Accident & Health | Frequently Asked Questions, Part 2

Read Part 2 of our Frequently Asked Questions on Accident and Health insurance.

Delta's A&H Senior Underwriter, Sophie Wunsch, answers common questions brokers and their clients have about Accident and health insurance coverage.

Let's delve into the most common:

What are common endorsements that can be added to enhance A&H protection? 

At Delta, we take a tailored approach to Accident & Health insurance, crafting solutions specifically designed to meet the unique needs of each client. Rather than offering a set range of endorsements, we work closely with brokers to identify the right coverage enhancements based on the individual risks and requirements of each business. 

This means we can tailor endorsements to provide the precise protection needed, ensuring clients receive the best possible coverage for their employees. Whether adjusting for specific roles, business activities, or other unique circumstances, Delta is committed to crafting policies that offer maximum flexibility and security. 

By collaborating with brokers, we ensure that every client receives a customised package that aligns with their unique needs, giving them the peace of mind that their coverage is as comprehensive and relevant as possible. 

Are wellness or mental health benefits bundled into modern A&H offerings? 

At Delta, we prioritise employee well-being, including mental health. Our Accident & Health insurance policies cover sickness, which can include mental health conditions, depending on the circumstances outlined in the policy. Additionally, our Overseas Medical Expenses (OME) coverage provides international employees access to services like psychology and psychiatry. 

We are committed to offering comprehensive support for employee wellness as part of a holistic A&H solution. 

What underwriting factors are most important when quoting or placing A&H coverage? 

When quoting Accident & Health coverage, Delta considers a few key factors to assess risk and tailor the offering: 

• Occupation and duties – Roles with physical or field-based tasks carry risk profiles different from those of office-based ones, especially for GPA and IPA. 

• Travel frequency and destinations – For Business Travel or Overseas Medical policies, we assess how often employees travel, where they go, and for how long. 

• Headcount and demographics – The size of the group, age mix, and nature of employment all influence the structure and pricing of cover. 

• Existing coverage or gaps – Helps identify where Delta can complement or improve existing benefits. 

• Claims history – If your client already holds similar cover, a recent claims history is essential for accurate underwriting and pricing. 

Each risk is individually assessed, and providing clear, complete information upfront helps us return tailored terms quickly. 

Are there specific risks that might raise red flags or exclusions in an A&H policy? 

Yes, certain risks or activities may trigger exclusions or require additional review, including: 

• High-risk occupations – Jobs that involve hazardous activities may need extra underwriting or come with specific exclusions. 

• Certain events like war, terrorism, or civil unrest – Coverage for these can be limited or excluded. 

• Participation in extreme sports or activities – These may require special consideration or be excluded. 

• Professional sports – Coverage for professional athletes may require special consideration or be excluded. 

• Travel to high-risk or restricted regions, including sanctioned countries – This can result in limited or excluded coverage. 

At Delta, we assess each risk individually and work with brokers to find the most suitable coverage for their clients. 

How flexible are these policies regarding tailoring to specific roles (e.g., field workers vs. office staff)? 

Delta A&H policies are highly flexible and can be tailored to meet the specific needs of your client’s workforce. Whether it’s for field workers, office staff, or any other role, we can adjust coverage to ensure it aligns with the risks associated with each position. This means you can offer the right protection for every employee, no matter their role. 

Can A&H cover events that happen outside of working hours? 

Yes, Delta A&H policies can cover events that happen outside of working hours, depending on the specific policy and the coverage selected. For example, Group PA and Individual PA can provide protection for accidents or injuries during personal time, such as travel to and from work or while engaging in recreational activities. 

Are there any lessons from claims that brokers should consider when advising clients? 

When advising clients on A&H coverage, it’s essential to highlight the value of clear communication and full disclosure during the underwriting process. Ensuring all relevant risks are disclosed upfront can help avoid complications later. Additionally, brokers should emphasise the importance of reviewing coverage regularly, especially as employee roles and business needs evolve. Understanding the full scope of coverage and tailoring it to match the client’s unique risks can help ensure a smoother claims process should an incident occur. Lastly, keeping clients informed about the claims process and offering proactive guidance can make a significant difference in how claims are handled. 

What does the claims process typically look like for an A&H policy, and what’s often misunderstood about it? 

The claims process for A&H insurance is designed to be straightforward and transparent. Here's a general outline: 

1. Notification: The insured or broker notifies us of the incident. 
2. Documentation: We’ll request the necessary supporting documentation (e.g., medical records, incident reports). 
3. Assessment: Our team reviews the claim and supporting documents. 
4. Decision: We’ll then make a decision on the claim. 
5. Payment: If approved, the payment is processed promptly. 

Common misunderstandings: 

• Claims are always complicated: We work to make the process as simple as possible, with clear communication at every step. 

• All claims are automatically covered: Claims must meet the criteria outlined in the policy. It’s important for the event to fall within the scope of coverage. 

• The process is slow: We’re committed to efficiency and keep brokers and clients informed at all stages. 

We strive to make the claims experience as smooth as possible for brokers and clients, ensuring clarity and prompt resolution. 

Contact the team at Delta to discuss a comprehensive Accident and Health insurance solution tailored to meet the unique needs of your clients—our team is here to provide expert guidance and support every step of the way.

Disclaimer: The content of this article has been prepared without considering the insured’s objectives, financial situation, or needs. In addition, Delta makes no representation as to the accuracy or completeness of the content provided. Please carefully consider the appropriateness of the information, and importantly, review the full policy wording with a broker before making any decisions regarding Delta’s products. All rights reserved. No part of this article may be reproduced without Delta’s prior written consent.