FRACTURE COVER – WHO OFFERS WHAT?
A simple accident, and a broken bone, can easily lead to unforeseen financial stress particularly for those who have physically demanding occupations. Fractures can make it difficult or even impossible for clients to work for weeks or even months whilst they recover. Providers who offer Fracture Cover include it as an added benefit which will not affect the client’s ability to claim on the core cover. Here we take a look at how insurers compare.
With almost 2.5 million fracture admissions to hospitals over a decade, many people will understand the pain, disruption and, at best, inconvenience they can cause. (https://publishing.rcseng.ac.uk/doi/pdf/10.1308/rcsann.2019.0002)
Hip fractures are the most common that require hospitalisation (although this is more likely in the elderly), with 69,000 emergency admissions into English hospitals each year, with arms, hands and ankles following closely behind. The most common causes are down to accident or injury, bone-weakening health conditions such as osteoporosis or repetitive strain on a particular bone, causing what is known as a stress fracture, common in sports people.
Each of these scenarios will bring its own individual problems and clearly breaking certain bones is more debilitating than others. But the financial disruption caused if a fracture prevents someone from working is often a consideration that comes too late, and can cause a lot of hardship for many, especially those in physical jobs.
Five providers’ plans have fracture cover available as an additional benefit that does not have an impact on the policyholder’s ability to claim on the main contract.
The products on which fracture cover is available vary across the five providers. Cirencester, Royal London and LV= only offer it on income protection and LV= only provide this benefit on their income protection plan on not on their Personal Sick Pay variant. Aviva and Zurich offer it on all product types.
The cover was included as a contractual benefit, outlined in the terms and conditions, with three providers, Aviva, LV= and Royal London’s plan.
Choosing the benefit will incur an additional charge for three of the providers, Aviva; Cirencester Friendly and Zurich. These additional monthly costs are £4 for Aviva plans, £4 for Cirencester plans. Zurich is more expensive, with a £6.90 additional charge each month, per life assured.
Clearly some people are more unfortunate than others, just as some incidents are more serious and cause more damage. Accounting for that, Royal London and Zurich both will pay out for multiple claims within a 12-month period, whereas Aviva, Cirencester and LV= will not.
With more than 200 bones in the human body, a long list of specific fractures are named, with the amounts paid out varying greatly.
Typically, the greater the impact a fracture is likely to have to a client’s lifestyle following a fracture, the greater the amount the insurer will pay.
Details are shown below.
At one end of the pay-out range is LV=, which would pay out £650 on a broken rib, while other injuries including a fractured skull, thighbone or pelvis might result in a payment of £6,000, as these would be far more debilitating.
On fractures alone, Zurich the more generous in most instances, paying out the most on 17 of the listed bones – in some cases with Aviva also paying out the same, highest amount. Interestingly, Aviva pays out more in claims for a fractured jaw, at £3,000, whereas Zurich and Royal London both paid out £2,000.
The widest range in terms of amounts paid out, relate to the pelvis and ankle, with Zurich paying out £6,000 in both cases, and LV= paying £1,250.
In recent times, some insurers have added exclusions to their fracture cover which were not applicable when the benefit was first offered. Cirencester Friendly and Royal London do not specifically state any standard exclusions on their policy however Royal London do state that fractures as a result of intentional self inflicted injury will not qualify. Aviva, LV= and Zurich state that they will exclude claims related to certain pastimes and the table below shows the specific pastimes they list within their policy documentation. This list, however may not be exhaustive. If an adviser has a client that takes part in a hobby or pastime that may be considered dangerous, we would encourage them to contact the insurer to check whether a fracture due to this would be covered.
|Aviva||Cirencester Friendly||LV=||Royal London||Zurich|
|Off road BMX||Excluded||Excluded||Excluded|
|Off road mountain biking||Excluded||Excluded||Excluded|
*LV= have applied these exclusions from the outset
In addition to standard fractures, Zurich also stands out for its inclusions relating to damaged soft tissue and dislocations, where healing can be more complex, often putting people out of action for a longer period of time than a broken bone.
Zurich is the only provider that offers cover on ligament tears and tendon ruptures, and it covers knee or Achilles tendon, in both cases making payments to £6,000.
Similarly, when it comes to dislocation – when a bone slips abnormally out of a joint – Zurich also stands alone.
On successful claims for a dislocated spine or hip, Zurich will pay out to the tune of £6,000. The same amount applies to claims on a knee or ankle, while payments for a dislocated shoulder will see the client receive up to £4,000.
In terms of all other joints, excluding fingers, thumbs and toes, Zurich will also pay out £4,000 if the claim relates to a dislocated shoulder, elbow or wrist, while a dislocated jaw, or middle ear bone would result in a payment of £2,000.
With their generous pay outs for fractures, the inclusion of damage to soft tissue and dislocations and the fact they offer the service across their whole product range, Zurich appear to be leading the way in Fracture Cover; the higher monthly premium paid to Zurich seems to be well reflected in the more comprehensive terms on offer.
For those clients who take part in “hazardous pursuits” the fact that Cirencester Friendly and Royal London do not automatically apply exclusions may be favourable, however we would encourage advisers to speak to their insurer if they have such a client to be sure.