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Choosing a Staff Absence Policy

In your search for staff absence insurance, here's what you need to know:

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Always ask for a full policy wording

When looking to buy staff absence insurance, the provider is obligated to attach a Summary of Cover to your quote – this is sometimes called Key Facts. However, this usually only outlines the main conditions and may not give you the detail you need to make a fully informed decision. Before buying a policy, we recommend asking for the full policy wording too - providers should provide you with one upon request.

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'Like-for-like' cover

No two insurers provide identical cover. It might seem like they do because the information on the quotes and summaries of cover are similar, but its more than likely that the policy wordings will be different – this is what separates one insurer's cover from another. Any slight difference in wording can mean the difference between a claim being paid or not.

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All insurance policies contain exclusions. While not necessarily a bad thing, it’s important to know from the outset how any may affect your school.

Pre–existing conditions

Many policies contain what is commonly known as ‘pre-existing illness exclusion’.

Some insurers only apply this when you first buy the policy. Others may apply it at renewal too. There’s a distinct difference between the two that can result in a significant difference in the premium being quoted.

We urge you to ask your provider questions. An example being: ‘A staff member was absent six months ago for three weeks with stress. Would you pay a claim if they were absent with stress next year? And what about the year after if they have stress next year?’

Pre-planned operations

Many, but not all, policies exclude pre-planned operations.

Some insurers may decline a claim if the person had consulted with their doctor in the past. The school may not know about that consultation because it never resulted in any absence.

Other policies may only exclude the claim if the school was aware of the staff member being on a waiting list.

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Sickness related to pregnancy

Most policies will not completely exclude pregnancy-related sickness. However, the extent of cover can differ vastly.

Some policies will provide cover until the fourth week before the baby is due. This is because a person experiencing a pregnancy-related sickness in that time must start their maternity leave.

However, there are policies which exclude pregnancy-related sickness for up to 20 weeks before the due birth date.

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Most policies won’t completely exclude stress. It’s the extent to which they do so that can significantly differ.

Some treat stress like any other illness, whereas others cover work-related stress, but not stress related to an Ofsted inspection. Some insurers apply an overall limit to the amount that they will cover and some treat bereavement as stress, whereas others don't.

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Making a claim

Along with looking into the detail of cover, we suggest asking how the claims process works. For example:

  • When absence occurs, within what period of time must you submit the claim?
  • What happens if the person who usually submits claims is ill themselves?
  • Are there multiple ways to make a claim? (online portal, phone, and email)
  • Will doctors have to be contacted? Staff may not like this or give you permission. 

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Maternity leave insurance

Absence for maternity leave is a different risk to sickness absence.

Most insurers offer cover for maternity leave and include paternity leave and adoption leave too but do check as this is not always the case.

Remember that a person’s entitlement to adoption is the same as that for maternity leave. Shared parental leave also needs to be considered.

Maternity cover differs significantly between insurers. Important questions to ask include:

  • When will my claim be paid?
  • Which members of staff won't be covered? Is anyone already pregnant at the time the policy is bought or is anyone's expected birth date due within a certain period?
  • Will I have to renew to get paid any benefit?
  • Will the person have to return to work for the claim to be paid?
  • Will the person have to return to work on the same hours?