Insurance schemes for the
Association of Garda
Sergeants and Inspectors

Personal Accident and Illness Policy Wording

Policy Conditions

Policy Exclusions

The leaflet is not definitive and reference should be made to the Policy Wording, for full terms and conditions, in order to understand the covers available to you in the event of a claim, Claims Handlers refer to the policy when assessing individual circumstances relating to an insured event. Claims Handlers require appropriate confirmation and proof of right to a claim.

We show here the current policies in the name of the Association. These terms may vary from year to year and therefore it is imperative that you ensure you are looking at the correct wording for the year in which any illness or accident first occurs.

IMPORTANT INFORMATION: All aspects of the Terms, Conditions and Exclusions of the Policy are relevant and taken into consideration when determining whether the subject and circumstances of each and every claim are answered by the Policy. Please use the information contained here as guidance only. Policy Conditions and Policy Exclusions can be found in the list of Essential Documents above.

Full Policy Document is available upon request from agsi@agsi.ie

THE PERSONAL ACCIDENT AND ILLNESS POLICY: It is the role of the claims handler, under instruction from the Underwriters, to determine whether the particular subject and circumstances of a claim are payable under the Terms of the AGSI Personal Accident and Illness Insurance Policy. Sometimes, the circumstances of a claim may mean that additional information is required from the insured person’s (your) doctor before a final decision may be made. Although doctors’ surgeries are helpful, sometimes it can take considerable time before the required information is produced and sent to the claims handlers which can lead to a delay in reaching a decision. In such circumstances, your help in requesting the early supply of necessary information can be of great assistance.

Where temporary total disablement extends over a period of several months, additional information may be requested from the doctor from time to time. There is no cost to the insured person (you) for medical information requested from the doctor by the claims handlers. Whilst most claims are settled in a timely fashion, in a low percentage of cases the circumstances or subject of a claim may be such that the Policy does not cover, therefore the claim must be declined.

What should I do if I have an accident or become ill and need to take time off work?

If you become ill or have an accident and are prevented from working and you believe you may be eligible to make a claim it is important that prompt notice of this is given to AGSI by contacting Jennifer Dunne, at the Association Head Offices: agsi@agsi.ie.

The claim form should be completed in full, including the Medical Authority Form. Your Doctor will need to complete the Medical Certificate. You can download and complete the Claim Form from the list of Essential Documents above.

As with all contracts of insurance, the terms and conditions of the Policy will determine whether or not a claim is admissible and can be accepted for settlement. For information about the Personal Accident & Illness Policy contact agsi@agsi.ie.

What if I am being discharged from the Force?

If you are to be discharged from the force on medical grounds you may be able to claim for Casting Benefit. For a Claim Form Contact: agsi@agsi.ie

• The sum assured (amount payable)
• The number of weeks for which benefit may be paid
• The time within which periods of temporary total disablement (time off work) must occur in order to be eligible for payment of benefit
• the Policy Conditions which must be satisfied by the circumstances of the claim. Please use the information contained here as guidance only. Full Policy Document is available upon request from agsi@agsi.ie
• the Policy Exclusions: circumstances which are specifically excluded from cover by the Policy. Please use the information contained here as guidance only.

Full Policy Document is available upon request from agsi@agsi.ie

Every claim is scrutinised by loss adjusters on behalf of underwriters in the context of each of the above elements of the Policy in order to establish eligibility for payment of benefit. You can use the leaflet as guidance, in the first instance, when deciding whether or not you may be eligible to claim, as it provides a summary of the benefits offered, Limits of Benefits and Exclusions (the circumstances which mean that a claim is inadmissible). Full information is contained within the Policy Document itself. A copy of the Policy Document is available upon request. Contact Jennifer Dunne at agsi@agsi.ie

You can access the full list of AGSI Essential Documents in the "Essential Documents" section above.

AGSI Head Office will provide you with appropriate forms to complete. Please download the Request Form here, and send to Jennifer Dunne at agsi@agsi.ie

The Information Leaflet (download  here) is not definitive and reference should be made to the Policy wording, for full terms and conditions, in order to understand the covers available to you. We describe here the current policy in the name of the Association. The terms may vary from year to year and therefore it is important you ensure you are looking at the correct wording for the year in which any illness or accident or claim first occurs. Further information may be obtained by contacting agsi@agsi.ie

In the event of an accident or illness claim, loss adjusters refer to the policy wording when assessing whether or not the circumstances are covered by the terms of the Policy. In a small number of cases claims may not be paid because the circumstances of the claim are subject the terms of the Policy Exclusions, the Limits of Cover (see the Policy Information Leaflet) or do not satisfy the conditions of cover.

Life assurance claims require appropriate confirmation and proof of right to a claim. Contact Jennifer Dunne at agsi@agsi.ie