Policy Wording | Sailors Direct Insurance

Sailors Direct – GENERAL CONDITIONS

Accurate as of 20th April 2026

General Definitions

You / Your

The person or the company that is noted as the insured in the Policy Schedule, and having a financial interest in the property that is insured under this insurance.

We / Us / Our

Sailors Direct Insurance as Product Partners and administrators of Canopius Syndicate 4444 for this insurance.

Accidental Bodily Injury

A specific physical injury caused in and of itself by a single, unexpected, sudden and unintended event, which occurs at an identifiable time and place to an Insured Person during the Operative Time and results solely and independently of all other causes and within 12 calendar months of the date of the event in the death, Loss of Limb, Loss of Sight, Loss of Hearing, Loss of Speech, Total Disablement, Partial Disablement or Permanent Total Disablement of an Insured Person.

Accident Event

All individual losses arising out of and directly occasioned by one sudden, unexpected, unusual specific event occurring at an identifiable time and place.

However, the duration and extent of any Accident Event shall be limited to 24 consecutive hours and within a 10-mile radius for any Accident Event hereunder, and no individual loss which occurs outside such period and/or radius shall be included in that Accident Event.

The Insured may choose the date and time when such period of consecutive hours commences and also the specific 10-mile radius determining for an Accident Event. If any event is of greater duration than the above period, the Insured may divide that event into two or more Accident Events, provided that no two periods overlap and provided no period comments earlier than the date and time of the first recorded individual loss to the Insured arising out of the event.

Aggregate Limit of Liability

The aggregate amount of all benefits payable hereunder.

Benefit Period

The maximum period from the date of Total Disablement for which Disability Income benefit is payable. This period commences at the end of the Deferment Period (if any).

Deferment Period

The period prior to the commencement of the Benefit Period during which no benefit is payable.

Disability Income

The sum insured listed in the policy schedule that is payable to an insured person.

Employee

Any person under a contract of employment, service or apprenticeship with the Insured. Excess

The first amount of each and every claim that the Insured shall pay.

Excess

The first amount of each and every claim that the Insured shall pay.

Hijack

The unlawful seizure or wrongful exercise of control of an aircraft or other publicly licensed conveyance or vessel in which an Insured Person is travelling as a fare-paying passenger, guest of the Insured or crew member of the Insured’s Vessel.

Insured

The Insured as stated in the Schedule.

Insured Person

Any person stated in the Schedule as being an Insured Person. Loss of Limb or Limbs

The permanent and complete loss of, or loss of use of a limb or limbs at or above the ankle or wrist.

Loss of Limb or Limbs

The permanent and complete loss of, or loss of use of a limb or limbs at or above the ankle or wrist.

Loss of Sight

Permanent and total loss of sight shall be considered as having occurred:

a) In both eyes, if an Insured Person’s name is added to the Register of Blind Persons on the authority of a fully qualified ophthalmic specialist and is without hope of improvement;

b) In one eye, if the degree of sight remaining after correction is 3/60 or less on the Snellen Scale and is without hope of improvement.

Loss of Hearing or Speech

Permanent loss of speech and or loss of hearing shall have occurred if in the opinion of two independent referees the insured person has suffered loss of hearing or speech permanently preventing him from performing any part of his occupation.

Referees shall be independent referees both qualified medical experts of recognised standing in their field and mutually agreed by the assured and Underwriters. The decision of the aforementioned to independent referees shall be binding on all parties.

Operative Time

The extent, nature and period of cover noted on the Schedule during which the Insured is insured by the terms and conditions of this Policy and the Schedule.

Policy Schedule

The certificate of insurance we issue to you upon your payment of the quoted insurance premium and agreement to be bound by this insurance. This certificate states the amount of insurance coverage you have purchased.

Repatriation

The return of the insured person following an illness or injury covered under this insurance policy, in order to continue care and recovery in the insured person’s home country. This may include bus, train or flight travel.

Total Disablement or Total Disability

An Insured Person’s complete and physical inability to attend to his usual business or occupation which results solely and independently of any other cause from Accidental Bodily Injury and or sickness or disease.

Temporary Total Disablement

Temporary disablement, which entirely prevents the Insured Person from engaging in his usual business or occupation

Permanent Total Disablement

Total Disablement caused other than by Loss of Hearing or Speech, Loss of Limb, Loss of Sight, which has lasted for at least 12 consecutive months and will in all probability prevent an Insured Person from engaging totally in gainful employment for the remainder of his life.

Sickness or Disease

Sickness of an Insured Person that manifests itself during the Operative Time.

Permanent Residence

The nation in which an individual has their primary and long-term home, where they are legally residing and where they typically reside for the majority of the year.

3. Coverage

Section 1 – Personal Accident

What is Covered:

If an Insured Person during the Operative Time:

Sustains Accidental Bodily Injury.
Dies or suffers Total Disablement solely as a result of unavoidable exposure to the elements.
Disappears and if, after a reasonable period of time has elapsed and all available evidence examined, there is reason to presume that the death of an Insured Person has occurred, the disappearance should be deemed to constitute death.

The Underwriters will pay the Insured an amount calculated based on the Continental Scale of Benefits in Section 7 as a percentage to the sum in Section 1 of the Schedule

Conditions Applicable Only to Personal Accident Cover – See also General Conditions:

4. Where an Insured Person is under the age of 18 years the Death benefit will be limited to GBP10,000/EUR12,500/USD 15,000.

5. Where an Insured Person is not in full time gainful employment or is a spouse of an Insured Person Disability Income benefit will be limited to a maximum 75% of the net weekly income based on the previous 6 months earnings, but in any event not to exceed GBP2,000/EUR2,500/USD3,000 per week.

6. If after Underwriters have made a payment to the Insured in respect of the disappearance of an Insured Person, the Insured Person is found to be living, the Insured shall reimburse the Underwriters in full all monies paid to them in respect of such disappearance.

7. If the consequence of an event giving rise to a claim under this insurance shall be aggravated by any condition or physical disability of the Insured Person which existed before the event occurred, the amount of any compensation payable under this Insurance in respect of the consequences of the event shall be the amount which it is reasonably considered would have been payable if such consequences had not been so aggravated.

Section 2 – Medical and Emergency Expenses

What is Covered:

If during the Operative Time an Insured Person becomes Sick or sustains bodily injury, or has to be rescued or evacuated, the Underwriters will reimburse the Insured for the following expenses reasonably and necessarily incurred by the Insured and/or Insured Person up to an amount not exceeding the sum stated in Section 1 of the Schedule and subject to the excess stated in the conditions of the policy:

Expenses incurred outside the United Kingdom for reasonable and customary medical, surgical, hospital, ambulance fees or other diagnostic treatment given or prescribed by a registered qualified medical practitioner;

Expenses incurred in the Insured Person’s country of domicile for reasonable and customary medical, surgical, hospital, ambulance fees or other diagnostic treatment given or prescribed by a registered qualified medical practitioner up to the Sum Insured.

Transport and accommodation expenses of an Insured Person and up to three person who, on the advice of a registered qualified medical practitioner, need to travel to, remain with or escort the Insured Person back to the United Kingdom, such transport expenses are limited to a one-way economy ticket per person for the most appropriate method of transport and other essential expenses incurred in the transportation of the substitute person;

Funeral expenses of an Insured Person incurred outside of the United Kingdom or expenses incurred in relation to transportation of an Insured Person’s body or ashes and Property back to the United Kingdom up to an amount not exceeding the sum stated in Section 1 of the Schedule;

Transport expenses of an Insured Person returning for the funeral of their spouse or blood relatives in the United Kingdom provided that the Insured Person’s journey started prior to the death of their spouse or blood relative and that death was unforeseen at that time and that the person whose death necessitated the expenses being incurred was under age 80 years at the time of death;

Expenses incurred in the repatriation of an Insured Person by any suitable means including any accompanying qualified medical staff to the Insured Person’s home or to the most suitable National Health Service Hospital in the United Kingdom provided that all expenses are approved and organised by Underwriters.

Expenses incurred in the repatriation of an Insured Person by any suitable means, following rescue or evacuation from the vessel noted in the policy schedule.

Conditions Applicable Only to Medical and Emergency Expenses – See also General Conditions:

8. The medical Emergency Services must immediately be informed by the Insured or an Insured Person of any incident which may give rise to a claim;

9. To avoid prejudicing the reimbursement of expenses, the Insured and/or the Insured Person will not try to provide solutions to problems encountered without involving the Underwriters Emergency Service;

10. If Underwriters acting in good faith, pay to transport someone not covered by this Policy back to their home country, the Insured must repay
those costs.

Exclusions Applicable only to Medical and Emergency Expenses – See also General Exclusions:

The Underwriters will not pay any claims:

11. If an Insured Person is travelling having received advice before departure from a registered qualified medical practitioner not to do so;

12. For dental expenses unless incurred as a result of an accident;

13. If the Insured and/or an Insured Person can recover costs from any other insurance policy or National Insurance Programme;

14. After 12 months from the time of incurring the first expense, or

15. On return to an Insured Person’s home country, medical expenses coverage is limited to a maximum period of 30 days, unless specifically agreed by underwriters.

16. Any costs associated with the Search and Rescue of the Insured Person whilst the vessel is at sea, or the recovery of the Insured Person whilst the vessel is at sea.

Section 3 – Personal Liability

What is Covered:

The Underwriters will indemnify the Insured in respect of its or an Insured Person’s legal liability to pay damages in respect of:

1. Accidental bodily injury (which, for the purposes of this section only shall include death, sickness, or disease, wrongful detention false imprisonment or malicious prosecutions, mental injury, mental anguish or shock but not defamation) to third parties arising from an accident.

2. Accidental damage to or loss or property belonging to the third parties.

3. Accidental trespass or nuisance occurring during the Operative Time. The Underwriters will not be liable to indemnify the Insured for any amount exceeding the Limit of Indemnity stated in Section 4 of the Schedule.

The Underwriters will indemnify the Insured for:

4. all costs and expenses recoverable by third parties from the Insured or an Insured Person.

5. any costs and expenses incurred with the Underwriters prior written consent.

Conditions Applicable only to Personal Liability – See also General Conditions and additional conditions applicable to this policy of insurance.

6. The Insured and/or an Insured Person or his legal personal representatives will give notice in writing to the Underwriters as soon as possible after any event, occurrence, or circumstance which may give rise to a claim under this Section and will provide full details of the event, occurrence or circumstance. Every claim notice, letter, writ or process or other document served on the Insured or an Insured Person shall be forwarded to the Underwriters immediately on receipt of the same.

Notice in writing shall be given to the Underwriters by the Insured or an Insured Person of any impending prosecution, inquest or fatal accident inquiry in connection with any such event. No admission of liability offer of settlement, promise, payment or indemnity shall be made by or on behalf of the Insured or an Insured Person without the prior written consent of the Underwriters.

7. The Underwriters may at any time and at its sole discretion pay to the Insured an amount equal to the sum stated in Section 3 of the Schedule (less any sum or sums already paid in respect or in lieu of damages) or any lesser sum for which the claim or claims against the Insured and/or an Insured Person can be settled and the Underwriters shall not be under any further liability in respect of such claim or claims except for any costs and expenses incurred prior to such payment.

Provided that in the event of a claim or series of claims resulting in the Liability of the Insured or an Insured Person to pay an amount in excess of the sum stated in Section 4 of the Schedule the Underwriters liability for costs and expenses shall not exceed the amount being in the same proportion as the Underwriters payment to the Insured Person bears to the total payment made by or on behalf of the Insured Person in settlement of the claim or claims.

8. The Underwriters shall be entitled to take over and conduct in the name of the Insured or an Insured Person, the defence or settlement of any claim against the Insured or an Insured Person or to prosecute in the name of the Insured or an Insured Person for its own benefit any claim for indemnity or damages or otherwise and the Underwriters shall have full discretion in the conduct of any proceedings and in the settlement of any claim and the Insured and/or an Insured Person shall give all such information and assistance as the Underwriters may require.

9. If at the time of any Accident Event, occurrence, or circumstance to which this Section applies there is or but for the existence of this Section there would be any other insurance covering the same potential liability the Underwriters shall not be liable under this Section except in respect of any excess beyond the amount which would be payable under such other insurance had this Section not been effected.

10. No endorsement or Amendment to this Certificate shall override the Terms, Conditions, Exclusions applicable to this Section.

Exclusions Applicable only to Personal Liability – See also General Exclusions

The Underwriters will not cover the Insured or any Insured Person for any legal responsibility to pay the following damages:

11. Arising out of the ownership, possession or use by or on behalf of an Insured Person of any:

a) Firearm;

b) Animal;

c) Aircraft, aero spatial device or hovercraft;

d) Waterborne craft; or

e) Mechanically propelled vehicle

12. For bodily injury to any person who is under contract or service or apprenticeship with the Insured or an Insured Person when such injury arises out of an in the course of their employment with the Insured or an Insured Person;

13. For loss of or damage to Property belonging to or held in trust by or in the custody or control of the Insured or an Insured Person;

14. Arising directly or indirectly in connection with:

f) The ownership or occupation of land or buildings; or

g) The carrying on of any trade business or profession

15. Attaching to the Insured or an Insured Person by reason of an express term of any contract unless such liability would have attached to the Insured or an Insured Person notwithstanding such term; or

16. Any kind of pollution and/or contamination.

4. General Conditions

All information supplied to the Underwriters by or on behalf of the Insured is deemed to be incorporated in and shall form the basis of the contract.

1. What sports are covered?

Sailing, Yachting, Boating, Surfing, Kitesurfing, Windsurfing, Wingfoiling, Bodyboarding, Paddleboarding, Kayaking, Road Cycling, Mountain Biking,
Swimming, Scuba Diving up to 18meters depth, Foiling Dinghy Sailing, Tennis, Paddle, Pickleball, Amateur Football, Netball, Basketball, Running,
Hiking, Walking, Snowboarding, Skiing.

2. What sports are not covered?

Americas Cup Sailing, Vendee Globe Sailing, Foiling Yacht Sailing, Sky Diving, Base Jumping, Freediving, Diving beyond 18meters depth, Lead
Climbing, Free Climbing, Mountaineering above 4000m altitude, Motor Sport Racing, Moped or Motorbike riding without helmet, Rugby, American
Football, Wrestling, MMA Fighting, Boxing, Street Luging, Bull Riding.

3. Interpretation

For Insured Persons not permanently residing in the United Kingdom any reference to the United Kingdom shall mean an Insured Person’s usual country of domicile.

Words in the masculine gender shall be deemed to include the feminine wherever they appear.

4. Change of Business

The Insured shall, within a reasonable period of time, not exceeding 30 days, notify the Underwriters of any change in their business, trade or profession.

5. Observance

The liability of the Underwriters to make any payment under this Policy shall be conditional upon the observance by the Insured and the Insured Persons of all terms, provisions, conditions and endorsements of this Policy.

6. Disclosure

Underwriters shall not be exposed to liability under this Policy and the Insured shall have no rights hereunder unless at inception of this Policy and at the time of any amendment:

i) the Insured was not in breach of any common law duty in regard to non-disclosure or misrepresentation, and further

ii) the Insured had no knowledge and had received no information of any material matter, fact or circumstances (not being a matter of common knowledge on which Underwriters ought, in the ordinary course of business, to know independently) that are likely to give rise to a loss hereunder.

Performance of these obligations shall be a necessary prerequisite to cover hereunder and in any proceedings by the Insured hereunder or between the parties hereto the burden shall in all circumstance be upon the Insured to establish that these obligations have been complied with.

5. General Exclusions

The Underwriters will not pay any claim directly or indirectly caused or contributed by:

any of the following regardless of any other cause or event contributing concurrently or in any other sequence to the loss or expense;
For the purpose of this exclusion;

i) Terrorist activity means an act, or acts, of any person, or group(s) of persons, committed for political, religious, ideological or similar purposes with the intention toinfluence any government and/or to put the public, or any section of the public, in fear.Terrorist activity can include, but not be limited to, the actual use of force or violenceand/or the threat of such use. Furthermore, the perpetrators of terrorist activity caneither be acting alone, or on behalf of, or in connection with any organisation(s) orgovernment(s).

ii) Utilisation of nuclear weapons of mass destruction means the use of any explosivenuclear weapon or device or the emission, discharge, dispersal, release or escape offissile material emitting a level of radioactivity capable of causing incapacitatingdisablement or death amongst people or animals.

iii) Utilisation of Chemical weapons of mass destruction means the emission, discharge, dispersal, release or escape of any solid, liquid or gaseous chemical compound which, when suitably distributed, is capable of causing incapacitating disablement or death amongst people or animals.

iv) Utilisation of Biological weapons of mass destruction means the emission, discharge, dispersal, release or escape of any pathogenic (disease producing) micro-organism(s) and/or biologically produce toxin(s) (including genetically modified organisms and chemically synthesised toxins) which are capable of causing incapacitating disablement or death amongst people or animals.

Also excluded hereon is any loss or expense of whatsoever nature directly or indirectly arising out of, contributed to, caused by, resulting from, or in connection with any action taken in controlling, preventing, or suppressing any, or all, of (a) to (o) above.

In the event any portion of this exclusion is found to be invalid or unenforceable, the remainder shall remain in full force and effect;

an Insured Person engaging in air travel except as a passenger in a properly licensed multiengine aircraft being operated by a licensed commercial air carrier or owned and operated by a commercial carrier.

any claim arising in connection with a condition which was diagnosed before the commencement date of any Period of Insurance of this Policy. In addition, no benefit will be payable for any condition which has resulted directly or indirectly from a condition for which the Insured Person has previously received treatment or of which they were aware at the commencement date of the Policy;

Acquired Immune Deficiency Syndrome (AIDS) or AIDS Related Complex (ARC) howsoever this syndrome has been acquired or may be named.

deliberate exposure to exceptional danger (except in an attempt to save human life) or the Insured Person’s own criminal act, or the Insured Person suffering from alcoholism and/or drug addiction except where the Insured Person is addicted to a drug prescribed by a qualified Medical Practitioner for the treatment of any condition other than drug addiction;

an Insured Person attempting to commit or committing intentional self-injury or suicide;

The Insured Person engaging in:

pregnancy, childbirth, miscarriage or abortion;

ionising radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel;

radioactive toxic explosion or other hazardous properties of any explosive nuclear assembly or nuclear component thereof or

the failure of any equipment, integrated circuit, computer chip, computer software and any other computer-related equipment which fails to recognise correctly the date change to the year 2000 or any other date.

6.Additional Conditions

1. Interest

No sum payable under this Policy shall carry interest.

2. Claims Procedure

On the happening of any occurrence likely to give rise to a claim under the policy, it is a condition precedent to Underwriters liability under this Policy that the Insured and/or the Insured Person will ensure that notice is given to Underwriters in writing as soon as possible after the date of the occurrence and in any event within sixty days. Such notice shall include full particulars of the occurrence. IN NO EVENT will Underwriters be liable to pay any claim where the Insured and/or an Insured Person has failed to notify Underwriters in writing within 120 days after the date of the occurrence.

3. Access to additional materials

An Insured Person shall furnish to Underwriters, or their designated representatives, all information that Underwriters may reasonably require with regard to matters pertaining to the Policy. All documents, books, records, medical information and any other information which may have a bearing on this Policy, claims or premium hereunder shall be made available for inspection by Underwriters or their designated representatives at all reasonable times during the term of this Policy, or until resolution of all claims hereunder, whichever is later.

4. Right to Medical records and medical examination

Following notice of claim, the Insured Person shall provide when requested by Underwriters all authorisation necessary to obtain an Insured Person’s medical records. Underwriters have the right to have an Insured Person examined by a physician or vocational expert of their choice, and at their expense, when and as often as they may reasonably request.

5. Claims Co-operation

The Insured Person and Insured shall provide, assist and co-operate with Underwriters or their representatives, in obtaining any other records Underwriters deem necessary to evaluate the incident or claim. In no event shall Underwriters be liable to pay any claim hereunder unless the Insured and/or the Insured Person co-operate with Underwriters and/or their representatives in the investigation of the claim.

6. Fraudulent Claims

If any claim submitted under this Policy by the Insured, or an Insured Person or by any person acting on behalf of the Insured or an Insured Person shall in any respect be false or fraudulent, the Underwriters shall be under no liability to make payment in respect of such claim.

7. Other Insurance

Underwriters will not pay any claim if any loss, damage payment, or liability under this Policy is also covered wholly or in part under any other insurance except in respect of any excess beyond the amount which would have been covered under such other insurance’s had this Policy not been effected.

8. Applicable Law and Jurisdiction

This Policy, any endorsement and the Schedule attaching hereto shall be governed by and construed in accordance with the law of England and Wales and the Insured, the Insured Persons and Underwriters irrevocably agree that the Courts of England and Wales shall have exclusive jurisdiction in respect of any dispute which may arise out of or in connection with this Policy or any claim arising thereunder.

9. Limitation

In no case shall the Underwriters liability in respect of an Insured Person exceed the largest sum insured stated in the Schedule. If the aggregate amount of all sums payable under this Policy exceeds the Aggregate Limit of Liability, the benefits payable to each Insured Person shall be proportionally reduced until the total of all benefits payable hereunder is equal to the Aggregate Limit of Liability. The Underwriters will not pay any claim in respect of an Insured Person aged 75 years or more except in circumstances where the Insured Person turns 75 years of age during the Operative Time.

10. Cancellation

The Underwriters may cancel this Policy or any cover thereunder by giving thirty days written notice to the Insured at their last known address and in such event the premium for the period up to the date when the cancellation takes effect shall be calculated and the Underwriters shall return any unearned portion of the premium paid. In the event of a claim on this Policy no premium shall be returned following the cancellation of this insurance.

11. Premium Adjustment

If the premium is calculated on a declaration basis the Insured shall within one month of the expiry of the Policy provide the premium adjustment information required by the Underwriters.

12. Kidnap and Hijack

If during the Operative Time an Insured Person is the victim of kidnap or Hijack, the cover shall continue in respect of that Insured Person for up to 52 weeks from the date of kidnap or Hijack or until the Insured Person returns home, whichever is the earlier.

13. Data Protection Act 1998

It is understood by the Insured that any information provided to the Underwriters regarding the Insured will be processed by the Underwriters, in compliance with the provisions of the Data Protection Act 1998, for the purpose of providing insurance and handling of claims, if any, which may necessitate providing such information to third parties.

14. Contracts (Rights of Third Parties) Act 1999 Clarification Clause

The Insured and The Underwriters do not intend any third parties to this contract to have the right to enforce the terms of this contract. Only the Insured and the Underwriters can enforce the terms to this contract. The Insured and the Underwriters can vary or rescind the contract without the consent of any third party to this contract who may assert they have rights under the Contract (Rights of Third Parties) Act 1999/.

15. Financial Services Compensation Scheme

Lloyd’s insurers are covered by the Financial Services Compensation Scheme. You may be entitled to compensation from the Scheme if a Lloyd’s insurer is unable to meet its obligations to you under this contract. If you were entitled to compensation under the Scheme, the level of extent of the compensation would depend on the nature of this contract. Further information about the Scheme is available from the Financial Services Compensation Scheme (7th Floor, Lloyds Chambers, Portsoken Street, London E1 8BN) and on their website (www.fscs.org.uk ).

7. Who to contact in an emergency

For 24-hour assistance Worldwide contact:

CEGA

A Charles Taylor Group Company

Emergency Medical Assistance

E: cega.assistance@cegagroup.com

T: +44 (0) 1243 975 325

When you notify a claim, please tell them the Cover Note / Policy number, details of the Insured person’s problem and a telephone number on which the Insured person or the policyholder may be contacted.

8. How to submit a claim

To notify us of a claim, you can choose any of the following notification options:

Contact CEGA

A Charles Taylor Group Company

PA Claims

E: claimsservice@cegagroup.com

T: +44 (0) 1243 975 404

Complete the claims form on our website: www.sailorsdirect.com/claims

9. How to make a complaint

We are dedicated to providing you with a high-quality service and we want to ensure that we maintain this at all times. If you feel that we have not offered, you a first-class service please write and tell us and we will do our best to resolve the problem. If you have a problem concerning any aspect of your insurance please contact the Lloyd’s Product Partner, Fifty North Group Ltd.

Fifty North Group Ltd Contact Details:

T: +44 (0)20 3488 3882
E: complaints@sailorsdirect.com

A: Fifty North Group Ltd,
70 Fenchurch Street
London
EC3M 4BR

In the event you remain dissatisfied and wish to make a complaint it may be possible in certain circumstances for you to refer that matter to the Complaints Department at Lloyd’s.

Lloyd’s Complaints Department:

Complaints Department

Lloyd’s of London
One Lime Street London

EC3M 7HA

T: 020 7327 5693

F: 020 7327 5225

E: Complaints@Lloyds.com

In the event that the Complaints Department is unable to resolve your complaint, it may be possible for you to refer it to the Financial Ombudsman Service.

Financial Ombudsman Contact Details:

T: 0800 023 4567

E: complaint.info@financial-ombudsman.org.uk

W: https://www.financial-ombudsman.org.uk/contact-us

10. Continental Benefits Scale of Permanent Disability by Accident

If the Insured Person is left-handed, the percentages set out below for the various disabilities of the right upper limb and left upper limb with be transposed (swapped).

The percentage of the sum insured under Section 1 in respect of Permanent Total or Permanent Partial Disablement shall be as follows: –
Permanent total disablement
Total loss of sight of both eyes.	100%
Total incurable insanity.	100%
Loss of both arms or both hands.	100%
Complete deafness of both ears, of traumatic origin.	100%
Removal of the lower jaw.	100%
Loss of speech.	100%
Loss of one arm and one leg.	100%
Loss of one arm and one foot.	100%
Loss of one hand and one foot.	100%
Loss of one hand and one leg.	100%
Loss of both legs.	100%
Loss of both feet.	100%
Permanent partial disablement Head
Loss of osseous substance of the skull in all its thickness:
surface of at least 6 sq.cm.	40%
surface of 3 to 5 sq.cm.	20%
surface of less than 3 sq.cm.	10%
Partial removal of the lower jaw, rising section in its entirety or half of the maxillary bone.	40%
Loss of one eye.	40%
Complete deafness of one ear.	30%
Upper Limbs	Right	Left
Loss of one arm or one hand.	60%	50%
Considerable loss of osseous substance of the arm (definite and incurable lesion)	50%	40%
Total paralysis of the upper limb (incurable lesion of the nerves).	65%	55%
Total paralysis of the circumflex nerve.	20%	15%
Shoulder anchylosis.	40%	30%
Elbow anchylosis
in favourable position (15 degrees round the right angle).	25%	20%
in unfavourable position.	40%	35%
Extensive loss of osseous substance of the two bones of the forearm (definite and incurable lesion).	40%	30%
Total paralysis of the median nerve.	45%	35%
Total paralysis of the radial nerve at the torsion cradle.	40%	35%
Total paralysis of the forearm radial nerve.	30%	25%
Total paralysis of the hand radial nerve.	20%	15%
Total paralysis of the cubital nerve.	30%	25%
Anchylosis of the wrist in favourable position (straight and in pronation).	20%	15%
Anchylosis of the wrist in unfavourable position (flexion or strained extension or supine position).	20%	15%
	30%	25%
Total loss of thumb.	20%	15%
Partial loss of thumb (ungula phalanx).	10%	5%
Total anchylosis of thumb.	20%	15%
Total amputation of forefinger.	15%	10%
Amputation of two phalanges of forefinger.	10%	8%
Amputation of the ungula phalanx of forefinger.	5%	3%
Simultaneous amputation of thumb and forefinger.	35%	25%
Amputation of thumb and a finger other than forefinger.	25%	20%
Amputation of two fingers other than thumb and forefinger.	12%	8%
Amputation of three fingers other than thumb or forefinger.	20%	15%
Amputation of four fingers including thumb.	45%	40%
Amputation of four fingers excluding the thumb.	40%	35%
Amputation of median finger.	10%	8%
Amputation of a finger other than thumb, forefinger and median.	7%	3%
Lower Limbs
Amputation of thigh (upper half).	60%
Amputation of thigh (lower half) and leg.	50%
Total loss of foot (tibio-tarsal disarticulation).	45%
Partial loss of foot (sub-ankle-bone disarticulation).	40%
Partial loss of foot (medio-tarsal disarticulation).	35%
Partial loss of foot (tarso-metatarsal disarticulation).	30%
Total paralysis of lower limb (incurable nerve lesion).	60%
Complete paralysis of the external poplitic sciatic nerve.	30%
Complete paralysis of the internal poplitic sciatic nerve.	20%
Complete paralysis of two nerves (poplitic sciatic nerve external and internal).	40%
Anchylosis of the hip.	40%
Anchylosis of the knee.	20%
Loss of osseous substance from thigh or both bones of the leg (incurable condition).	60%
Loss of osseous substance of the kneepan with considerable separation of the fragments and considerable of movements in stretching the leg. difficulty	40%
Loss of osseous substance of the kneepan while the movements are preserved.	20%
Shortening of the lower limb by at least 5 cm.	30%
Shortening of the lower limb by 3 to 5 cm.	20%
Shortening of the lower limb by 1 to 3 cm.	10%
Total amputation of all the toes.	25%
Amputation of four toes including big toe.	20%
Amputation of four toes.	10%
Anchylosis of the big toe.	10%
Amputation of two toes.	5%
Amputation of one toe other than the big one.	3%
Anchylosis of the fingers (other than thumb, and forefinger) and of the toes (other than the big toe) shall only entitle to 50% of the compensation which would be due for the loss of the said members.
Permanent disabilities by accident not mentioned above shall be compensated in accordance with their seriousness as compared with that of those mentioned, the occupation of the Assured not being taken into consideration.
The partial or total “functional” disablement, not specifically dealt with in the Scale of Permanent Disabilities, of a limb or an organ is treated like the partial or total loss of the said limb or organ.
The total compensation payable in respect of several disablements due to the same accident is arrived at by adding together the various sums but shall not exceed the total sum insured under Item 2 of the Schedule of Compensation.

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Sailors Direct Insurance is a trading name of Fifty North Group Limited. Fifty North Group Limited is an Appointed Representative of Innovative Risk Labs Ltd, under Firm Reference Number 794850. Innovative Risk Labs Ltd are Authorised and Regulated by the Financial Conduct Authority. Under FRN 609155. We are registered in England and Wales under Company Number 10852097. Registered Office Address: 70 Fenchurch Street, London, United Kingdom, EC3M 4BR.