What is Accident Cover and how does it work? Dis-Chem Health

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What is Accident Cover and how does it work? 

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What is Accident Cover and how does it work?

The worst thing about accidents, is that you never know when they will happen. That situation is made even worse, when you don’t have access to the healthcare you need.

Accident Cover might not stop an emergency, but having a plan like this gives you the power to protect yourself when the unexpected happens. That power is so important, it could be the difference between life-or-death.

But, what is Accident Cover and how does it work? Let’s take a deep dive into that very question.


What is Accident Cover and how does it work?

Often referred to as accident insurance, Accident Cover is designed to make sure you get private healthcare in case of an emergency. The fact that this policy only becomes active during an emergency, also influences the claims process:

With certain insurers, you don’t have to worry about paying the healthcare provider directly. The bill is sent to the hospital network responsible for your treatment, which they send to the insurer you joined as a claim.


What is covered in an Accident Cover policy?

Naturally, this depends on the service provider and plan that you choose. But in general, benefits include ambulance services, emergency department visits, hospitalisation for accidents and more. Some plans may also cover costs that are sadly related to a death or disabilities caused by an accident.

It’s worth mentioning that an “accidental event” is defined as any accidental harm that happens when you’re forced to get treatment in an emergency casualty room. Some plans may include cover for heart attacks and strokes, as well as unfortunate injuries that happen on the sports field or at home.

You might be wondering: What’s the difference between emergency department visits and hospitalisation?

Well, hospitals have different sections that deal with different types of medical issues called wards. For example: If you’re first admitted into an emergency room then transferred to a general ward for recovery, they can be considered as two separate costs. That’s why to make sure that you have cover for both, many services providers will have separate benefits in one plan for emergency room visits and hospitalisation.

Benefits do have limits and exclusions, so it’s important to check policy documents or speak to authorised representative to find out more about the plan you want.


What is not covered in an Accident Cover plan?

The biggest difference between Accident Cover and Medical Insurance for example, is that daily medical needs like visits to a doctor or over-the-counter medicine are not covered.

The limits and exclusions of the Accident Cover policy you choose will also give you a good idea of what is not covered. There may be accidents that are not covered like self-harm, or there may be a limit on how much an Insurer will pay if you must visit the emergency casualty room. Remember, you can find out more about these finer details in the policy documents you receive.


The requirements to you need to qualify

This plan is different from standard medical schemes, where there are many boxes you need to tick to qualify. Some service providers even offer cover to minors only!

In truth, the only requirement you need for Accident Cover is the desire to be protected.

Other than that, the main requirement when it comes to qualifying is your ability to keep up with your monthly premiums. For many service providers, access to benefits depends on whether you are up to date with your monthly payments.


Who needs an Accident Cover policy?

The simple answer is everyone, right? That’s because none of us know when we will need the type of help accident cover provides.

Accidents happen to people from all walks of life. You could trip and hurt yourself as you try to catch the train, or at home while you’re using a ladder. There are other examples which we don’t even want to talk about, considering just how bad those scenarios can be.

However, you could argue that some people do need it more than others. If most of your time is spent on the road for example, getting a policy makes sense. If you love to be active, the injuries that could happen may need the benefits you will find in an accident cover policy.

You might also think that this policy is suited to a loved one. Your kids may hurt themselves playing on their swings, or the work your spouse does may expose them to risky situations.  Ultimately, you may need to be covered if you always want to stay prepared for the unexpected.

Why having cover is important

Accidents can be life-changing for all the wrong reasons. The pain, trauma and uncertainty you may feel after a serious accident could literally change how you look at life.

Imagine if you collapsed from a heart attack, but you can’t be stabilised by paramedics because you have no way of paying for that service. Imagine not knowing who or where to turn to for help, after an accident leaves you needing help immediately.

Accident cover is important, because it can genuinely be lifesaving in situations like this. For a small monthly premium, you get access to private healthcare designed to help you when you need it most.

Remember: It’s much better to have something and not need it, than to need something and not have it.


Frequently asked questions

Is Accident Cover the same as regular health insurance?

No, Accident Cover is designed to provide financial protection in case of medical emergencies caused by accidents and does not cover routine medical expenses.

Can Accident Cover be used for pre-existing medical conditions?

Accident Cover typically does not cover pre-existing conditions. It focuses on injuries resulting from medical emergencies caused by accidents.

Are doctor’s visits covered by Accident Cover?

No, Accident Cover usually doesn’t cover routine doctor’s visits or non-accident-related medical consultations.

Does Accident Cover include coverage for dental or vision care?

Generally, Accident Cover does not include dental or vision care. It primarily focuses on accidents and related medical expenses.

Is self-harm covered by Accident Cover?

Self-harm is typically not covered by Accident Cover. It is meant to address accidental injuries caused by external events.

What happens if I miss my monthly premium payments?

Your access to Accident Cover benefits may be affected if you fail to keep up with your monthly premium payments. Check with your provider for specific details.

Can Accident Cover help with non-medical expenses related to accidents, like property damage?

Accident Cover primarily focuses on medical expenses, so it may not cover non-medical costs such as property damage. Be sure to review your policy for any specific coverage details.


Not all Accident Cover plans are the same and benefits as well as limitations may vary. Descriptions of benefits given are meant to be for general educational purposes only and you must ensure that you seek the advice of a broker to ensure any product choice you make suits your individual needs

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