Personal Accident Insurance vs Health Insurance: What’s the Difference?

By Laxita Gautam
  | Published: 12 July 2021

Don’t gamble with your health, get the right cover at the right price.

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The most predictable thing about life is ironically its unpredictability. Good news can knock on your door in a matter of seconds but so can the bad news. There is no telling when an unfortunate incident takes place and you are in need of a little support system. Both health insurance and personal accident insurance/covers act as fine helping hands but in slightly different ways. A health insurance plans are your protective umbrella in the face of most diseases while the personal accident insurance is your financial support in case of an accident. Event though both these insurance covers aim to help you in a health-related emergency, they are innately different in many ways. But there have been several confusions surrounding the personal accident insurance vs health insurance topic. Let us cover the basic differentiating parameters.

Personal Accident Insurance vs Health Insurance

Parameters Health Insurance Plans Personal Accident Cover
Definition A cover for medical expenses for a variety of situations including covered diseases and accident Offers coverage for medical expenses to treat accidental injuries
Nature of Cover A complete insurance plan An add-on or rider to be taken in combination with a full-fledged insurance plan – health or motor
Additional Premium No, unless riders are taken Yes, because it is a rider
Option for more Add-ons Yes. Any available add-ons can be included with the plan No. Additional add-ons cannot be taken
Pre-existing Diseases Cover Yes – available after a waiting period   No
Maternity Cover Yes – available as an add-on No
Critical Illness Cover Yes – available as an add-on No
Complete Accident Cover No. Covers for hospitalisation only Yes
Sub-Categories of Plans Family, senior citizen, individual, group, etc. No sub-categories or types. But can be bought with motor and health insurance
Applicable Waiting Period Yes. Can differ for each eligible benefit No. coverage starts right away

Understanding Health Insurance Covers

A health insurance plan can cover several kinds of medical expenses taken on by the policyholder to treat a covered illness or health condition. This can include hospitalisation costs, day car fees, prescription medicine cost, or diagnostic test costs along with many other things. Health insurance plans not only cover for most illnesses but also special needs during pregnancy, physiotherapy, etc. The benefits of a health insurance plan can differ as per the type of coverage you have chosen. On top of that, health insurance plans are not just for the individuals. One single plan can also be used cover the whole family.

Following are the different types of health insurance plans available in the UAE:

Individual Health Insurance Plans: As evident, these health insurance plans are designed for an individual person. They come with all basic benefits and can include as many additional benefits as the plan holder opt for.

Senior Citizen Health Insurance Plans: These health insurance plans are specifically designed for senior citizens and offer them medical coverage of their choice. They are generally available for people aged 60-65 years, depending on the providers.

Critical Illness Health Insurance Plans: These plans are specifically designed to offer compensation in case the policyholder is diagnosed with one of the covered critical illnesses. This can include critical illnesses like cancers, heart diseases, etc.

Family Health Insurance Plans: A plan that covers all your family members listed as dependents. It extends the same kind of benefits as that of an individual health insurance plan but to everyone insured in the plan.

Group Health Insurance Plans: These plans are specifically designed for commercial use by companies to insure their employees. They are often offered as a part of the job benefit package.

Any basic health insurance plan would cover the following basic benefits:

Hospitalisation charges

Most health insurance plans cover for the hospitalisation charges for the treatment of diseases that are covered by the plan. This includes the cost of the room and the services taken during the time of hospitalisation of the policyholder. If you are getting treated in of the network hospitals of your insurance company, they will pay for the hospitalisation from the very start under the cashless claim policy. If it is outside of network list, you can claim a reimbursement.

Pre-hospitalisation benefits

Expenses that are made on services like ambulance are categorised as pre-hospitalisation benefits. Most health insurance plans also offer a cover for these expenses. Although, the terms may differ for each provider. It is often the case that only the ambulance services called for an emergency case hospitalisation are covered by insurance. Make sure you always read the terms of your provider.

Post-hospitalisation services

Expenses like follow-up doctor consultations, additional tests and diagnosis reports, etc. are classified as post-hospitalisation expenses. These are basically all those expense that are incurred after the hospitalisation in concern. Most health insurance plans cover for them as well.

Prescription Pharmaceuticals

One of the most basic coverage for any health insurance plan after hospitalisation is the prescription pharmaceuticals. Although, the list of these medicines can be specified by each insurance provider so it is better to check it out beforehand.

Diagnostic tests

Laboratory tests and diagnostic tests like blood tests, MRIs, CT scans, X-rays, etc. are also covered under your basic health insurance plan in the UAE.

Consultation

Almost every health insurance plan cover for doctor’s consultation in the UAE. Some plans even cover for specialist opinions and second opinion consultation. However, that is completely dependent on the terms of the plan under consideration.

Therapy and rehabilitation

Rehabilitation therapies are generally covered by mid-level health insurance plans. They may be available as an add-on benefit for a few variants as well.

Day care expenses

Most health insurance plans cover for day care expenses for the policyholder. However, the allowed amount and coverage level can differ as per each individual provider and plans offered by them.

Personal Accident Insurance – A Detailed Overview

As the name suggests, a personal accident cover would offer an all-round financial support in case of an accident. This may include several different benefits depending on the situation at hand. The main difference between a personal accident cover and a normal health insurance plan is that the first provide complete coverage any personal bodily damage incurred during an accident while the latter may only cover for emergency hospitalisation costs. Personal accident cover is an add-on cover also known as riders. It can be bought with both health and motor insurance.

All personal accident covers include the following basic benefits:

Protection Against Collisions

A complete protection and financial support in case of a collision during an accident with another vehicle or any object in general. From emergency services to other additional compensations, everything is covered in a personal accident cover.

Accidental Death Coverage

If the policyholder happens to meet their demise in an accident, the dependents or the nominee of the insurance plan gets compensated in their place. The compensation amount is pre-decided at time of buying the personal accident cover.

Permanent Partial/Complete Disability

If the policyholder happens to incur a permanent partial or complete disability due to an accident, the personal accident cover will provide a lump-sum compensation. This can include any form of life-long disability such as loosing limbs, one or all.

Temporary Complete Disability

If a policyholder happens to incur a temporary but complete disability that has left them bed-ridden, the personal accident cover offers a compensation. This compensation is generally offered in the form of a weekly or monthly allowance, as per the terms of the cover. The idea here is to make up for the lost time and income during the bed-ridden time of the policyholder.

Transportation and Repatriation Benefits

If the accident happens in a foreign country, the personal accident cover pays for the transportation expenses of the policyholder to come back to the home country, the UAE, for treatment. This also applies if the accident results in death of the policyholder. In that case, the insurance company covers for the repatriation expenses of the deceased.

Conclusion

Although health insurance plans cover the emergency hospital charges but they do not provide a coverage as wholesome as personal accident covers when accidents are concerned. If added with a health or motor insurance policy, a personal accident cover extends the coverage to the maximum. From a complete coverage for accident-related injuries to compensation for disabilities and the untimely accidental deaths. If you live or work in areas prone to accidents and collisions, getting a personal accident cover is a good idea. With the right cover, you can get the ideal protection that you need.

Laxita Gautam
Laxita Gautam63 Posts

Senior Content Writer | She functions on classic British fiction, Japanese manga, and strong americanos. Laxita is tailor-made to create engaging, interactive pieces that offer simplified insights into complex subjects.