Personal Accident
Death Benefit (1-26)
  • Covers death or injury sustained outside normal working hours under the schedule of benefits from 1 to 26. The schedule of benefits is available at FijiCare Insurance Head Office.
  • Claim is paid out 100% upon the death of the member by accident.
Total & Permanent Disability (2-26)
  • Total and Permanent Disablement means TPD which has lasted for more than 12 months from the date of injury.
  • Claim is paid as per the disability with the correct percentage as per the terms and conditions of the policy as stated in the table.
  • Maximum age limit is sixty five (65) years.
Lump Sum Benefits Injury as Defined, resulting in Ratio of Benefits
Total & permanent loss of all sight of both eyes 100%
Total & permanent loss of the use of both hands 100%
Total & permanent loss of the use of both feet 100%
Total & permanent loss of use of one foot 100%
Total & incurable paralysis for all further work 100%
Total & incurable paralysis of all limbs 100%
Total & permanent loss of the use of one arm or greater
part of one arm
80%
Total & permanent loss of the use of one arm or greater
part of one arm
80%
Total & permanent loss of the use of one leg 75%
Total & permanent loss of all sight of one eye together with serious
diminution of the sight of the other eye
75%
Total & permanent loss of the use of one hand or of five fingers of one
hand, or the lower part of arm
70%
Total & permanent loss of the use one foot of the lower part of the leg 60%
Total & permanent loss of hearing 50%
Total & permanent loss of one eye 50%
Total & permanent loss of the lens of one eye 50%
Total & permanent loss of one thumb 30%
Total & permanent loss of the use of one forefinger 20%
Total & permanent loss of the use two joints of one finger 15%
Total & permanent loss of one little finger 12.5%
Total & permanent loss of one big toe 12%
Total & permanent loss of one big toe 10%
Total & permanent deafness of one ear 10%
Total & permanent loss of the use of two joints of one little finger 8.5%
Total & permanent loss of the use of two joints of one little toe 8.5%
Total & permanent loss of the use of two joints of one middle or one ring finger 6.5%
Total & permanent loss of the use of one toe other than a big toe or one joint of a finger 5%
Personal Accident Exclusions

No benefits are payable under this policy for any condition resulting from the Injury or Sickness of an Insured which:

  • Is deliberately self-inflicted or caused by the Insured.
  • Injury as a result of war whether declared or not or services in armed forces of any country or international organization, invasion, acts of foreign enemies, civil commotion, rebellion, insurrection and military or usurped power.
  • Results from engaging in or taking part in or training for professional ports of any kind.
  • Is attributed wholly or partly to childbirth or pregnancy of the complications of these.
  • Is attributed wholly or partly to AIDS or HIV virus in any of their forms and any disease or injury associated with them.
  • Results from any aerial activity unless as a passenger in a properly licensed aircraft.
  • Occurs as a result of the use, existence or escape of nuclear weapons material or ionizing radiation from or contamination by radioactivity from any nuclear fuel or nuclear waste from the combustion of nuclear fuel.
  • Results directly or indirectly from neurosis, psychoneurosis, psychosis, mental, emotional, stress or anxiety condition, disease or disorder unless.
  • a) the insured is being treated by a psychiatrist, Psychologist or similar specialist and a full report must be provided at the insured’s expense; and
  • b) no benefit will be payable unless such disabled continues for more than twenty eight (28) consecutive days
  • Arises from the consumption of alcohol in excess of 0.1 or more per milliliter of blood or taking drugs or narcotics otherwise than under the direction of a registered medical practitioner provided that such direction is not given due to treatment of the insured person for drug addiction or dependence
  • Pre-existing sickness or injury for which an insured has received treatment, advice or taken prescribed medicines or drugs