Automatic extensions to basic cover for Motor Personal Accident

You automatically receive this extended cover for up to the maximum amount of cover shown in the schedule for each of these extensions.

6.1 Additional medical expenses

We will pay up to the maximum amount of cover shown in the schedule for any medical expenses that you incur in the 12 months after the accident.

We only pay if the costs cannot be recovered from any other source including medical aid. Additional top up cover to the maximum amount of cover can be bought at extra premium.

6.2 Trauma counselling

We pay for trauma counselling if you are the victim of an act of violence or traumatic accident. We also pay for trauma counselling for any person who is with you at the time of the event. We pay up to the maximum amount of cover for each person. We pay only if all these conditions are true: 6.2.1. The treatment is given by a registered professional counsellor;

6.2.2. The treatment costs cannot be recovered from any other source; 6.2.3. The act of violence is reported to the police.

6.3 Bereavement expenses

If you die from an accident, we pay your beneficiary or your estate for bereavement expenses up to the maximum amount of cover shown in the schedule.

Bereavement means the period of mourning after the death of a loved one.

6.4 Returning your body to South Africa

If you die from an accident while you are outside South Africa, we pay your beneficiary or your estate for the reasonable costs up to the maximum amount of cover shown in the schedule to return your body to South Africa. We will only pay if your death resulted from an accident that we cover. We only pay if the costs cannot be recovered from any other source.

6.5 Life-support machinery

We will pay up to the maximum amount of cover for the cost of life-support machinery and equipment following an accident.

You are not covered for death under this section if your life is extended solely because of life-support machinery by more than one month after the 24-month limit for death claims.

7. Table of benefits

Description of injury Percentage of compensation

Death 100%

Permanent disability

Loss by physical separation at or above the wrist or ankle of one or more limbs

100%

Senses (ears, hearing, eyes, eyesight and speech)

The complete and irrecoverable loss of sight in one or both eyes

100%

sight, except perception of light

75%

lens of eye 75%

speech 100%

Total paralysis or permanent bedridden 100%

Loss of both hands or feet or one hand and one foot 100%

Any other injury causing permanent disability 100%

Loss of four fingers 70%

Loss of thumb both phalanxes 25%

one phalanx 10%

Loss of index finger

three phalanxes 10%

two phalanxes 8%

one phalanx 4%

Loss of middle finger

three phalanxes 6%

two phalanxes 4%

one phalanx 2%

Loss of ring finger

three phalanxes 6%

two phalanxes 4%

one phalanx 2%

Loss of little finger

three phalanxes 4%

two phalanxes 3%

one phalanx 2%

Loss of metacarpals

first or second (additional) 3%

third, fourth or fifth (additional

2%

Loss of toes

all 30%

great – both phalanxes 15%

one phalanx 2%

other than great – each toe lost

1%

Description of injury Percentage of compensation

Burns

Permanent disfigurement from burns to 100% surface area of the neck and face, or both

Maximum of 60% depending on the percentage of the surface area that was disfigured Permanent disfigurement

from burns to 100% surface area of the body other than the neck or face

Maximum of 30% depending on the percentage of the surface area that was disfigured If the percentage disfigurement for burns is less than 100% of the surface area we apply a percentage to the compensation that is consistent with the actual disfigurement you suffer

We do not pay if the disfigurement is less than 10% of the surface area described above Permanent total loss of use of a part of the body will be treated as loss of that part Permanent total loss of use of a body part shall be treated as loss of such part

Where the injury is not specified, we will adopt a percentage of disability which in its opinion is not inconsistent with the above benefits. We might follow the advice of our medical advisors in making the assessment.

8. How we pay

We will pay up to the maximum amount of cover shown on the schedule. There are maximum amounts for individuals as well as maximum amounts where more than one person dies or suffers an injury in the same motor accident.

We pay you, your beneficiary or your estate:

8.1 We will not pay more than R2,080,000 for any one person and R20,000,000 irrespective of the number of persons injured resulting from an occurrence or series of occurrences arising from one cause. 8.2 We will not pay more than R10,000 death for any person under the age of 6 years.

8.3 We will not pay more than R30,000 death for any person under the age of 14 years.

8.4 We will not pay more than 50% of the maximum amount of cover if you were not wearing a seat belt. 8.5 If you die from the same motor accident that caused a permanent total disablement we paid you for, we will deduct any payments made for permanent total disablement from the amount we pay for death. 8.6 For injury to you we will pay the percentage as noted in the table of benefits.

8.7 We only pay you for either death or permanent total disablement caused by the same accident. 8.8 We only pay you up to the maximum amount of cover for permanent total disablement caused by one

accident. The total we pay for any one accident will not be more than 100% of the maximum amount. If there are more people in the vehicle than are covered under this section and all suffer injury in the same motor accident, we pay the benefits in proportion to the number of people covered.

For example:

John has chosen to cover the driver and three passengers under this section. If the driver and all three passengers are injured, we pay 100% of the benefit. However, if there is an extra passenger, and the driver and all four passengers are injured, we pay 80% of the benefit to each person.

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