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.