PERSONAL ACCIDENT INSURANCE - Policyicon

PERSONAL ACCIDENT INSURANCE

Personal Accident Insurance policy provides compensation to the insured or their nominees in case of unfortunate uncertainties such as accidental death, accidental bodily injury, and partial/total disability, permanent or temporary resulting from an accident. In the case of accidental death of the policyholder, the nominee gets compensation from the insurer. There are various other compensation that are offered for accidental disability such as loss of eyes, limbs, and speech, fracture etc. This policy operates on a 24-hour basis and anywhere in India.

WHAT DOES IT COVER

A Personal Accident policy is intended to compensate the individual insured in case of an Accident, as under following sections:

1) Accidental Death (AD)– If an Insured Person suffers an Accident during the Policy Period which becomes the cause of death within 365 days from the date of the Accident, then full Sum Insured is paid to the nominee.

2) Permanent Total Disablement (PTD) – If such an accident leads the Insured to Permanent total disability within 365 days from the date of an accident then the compensation will be paid as follows:-

Types of PTD

% of Sum Insured

Loss of 2 Limbs (both hands or both feet or one hand and one foot)

100%

Loss of a Limb and an eye

100%

Complete and irrecoverable loss of sight of both eyes

100%

Complete and irrecoverable loss of speech & hearing of both ears

100%

Loss of a Limb

50%

Complete and irrecoverable loss of sight of an eye

50%

3) Permanent Partial Disablement (PPD)– In case an Accident leads to Permanent partial Disablement i.e., Disablement is irrecoverable however it is partial then policy would pay the amount as per the table or as certified by the doctor: -

Types of PPD

% of Sum Insured

Each arm at the shoulder joint

70%

Each arm to a point above elbow joint

65%

Each arm below elbow joint

60%

Each hand at the wrist

55%

Each thumb

20%

Each index finger

10%

Each other finger

5%

Each leg above centre of the femur

70%

Each leg up to a point below the femur

65%

Each leg to a point below the knee

50%

Each leg up to the centre of tibia

45%

Each foot at the ankle.

40%

Each big toe

5%

Each other toe

2%

Each eye

50%

Hearing in each ear

30%

Sense of smell

10%

Sense of taste

5%

Subject to the limit of the Sum Insured

4) Temporary Total Disablement (TTD) – TTD cover must be obtained in addition to the PA sum insured depending on your income eligibility form Rs.5,00,000 to Rs.15,00,000/-. This benefit is applicable when a person due to an accident cannot do / is prevented to do his daily work pertaining to employment however this is just a temporary disablement & will get recovered within a short period in such scenario policy will pay weekly benefit (1% of TTD Sum Insured per week up to 104 weeks max). Housewives & Students are not eligible for this benefit. Example of such a disability can be fracture.

5) Emergency Ambulance Charges – If it is necessary to immediately transfer the insured person to the hospital policy will in addition pay the actual expenses incurred while transferring or max Rs.2000.

6) Education Fund – If claim under AD & PTD is admitted then policy will in addition pay some percentage of the Accidental death Sum Insured for education of dependent children.

7) Family Transportation – If claim under AD & PTD is accepted then in addition policy will pay the actual expenses incurred for transporting one immediate family member to the hospital where insured person is admitted following an accident, however the destination should be at least 200km from the insured house.

8) Transportation of Mortal Remains – In addition to the claim settled in case of AD, policy will also pay Actual expenses for transporting of the mortal remains (dead body) to the cremation or burial ground.

9) Accident Medical Expenses (In patient) – If the claim under AD, PTD, PPD or TTD is accepted then policy will in addition pay the medical expenses incurred by the Insured due to an accident upto certain percentage of the AD Sum Insured. 10) Broken bones – A lump sum payment would be made as per scale provided in the policy, in the event of fracture of bone due to an accident

All these sections aren’t automatic and will depend on the policy & riders you choose

Advantages of Personal Accident Insurance Policy

Imagine a situation, you are hit by a motor vehicle and are permanently disabled? There would be no monthly or annual earnings but bank EMIs, medical expenses, and other expenditure will be ongoing. To deal with such an emergency situation, it is advisable to get a personal accident cover. Here’s a quick rundown of some of the major advantages of buying a personal accident insurance policy:

• Family security
• No requirement of medical tests and documentation
• Substantial coverage at a lower premium
• Worldwide coverage
• Both individual and family plans are available
• Easy and certified claim process
• Legal and funeral expenses are covered
• Child education benefit
• Customizable plans

WHAT IS NOT COVERED?

• Natural Death
• Pre-existing Injury
• Pregnancy or childbirth or its complications, congenital internal & external diseases, HIV/AIDS, sexually transmitted diseases, Pre-existing conditions & their complications.
• Self-inflicted injury, suicide or attempted suicide or abuse of intoxicants or hallucinogens including drugs and alcohol.
• Participation or involvement in naval, military or air-force operations, racing, diving, aviation, rock or mountain climbing, any breach of law with criminal intent.
• War or any act of war, act of foreign enemy, public defense, rebellion, revolution, insurrection, military or usurped acts, chemical, radioactive or nuclear contamination.
• Please refer to the Policy Wording for the complete list of exclusions.