Cover your bases: from slipping to snake bites, accidents happen

Keshnee Thulsie, Claims Manager at Hollard

A “play fight” at school leading to a fracture and an emergency room visit. A snake bite in the shower resulting in a lengthy hospital stay and expensive medical treatment. A mishap during an exercise routine translating to a broken bone and extended time off work.

These are all real-life examples of accidents leading to insurance claims that have crossed her desk, says Keshnee Thulsie, Claims Manager at Hollard.

In South Africa, she explains, most big claims stem from road accidents or crime. But over the past few years, she has also seen various unusual and sometimes even bizarre claims.

In the above instances, all the victims were covered by group personal accident policies, taken out by their school (in the learner’s case) or employers (in the case of the adults), with the specific intent to protect them against risks related to an unforeseen personal accident.

“We see lots of school claims,” says Thulsie. These may stem from children injured in class, on the sports field or in the boarding house and are “often upper-limb injuries, particularly fractures”. But she has also handled a surprising number of claims following injuries “due to play fighting” – including one where one unfortunate learner ended up with a fractured radius.

Some of the more unusual claims she has processed related to injuries caused by animals or insects. One stemmed from a man being bitten on his lip by a snake that unexpectedly appeared while he was showering at home. Fortunately, the victim had 24-hour group personal accident insurance through his employer. He survived – and the claim was paid out.

Another man was bitten on his leg in a separate brush with a snake, requiring a lengthy hospital stay and extensive medical treatment. Again, the claim was honoured, says Thulsie – as was that of a claimant who suffered a disability after being bitten by a highly poisonous violin spider.

Some claims stem from accidents that may seem almost innocuous – but while slipping on a wet bathroom floor at work may remind you of slapstick comedy, it’s far from funny when it leads to a serious injury and potential loss of income.

Thulsie recalls a claim triggered by just such a slipping incident. She has also seen claims resulting from injuries caused when people tripped and fell in the parking lot, and one where the claimant fell backwards during a home exercise routine, shattering a bone in her spine.

Personal accident cover can’t turn back the clock after a freak accident, but it can go a long way in returning you to the same financial position you were in before such an incident, allowing you to continue to lead the lifestyle you had before – even if it’s with the help of technology, prosthetics or other equipment covered by the insurance payout, she says.

The intention of the cover, she says, is to “create a safety net”. Ideally, companies should (and many do) take out 24-hour policies, protecting their people at work, at home and on the road.

Accidents happen, and their repercussions can mean that “something small” (such as a non-life-threatening injury) can quickly turn into “something big”, considering the resultant medical costs and how a potential loss of income can affect extended families.

This is why, Thulsie stresses, companies have a duty of care towards their employees. By taking out group personal accident policies, they not only cover their staff against the cost of injuries, but they also protect their business.

Claims have a monetary value, she concludes. “But for employees to know that their employers care – you can’t put a value to that.”