Accident Insurance: What it Covers and How the Accident Insurance?

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Accident Insurance: What it Covers and How the Accident Insurance?


The Injury is by definition an event due to fortuitous, violent and external that produces objectively ascertainable physical injuries that result in death, permanent disability or temporary disability.

This is what most often we read in the Glossary of Accident Insurance.

An injury to be considered as such and therefore allow opening of the Left and the eventual liquidation of the damage is represented by an event due to fortuitous (not predictable or inevitable. It is not an accident, for example, that we suffer as a result of participation in a fight, a car race or following a suicide attempt), violent (immediate, concentrated in time. This feature is important to distinguish accident from diseases that manifest themselves in the longer term) and outside (not inside the body. That's because a heart attack is not considered an accident. Although violent and unpredictable originates within our bodies).

The injury must result in physical injury (not psychological) and objectively ascertainable (resulting from medical certification). Such injury must result in death, permanent disability (loss of working capacity generic) or temporary disability (inability to continue, for a specified period, to their work).



That said, we can now identify the event of an injury (as defined in our Policy) more smoothly.

Such as an insect bite is an injury? It is an event that produces injury, is due to an accidental, violent and external.

Physical injuries suffered as a result of a car accident by the driver that driving under the influence of alcohol are eligible for compensation by virtue of the foregoing? No, the event "car accident" is certainly violent and external, but in this case it is almost predictable (lacking reason or another). This case actually falls increasingly under the exclusions.

The rupture of a tendon suffered by the worker due to an effort is claimable? In principle no, as it is not said that the cause is external (it is likely that the tendon was already damaged by time and that this extra effort that caused its rupture), it is said that the cause is violent (in effect If the tendon was already damaged, a missing feature of immediacy) and is finally told that the cause is accidental (so if the worker is usually make such efforts because of his work, it is expected that the first tendon or later can yield). In most cases, this case is not eligible for compensation, but there are insurance products which compensate the injury or tendon rupture in the limit of a fixed amount.

Normally in the Policy are also considered accidents, suffocation, poisoning, drowning, freezing, sunstroke or heat, injuries caused by efforts, injuries sustained in a state of illness or unconsciousness or injuries suffered in occasions of popular riots and acts of terrorism.

Who can take out accident insurance? To whom it may be useful?

Generally, everyone can take out accident insurance and its usefulness can not be questioned, not even for those who perform gainful employment and who therefore already protected by the Insurance compulsory INAIL for accidents at work.

However, there are non-insurable, or those suffering from particular diseases such as alcoholism, drug addiction, AIDS or depression. If these diseases present themselves even after the contract (when the subject is healthy), they would become due to termination of the Agreement. In some cases, you can increase the range of accident insurance to infection by HIV It occurred during the course of professional activity stated in the policy.

Then there are special risks that the Insurance Companies do not want to hire or hire only under certain conditions and with severe restrictions, as the risks sports (motoring, motorcycling, mountain climbing, boxing, and generally all sports played in competition).

The age of the insured is another limit and normally you can not take out an accident insurance after 75 years of age.

What is covered under the Accident Insurance?

To answer this question we should ask ourselves what could be the consequences of an accident.

Physical injuries sustained as a result of a car accident, for example, may give rise to a permanent disability that compromises partially or totally our working capacity. This means that after any accident we may not be able to do our work and therefore unable to produce income. If we are single and affluent perhaps the problem arises only from the psychological point of view, as if ours is a normal job, we have a mortgage on their shoulders, a wife and a dependent child, the problem becomes much more serious.

The injury could also not give rise to a disability, but put us in a position to not work for a certain period (temporary disability) or force us to deal with medical expenses (eg for surgery) at that time we can not support. It is therefore possible for economic reasons that inevitably arise as a result of an injury that we intend to protect with this Policy.

It is therefore possible to ensure capital for the Life product, for permanent disability, or a sum for the Reimbursement of care expenses, a daily allowance in case of application of immobilizing brace or plaster, a daily allowance in case of hospitalization or in hospital a daily allowance in case of Temporary Disability. (We will analyze in detail every Warranty reserving un'apposito Article)

The Accident Insurance can be taken to protect themselves from any injuries that may occur while driving the vehicle (the driver Accidents), leisure (Accidents Extra-Professional), during working hours (Accidents Professional, including the so-called risk Ongoing - risk of suffering an injury during the period required to or from work and work-home) or 24 hours of 24.

It 'clear that those who perform the profession will need to protect themselves 24 hours a 24, while the employee will be more interested in protecting off-hours. Although not always the case (Read "Compulsory insurance INAIL and Private Accident Insurance. The Differences").

Another very important aspect of the accident insurance concerns the so-called causes.

If in the past I suffered an injury to his right knee because of a permanent disability which is left over 7%, a further injury to the same knee would give rise to a contributory cause of disability not claimable. In practice if the second injury of a healthy person would bring a disability 4% while in my case has only worsened the preexisting disability raising it to 11%, it will not be paid any compensation. If the second accident of a healthy person would bring a disability of 11%, it will recognize the 4% (that is, subtracting 11% of the pre-existing disability 7%) regardless of whether this additional left actually raised my degree of disability of 20% overall. In fact with the Accident Insurance are eligible for compensation only exclusive and direct consequences of the accident, measured as if it had hit a person physically intact and healthy. The preexisting disability shall be excluded or subtracted difference if the same injury on a healthy subject have also caused higher than the pre-existing disability.

If the personal injury resulting from an accident are aggravated by a previous illness, such consequences will not be eligible for compensation. In fact, following the principle that they are eligible for compensation only exclusive and direct consequences of the accident, the aggravation brought the disease is excluded from compensation.

Different is instead the case in which the pathology is a consequence of the accident. For example an eye infection following an insect bite. In this case the contributory cause of injury is compensable.

What the insurance does not cover injuries?

Usually the warranty are excluded accidents occurring during driving if the driver is not entitled to drive, risks sports (although these are insurable with appropriate exceptions), injuries suffered while intoxicated or under the influence of substances narcotic drugs or psychotropic drugs, injuries resulting from surgery, injuries suffered when crimes or acts contrary to the law committed by the Insured and injuries suffered during catastrophic events (these can also be secured with special dispensation).

How is the prize of protection insurance Accident?

The most important parameters used in determining the award, in addition to the sums insured and guarantees choices are:

the temporal scope of operations (A cover 24 hours 24 will clearly be more burdensome than on the only occupational hazard). the occupation (A mason working on scaffolding risk much more than an employee without external tasks and therefore certainly pay a prize more important).



Any risks sports agreed (The exercise of dangerous sports, if granted under the cover, will affect so important in the determination of the award).

Aggravation, Risk Reduction and Coinsurance Indirect.

Also to accident any aggravation of the risk (for example the performance of a new job more risky than previously insured) must be communicated in writing to the Insurance Company. Failure to disclose can result, according to Art. 1898 of the Civil Code, the total or partial loss of the allowance.

In the reverse situation, namely Risk Reduction, the Company must reformulate Contract according to the new requirements.

In the concluding more contracts of insurance with different insurers, Art. 1910 of the Civil Code provides for the obligation of the Insured at the inception, to disclose the existence of other contracts with each insurer and in the case of the Left must be reported to all the insurance companies that provide the same risk .

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