Skip to main content

Medical Expenses Cover under CGL Policies

 

A Commercial General Liability (CGL) policy grants insurance for third-party liabilities arising from bodily injury and property damage.

The Medical Expenses coverage is one of the specific parts of the overall bodily injury liability coverage section under CGL policy. Let us look at how the Medical Expenses coverage usually applies in a CGL policy.

Medical Expenses Coverage

Purpose: The medical expenses coverage under a CGL policy is intended to pay for all resultant medical costs arising out of accidental bodily injury to third parties who are not employees arising on the insured business' premises or as a result of the operations of the insured company.

Scope: It pays for reasonable medical costs, including,

·       Ambulance charges

·       Hospitalization expenses

·       Surgery costs

·       Consultations with medical practitioners

·       Medication and treatment

No-fault Coverage: This part of the cover pays out whether the insured is legally responsible for the injury. This is a "no-fault" cover, which means the injured party does not need to prove that the business is at fault for the expenses to be paid out.

Who is Covered

Those people who incur accidental injuries at or through the insured business's premises or as a result of its business activities.

Note: Employees and Directors/ Partners are not generally covered under this section of the policy. They shall be covered under Workers' Compensation or other employee benefit insurance.

Exclusions in Medical Expenses cover in CGL policies

·       Injuries caused intentionally by the insured or its employees 

·       Employees injuries (covered under separate policies taken as pert of the employees benefit plans)

·       Injuries due to war, terrorism, or dangerous activities etc 

Limits in Medical Expenses Cover

Most times, CGL policies have sub-limits for medical costs. What that typically means is that the sum spent by the insurer on medical expenses will have an upper cap, which may or may not be the same as the general liability limits.

Claim Process: Medical expense claims are not really complicated since fault or negligence of the business need not be proven, and that is what accelerates the process covering instant medical costs immediately.

Since coverage is offered on a no-fault basis, there is no defense or legal liability coverage, unlike with bodily injury and property damage (Coverage A) and personal and advertising responsibility (Coverage B).

Medical expense cover in CGL insurance in India provides a cushion to the businesses by allowing minor injuries to third parties not turning into more severe liability claims. It gives relief directly to the injured party and helps the business maintain good relations without admitting legal liability. However, companies must check coverage limits and exclusions to ensure that it caters to specific exposure to risk.

 

We at Zen Insurance brokers assist in choosing an insurance policy with clauses suited to your requirements. Choose your insurance policy wisely. Get in touch with us for any assistance.

 

Disclaimer:

Zen Insurance Brokers is an IRDAI registered broker which facilitates quick and adequate insurance broking services. We deal with only regulator approved products of insurers. We do not underwrite the products.

Comments

Post a Comment

Popular posts from this blog

Insurance in a Time of Conflict: The Truth About War Risk Coverage

  In the wake of the recent confrontation between India and Pakistan through Operation Sindoor, a question in the minds of those with an insurance policy was if their policy will cover war-related damages. Our clients were no exception; we got queries on insurance coverage for wars during this period. War seemed a remote possibility until Operation Sindoor, but this operation made everyone believe that war was a reality and prompted the exploration of insurance coverage for such an incident.  In this blog, we will explore the coverage for war in insurance policies. War Coverage in Insurance Policies Most insurance policies—whether for property, auto, life, health, or travel—include a war exclusion clause . This clause denies coverage for losses or damages resulting directly or indirectly from war, invasion, civil unrest, rebellion, insurrection, or military action. Importantly, this exclusion generally applies even if war is not officially declared. Declared Wars: When...
Post a Comment
Read more

AOG (Act of God) Perils Extension in CGLpolicies

      A OG (Act of God) Perils Extension in Commercial General Liability (CGL) policies refers to the inclusion of natural and unpredictable events under the coverage of the policy. AOG perils are events beyond human control, often caused by natural forces, and their inclusion can significantly broaden the scope of a standard CGL policy. These perils are not covered automatically in a CGL but have to be purchased separately as an add-on. Let us look at this aspect of CGL policies in more detail. Indian firms looking to buy a CGL policy should ideally opt for an AOG perils extension because the country is geographically prone to various natural disasters such as earthquakes, cyclones, and floods. Including AOG perils in a CGL policy will help businesses in disaster -prone areas to protect against liabilities arising from damage or injury caused during such events. AOG Perils covered in a CGL policy Earthquake Floods (including inundation, cloudburst, etc.)...
Post a Comment
Read more

What Group Health Insurance Doesn't Cover: Key Exclusions You Must Know

  Many employees covered under a group health insurance policy are under the impression that this policy will cover any cost they incur for illness or hospitalization. But the fact is the insurance cover by a group health insurance policy has several exclusions which employees discover much later. Due to these exclusions, an employee who has to undergo medical treatment might not get the required coverage due to exclusions, which can cost him financially and emotionally. Employees need to be aware of what is not covered in a group health insurance policy so that when medical treatment is necessary for them or their family members, they know whether coverage is available or not and they can be in a better position by taking a personal health insurance policy. In this blog, we will focus on exclusions in a group health insurance policy. What are exclusions in group health insurance? Exclusions are conditions or treatments that a group health insurance policy will not cover...
Post a Comment
Read more