Blog article

What is accident cover and how does it work?

By HBF
3 minutes
4 November 2021
Four women chatting on mountain bikes
If you had a crystal ball that predicted every mishap and accident before it happened – and maybe the winning lottery numbers – you might not need health insurance to cover you for accidents.

But life doesn't always work out that way, and health insurance can play an important role in protecting your number one asset in life – your health. If you are young and healthy, you might not need a Gold Hospital Elevate policy, but it could still make a lot of sense to have cover for accidents.

What is accident cover?

Accident cover helps pay for treatment you receive if you’re admitted into hospital as a result of an accident. It’s a feature on some private hospital covers, so it applies when you’re admitted to a hospital as a private patient. At HBF, accident cover is included on Basic Hospital Plus and Basic Hospital Plus Elevate covers.

HBF defines an accident as
An unforeseen event, occurring by chance and caused by an external force or object which results in an injury to the body requiring admission to Hospital for medical treatment.

In layman’s terms an accident could be falling off your bike, getting tackled during a footy match, or slipping on water and you need to be hospitalised to treat the injury.

Just for clarity, any illness or condition that develops over time, like heart disease or osteoporosis, would not be considered an accident.

If I have an accident, what is covered?

If you have HBF's Basic Hospital Plus or Basic Hospital Plus Elevate you’ll be covered for treatment if you are admitted into hospital resulting from an accident – even if the treatment you need is not an included service on your policy.

For example, a knee replacement is excluded on Basic Hospital Plus and Basic Hospital Plus Elevate but if you require knee replacement surgery as a result of an accident, you’d be covered for the treatment.

This also means you can choose a private hospital for your treatment. You’ll potentially avoid a long public hospital waiting list and enjoy all the perks of private hospital treatment.

Here is what HBF members are entitled to for agreed services at a Member Plus hospital:

Remember though, accident cover only pays benefits for treatment you receive while admitted into hospital. This means that other costs like GP visits or visits to the emergency department won’t be covered.

Normal rules for medical gap benefits apply. You can call us on 133 423 for more information.

How do I use accident cover?

For a benefit to be paid under accident cover for hospital treatment after an accident the following criteria must be met.

When can't I use accident cover?

There are a few scenarios where benefits may not be payable, for example, if your premium payments are not up to date when you get treatment, or if the accident occurred as a consequence of your employment.

Again, remember that accident cover only pays benefits for treatment you receive while admitted into hospital. This means that other costs like GP visits or visits to the emergency department won’t be covered.

Is accident cover right for me?

If you're looking for entry-level hospital cover that provides you with accident cover, Basic Hospital Plus offers just that. If you’re looking for a step up, you can consider Basic Hospital Plus Elevate which also has accident cover.

But before you decide on cover, make sure you consider your needs – not just the price tag. The best value cover for you is the one that caters to your needs.

If you're thinking about planning a family, need some peace of mind or have a few health concerns, we strongly recommend you chat with our friendly team to find the right cover for you.


Please note: This blog was originally published on 26 June 2020 and has been updated to include the latest information.

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