This is a document providing key information about benefits you may be covered under in the policies you may hold. Please refer to your policy documents for the full terms and conditions.

Accident
A physical injury to your body that happens because of a sudden, unexpected, and forceful event that happened outside your control. This injury must not be related to any sickness, disease, or physical condition you already have, and it doesn’t result from something that occurs naturally or gets worse over time. Please note that accident does not include post-traumatic stress.
 

Confining or Non-Confining Sickness
The Confining and Non-Confining Sickness benefit pays if you cannot perform your daily duties* due to illness. Payment is not linked to a hospital stay, but sometimes the benefit is not paid for the first few days. Please check your policy or contact us to confirm any waiting period and the maximum benefit duration.

* If you are not employed or in business - for example, if you are a housewife or retired - the benefit applies to periods when you are unable to perform your usual day-to-day duties. If you are a student, it covers times when you are unable to attend college or undertake any study work.

Convalescence
You MUST have qualified for the Hospitalisation benefit part of your policy to be able to claim under the Convalescence benefit.

Convalescence is the period after being hospitalised* for an accident or illness when you are unable to perform your usual daily activities#. It starts immediately after being discharged from hospital and must be continuous. The benefit is typically capped and depends on your hospital stay duration. Please review your policy wording or contact us to confirm the payment rate, maximum benefit period, and whether it applies to sickness or accident.

* See the Hospital section of this glossary for the definition of Hospitalisation.
# If you are not employed or in business - for example, if you are a housewife or retired - the benefit applies to periods when you are unable to perform your usual day-to-day duties. If you are a student, it covers times when you are unable to attend college or undertake any study work

Fractures
In most cases, if you sustain multiple fractures from one accident, we would pay out for the most serious fracture. Please review your policy wording or contact us to confirm if this is the case for your policy.

Hospital
A hospital is an institution that:

• Primarily exists to diagnose, care for, and treat sick or injured people on an in-patient basis

• Provides facilities for major surgery and diagnosis within its own premises

• Employs qualified medical and surgical practitioners

• Operates under the supervision of a consultant physician who is always available for consultation

• Offers 24-hour nursing care by qualified staff

A hospital does not include:

• Clinics

• Nursing homes

• Convalescent care facilities (even if they are part of a hospital)

• Community hospital

Multiple Claims at the Same Time
Overlapping claims and benefits are not permitted. You can only receive benefits for one claim at a time
 

Partial Disability
Partial disability means you are able to perform some, but not all of your usual business or occupation. If you are not in paid work, partial disability refers to being unable to carry out some, but not all, of your activities of daily living, which include moving around, dressing, eating, maintaining continence, using the toilet, and washing or bathing.


Pre-Existing Conditions
A Pre-Existing Condition is any medical condition that existed before the Start Date of the policy, whether diagnosed or not, for which you had sought or received medical advice, treatment, or medication, or experienced symptoms.

Alternatively, it includes any condition present before a claim is made that was the subject of a previous claim under this policy, where, in the opinion of our Chief Medical Officer, the current and previous claims arise from the same or a related condition.

Recurrent Disability
Successive periods of disability from the same or related covered sickness during the policy term will be treated as a single period of disability, unless each period is separated by at either 12 or 24 months (depending on your policy) without any symptoms of the covered sickness.

Sickness
A bodily sickness or disease which is not related to an accident (see above for definition of an accident) or any pre-existing condition (see above for definition of an pre-existing condition).

Total Disability
Total disability means you are unable to perform every duty of your usual business or occupation. If you are not in paid work, total disability refers to being unable to carry out your activities of daily living, which include moving around, dressing, eating, maintaining continence, using the toilet, and washing or bathing.