Exclusions may vary depending on your policy structure, but here are some of the most frequently applied ones to be aware of

• This cover doesn’t apply while flying as a pilot or aircrew member. The cover will still apply if you’re ballooning, hang-gliding, paragliding, or parachuting for fun or leisure – as long as it’s not competitive or for payment purposes. 
•  Injury or death caused by suicide or intentional self-harm are not covered.
•  Injuries caused entirely by a pre-existing physical condition or illness are not covered.
•  Injuries or death caused by the insured person’s use of drugs or narcotics aren’t covered, unless prescribed and taken exactly as directed by a medical professional (not the insured person), or administered by a member of the medical profession (other than himself).
•  Injuries sustained while the insured person is driving or operating any motorised or mechanically operated vehicle under the influence of alcohol are not covered. ‘Under the influence’ means having a blood alcohol level above the legal limit at the time of the accident.
• Injuries caused by the insured person taking part in any riot or civil unrest are not covered.
• Injuries resulting from the insured person deliberately exposing themselves to extreme danger (unless trying to save a life) or from their own criminal acts are not covered.
• Injuries sustained while playing sports professionally are not covered.
• Injuries caused directly or indirectly by radiation or radioactive contamination from nuclear fuel, nuclear waste, or from the combustion of nuclear fuel or nuclear weapons are not covered. This includes any nuclear fission process.
• Injuries or death caused by venereal disease, or Acquired Immune Deficiency Syndrome (AIDS), or AIDS-related complex (ARC) conditions are not covered, regardless of how they were acquired or may be named.
• Mental or nervous disorders, including stress-related conditions, are not covered, unless they are directly caused by an accident covered by this policy.
• We won’t pay any claims or provide any benefits if doing so would violate laws, sanctions, regulations, or restrictions set by the United Nations (UN), the European Union (EU), United Kingdom (UK), or the United States of America (USA) – even if those laws don’t apply locally.

Personal Accident claims must be reported as soon as possible, and no later than 180 days of the injury. Late notification may result in the claim being denied.

If supporting documents aren’t immediately available, please submit a fully completed claim form within the notification period to register your claim. You can send the supporting documents as they become available.

Temporary Disability/Income Protection covers only the employee named on the policy who is actively employed by the business at the time of the accidental injury.

Employee Injury Assist offers Insured’s a seamless COID/RMA/FEM claims experience, end to end, via the use of a unique Insured specific portal and a dedicated team of Injury on Duty claims specialists, who will pre-assess all claims to ensure that all recoveries are made timeously. The services offered are not only limited to assistance with Injury on Duty claims via the relevant Commissioners office, but also includes:

• A call centre to assist with incidents as they occur, to ensure that the injured employee is transported to an appropriate medical facility for immediate medical treatment.
• Collection of and assistance with annual Return of Earnings and Annual Assessments. 
• Easy access to letters of hospital admission guarantee.
• Please contact your SHA A&H team for further details and assistance in registering your business on the Employee Injury Assist portal.