If you’re injured or become ill and can’t work, the financial impact can be significant — particularly for self-employed people, contractors and business owners. Personal Accident & Illness Insurance is designed to provide financial support if you’re temporarily or permanently unable to work due to an accident or illness.

At Rivergum Insurance Brokers, we help clients understand how this type of insurance works, what it can cover, and how it can complement other personal or business insurance arrangements.

What Is Personal Accident & Illness Insurance?

Personal Accident & Illness Insurance provides benefits if you suffer:

• An accidental injury, or

• A defined illness

that results in death, disability or loss of income, subject to policy terms.

It is often used by:

• Self-employed individuals

• Sole traders and contractors

• Company directors

• Business owners

• Employees seeking additional protection

Unlike workers compensation, this cover can apply 24/7, not just while working.

General Scope of Cover

Personal Accident & Illness Insurance is usually structured to include a combination of weekly benefits and lump-sum (capital) benefits.

Weekly Income Benefits

If you are unable to work due to an insured injury or illness, the policy may pay a weekly benefit for a defined period.

Key features typically include:

• Benefit based on a percentage of income or a fixed amount

• Waiting periods (e.g. 7, 14, 30 days)

• Maximum benefit periods (e.g. up to 2 years or longer, depending on policy)

Weekly benefits are designed to help cover:

• Living expenses

• Mortgage or rent

• Business or personal commitments

Medical & Rehabilitation Expenses

Some policies provide limited cover for:

• Medical treatment

• Rehabilitation

• Physiotherapy or recovery costs

This is usually subject to sub-limits and conditions.

Accident-Only Cover Option

Many Personal Accident policies can be arranged on an accident-only basis, excluding illness.

Why Choose Accident-Only Cover?

Accident-only cover may suit:

• High-risk occupations

• Trades and manual workers

• Clients seeking a lower-cost option

• Businesses arranging cover for groups of workers

Accident-only policies typically:

• Have fewer exclusions

• Are easier to underwrite

• Offer lower premiums than accident & illness cover

However, they do not respond to illness, which is an important consideration.

Permanent Disability & Capital Benefits

What Are Capital Benefits?

Capital benefits are lump-sum payments made if you suffer a serious injury resulting in permanent disability or death.

These benefits are paid in addition to, or instead of, weekly income benefits.

Types of Capital Benefits Commonly Available

Accidental Death

A lump-sum payment to your estate or beneficiaries if death results from an insured accident.

Permanent Total Disability (PTD)

A lump-sum benefit if an injury permanently prevents you from working again, as defined by the policy.

Permanent Partial Disability

Lump-sum benefits for specific permanent injuries, such as:

• Loss of limbs

• Loss of sight or hearing

• Loss of use of body parts

Benefits are often calculated based on a percentage of the sum insured.

How Capital Benefits Can Be Used

Lump-sum payments can help with:

• Paying off debts or mortgages

• Funding long-term care or home modifications

• Supporting family members

• Business continuity planning

Capital benefits provide financial certainty where long-term earning capacity is permanently affected.

What’s Not Automatically Covered?

Common exclusions may include:

• Pre-existing conditions

• Self-inflicted injuries

• Certain high-risk activities or sports

• Injuries under the influence of drugs or alcohol

Policy wording varies, so understanding conditions is critical.

How Personal Accident & Illness Insurance Differs from Other Covers

• It is not means-tested like some government benefits

• It can apply regardless of employment status

• It complements (but does not replace) income protection or workers compensation

• Benefits are defined by policy terms rather than medical assessment alone

Who Should Consider This Cover?

Personal Accident & Illness Insurance may be appropriate if:

• Your income would stop if you couldn’t work

• You don’t have sick leave or workers compensation cover

• You want a simpler alternative to income protection

• You want capital benefits in the event of serious injury

Why Arrange Personal Accident Insurance Through Rivergum?

As brokers, we help clients:

• Decide between accident-only vs accident & illness cover

• Structure appropriate weekly and capital benefits

• Understand definitions of disability

• Align cover with personal and business needs

• Avoid overlaps or gaps with other insurance

Our focus is on practical protection that fits your circumstances.

Speak With Us

If you’d like to discuss Personal Accident & Illness Insurance, or review your existing cover, we’re here to help.

Contact Rivergum Insurance Brokers to discuss your income, occupation and protection needs.