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Family personal accident plan application

Please select one of the cover options below

Policy type	Bronze cover	Silver cover	Gold cover
Adult only	£3.94	£6.82	£11.02
Adult and children	£6.09	£9.97	£16.27
Adult and partner	£7.88	£13.65	£21.53
Family	£10.24	£16.80	£26.78

Table of benefits

	Adult benefit			Child benefit
	Bronze cover	Silver cover	Gold cover	All cover levels
Section A - Accidental death
Accidental death	£12,500	£25,000	£50,000	£5,000
Section B – Permanent bodily injury
Amputation or loss of use of a limb One limb Two limbs Three limbs Four limbs	Up to £18,750 £37,500 £75,000 £100,000	Up to £37,500 £75,000 £100,000 £125,000	Up to £75,000 £150,000 £175,000 £200,000	Equal to adult benefit
Amputation or loss of use of an entire thumb, finger or toe Thumb Forefinger Finger Big toe Other toe	Up to £3,750 £3,750 £1,250 £1,250 £250	Up to £7,500 £7,500 £2,500 £2,500 £500	Up to £15,000 £15,000 £5,000 £5,000 £1,000	Equal to adult benefit
External burns Full thickness (3rd degree) covering 9% or more of the body surface Full thickness (3rd degree) covering less than 9% of the body surface	Up to £5,000 £500	Up to £10,000 £1,000	Up to £20,000 £2,000	Equal to adult benefit
Other permanent injury –maximum age 64	£12,500	£25,000	£50,000	No benefit for children
Section C – Sensory disability
Loss of sight In one eye In both eyes	Up to £12,500 £25,000	Up to £25,000 £50,000	Up to £50,000 £100,000	Equal to adult benefit
Loss of hearing In one ear In both ears	Up to £5,000 £25,000	Up to £10,000 £50,000	Up to £20,000 £100,000	Equal to adult benefit
Loss of speech	£25,000	£50,000	£100,000	Equal to adult benefit
Section D – Hospitalisation
Hospitalisation – for a stay of over 72 hours, we will pay for each 24hrs hospitalised up to a max 100 days per person during the life of the policy.	£50 p/day	£50 p/day	£50 p/day	Equal to adult benefit

Please note:

Benefit for children is reduced.