What is group personal accident and sickness insurance in Australia?

Group personal accident and sickness insurance may help replace part of a person's income if injury or illness stops them working, subject to policy terms. It can be arranged for an individual sole trader, contractor, or business owner, or for a group such as employees, members, volunteers, or contractors under one policy.

It is different from workers compensation insurance, which is state-based and generally covers employees for work-related injury or illness. Personal accident and sickness insurance is often considered where a person does not have paid sick leave or workers compensation for themselves.

At a glance

• Personal accident and sickness insurance may help replace part of income if injury or illness stops work
• Cover may apply to accident only, sickness only, or both, depending on the policy
• Benefits may include weekly income payments, lump sums for permanent disability, or death benefits
• It can be arranged for sole traders, contractors, business owners, or groups
• It is different from workers compensation and income protection insurance
• Waiting periods and benefit periods affect how and when payments may start
• Some policies cover 24/7, while others may cover work hours only
• upcover arranges group personal accident and sickness insurance for eligible Australian businesses and sole traders.

What is group personal accident and sickness insurance?

Group personal accident and sickness insurance is a general insurance product designed to pay income-style benefits if the insured person cannot work because of injury or illness. It is also known as personal accident and illness insurance or accident and sickness insurance. It is not workers compensation. It is not income protection through a life insurer. It is a standalone product arranged through the general insurance market.

How it works: you choose a weekly benefit amount, a waiting period, and a benefit period. If an injury or illness prevents you from working, you lodge a claim. If the claim is accepted, payments may begin after the waiting period and continue for the benefit period or until you return to work, subject to policy terms.

Cover may apply to accident only, sickness only, or both accident and sickness, depending on the policy selected. Accident-only cover will not usually respond to illness.

What does "group" mean?

The word "group" refers to the policy structure. A group personal accident and sickness policy can cover a defined group of people, such as contractors, employees, association members, volunteers, or sporting club participants, under one policy.

Depending on the insurer, similar cover may also be arranged for a sole trader or single-person business. The label describes how the policy is structured, not how many people it covers.

What does personal accident and sickness insurance cover?

The exact benefits depend on the insurer and policy selected. These are the common cover options.

Weekly income benefit

May pay a weekly benefit if the insured person is unable to work because of an insured injury or illness. The amount is typically a percentage of pre-disability income, up to the policy limit. Payments begin after the waiting period and continue for the benefit period or until return to work.

Injury cover

Commonly available under personal accident and sickness policies. Designed to respond to accidental injury that prevents work, subject to policy terms. Some policies offer 24/7 cover, while others are limited to work hours, commuting, or specific activities.

Sickness cover

May be included or optional depending on the policy. Where selected, it covers illness or disease that prevents the insured person from working. A broken leg and pneumonia are different claim triggers: unless both accident and sickness are selected, illness alone may not be covered.

Permanent disability and death benefits

A lump sum may be payable if the insured person becomes permanently disabled or dies because of an insured event, subject to policy terms. The amount depends on the sum insured selected.

Fracture benefits

Some policies pay a defined lump sum for specific fracture types. This is separate from the weekly benefit.

Business expense cover

An optional add-on. May help cover fixed business expenses such as rent and utilities while you are unable to work. The weekly income benefit covers personal income, not business overheads. Business expenses need a separate section if relevant.

Who may consider personal accident and sickness insurance?

Sole traders

Sole traders are not employees of their own business, so workers compensation does not usually cover their own injury or illness. If a sole trader relies on their own labour to earn income, personal accident and sickness insurance may be relevant. For more on sole trader insurance needs, see is workers compensation compulsory in Australia.

For example, a sole trader electrician breaks their wrist on a weekend project and cannot work for eight weeks. A personal accident and sickness policy with a 7-day waiting period may begin paying a weekly income benefit after that waiting period, if the claim is accepted and the injury is covered.

Working directors

Working director rules vary by state, company structure, and policy wording. In most states, directors are generally excluded from the workers compensation definition of "worker." Personal accident and sickness insurance may address that gap. For more detail, see employers liability insurance.

Contractors, freelancers, and gig workers

Some contractors and platform-based workers sit outside workers compensation depending on state rules. This includes NDIS support workers, delivery drivers, and other independent contractors. Income depends on ability to work. No paid sick leave means no income buffer if injury or illness stops work.

Tradies, allied health, fitness, and beauty professionals

Physical and appointment-based work carries higher injury risk. A broken wrist can stop a tradie for months. A back injury can stop a physiotherapist or personal trainer from delivering sessions. Some worksites or contracting arrangements may ask for a Certificate of Currency before access is approved.

Groups, associations, and clubs

Employers, sporting associations, unions, volunteer organisations, and member groups can arrange group personal accident and sickness cover for their people under one policy. This is where the "group" policy structure is most commonly used.

PA&S vs workers compensation

Workers compensation covers employees for work-related injury or illness under state-based schemes. PA&S may provide income-style benefits for insured sole traders, contractors, directors, or group members, subject to policy terms.

Workers compensation is mandatory for employers. PA&S is voluntary. Workers compensation covers work-related injury and illness only. PA&S with 24/7 cover may respond to injuries outside of work, depending on the policy. PA&S is not a replacement for mandatory workers compensation.

For more on workers compensation, see what is workers compensation insurance in Australia.

PA&S vs income protection

These are different products, not different names for the same thing. PA&S is generally arranged through the general insurance market and often uses shorter benefit periods, such as 52 or 104 weeks, depending on the policy. Underwriting may be simpler than some life-insurance-style income protection products, but this varies by insurer and occupation.

Income protection is a life insurance product with longer benefit periods (which can run to age 65), higher premiums, and medical underwriting. It is usually arranged through a financial adviser or superannuation fund.

Some people compare both products because they have different benefit periods, underwriting requirements, exclusions, and claim triggers.

The income gap test

This is the practical question behind the product: what happens to your income if you cannot work for 4, 8, or 12 weeks?

Do you have paid sick leave?

Employees may have sick leave entitlements. Sole traders and contractors usually do not.

How long could savings cover your personal bills?

Waiting periods mean benefits may not start immediately. If you choose a 14-day or 28-day waiting period, you need enough savings to cover that gap.

Would the business still earn income if you stopped working?

A solo physiotherapist, personal trainer, hairdresser, or electrician may earn only while they are physically working. If the business relies on that person's labour, income may stop or reduce when they cannot work.

Would business expenses continue?

Vehicle repayments, software, rent, and tool leases do not stop when you do. If fixed costs continue while income stops, business expense cover may be relevant.

Is sickness included or accident only?

A broken leg and pneumonia are different claim triggers. Unless both accident and sickness are selected, illness alone may not be covered.

Are you covered 24/7 or work hours only?

An injury on a weekend bike ride is not covered under a work-hours-only policy.

Do you know how your benefit would be calculated?

Insurers calculate benefits from average weekly earnings over a defined look-back period, based on net business income rather than gross revenue. If income is variable, the benefit may differ from what you expect. Insurers may ask for BAS lodgements, tax returns, or profit and loss statements when assessing income at claim time.

Want to check cover options for your situation? Get a quote.

Key policy terms to check

• Accident only vs accident and sickness. Injury-only cover may cost less because it responds to fewer claim triggers. Adding sickness means illness is also covered.
• 24/7 cover vs work hours only. 24/7 covers injuries anytime. Work-hours-only cover may cost less but only responds during covered work activities.
• Waiting period. Common options: 7, 14, or 28 days. A longer waiting period means a lower premium but a longer gap before payments.
• Benefit period. Common options: 52 weeks or 104 weeks. Longer benefit period means higher premium but longer income support.
• Benefit amount. The insurer verifies the benefit against actual income at claim time, not at policy setup.
• Own occupation vs any occupation. This is an important policy detail. "Own occupation" means unable to perform your specific job. "Any occupation" means unable to perform any job you could reasonably do. A plumber with a broken wrist would not claim under an "any occupation" wording if the insurer considers they could do desk-based work. Check the wording.

What PA&S insurance does not usually cover

Common exclusions may include pre-existing conditions not accepted by the insurer, self-inflicted injury, drug or alcohol-related incidents, excluded high-risk activities, elective surgery, pregnancy or childbirth, and some mental health conditions.

Every policy is different. Always read the Product Disclosure Statement before purchasing.

What you need for a quote

To get a quote, you generally need your ABN, business name, occupation, number of people to insure, age, annual income or desired weekly benefit, whether you want accident only or accident and sickness, preferred waiting and benefit periods, whether you want 24/7 or work-hours-only cover, claims history, and any high-risk activities.

Ready to compare options? upcover arranges group personal accident and sickness insurance for eligible Australian businesses and sole traders.

How upcover can help

upcover arranges group personal accident and sickness insurance for eligible Australian businesses and sole traders with selected insurers and underwriters. Depending on your occupation and insurer, you may be able to compare cover options, select a benefit level, and access a Certificate of Currency.

• 70,000+ businesses covered across Australia.
• 4.9/5 customer rating.
• Instant Certificate of Currency on policy confirmation, where available for the relevant policy.

upcover Pty Ltd ABN 17 628 197 437 is a Corporate Authorised Representative (CAR 1299211) of Experience Insurance Services Pty Ltd ABN 41 657 596 506, AFSL 539078.

Frequently asked questions

What is group personal accident and sickness insurance?

A general insurance product that may help replace part of income if injury or illness stops work, subject to policy terms. It can be arranged for individuals or groups.

What does personal accident and sickness insurance cover?

Benefits may include weekly income payments, lump sums for permanent disability or death, and fracture benefits. Cover may apply to accident only, sickness only, or both.

Is personal accident and sickness insurance the same as income protection?

No. PA&S is generally arranged through the general insurance market with shorter benefit periods. Income protection is usually a life insurance product with longer benefit periods and more detailed underwriting.

What is the difference between PA&S and workers compensation?

Workers compensation is mandatory for employers and covers employees for work-related injury or illness. PA&S is voluntary and may cover sole traders, contractors, and directors, including outside work hours.

Does PA&S cover sickness or only accidents?

It depends on the policy. Accident-only cover does not respond to illness. Sickness cover may be included or available as an option.

What is a waiting period?

The number of days you must be unable to work before payments begin. Common options are 7, 14, or 28 days. A longer waiting period reduces the premium.

What is not covered by PA&S insurance?

Common exclusions may include pre-existing conditions, self-inflicted injury, drug or alcohol-related incidents, excluded high-risk activities, elective surgery, pregnancy or childbirth, and some mental health conditions. Check the PDS.

Does personal accident and sickness insurance cover sole traders?

Sole traders are not usually covered by workers compensation for their own injury. PA&S may be relevant for sole traders who rely on their own labour to earn income.

Does PA&S insurance cover business expenses?

The weekly income benefit covers personal income. Business expense cover is a separate optional add-on that may help cover fixed costs like rent and utilities while you are unable to work.

How do I arrange group personal accident and sickness insurance?

You need your ABN, occupation, income details, preferred cover type, waiting period, and benefit period. upcover arranges group personal accident and sickness insurance for eligible Australian businesses.

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_{The information in this article is general in nature and provided for informational purposes only. It does not constitute personal insurance, financial, or business advice. Personal accident and sickness insurance terms, benefits, limits, waiting periods, benefit periods, and exclusions vary between insurers and policies. This article does not compare personal accident and sickness insurance with income protection or workers compensation for the purpose of recommending one over the other. Always read the relevant Product Disclosure Statement before purchasing. All insurance products arranged through upcover are subject to the terms, conditions, limits and exclusions contained in the relevant policy wording and Product Disclosure Statement. Before deciding whether a particular insurance product is right for you, please read the relevant PDS and consider your personal circumstances. upcover Pty Ltd ABN 17 628 197 437 is a Corporate Authorised Representative (CAR 1299211) of Experience Insurance Services Pty Ltd ABN 41 657 596 506, AFSL 539078. upcover arranges insurance products with selected insurers and underwriters and does not compare all general insurers or insurance products available in the market.}