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48
Defining Trauma
When purchasing insurance, nothing is more
important than reading the fine print. This
holds true not just for home or car insurance
but also when insuring your most important
assets ­ yourself and your family.
Where total and permanent disability
(TPD) and income protection insurance insure
your ability to work, trauma insurance is
payable entirely upon meeting the definition
of one of the listed illnesses or injuries. This
makes the list of conditions and the definitions
behind them of the utmost importance.
To re-cap, trauma insurance is known
by many names, including Crisis, Critical
Illness, Recovery, Living and Trauma. The
names all refer to what the cover is designed
to do, provide a lump sum of money to
support you and your recovery if you suffer
from a traumatic illness or injury. The
amount of cover you take out is then payable
to you if you suffer one of these events. For
example, if you insure yourself for $500,000
and then have a heart attack, meeting the
policy definition as this is an insured event,
the $500,000 would be payable.
LEVELS OF COVER
Most insurers have a standard and a premier
policy. Unlike other types of insurance, over
95% of policies purchased are the premier
type. Standard policies will generally have
between 10 and 40 conditions, whereas
premier policies will have the maximum,
usually more than 40.
Premier policies will also provide partial
payments (between 10 and 25%) of the
sum insured for early stage or more minor
conditions. For example, this could be
carcinoma in situ of the breast, early stage
leukaemia or loss of hearing in one ear.
One of the main areas policies can differ
is where the insurer puts the line between
a full payment and a partial payment,
particular for common cancers.
Specific conditions for medical
professionals
Most trauma policies have a condition for
occupationally acquired HIV. This means you
would be covered if you acquired HIV in your
workplace, which may be due to a needlestick
injury, blood splatters or even inhalation of
bone dust.
You can also add an additional amount
of cover, usually referred to as a Needlestick
benefit. Despite its name, Needlestick cover
is not limited to needlestick injuries alone ­
it will pay a lump sum in the event you are
diagnosed with occupationally acquired HIV,
Hepatitis B or Hepatitis C.
Needlestick cover will provide a lump sum
of up to $1million, dependent on your sum
insured. The amount you choose does not
need to be the same as the trauma sum you
are insured for, and the cover is significantly
cheaper. For this reason it is common for
medical professionals to have much higher
cover amounts for needlestick than trauma.
Cover for children
Trauma cover isn't just for adults. Insurers
also provide Child cover, which covers children
aged two and above in the event of death or
suffering a significant illness or injury.
The most common claims for children are for
cancer and injuries caused by accidents, such
as severe burns or major head trauma.
Katherine Ashby is the
Senior Product Technical
Manager, Life Insurance
at BT Financial Group.
In the final instalment of a three-part series,
Katherine Ashby examines
the different levels of coverage between trauma policies.