5.
Exclusions – When Sovereign won’t pay a benefit?
Sovereign will not pay Accidental Injury Cover if a specified injury arises directly or indirectly from any of the following:
Any illness, disease or degenerative condition.
Any act or omission by the life assured intended to cause harm to him or herself. Sovereign will not pay any Accidental Injury Cover if the life assured participates in any criminal activity or suffers a specified injury when under the influence of alcohol or drugs, except where the drugs were prescribed by and were being used in accordance with the directions of a Registered Medical Practitioner.
6.
Key terms
limb(s)
An arm, leg, hand or foot. In respect of this definition:
accidental injury
Bodily injury caused solely, suddenly and directly by violent, accidental, external and visible means.
the arm starts from the shoulder joint and ends at the wrist joint; the hand starts from the wrist joint; the leg starts from the hip joint and ends at the ankle joint; and the foot starts from the ankle joint.
fracture
The disruption in continuity of bone, with or without displacement.
general anaesthesia
The induction of a state of unconsciousness with the absence of pain sensation over the entire body, through the administration of anaesthetic drugs. Means a Registered Medical Practitioner has certified that, as part of the recommended medical treatment for that fracture , the life assured requires a:
permanent total blindness
Irrecoverable loss of the sight of both eyes (whether aided or unaided). This is evidenced by:
immobilisation
visual acuity of 6/36 or less in both eyes; or field of vision reduced to 10 degrees or less of arc in the better eye; or a combination of visual defects resulting in the same degree of visual impairment as either of the points above.
moon boot;
halo;
surgical wires;
externally or internally fixed plates and/or screws;
wrist guard;
permanent total loss of hearing
The life assured loses all hearing in both ears (aided or unaided). The loss must be total and permanent as assessed three months after the accidental injury .
splint;
support;
crutches;
sling;
you/your
The 'Policy Owner' named in the schedule .
wheelchair; and/or
other mobility equipment, aid or device.
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867 TCB-AIC Version 1 Effective 1 September 2017
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