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What is Protection Insurance?
Also known as Income Protection, this kind of cover is designed to provide income during periods of long term incapacity.
Cover can be arranged on an individual basis or employers can arrange a group policy to benefit their employees.
Benefits are paid monthly and limited to an agreed percentage of annual salary. Any salary continuing to be paid and state benefits are deducted from these payments.
The policy would come into effect following a ‘deferred period’ chosen by the policyholder at inception, usually 4, 13, 26 or 52 weeks. Payments would continue until the individual/employees full return to work, death or expected retirement date.
The definition of disability can vary from being totally unable, through sickness or accident, to follow their stated occupation to being totally unable to follow any remunerative occupation whatsoever and care should be taken when choosing a contract and all implications must be fully considered.
As with any policy there are restrictions and exclusions which will be detailed in your policy document. The most common ones would include Pre Existing Conditions, Self Injury, Drugs & Alcohol, Pregnancy and Aids.
Naturally, the policy will also require that the individual is in employment immediately before the onset of the illness. Premiums vary depending on the levels of cover required but factors would include Age, Sex, Occupation, Medical History and Hazardous Pastimes.
Personal Accident/Sickness Insurance
Can provide compensation in the event of disablement or death due to:
Accident & Specified Illnesses
Accident & All Sickness (excluding exclusions)
Accident & Sickness in Specified Circumstances
Many employers buy such policies to both fill the gap on PHI waiting periods and to make sure that accidents are compensated, whether or not the employer is legally liable due to negligence. Personal Accident and Sickness cover is also often included as an additional benefit in other policies such as holiday and travel insurances, motor insurances covering sporting activities.
Policies can be on an individual or group basis with the benefits of lump sums and short term income benefits generally payable for no more than two years.
Benefits are scaled and would depend upon disablement being temporary or permanent and would in most policies be restricted to the total payable under the fatality benefit.
The definition can vary between policies and again great care must be taken when choosing a policy for example one policy may state that the limb must be severed yet another may include the total and permanent loss of use of the limb.
Exclusions would include:
Pre Existing Medical Conditions
Drug or Alcohol Abuse
Self Inflicted Injury
In some cases Age, Claims History and even Medical Evidence may result in exclusions or restrictions in cover provided. Premiums would be calculated upon Age, Sex and Occupation. Policies would normally be written on an annual basis although short term policies can be arranged if required although these policies are generally more expensive.
Medical Expenses Insurance
Designed to cover the costs of medical treatment and hospitalisation. Depending on the plan chosen, treatment can be carried out at a number of privately run establishments or be extended to include a number of NHS hospitals.
Benefits would include:
Specialist treatments such as radiotherapy, nursing at home, private ambulance, emergency NHS treatment and cash payments for hospital stays
The premiums would depend upon which level of cover was required and if the policy was extended to include family members. Age, Sex and Health would also be factors for consideration. As with any policy there are restrictions and exclusions and would include Aids, Pre Existing or Chronic Conditions.
Most policies can now be extended to include Dental Plans, Counselling Services and Alternative Therapies. Policy excesses or contributions can be arranged to suit your own needs and will often result in a reduction in premium. Employers often fund such policies as a benefit to staff and to make sure that key personnel are not left unable to work through lack of capacity under the NHS.
Critical Illness Insurance
Provides a lump sum on diagnosis of major illness or disease rather than death. Policies initially covered the following diseases:
Coronary Artery Disease
However, increased competition has meant that most policies now also cover Kidney Failure, Major Organ Transplant, Alzheimer’s, Parkinson’s, Motor Neurone Disease, Total Permanent Disablement, Blindness and/or Deafness, Multiple Sclerosis, Paralysis and Terminal Illnesses in addition to other conditions. Cover can be obtained on a standalone basis or added to a variety of life policies. Cover can be offered up to retirement age or on a ‘whole life’ basis and benefit levels can be arranged as required.
Exclusions would include:
Self Inflicted Injury/Illness
Pre Existing Conditions
Premiums would depend upon levels required and factors including Age, Medical History etc. Depending upon your own circumstances you may wish to consider a group policy or ‘Key Person’ policy as it is also known.
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Frequently Asked Questions
This product is designed for anyone who might struggle to meet financial commitments if they’re unable to work.
There are three main cover areas to choose from:
- Accident and sickness only
- Unemployment only
- Accident, sickness and unemployment cover (ASU)
You can take out Income Protection Cover anytime, but most people tend to think about taking out a plan when they’re changing jobs, getting married or starting a family.
When picking your plan, you need to decide whether you want long-term or short-term cover:
Short Term Income Protection Cover gives you payouts for a maximum period of 24 months per condition.
Primary and Comprehensive plans can give you payouts as long as the plan lasts, if you can’t or are unlikely to ever work again.
Yes, the self-employed are one of the most common groups who take out IP cover.
It’s not possible to take out joint income protection insurance because policies need to be tailored to individual circumstances, although the entire household income and requirements should be considered when arranging cover.
You should always check the terms and conditions of any insurance policy very carefully before you sign up to make sure it meets all your needs. You will need to be sure of exactly what you can claim for, when you can claim and how much you’re likely to get.
There are rules which say the policy documents must be written in easy-to-read plain English, so you can understand what you’re signing up to.
The policy is designed to only pay out if you’re unable to work due to accident or sickness during the term of your policy. Once your policy has reached its end date, your cover stops and you won’t get anything back.
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Making the small print...BIG
A Fair Presentation of the Risk At the heart of insurance contracts is an obvious truth: you have an enormous advantage over the insurer. You know all about your business, its history, processes, people and management, but the insurer knows nothing – other than what you tell them. Your Duties You have a statutory duty to make a fair presentation of the risk. You must tell the insurer: • Every material circumstance which you know or ought to know and/or • Sufficient information that would cause the insurer to make further enquiries, if necessary, to review those material circumstances Your Knowledge • You are deemed to have the knowledge of the company’s senior management. • You are deemed to have the knowledge of the person arranging the insurance (who is deemed to be a senior manager under statute). • Anything that can be discovered by a reasonable search. A failure to make a fair presentation of the risk gives the insurer various remedies, depending upon the nature of the failure, from avoiding the contract and not paying claims to modifying the basis of settlement.
A reprocessing plant did not reveal a series of small fires during their insurance year.
Following repeated false alarms, a retailer didn’t reveal that Police Response had been withdrawn.
A restaurant omitted to reveal repeated minor floods from an upstairs nightclub.
A construction company didn’t reveal potential employee claims recorded in their accident book.
A company failed to reveal written warnings to an employee over repeated dangerous driving.
A company failed to reveal that it had been ‘struck off’ by Companies House and was trading as a new legal entity under a different designation.
Compiling the Risk Presentation: an ongoing process The compilation of risk information for presentation to an insurer might be thought to be simply contained in a proposal or risk presentation form, however, such forms are not exhaustive and cannot take account of circumstances which change beyond their compilation. Moreover, merely referring insurers to your website or dumping data is not making a fair presentation of the risk. ’Fairness’ is a subjective test but it would certainly involve simplicity, clarity and relevant selection. Ongoing communication is vital, because the duty to disclose material circumstances is ongoing throughout the insurance year and at renewal of the insurances. It’s important… It is not possible to overstate the importance of researched, adequate risk presentation – there have been countless legal disputes, repudiated claims, ruined businesses and lives arising from the simple failure to reveal all the facts to an insurer. A failure to present risk adequately is a bigger risk than the risk you present. It doesn’t matter that the failure is innocent, something overlooked, forgotten or discounted as unimportant – it might be important to the insurer, in which case it must be revealed. Should there be anything not yet disclosed, or that you are unsure would influence your insurers about this insurance tell your broker/insurer immediately.
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Who are The Business Insurance Bureau?
The Business Insurance Bureau is a niche specialist underwriter and commercial insurance broker, defying conventional categorisation, comprising of a small number of gifted individuals forming a collective intellectual giant.
We have developed our own unique range of quality insurance products, which has given the business a competitive advantage in several areas. Being in control of the entire process, from enquiry to policy issue, has allowed our business to deliver service levels hitherto unimaginable in this sector, or indeed for a business of its physical size.
We insure a spectacularly diverse clientele, similarly exclusive and excellent in their field, who rely on The Business Insurance Bureau to protect their assets, minimise their liabilities and secure their future.