Personal Accident Insurance in Thailand
TL;DR: PA insurance pays lump-sum for specified injuries/death (not illness). Common exclusions: motorcycles without helmets, extreme sports. PA is NOT a substitute for health insurance—use as gap cover with high deductibles. Claims tip: police report required for certain incidents.
Before You Start
What PA Covers vs. Health Insurance
Personal Accident (PA) coverage:
- Lump-sum payouts for specific injuries listed in benefit schedule
- Accidental death benefits to beneficiaries
- Permanent disability payments
- LIMITED medical expenses (not comprehensive treatment)
What PA does NOT cover:
- Illness or disease (heart attack, stroke, cancer)
- Comprehensive medical treatment costs
- Ongoing medical care
- Pre-existing conditions
When PA is Useful
- Gap cover with high-deductible health plans
- Income replacement during recovery periods
- Family protection against loss of income from accidents
- Activity-specific coverage for dangerous occupations
How PA Benefit Schedules Work
Typical Benefit Schedule
PA policies pay fixed percentages of your "sum insured" for specific injuries:
- Total permanent disability: 100% of sum insured
- Loss of both hands/feet: 100% of sum insured
- Complete blindness: 100% of sum insured
- Loss of one hand/foot: 50% of sum insured
- Loss of sight in one eye: 30% of sum insured
- Loss of thumb and index finger: 25% of sum insured
Sum Insured Options
- Basic: 500,000-1,000,000 THB
- Standard: 1,000,000-3,000,000 THB
- High coverage: 3,000,000-10,000,000+ THB
Example: If you have 2,000,000 THB sum insured and lose one hand, you receive 50% = 1,000,000 THB lump sum.
Common Exclusions (Read Carefully)
High-Risk Activities
Often excluded or require additional premiums:
- Motorcycles: Riding without proper license or helmet
- Extreme sports: Bungee jumping, skydiving, rock climbing
- Motor racing: Any competitive motor vehicle activity
- Professional sports: Competitive athletic activities
- Hazardous work: Mining, offshore oil, commercial fishing
Health-Related Exclusions
- Pre-existing conditions: Medical issues before policy start
- Suicide/self-harm: Intentional injury
- Mental health episodes: Accidents during psychological crises
- Substance abuse: Accidents while under influence
- Medical treatment: Accidents during medical procedures
Geographic/Activity Exclusions
- War zones: Areas of active conflict
- Illegal activities: Accidents during crimes
- Nuclear incidents: Radiation exposure
- Terrorism: May be excluded depending on policy
Claims Process & Documentation
Immediate Steps After Accident
- Get medical treatment (priority: proper care)
- Notify insurer within 24-48 hours
- File police report if required by policy terms
- Document everything: Photos, witness contact info
- Keep all receipts and medical records
Police Report Requirements
When police reports are typically required:
- Vehicle accidents (car, motorcycle, bicycle)
- Workplace accidents in commercial settings
- Public place accidents with potential liability
- Any accident involving criminal activity
- Accidents with disputed circumstances
Medical Documentation Needed
- Doctor's injury assessment with specific diagnosis
- Hospital reports for serious injuries
- Specialist evaluations for permanent disability claims
- Independent medical examination (arranged by insurer)
- Ongoing treatment records for disability assessment
Costs & Premium Factors
What Affects Your Premium
- Age: Premiums increase with age
- Occupation: High-risk jobs = higher premiums
- Coverage amount: Higher sum insured = higher cost
- Activity riders: Additional coverage for sports/hobbies
- Geographic coverage: Worldwide vs. regional coverage
Typical Annual Premiums
- Basic coverage (1M THB): 2,000-5,000 THB
- Standard coverage (3M THB): 5,000-12,000 THB
- High coverage (10M THB): 15,000-30,000 THB
- Activity riders: +20-100% of base premium
Where to Verify Information
Office of Insurance Commission (OIC):
- Website: oic.or.th
- Services: License verification, complaints, policy disputes
- Hotline: 1186 for consumer assistance
When to contact OIC:
- Verify insurer licensing before buying
- File complaints about claim denials
- Report unlicensed agents or brokers
- Get assistance with policy disputes
Policy Wording Review:
- Read benefit schedule carefully
- Understand specific exclusions
- Verify activity coverage if needed
- Confirm geographic coverage areas
Important Notes
PA vs. Health Insurance: Personal accident insurance is gap coverage, not primary medical insurance. You still need comprehensive health insurance for illness, ongoing treatment, and full medical coverage.
Claims Reality: Most PA claims are for partial disability (fingers, toes, partial vision loss) rather than major injuries. The benefit schedule determines exactly what you receive.
Activity Disclosure: Fully disclose risky activities when applying. Non-disclosure can void your entire policy, not just exclude specific activities.
Need Insurance Help? Our team can connect you with licensed brokers who understand PA coverage and can explain benefit schedules in detail. Contact us for personalized guidance on accident coverage options.