Policy wording is not a novel, and nobody expects you to read it cover to cover. There are, however, five points which, if you check them deliberately, show you the essence – and tell you exactly what your company has bought. Here is the method for non-lawyers.
- Five steps: benefit table → waiting periods → exclusions → limits → claim notification rules.
- The benefit table is the heart of the contract: event and amount, in pairs.
- When you request quotes, it is worth going through these five points – it helps if you know where to find them yourself.
Step 1: the benefit table
Start at the end: the benefit table – typically an annex to the conditions or the summary of the offer – lists which event pays how much. This is the heart of the contract – it shows whether the package's centre of gravity lies on the accident elements, the life cover or the health-related fixed-sum elements. It is worth keeping the crash course on basic terms next to it: once sum, limit and tier are clear concepts, the table speaks for itself. Already here you can see where a given package is strong and where it is restrained – this becomes the basis of the later comparison.
Step 2: the waiting periods
Check which covers run from the start of risk-bearing and where a waiting period applies. The typical pattern: the accident elements start immediately, while the illness-related covers carry a wait of a few months. The details, including what happens when you switch insurer, are unpacked in the article on Waiting periods. Note down the numbers cover by cover: at a switch and for new joiners, these will make the difference.
Step 3: the exclusions
The exclusion list tells you in which situations the insurer does not pay. The typical groups – extreme sports, intoxication (the latter typically grounds for exemption), rules on pre-existing conditions – appear with detail rules that differ from insurer to insurer, so this is not a section to skip but a comparison criterion. A plain-language guide: Exclusions explained. It deserves special attention how the conditions define accident and sport – borderline cases are decided here.
Step 4: the limits and budgets
The table fixes maximums per cover: an amount limit per event, an annual cap, sometimes a threshold – for example for the first days of the hospital daily benefit. This is also where the difference between the executive and staff tiers becomes visible. The right question is never whether an amount is “a lot or a little”, but whether the limits fit the team's real risks. Be cautious with a package that hides low sub-limits behind a spectacular headline sum.
Step 5: the claim notification rules
Finally, look at how, with which documents and within what timeframe a claim has to be notified. A routine case is fastest on the insurer's own channel – its online portal or phone line; if a case gets stuck or the claim is disputed, I help the client, as their broker, where I can. Before signing, it is also worth walking through the list 5 questions for your insurer, and you will find answers to frequent questions on the FAQ page. To close, make a one-page note of the five points – it will be your map when comparing offers; on request, I provide such a comparison template with the quotes as well.
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