InsureGuru Learn

5 Real-Life Examples Of Successful Personal Accident Claims

Personal accident claims usually vary from those considered to be small claims associated with sprains, burns, injury from falling to large claims that involve payment for total or partial disability as well as death.

The claims pay-out increase as someone ages. Similarly, the likelihood of you being paid depends on your stage of life. For instance children, less than 18 years are more likely to be injured thus there are more personal accident claims for children than adults.

However, these claims are smaller in size compared to those of adults. Indicating that there is a relationship between the amount paid for claims and your age.

Here are some instances of insurance claims being paid out. They may give you a better understanding of what a Personal Insurance plan can be used to cover.

Case 1: Claim for out-patient treatment

55-year-old Caleb Ho (not his real name) encountered an accident and injured his neck, shoulder, and back. Ho went for an X-ray scan at a Chinese clinic where he was given treatment at the cost of $165.

Ho had a family insurance plan of an annual premium of $338 that gave him $100,000 of the assured sum for him and his wife. Additionally, his plan paid $25,000 of the assured sum for his child.

Case 2: Claim for accidental death

Aaron Lim(not his real name), 5, suffered fatal injuries after falling from a third storey staircase. The fall caused a brain injury that led to brain death.

Lim was taken to Tan Tock Seng Hospital for treatment but died ten days later. Lim was insured as a child with Sompo under their family plan for $12,500 with his parents covered for an assured sum of $200,000.

The insurer paid the family $12,500 for the accidental death of their child as well as $1,500 in medical costs. The family had a family plan cover with a $383 annual premium.

Case 3: Claim for accidents that occur overseas

You can make a claim for accidents that occur outside the country as the case of 36-year-old Mr. David Soh. Soh was injured in a motorbike accident while visiting Malaysia.

Soh had a personal accident cover of $223 annual premium that had an assured sum of $50,000 for himself and his spouse. He also had an additional $12, 500 for his child.

He claimed compensation for injuries sustained for a foot fracture and his insurer, Sompo, paid him a total of $1,644. This comprised of medical expenses at $965, miscellaneous benefits at $100, and a weekly stipend of $579 for the 49 days that he was on medical leave.

Case 4: claims for occupational accidents

Mr. Thomas Tan was involved in an accident while at work when he was pinned by a tire, dying on the spot. Tan was insured under the group personal accident cover with AXA that has $40 to $200 annual premiums for each employee.

Tan’s beneficiaries received $257,000 from AXA. This included $200,000 death gratuity, $2,000 burial expenses as well as $5,000 as a family security benefit. The extra $50,000 was a payout for not having made any claims before.

Case 5: Claim for out-patient treatment in a public hospital

When Carina Loh (not her real name) was injured while on a staycation, she went to a public hospital and received out-patient treatment for cuts sustained and the ankle sprain.

However, she could not settle the bill using the Medishield Life or Integrated Shield Plan because she was not hospitalised.

Loh claimed compensation of the $450 that she had spent from her Tokio Marine Personal Accident plan which was successfully reimbursed.

Angie Quek

Financial Advisor

Angie Quek has been in Pana Harrison since 2008 and specialised in Life Insurance, Investment schemes, Estate Planning and General Insurance.