Personal Accident & Sickness Wording

Assured Scheme:

Caunce O'Hara & Company Limited as agents for each Insured Person, each or his/her own rights and interests or those of his/her legal representatives.

Insured Person(s):

Any computer contractor who opts to effect cover and is declared to Underwriters

Period of Insurance:

6th February 2002 to 31st December 2002

Schedule of Compensation

The Underwriters will pay the Sum Insured to the Insured Person, or his Executors or Administrators, in accordance with the following Schedule of Compensation in the event of the Insured Person sustaining Bodily Injury or Illness, subject to the terms, Definitions, Exclusions and Conditions, contained in this Insurance.

If however an Assured is named in this Insurance, Underwriters will pay the Assured and not the Insured Person.

Compensation payable in respect of accident

Item

  1. Death
  2. Permanent Total Loss of Sight of One or Both Eyes
  3. Loss of One or More Limbs
  4. Permanent Total Loss of Speech &/or Hearing
  5. Permanent Total Disablement (other than loss of sight of one or both eyes or loss of limb(s) )
  6. Temporary Total Disablement (subject to a 7 day excess each and every claim).

Optional additional benefit
Compensation payable in respect of illness

7. Temporary Total Disablement (subject to a 7 day excess each and every claim).

Cover Options

Items 1 to 5Item 6Item 7
1.£20,000£150£150
2.£40,000£300£300
3.£60,000£450£300
4.£80,000£500£300
5.£100,000£500£300

The maximum amount payable under Items 6 and 7 of the Schedule of Compensation shall be the Sum Insured selected or 65% of the Insured Person's Gross Average Weekly Wage during the twelve months immediately prior to any claim, whichever is the less.

Premiums

 Standard CoverIllness Extension
Option 1£32.50£75.00
Option 2£65.00£150.00
Option 3£97.50£150.00
Option 4£150.00£150.00
Option 5£175.00£150.00

All Premiums inclusive of IPT

Provided always that:

  1. (a) Compensation shall not be payable under more than one of the items of the Schedule of Compensation in respect of the consequences of one Accident or of the same Illness, and
    (b) No weekly compensation shall become payable until the total amount thereof has been ascertained and agreed by Underwriters. If, nevertheless, payment be made for weekly compensation, the amount so paid shall be deducted from any lump sum becoming claimable in respect of the same Accident or Illness.
  2. The total sum payable under this Insurance in respect of any one or more claims shall not exceed in all during the Period of Insurance the largest amount of benefit payable under any one of the items contained in the Schedule of Compensation or added to this Insurance by endorsement.

Definitions

In this Certificate:-

  1. "BODILY INJURY" means identifiable physical injury which:-
    (a) is sustained by the Insured Person and
    (b) is caused by an Accident during the Period of Insurance and
    (c) solely and independently of any other cause, except illness directly resulting from, or medical or surgical treatment rendered necessary by such injury, occasions the death or disablement of the Insured Person within twelve months from the date of the Accident.

  2. "ACCIDENT" means a sudden, unexpected, unusual, specific event which occurs at an identifiable time and place, but shall also include exposure resulting from a mishap to a conveyance in which the Insured Person is travelling.

  3. "ILLNESS" means illness of the Insured Person which declares itself during the Period of Insurance and occasions the total disablement of the Insured Person within twelve months after declaring itself.

  4. "LOSS OF LIMB" means permanent loss by physical separation of a hand at or above the wrist or of a foot at or above the ankle, and includes permanent total and irrecoverable loss of use of a hand, arm or leg.

  5. "PERMANENT TOTAL DISABLEMENT" means disablement which entirely prevents the Insured Person from attending to the duties of his usual business or occupation and which lasts twelve months and at the expiry of that period is beyond hope of improvement.

  6. "TEMPORARY TOTAL DISABLEMENT" means disablement which temporarily and totally prevents the Insured Person from attending to the duties of his usual business or occupation and shall be payable during such disablement from the date on which the Insured Person first became disabled but not beyond 52 weeks.

  7. Words in the masculine gender shall include the feminine.

Exclusions

This Insurance does not cover death or disablement:

  1. Whilst the Insured Person is engaged or taking part in military, air force or naval service or operations (other than reserve or volunteer training).

  2. Whilst the Insured Person is engaged or taking part in aeronautics or aviation, other than as a passenger.

  3. Whilst the Insured Person is engaged or taking part in mountaineering or rock climbing normally involving ropes and/or guides.

  4. Whilst the Insured Person is riding or driving in any kind of race.

  5. Directly or indirectly caused or contributed to by the Insured Person's intentional self-injury, suicide or attempted suicide, provoked assault, dueling or fighting (except in bona fide self-defence), venereal disease or from the Insured Person's own criminal act, or whilst engaged or taking part in civil commotions or riots of any kind.

  6. Consequent on war, invasion or civil war except whilst the Insured Person is travelling outside the United Kingdom.

  7. Occasioned by or occurring while the Insured Person is in a state of insanity temporary or otherwise.

  8. Arising out of any condition caused by, prolonged by, or aggravated by any psychiatric, mental or nervous disorder of the Insured Person, including anxiety and/or depression.

  9. Arising out of or consequent upon or contributed to by radioactive contamination.

  10. Arising from physical or mental conditions or disabilities of a recurring or chronic nature from which an Insured Person suffered, and was known to suffer, prior to the inception of this Insurance or any renewal thereof.
    Additional Exclusions applicable where this Insurance includes compensation for Illness.

  11. Consequent upon the Insured Person's pregnancy or childbirth.

  12. Directly or indirectly arising out of, consequent upon or contributed to by venereal disease or Acquired Immune Deficiency Syndrome (A.I.D.S.) or A.I.D.S. Related Complex (ARC) howsoever this syndrome has been acquired or may be named.

Conditions

  1. If the Insured Person shall engage in any occupation in which greater risk may be incurred than in the occupation disclosed in this Insurance without first notifying the Underwriters and obtaining their written agreement to the amendment of this Insurance (subject to the payment of such reasonable additional premium as the Underwriters may require as the consideration for such agreement), then no claim shall be payable in respect of any Accident or Illness arising out of or in the course of such occupation

  2. Notice must be sent to the Underwriters as soon as practicable of any Accident or Illness to the Insured Person, and the Insured Person must as early as possible place himself under the care of a duly qualified medical practitioner. Notice must be sent to the Underwriters as soon as practicable in the event of death of the Insured Person, resulting or alleged to result from an Accident. In no case will the Underwriters be liable to pay compensation to the Insured Person or to his representatives unless the medical adviser or advisers appointed by the Underwriters for the purpose shall be allowed so often as may be deemed necessary to make an examination of the person of the Insured Person.

  3. Any fraud, misstatement or concealment in relation to any matter affecting this Insurance or in connection with the making of any claim hereunder shall render this Insurance null and void and all claims shall be forfeited.

  4. This Certificate is issued on the condition that the Insured Person has no other Illness Insurance except as specifically declared to the Underwriters at inception or agreed by them during the Period of Insurance.

Notice to the insured person or assured if applicable

The cover referred to in this Certificate is subject to English Law.

Any enquiry or complaint should be addressed in the first instance to the Issuing Agent.

If you are not satisfied with the way a complaint has been dealt with you may ask the Complaints Department at Lloyd's to review your case without prejudice to your rights in law.

The address is:
Complaints Department
Lloyd's
One Lime Street
London
EC3M 7HA

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