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PHI Permanent Health Insurance

Introduction | Who needs PHI? | Inclusions & exclusions
Types of Premium | Cost of cover | PHI benefits | PHI quotes

Inclusions & Exclusions

To complicate matters, different insurers have their own definition of disability. You are only classed as disabled, sick or injured if you are unable to go back to the type of work that is covered by your policy. The four most commonly used are:

Own job. The same job within the same company.
Own occupation. The profession or occupation that you worked in before the enforced absence.
Suited occupation. A suited occupation is one that may require a similar level of education, training, or experience.
Any occupation. As it says, really. To fit this bill you have to be considered as totally unable to perform any occupation whatsoever.

In addition to this, there are certain diseases and causes of disability that are usually excluded. The insurer will rarely pay out if you suffer disability caused by:

Yourself. Intentionally self-inflicted injuries are virtually never covered.
War or rioting
Alcohol or non-prescribed drug use
Failure to follow medical advice
Complications with pregnancy or childbirth
Aids, though if you contract it through accidental exposure in the medical professions, you may still be covered

If you keep your part of the bargain, the insurer must keep theirs. As long as you pay your premiums on time and comply with the terms of the policy, the insurer cannot cancel the policy or increase the premiums no matter how many claims are made. Part of your responsibility is to keep the insurer informed about changes in your circumstances, such as a new job. They will usually then have the right to reassess your premium. If you go from being a telephone operator to a nightclub bouncer, you are likely to face a steep hike in your premiums, based on the the obvious increase in risk to your health.

If you become unemployed for any reason not covered by the policy, you must still inform them. They will probably be keen to discontinue the policy (at least until you return to work), as you do not have an income to protect!