Accidental death and dismemberment: how the benefit scale works
A personal accident policy rarely pays a flat amount for every injury. Here is how the benefit scale that decides your payout actually works.
Accidental death and dismemberment cover, usually sold as a feature of a personal accident (PA) plan rather than as a policy of its own, is often described to buyers with a single headline number: the sum insured. What that number does not tell you is that most injuries do not pay out the full amount. They pay a percentage of it, set by a benefit scale, and understanding how that scale works matters more than the headline sum.
What AD&D actually is
Accidental death and dismemberment cover is a form of limited life and injury insurance that pays out specifically when death or a defined bodily loss results from an accident, rather than from illness, degeneration or natural causes. Because the trigger is narrower than an ordinary life policy, which pays regardless of cause of death, AD&D cover is generally priced more cheaply for the same sum insured, and is often included as a rider on a life policy or sold as the core benefit of a standalone personal accident plan.
The "dismemberment" half of the name covers the loss of, or permanent loss of use of, specific body parts or functions: limbs, sight, hearing, and speech are the most commonly listed. Full accidental death pays the complete sum insured, once a claim is admitted. Dismemberment claims pay a defined fraction of it.
Why the benefit scale exists
If every injury paid the full sum insured, the premium for that level of cover would be prohibitively expensive, since the policy would effectively behave like several separate death benefits bundled together. Instead, insurers use a benefit scale, sometimes called a table of compensation or schedule of benefits, that assigns a specific percentage of the sum insured to each listed injury, calibrated roughly to the severity and permanence of the loss.
A benefit scale typically groups injuries this way, though the exact structure and percentages differ by insurer and plan:
- 100% of the sum insured, generally reserved for accidental death and the most severe forms of permanent total disability, such as loss of both hands, both feet, or sight in both eyes.
- A defined lower percentage, for the loss of a single limb, one eye, or hearing in one ear, reflecting a serious but less catastrophic loss.
- A smaller percentage again, for the loss of fingers, toes, or partial loss of function, scaled down further still.
Because these percentages, and the specific list of injuries they attach to, vary from one insurer's policy wording to the next, there is no universal scale you can assume applies to a plan you are considering. The schedule of benefits is a specific, contractual document attached to the policy, and it is the one that governs at claim time, not a general industry convention.
What sits outside the scale entirely
Two things commonly catch claimants out. First, AD&D cover responds to accidents, and most policies define what qualifies fairly precisely, generally excluding self-inflicted injury, injury sustained while intoxicated, and injury arising from a pre-existing medical condition rather than an external accidental event. An injury that arguably resulted from a medical episode, a fall caused by a stroke, for instance, can fall into a grey area the insurer will investigate before admitting a claim under this benefit rather than treating it as an ordinary illness claim. Second, many personal accident plans list specific higher-risk activities, certain sports and occupations among them, that are either excluded outright or covered only if declared and priced for upfront. Check both before you assume a specific scenario is covered.
What to check before you rely on the sum insured
Ask to see the actual benefit scale or schedule of compensation, not just the headline sum insured. Confirm what percentage applies to the injuries most relevant to your own occupation and lifestyle, rather than assuming the worst-case 100% figure applies broadly. If you are comparing two PA plans with the same advertised sum insured, compare their benefit scales directly, since a materially different percentage table can mean two policies advertised at the same headline figure pay very different amounts for the same injury.
Talk to an advisor
The number that matters at claim time is what percentage of the sum insured your specific injury falls under, not the sum insured itself. An advisor on the portal can walk through a policy's actual benefit scale with you, or you can compare personal accident plans at /compare/singapore/personal-accident before choosing one.
Sources
This content is educational information from a licensed advisor, not financial advice. Product details vary by insurer — verify specifics with an advisor.
