Personal Accident Coverage
So what exactly does a Personal Accident protection plan seek to protect? PA plan has 2 main parts:
Part 1 covers ‘Major‘ disability due to an accident – Accidental Death, Total Permanent Disability (TPD) & even Partial Disability. The payout is in the form of a lump sum (cheque) to be used to sustain the quality of life (yourself &/or beneficiaries) after the accident.
Part 2 covers for ‘Minor‘ disability due to an accident – treatment for food poisoning, fractures, sprains, physio, and even TCM / Chiropractic, dengue fever, physiotherapy, MRI scans (slipped disc, dislocation), etc. The payout is in the form of reimbursement (ie pay first and claim later). Lastly, as per most plans, there will be optional add on (‘riders‘) to enhance overall coverage, which I will not discuss here as the list goes on & varies between the different insurers.
Myth #1: Expensive & Overlapping
Late last year in 2019, few of my friends called me up with reported injuries – dengue fever, muscle imbalanced (physiotherapy required), 2 cases of slipped disc, shoulder dislocation (MRI required), injury to eyes during soccer games, and other cases of sprain injuries requiring TCM treatment. To my surprise, some of them are not covered by any personal accident (PA) protection plan, why is that so?
I feel that a common misunderstanding is that the PA protection plan is expensive & overlaps with hospitalisation plan.
Firstly, for a basic entry-level PA protection plan, with comprehensive coverage ($100K major, $2K medical reimbursement & $500 TCM/Chiro), the premium is only $15.34/mth!
Secondly, for most of the scenarios that I’ve mentioned above, they do not require hospitalisation stay or surgery, as such hospitalisation protection plan will not be activated to cover for these outpatient treatment & scans.
Myth #2: Only for those Active in Sports
From my conversations with some clients, I feel that there is another common misunderstanding is that the PA protection plan is designed & meant for those who are active in sports or in a high-risk occupation.
Taking examples of the above common minor claims processed by me, I realized that the bulk of incidents/ claims arise from mundane daily routine & they are not specific to any particular activity, or age group. In fact, it happens to Anyone, Anytime, Anywhere, w/o any telltale warning signs. Which is why insurance company charge a flat rate across age (0-65), regardless of gender, and will not increase in premium even after any ‘minor’ disability claims has been paid out. And yes, only for those in higher-risk occupations, the premium will be higher due to the risks involved.
Understanding the Claim Process
Understanding the claim process is as important as understanding the coverage. Honestly speaking, if you secure a PA plan w/o knowing how to file for a claim or through a telemarketer, it is as good as not having the protection at all, cos you will end up not getting the medical reimbursement back from us. It is very important to appoint someone who is well-versed with the claims process as your Financial Service Consultant.
Processing claims with is a breeze, as I will be there physically to guide you through the whole process of filing & signing a ‘minor’ claim form (usually about 10-15mins). Upon submission to AIA, it will usually take appx 4weeks for the claims to be processed & for the funds to be reimbursed back to your account. Moving on in 4Q 2020, we are moving to digitise this process to serve you better, & to enhance your overall experience with us.
Ever since I started out in this career, I have processed countless claims, helping to reimburse >$10,000 of outpatient medical bills (under personal accident) & another >$30,000 for hospitalisation bills (post-treatment) & benefits. If this is the first time you hear about the coverage of personal accident protection plan, and do not have one(right-sized) in place, or do not know how to file a claim, you need to speak with for a consultation & professional second opinion!
I stay fully Committed to Protecting 10,000 Families, & in Touching Lives with my Heart (Hard) Work.
Case Study #1
Client X texted me one day about his fiancé having backache one morning, and was subsequently diagnosed to have slipped disc. In a separate case, Client Y felt numbness in his hamstring & thigh areas after a game of badminton with his sons and was subsequently diagnosed to have nerve compression issue near his spinal area. Under both scenarios, medical bills like MRI, specialist follow up & physiotherapy (with referral) can be filed under PA.
Expected bill (at private clinics/ hospitals) can go up $1,000+ for MRI scan, & $150/ session of physiotherapy (number of sessions as required), $100+ for consultation with specialist.
Case Study #2
Client Z was down with Dengue Fever, & require treatment & regular blood tests for the duration of a few weeks. Under such scenarios, all outpatient medical bills are filed under PA.
The expected bill (at Gvt hospital) can go up to $350+.
Case Study #3
Client A slipped & fractured her knee while she was back in her hometown (m’isa) over the weekend. As Personal Accident protection plan is 24/7 worldwide coverage, we are able to process this claim.
Expected bill (A&E) $100+ for x-rays & casting, & TCM treatment $80+ / session (number of sessions as required).
Case Study #4
Personally, I was down with food poisoning (Gastriatirc) in mid-2019 after having family dinner at Bedok hawker 511 (our regular eating place). My family was down with vomiting & diarrhea the whole night, and we visited a 24Hr clinic for consultation & to have an injection.
Expected bill (24hrs clinic off-hour) $120 x family pax.
Case Study #5 – Rejection
Client B injured his hip during exercise (gym), & got a referral letter for physiotherapy. However, he did not realise that his therapist is actually an exercise therapist, & not a physiotherapist by qualification. The claim of 4 treatment sessions amounting to ~$700 was rejected.
Conclusion: it is very important to make sure that you are seeking medical care from a qualified & registered practitioner. If you do not know of any physiotherapist, you can choose to speak with our certified partners.
Case Study #6 – Rejection
Client C brought a full package of chiropractic treatment, with a portion of it not utilised. This is a compliance issue, as this benefit is provisioned for medical reimbursement, ie to pay & utilise the treatment session, & then to claim. We do not allow for claims for package-buy (future usage of remaining treatment plans). There have been uncovered in the past. I seek your understanding of the claims & compliance check processes before making any decisions to purchase package plans (as there might be a chance of under-utilising the package sessions).
Overall Such a protection plan seeks to help offload medical bills & other treatment options associated with an injury, to have peace of mind, & focusing on a speedy recovery. If this is the first time you hear about the coverage of a personal accident protection plan, do not have one, or do not know how to file a claim, you need to speak with for a professional second opinion!
The article was written by,
“Committed to Protecting 10,000 Families, to Touching Lives with my Heart (Hard) Work”
Chris Zheng Liyuan
Senior Premier Consultant (AIA)
Million Dollar Round Table (MDRT)
Associate Financial Planner (AFP)