not vary by more than 10% from the information upon which the Premium at inception or last renewal (whichever occurred last) was calculated. Underwriting information for the purposes of this Condition shall mean whichever of the following elements has formed the basis of the Premium calculation estimated salaries; numbers of Insured Persons; travel pattern; fixed benefits. If the revised underwriting information varies by more than 10%, Insurers agree to provide cover from the date of creation or acquisition of such subsidiary or Associated Company, for a period of 30 days during which time the Policyholder shall provide any additional information as Insurers may require and pay such additional Premium as may become due. Cancellation Insurers may cancel: this Policy by giving thirty days written notice to the Policyholder at their last known address and in such event the Premium for the period up to the date when the cancellation takes effect shall be calculated and Insurers shall promptly return any unearned portion of the Premium paid; any cover provided by this Policy for War by sending seven days written notice to the Policyholder at their last known address. Change in Business Description The Policyholder shall give written notice within a reasonable time of any alteration in the Policyholder's Business. Choice of Law This Policy shall be governed by and construed in accordance with the Law of England and Wales and the English Courts alone shall have jurisdiction in any dispute. Communication of and in connection with this Policy shall be in the English language. Page 7

9 Claims Conditions On the happening of any occurrence likely to give rise to a claim under this Policy notice shall be given to Maven Underwriters claims department as soon as reasonably possible after the date of the occurrence. Postal address: Maven Underwriters claims department Somerset House London Road Redhill Surrey RH1 1LU Telephone: +44 (0) (switchboard) Facsimile: +44 (0) aon.protect.claims@aon.co.uk 1. The Policyholder shall at their own expense provide to Insurers such certificates, information and evidence as may be required. 2. Insurers shall be allowed at their expense and upon reasonable notice to the Policyholder to request a medical examination of an Insured Person if required by Insurers. 3. In the event of the death of an Insured Person who is also the Policyholder the benefit payable for death will be paid to the estate of such Policyholder/Insured Person. 4. Any Excess where applicable will apply separately under each Section or sub-section in respect of each and every claim and for each Insured Person. 5. Where claims are to be settled in foreign currency, the conversion rate against sterling will be based on the selling rate of exchange published in the Financial Times on the day nearest to the date of loss. 6. The Insured Person shall as soon as possible after the occurrence of any Bodily Injury or illness: a) obtain and follow the advice of a Qualified Medical Practitioner and b) co-operate with and follow the advice of an independent rehabilitation case manager where appointed by Insurers. Insurers shall not be liable for any consequences of the Insured Person failing to cooperate and obtain and follow such advice and use of such appliance or remedies as may be prescribed. Compliance with Policy Requirements Where the Policyholder or an Insured Person or their personal representatives do not comply with any obligation to act in a certain way specified in any Section or sub-section of this Policy Insurers reserve the right not to pay a claim only under such Section or sub-section. Contracts (Rights of Third Parties) Act The Contracts (Rights of Third Parties) Act 1999 or any amendment thereto shall not apply to this Policy. Only Insurers and the Policyholder can enforce the terms of this Policy. No other party may benefit from this contract as of right. The Policy may be varied or cancelled without the consent of any third party. Fraud All benefit under this Policy shall be forfeit if a claim is fraudulent in any respect or if fraudulent means are used by the Policyholder or anyone acting on the Policyholder s behalf or by an Insured Person or an Insured Person s legal representatives to obtain benefit under this Policy. Hi-jack/Kidnap If an Insured Person is the victim of a Hijack or Kidnap the insurance provided by this Policy for such Insured Person shall continue for a period not exceeding twelve months from the date of Hijack or Kidnap to enable the Insured Person to complete the original Journey or to return to the United Kingdom. Page 8

10 Interest No sum payable by Insurers under this Policy shall carry interest unless payment has been unreasonably delayed by Insurers following receipt of all the required certificates, information and evidence necessary to support the claim. Where interest becomes payable by Insurers, it will be calculated: from the date of final receipt of such certificates, information or evidence and at the base rate established by the Bank of England on such date. Journeys continuing beyond expiry of the Period of Insurance Where a Journey continues beyond the expiry of the Period of Insurance such period is extended for up to a maximum of twelve months or until the completion of such Journey whichever is sooner. Misdescription This Policy will be voidable in the event of misrepresentation, misdescription or non-disclosure of any material particular by or on behalf of the Policyholder. Other Insurance The cover provided under Section B Travel in respect of any Additional Insured Person shall apply fully where no more specific insurance is in place for such person. Where more specific insurance is in place covering the same claim this Policy shall apply only in excess of any amount paid under such other more specific insurance and shall not cover the first amount of any claim that the Insured Person is liable to bear themselves under such Policy. Payment of Benefits Other than as provided under the Assignment Condition Insurers will pay all benefits to the Policyholder. Where the Policyholder directs Insurers to pay benefits or indemnify an Insured Person the receipt of benefit or indemnity by such Insured Person shall be deemed sufficient discharge of Insurer s liability to indemnify or pay benefits under this Policy. Payments on account Payments on account may be made to the Policyholder (or at the Policyholder s request to the Insured Person), subject to Insurers prior consent. Reasonable Precautions The Policyholder and Insured Person shall take all reasonable steps to avoid or minimise any loss or damage and to recover any property which has been lost or stolen. PLEASE NOTE that Specific Conditions relevant to the individual Sections and sub-sections of this Policy are located and contained in the appropriate Sections or sub-sections. Page 9

11 General Exclusions Insurers shall not be liable for payment of any benefit for Bodily Injury, loss, damage or expense resulting from or contributed to by, directly or indirectly: Armed Forces the Insured Person being a full time member of the armed forces of any nation or international authority or a member of any Reserve Forces called out for Permanent Service. Aviation the Insured Person engaging in aviation as a pilot or crew member of an aircraft or other aerial device. Suicide the Insured Person committing or attempting to commit suicide or intentionally inflicting self injury. War War, whether declared or not in the United Kingdom or Country of Domicile. PLEASE NOTE that Specific Exclusions relating to individual Sections or sub-sections of this Policy are located and contained in the appropriate Sections or sub-sections. Page 10

12 AonProtect Assistance Consistent with its philosophy of customer care, Maven Underwriters has arranged with the Insurers to provide a number of assistance services which are available to all employees. Some of the assistance services are only available to employees whilst they are on a Journey. The assistance services are included automatically with the Personal Accident and Travel Insurance Policy and are summarised below. Please note that whilst Maven Underwriters takes every care in selecting business partners to provide assistance services, it cannot accept responsibility for any advice given or information provided by them. AonProtect Assistance During a Period of Insurance the Policyholder and Insured Person may call AonProtect Assistance for a number of counselling, advice and information services providing emotional support and practical advice including, but not limited to, the following: 1. Counselling a) Identifying and managing stress and stressful situations. b) Crisis counselling. c) Debt counselling. d) Addiction counselling. e) Advice on the practical and emotional aspects of living with a long-term injury or disablement. f) Following death, support and help for the bereaved family and colleagues to cope with the trauma of their loss. g) Support in dealing with the psychological impact of not being able to continue in employment due to injury and advice about finding more suitable employment. h) Providing information and details of organisations which provide face-to-face counselling. 2. Legal Advice a) Advice where injury has been caused by the negligence of a third party. b) Advice on employment issues including redundancy, bullying, harassment, unfair discrimination and retirement. 3. Personal Tax Advice General advice on tax issues of a personal nature (but excluding financial planning advice relating to ways of avoiding or reducing personal tax liability). 4. Medical Advice a) General medical advice which can be given over the telephone b) How to access details of the length of hospital waiting lists. c) Providing details of additional sources of information and societies who specialise in dealing with particular disabilities. d) Information on facilities available through Social Services. e) Advice on how to obtain a second opinion. 5. Bereavement Advice a) Information on locating wills, obtaining Grant of Probate or Letters of Administration or the need to consult a solicitor. b) Advice on how to register death, the duties of the Coroner and information on the documents required by the Registrar. c) Referral to a funeral director and advice on the practical details. 6. State Benefit Advice a) Information on entitlements to State Benefits. b) Advice on the financial implications of long term absence from work due to injury. Page 11

13 7. Concierge Service a) Assistance with finding, arranging or booking Travel & Transport, Accommodation, Entertainment, Restaurants, Places of Interest, Theatre & Sporting Tickets. 8. Secure Document Storage a) Store important documents online for access in the event of loss or an emergency including: Travel itinerary, passport details, driving licence, insurance documents, medical information. 9. Best Doctors a) During a Period of Insurance if an Insured Person, their Partner or Children suffer a medical condition for which they wish to seek additional medical advice they may contact Best Doctors who will offer a medical second opinion service for certain medical conditions. b) Best Doctors will source an appropriate Qualified Medical Practitioner to assess medical records and provide a written report Page 12

14 AonProtect Assistance for Pre Travel and Travel Assistance 1. Pre -Travel Assistance During a Period of Insurance the Policyholder and Insured Person may call AonProtect Assistance or they may log on to the website for pre-travel information about the country they intend to visit. Some of the details available are as follows: General Advice Business and social customs. Political situations. Medical advice and medical facilities overseas. Health precautions, including vaccinations. Visa and entry permit requirements. Currency and Banking hours. Time zones and Climate. Driving restrictions. Security Advice i) Over 135 countries covered and details are updated by a team of impartial security analysts every day of the week: ii) Terrorist, kidnap and cultural threats are included in the range of topics covered: iii) updates free concise security updates will be ed daily to the Insured Person s inbox. The Insured Person must first register. Instructions are contained in the website: iv) Tailored Travel Briefings - customised reports tailored to the itinerary of a specific trip. Such reports will be made available within 24 hours of the request. 2. Travel Assistance If during a Period of Insurance the Insured Person requires medical or personal assistance or advice during a Journey they may call AonProtect Assistance (or in non emergency situations log onto the website) in respect of: Medical Assistance i) 24 hour service ii) 24 hours a day, 365 days a year multi-lingual service. Medical Expertise On hand for advice, referral or treatment. iii) Air Ambulance Emergency repatriation including use of air ambulance or scheduled flights as necessary and appropriate. Organisation of transport, medical escorts and the provision of special medical equipment. iv) Local payment of hospital bills. No need for the Insured Person to use their own cash. v) Drug replacement Replacement of essential maintenance medication or prescribed drugs. vi) Arranging overseas hospitalisation Locating and arranging for Hospital Confinement and monitoring patients in co-operation with the attending local physician. vii) Local Agent Arranging for the services of a local agent to provide assistance and advice. viii) Funeral Arrangements Organising the repatriation of human remains and arranging the necessary import/export documents. ix) Liaising with patient s relatives, employer, United Kingdom General Practitioners and Hospital Services. x) Relatives travelling to be with the Insured Person Assisting accompanying relatives of the patient by arranging and paying for transport costs and additional accommodation costs door to door. Page 13

15 xi) Locating and dispatching drugs plus contact lenses glasses blood and medical equipment which are unavailable at the patient s location. Non-medical Assistance i) Replacing Lost or Stolen Documents Help with replacement of lost or stolen passport, tickets, or other travel documents. ii) Cancelling Financial Cards Advice on cancellation of lost or stolen financial cards or travellers cheques. iii) Emergency Cash Advance of emergency funds following loss or theft of money overseas. (Temporary loan only - Insured Person will be required to provide proof of ability to repay). iv) Lost luggage location Help with the tracking of lost luggage. v) Business Documents and messages Forwarding essential business documents and urgent messages. (Not insured - but the service is available at the Policyholder s/insured Person s expense). vi) Legal advice vii) Interpreters The provision of interpreters at business meetings or the translation of documents. (Not insured - but the service is available at the Policyholder s/insured Person s expense). 3. Security Advice and Services During a Period of Insurance the Policyholder or Insured Person may call AonProtect Assistance (or in non emergency situations log onto the website) for advice/assistance on many security issues as follows: a) Security Advice - the details are set out under the Pre-travel Assistance above. b) SMS and Security Alerts following an on-line request to register. c) Personal Security Specialist Service to extricate you from a life-threatening situation occurring whilst on a Journey outside the United Kingdom. Fuller details are set out in the Personal Security Specialist Expenses sub-section of this Policy. d) Identity theft - guidance on preventative advice, credit file monitoring, re-establishment of identity and repair of the Insured Person s credit rating standing. e) Access to a range of other security services the cost of which must be borne by the Policyholder/Insured e.g. support following a serious crime while at home, crisis management, close protection services (other than Personal Security Specialist Expenses abroad where covered by Insurers). 4. Home Emergency Advice If, whilst on a Journey, a home emergency (e.g. a burst pipe, a broken window or a leaking roof) occurs at the Insured Person s private residence, the Insured Person may call AonProtect Assistance to access a network of reliable tradesmen who will come and carry out repairs. The cost of any work undertaken must be borne by the Insured Person. Page 14

16 How to Access AonProtect Assistance Telephone Based Services To access AonProtect Assistance, simply call: (for calls made from outside the United Kingdom); or (for calls made from within the United Kingdom). To help monitor and improve service standards, calls may be recorded. On calling the helpline, a number of options will be given to direct you to the appropriate service needed e.g. Press 1 for Medical Assistance or pre-travel advice; Press 2 for counselling, personal tax, medical, bereavement, state benefit advice or home emergency assistance; Press 3 for Security Services or advice; Press 4 to access the concierge service; Press 5 for Best Doctors; Press 6 to hear the options again. You will be requested to provide a) your name; b) your company s name; c) the name of your parent company, if any; d) the nature of the assistance needed and e) a contact number or address where you can be reached. It would be helpful, but not essential to receive assistance, if you had your Policy number to hand. The Assistance Line cannot provide details of your cover nor should they be contacted to make a claim when the Insured Person returns home. Details of cover should be sought from your local Aon service team. All claims matters should be referred to Maven Underwriters claims department at London Road, Redhill, Surrey RH1 1LU telephone number +44 (0) or by to aon.protect.claims@aon.co.uk Web based Services To access services that are available through the internet please log onto and click on the appropriate links When prompted for a password please enter the last four digits of the AonProtect Assistance telephone number (7797). Page 15

17 Section A Personal Accident The cover provided by this Section or its sub-sections will apply only if a benefit amount is shown in the relevant Section or sub-sections in the Schedule of Benefits. If during a Period of Insurance an Accident occurs during the Effective Time shown in the Schedule of Benefits or during a Journey and causes Bodily Injury to an Insured Person, Insurers will pay the appropriate amounts under Items 1 to 5 below: 1. Death Where Bodily Injury results in death Insurers will pay up to the amount shown in the Schedule of Benefits. Specific Provision applicable to Death Disappearance If an Insured Person disappears and after a suitable period of time it is reasonable for the Police or registration authorities to believe that such Insured Person has died as a result of Bodily Injury, the death benefit shall become payable subject to a signed undertaking being given by the Policyholder that if the belief is subsequently found to be wrong such death benefit shall be refunded to Insurers. Insured Persons over 75 The death benefit is limited to the amount shown in the Schedule of Benefits in respect of an Insured Person who is aged 75 or over at the date of sustaining Bodily Injury. Children The death benefit is limited to the amount shown in the Schedule of Benefits in respect of a Child except where an Insured Person who is aged 16 or 17 at the date of sustaining Bodily Injury is a Director, Business Partner or Employee of the Policyholder. 2. Permanent Total Disablement Where Bodily Injury results in Permanent Total Disablement Insurers will pay up to the amount shown in the Schedule of Benefits. Specific Provision applicable to Permanent Total Disablement Excluded Persons No benefit shall be payable for Permanent Total Disablement, however defined, to an Insured Person who is: a Child, except where such Child is an Insured Person aged 16 or 17 and is a Director, Business Partner or Employee of the Policyholder; or aged 75 years or over; or not usually engaged in Remunerated Employment. at the date of sustaining Bodily Injury 3. Permanent Disabling Injuries Where Bodily Injury results in: 3 A) Permanent Disabling Injuries (Any), Insurers will pay a percentage of the amount shown under Variable Injury Benefit 3 in the Schedule of Benefits. The percentage payable will be relative to the degree of disablement as shown in the following Scale of Injuries which prescribes the maximum percentage payable for a range of Permanent Disabling Injuries. Page 16

18 Scale of Injuries A. Loss of or total loss of use of one or more limbs 100% B. Loss of sight in one or both eyes 100% C. Loss of speech 100% D. Loss of hearing in both ears 100% E. Loss of intellectual capacity 100% F. Loss of hearing in one ear 25% G. Post Traumatic Stress Disorder 20%* *Subject to a maximum payment of GBP15,000. H. Total loss of use of: i) the back or spine below the neck with no damage to the spinal cord 40% ii) the neck or cervical spine with no damage to the spinal cord 30% iii) a shoulder, elbow or wrist 25% iv) a hip, knee or ankle 20% I. Loss of or total loss of use of: i) a thumb 30% ii) a forefinger 20% iii) any other finger 10% iv) a big toe 15% v) any other toe 5% J. Payment for any Permanent Disabling Injury not noted above will be calculated using a medical assessment by Insurers of the degree of disablement relative to this scale. No account shall be taken of the Insured Person s occupation. Or 3 S) Permanent Disabling Injuries (Specified) Insurers will pay a percentage of the amount shown under Variable Injury Benefit 3 in the Schedule of Benefits. The percentage payable will be relative to the degree of disablement as shown in the following Scale of Injuries which prescribes the maximum percentage payable for a range of Permanent Disabling Injuries. Scale of Injuries Loss of or total loss of use of one or more limbs 100% Loss of sight in one or both eyes 100% Loss of speech 100% Loss of hearing in both ears 100% Loss of intellectual capacity 100% Loss of hearing in one ear 25% Specific Provisions applicable to Permanent Disabling Injuries Children and Persons not in Remunerated Employment Cover under Permanent Disabling Injuries (Any) shall automatically apply to Insured Persons who are Children or Insured Persons not usually engaged in Remunerated Employment. The benefit amount applicable shall be that shown in the Schedule of Benefits under Section A, Item 3. Where the Schedule of Benefits shows different amounts under Section A, item 2, and under Section A, item 3, the higher benefit shall be used to determine the percentage payable. Maximum Benefit The total amount payable shall not exceed 100% of the amount shown in the Schedule of Benefits for Permanent Disabling Injuries Injury Benefit 3, for each Insured Person in respect of any one Accident. If benefit is payable for Loss of or Loss of use of a limb then benefit for loss of or loss of use of parts of that limb cannot also be claimed. Persons over 75 years of age Cover for an Insured Person who has attained the age of seventy-five years shall be limited to Loss of one or more limbs or Loss of sight in one or both eyes and the maximum benefit amount payable shall not exceed the amount stated in the Schedule of Benefits. Page 17

19 4. Temporary Total Disablement Where Bodily Injury results in Temporary Total Disablement, Insurers will pay up to the amount shown in the Schedule of Benefits. This benefit will be payable in addition to any amount claimed under Items 2 or 3 of this Section. 5. Temporary Partial Disablement Where Bodily Injury results in Temporary Partial Disablement, Insurers will pay up to the amount shown in the Schedule of Benefits. This benefit will be payable in addition to any amount claimed under Items 2 or 3 of this Section. Specific Provisions applicable to Temporary Total Disablement and Temporary Partial Disablement Persons 75 years of age or over No benefit in respect of Temporary Total Disablement or Temporary Partial Disablement shall be payable to an Insured Person who is 75 years of age or over. Temporary Total Disability Periods of less than a week Where a period of Temporary Total Disablement or Temporary Partial Disablement, or part thereof, is less than a complete week the amount payable for each Working Day shall be an appropriate percentage of the Insured Person s normal days/hours of work per week as set out in their contract of employment, reasonably adjusted to take into account any overtime or other payments earned by the Insured Person prior to the period of Temporary Total Disablement or Temporary Partial Disablement. Accident Medical Expenses Where Bodily Injury results in a valid claim under Items 1, 2, 3, 4 or 5 of Section A of this Policy, Insurers will reimburse Accident Medical Expenses incurred but not exceeding the amount shown in the Schedule of Benefits. Rehabilitation Case Management Where an Insured Person suffers Bodily Injury which is likely to result in a valid claim under: items 2 or 3 of the Injury Benefits shown in the Schedule of Benefits; or items 4 or 5 of the Injury Benefits shown in the Schedule of Benefits and such claim exceeds the Deferment Period Insurers will, for the case management period stated in the Schedule of Benefits, appoint a firm of independent injury management specialists to: 1. carry out an initial telephone assessment of the situation with the Insured Person, the Insured Person s medical advisors, the Policyholder and Insurers; 2. advise the Insured Person on, recommend, coordinate and arrange on their behalf the most appropriate: a)beneficial medical or therapeutic intervention b)prosthetic and counselling services 3. taking into account the Insured Person s entitlement to benefits and services under this Policy (including Accident Medical Expenses benefit and counselling Helpline), benefits under any other policy of insurance and state benefits and services 4. provide support to the Insured Person throughout their recovery encouraging the Insured Person to minimise the effects of their injury and follow the recommended course of rehabilitation 5. advise on and co-ordinate an achievable return to employment 6. regularly update the Policyholder on the Insured Person s progress or recovery Insurers may, at their sole discretion, extend the case management period where it is considered that to do so would be in the best interests of the parties concerned. Page 18

20 Section A Personal Accident - Extensions The cover provided by these extensions will apply only in respect of categories of Insured Persons defined under the Schedule of Benefits - Section A Personal Accident. If during a Period of Insurance an Accident occurs during the Effective Time shown in the Schedule of Benefits or during a Journey and causes Bodily Injury to an Insured Person, Insurers will, subject to the maximum per Insured Person limits stated in the Schedule of Benefits, pay the following expenses and/or benefits as appropriate Chauffeur expenses Where Bodily Injury results in a valid claim paid under Items 2, 3, 4 or 5 of Section A and the Insured Person is unable to travel to and from work using the method of transport they normally used prior to the Accident, Insurers will pay up to the amount shown in the Schedule of Benefits for the reasonable costs of a chauffeur or taxi service to convey the Insured Person to and from work until: such time as the Insured Person is well enough to resume using the method of transport normally used prior to the Accident; benefit ceases to be payable under Items 4 or 5 of Section A; 12 months from the date the Accident occurred; whichever is earlier. Where the Policyholder or Insured Person requests payment of benefit under this extension in order to mitigate a claim that would otherwise be payable under Section A - Items 4 or 5 then, subject to the limitations above, Insurers will pay the benefit for chauffeur or taxi service expenses based on the benefit amount that would otherwise have been payable under Section A - Items 4 or 5. Coma Benefit Where Bodily Injury results in Coma, Insurers will pay the Policyholder on behalf of the Insured Person the amount shown in the Schedule of Benefits for each day the Insured Person remains in a Coma up to the number of days shown in the Schedule of Benefits. Compassionate travel If during a Period of Insurance any relatives, friends or close Business associates (who are not included in any other category of Insured Person) of an Insured Person suffer Bodily Injury resulting in Permanent Disabling Injury (Specified) whilst on a Journey outside the United Kingdom solely for the purposes of being with an Insured Person who has sustained Bodily Injury or suffered illness on a Journey outside the United Kingdom for which cover is provided by this Policy Insurers will pay the Policyholder, on behalf of the Insured Person, the amount shown in the Schedule of Benefits. Specific Conditions applicable to Compassionate Travel Aggregate Limit Subject otherwise to the overall Event limits shown in Section A Personal Accident, an Aggregate Limit as shown in the Schedule of Benefits will apply to relatives, friends or close Business associates who sustain Bodily Injury in any one Event. Other Extensions do not apply to persons covered under this Extension Section A Personal Accident Extensions, other than this extension, do not apply to persons on Compassionate Travel. Recommendation by Qualified Medical Practitioner The Journey must be made only where a Qualified Medical Practitioner has recommended that such relatives, friends or close Business associates be with such injured/ill Insured Person. Page 19

21 Corporate Event Attendees If during a Period of Insurance a Director, Employee and/or guest (including accompanying Children) of the Policyholder (Corporate Event Attendees), who is not included in any other category of Insured Person, suffers Bodily Injury whilst a) travelling to; b) travelling from; and c) participating in; any Corporate Event, Insurers will pay the Policyholder, on behalf of the Insured Person, the amount shown in the Schedule of Benefits. Cover will start from the time of leaving home or normal place of Business (whichever is left last) and continue until arrival back at home or normal place of Business (whichever is reached first). Specific Conditions applicable to Corporate Event Attendees Aggregate Limit Subject otherwise to the overall Event limits shown in Section A Personal Accident, an Aggregate Limit as shown in the Schedule of Benefits will apply to Corporate Event Attendees who sustain Bodily Injury in any one Event. Children The death benefit for an Insured Person who is a Child is limited to the amount shown in the Schedule of Benefits. Main Insured Persons must have 24 hour or occupational cover The Effective Time for the main categories of Insured Person must include ET1 24 hours a day or ET2/3 - Occupational Cover only including/excluding commuting. Other Extensions do not apply to persons covered under this Extension Section A Personal Accident Extensions, other than this extension, do not apply to Corporate Event Attendees. Corporate Reputation Protection If during a Period of Insurance an Insured Person or a Visitor suffers Bodily Injury whilst legally in or on the Policyholder s Premises resulting in death, Loss of one or more limbs, Loss of one or both eyes, Loss of Speech or Loss of hearing in both ears, Insurers will reimburse the Policyholder up to the Aggregate Limit specified in the Schedule of Benefits in total for all costs (other than the Policyholder s own internal costs) incurred for:- the engagement of image and/or public relations consultants; and/or the release of information through the media within 15 days of, and directly in connection with, such Bodily Injury, to protect and/or positively promote the Policyholder s image. Specific definition applicable to Corporate Reputation Protection Aggregate Limit shall mean the maximum amount shown in the Schedule of Benefits that Insurers will pay for any one Event and/or all Events occurring during any one Period of Insurance. Where more than one Schedule, Schedule of Benefits or Policy showing benefits has been issued by Insurers in the name of the Policyholder, the highest individual Aggregate Limit will apply. Specific Conditions applicable to Corporate Reputation Protection Aggregate Limit If the total of all claims under this sub-section in any Period of Insurance exceeds the Aggregate Limit, the amount payable in respect for each Insured Person shall be proportionately reduced until the total does not exceed the Aggregate Limit. Payment of benefit This benefit shall be payable only once in respect of all instances of Bodily Injury arising out of and directly occasioned by any one Event. Page 20

22 Dependent Child Benefit Where Bodily Injury results in death of an Insured Person and a benefit amount is shown for such Insured Person for death under Section A Item 1 of the Schedule of Benefits, Insurers will pay the amount shown in the Schedule of Benefits for each Dependent Child of the Insured Person. This benefit is payable in addition to the death benefit. Dependent Adult Benefit Where Bodily Injury results in death of an Insured Person and a benefit amount is shown for death under Section A Item 1 of the Schedule of Benefits, Insurers will pay the amount shown in the Schedule of Benefits for each Dependent Adult. This benefit is payable in addition to the death benefit. Domestic Service Expenses Where Bodily Injury results in a valid claim under Section A - Items 2, 3, 4 or 5 of this Policy Insurers will pay up to the amount shown in the Schedule of Benefits for the reasonable costs of providing domestic cooking, cleaning, laundry, shopping and similar services until: benefit ceases to be payable under Section A - Items 4 or 5; or 12 months from the date the Accident occurred; whichever is earlier. Funeral Expenses Where Bodily Injury results in death and a benefit amount is shown for death under Section A Item 1 of the Schedule of Benefits, Insurers will, on production of the interim Death Certificate, pay the Policyholder, up to the amount shown in the Schedule of Benefits to cover reasonable funeral expenses in the United Kingdom. This benefit is payable in addition to the death benefit. Home Adaptation/Relocation Expenses Where Bodily Injury results in Quadriplegia or Paraplegia, and the benefit for Permanent Total Disablement becomes payable, Insurers will also indemnify the Policyholder for expenses incurred, up to the amount shown in the Schedule of Benefits, for adapting the Insured Person s home or for relocating to another home to cater for the practical changes involved in living with the disablement. Hospital Confinement Benefit (The following additional cover applies to all injuries, including less serious injuries, and is not dependent on Bodily Injury as defined in this Policy.) If during a Period of Insurance, an Accident occurs during the Effective Time shown in the Schedule of Benefits or during a Journey and the Insured Person sustains injury which, independently of illness or any other cause, results in their Hospital Confinement within twelve calendar months from the date of the Accident, Insurers will pay the Policyholder the amount shown in the Schedule of Benefits for each complete twenty-four hour period of such Hospital Confinement up to the maximum Benefit Period shown in the Schedule of Benefits. Page 21