Personal Accident Insurance
Cambodian National Insurance Company (CAMINCO) provides 24-hour Personal Accident Insurance coverage for
Cambodian citizens from 4 to 65 years of age and foreigners who are training or working in Cambodia
(hereinafter called the Insured) according to the provisions specified in these regulations; this insurance
coverage shall provide financial protection to an insured against the risk of death or bodily injury.
- Bodily injury which is caused solely, directly and independently of any other cause by external
means. The bodily injury must have been caused solely and directly by the accident.
- Bodily injury caused by violent accidental external and visible means which is the sole cause
of death or disablement...
- However the policy excludes:
- Persons who are suffering from mental illness or nervous disorder, and
- Persons who are being permanently disabled or injured and the degree of disability is
50% or above.
- Specifically, it provides monetary compensation in the event of accidental death and disability
Scope of Cover
- Accidental: an event which is unintended or unforeseeable and it does not include the cumulative
result of a series of small incidents.
- Solely, directly: the bodily injury must have been caused solely and directly by the accident and it can
also be "proximately" caused by the accident.
- External opposite of "internal" i.e. if an accidental means is not internal, then it must be external
- Bodily injury: use of this term excludes disease from natural causes, but disease proximately caused by
accident is regarded as bodily injury.
- Any accident which has occurred in the territory of Cambodia, due to:
- A sudden external event, beyond the will of Insured, which affects his body from without and
is a proximate cause of the death or bodily injury that the Insured suffers from.
- Salvage actions of the Insured in rescuing human being, state' or people's property from
disaster and, participating in the fight against unlawfully malicious acts.
- Death: compensation is in the form of a capital benefit, which usually equals the full amount of the sum insured.
- Permanent total disability: compensation is usually in the form of a cash lump sum and is usually payable for disablements suffered
within a time frame after an accident which prevents a person from engaging in any business or gainful occupation of any kind. The following types of disablement usually qualify for the same (or higher) benefit under total permanent disablement:
- Loss of sight of both eyes
- Loss of both hands or both feet
- Loss of any two members
- Loss of speech and hearing
- Other permanent disblement
- Benefits are provided for the loss of parts of limbs, e.g. toes or fingers.
- % of the capital sum paid for such disabilities is usually a smaller % than that paid for the loss of an entire limb or eye.
- Disablement benefits are commonly reflected under a "Table of Compensation".
- Temporary disablement
- For temporary total disability, the insurer will pay weekly cash benefits to the insured, usually payable for a maximum of 104 weeks.
- Definition for temporary total disablement is usually less restrictive than that of permanent disablement, i.e. it requires the insured to not be able to perform every duty pertaining to the insured's profession or occupation only.
- Temporary partial disability, when included, provides even lower levels of benefit than temporary total disablement (about half of the benefitss).
- Medical expense
- Covers medical expenses incurred for treatment following an accident, up to a prescribed limit.
- Medical expenses include cost of medical, surgical or other remedial attention, treatment or appliances (such as wheelchair and crutches) given or prescribed by a doctor and all hospital, nursing home and ambulance charges.
- Strictly on a reimbursement basis
- Hospital cash
- Provides a fixed benefit (e.g. $100 per day) based on the period of hospital confinement without regard to the actual hospital charges.
- The hospitalisation must have been a result of accidental injury as defined under the main benefit. (refer to Definition of "Accident").
- Incremental sum insured
- The rewards insureds who do not make any claims during the policy period, with additional sum insureds during renewal.
The three primary underwriting factors for this class of business are:
- Occupation of Insured: rates are not issued for every single occupation, rather, similar occupations are grouped into broad classes for rating purposes, e.g.:
- Class I: involving indoor work mainly of a deskbound nature, e.g. clerks
- Class II: skilled/semi-skilled occupations, e.g. tour guides
- Class III: manual work, e.g. builders
- Level of coverage or benefits chosen
- Level of benefits the insured elects to buy
- Health and physical impairments
- Those accidents or illnesses that appear to be repetitive are important considerations, as they can increase the likelihood of a claim during the coverage period.
If any event giving rise to or likely to give rise to a claim under this Policy comes to his knowledge the Insured shall:
- Notice of claim must be informed to CAMINCO as soon as possible.
- Insured is required to furnish certificates include the claim form and supplemented supporting documents as under
- Police report of the accident (if involving malicious intent)
- Death certificate (for death benefit claims)
- Medical report (to certify disablement)
- Medical certificates and original medical invoices/bills (for claiming medical expense reimbursements)
- Others required as mentioned in Policy Wording