Health · Chapter 13 · Covered Perils
Covered Perils: Accident & Sickness
Definition
All health and accident policies address the same two broadly defined causes of loss: accidents and sickness. An illness is an internal occurrence — sudden onset or developing over time, acute or chronic (including occupational diseases from workplace exposure). An accident is an unintended occurrence caused by an EXTERNAL source, fixed in time and space; losses intentionally caused by a deliberate act are excluded.
In plain English
Sickness comes from inside the body; accidents hit from outside at a specific moment and place.
Exam tip
Illness = INTERNAL factors · Accident = EXTERNAL event. The exam uses exactly this contrast.
Easy to confuse with
These are what this term gets tested against — if you can't tell them apart cold, drill the contrast.
Related terms