This Policy Provides financial compensation to the insured or his/her Nominees on account of injuries resulting in disability, or death due to an accident caused by external, visible, and violent means. The Insurer will pay the entire sum insured either on account of death or Permanent total disability (PTD) due to accident which should occur within 12 Calendar months from the date of accident.
Scope of Cover
This Policy covers Death or Bodily Injuries resulting in PTD ( Permanent total disability ),PPD( Permanent Partial disability) or TTD( Temporary total disability) of the Insured Person sustained solely due to accident caused by external, violent and visible means. In the event of a death & PTD, the Capital Sum Insured will be paid. It pays 50% of the Sum Insured towards PPD i.e. Loss of one hand, loss of one leg, loss of one eye, and loss of both ears. The compensation towards PPD depends upon the kind of disability. TTD makes the injured person unable to perform regular duties / activities which ceases his earning capacity. The insured is entitled to compensation @ 1% of Sum insured per week (Maximum eligible compensation varies from Insurer to Insurer) subject to a maximum of 104 weeks under TTD.
Cumulative Bonus: Compensation payable under the policy viz. death, loss of limb(s), loss of sight and permanent total disablement arising out of accidental injuries shall be increased by 5% in respect of each completed year, not exceeding 50% of the capital sum insured without paying extra Premium provided the Policy is continuously renewed and subject to no claims being reported.
Value added Benefits
A lump sum of two per cent of capital insured will be paid for transportation of dead body in the event of accidental death outside the residence.
Coverage under this policy is WORLDWIDE. Claims, if any, will be paid in Indian currency only.
No requirement of medical tests.
Reimbursement of medical expenses
The policies are not contracts of Indemnity &they are benefit Policies. In the event of happening of an insured event a specified sum of money is payable irrespective of the amount of pecuniary loss actually suffered by the insured or dependent.
Insurable Interest: It differs from Other Policies. A person has unlimited interest in his own life. A husband has an Insurable Interest in the life of his wife and vice versa. Insurable Interest also arises for a creditor in his debtor’s life to the extent of the debt due to the creditor. The employers are deemed to have an Insurable Interest in the lives of their employees in so far as they would suffer in a pecuniary loss by the death or disablement of their employees.
Contribution: Contribution does not apply since the Policy is not a contract of Indemnity .
An insured person may hold several personal accident policies and is entitled to the full benefits of each.
Unlike Life Insurance, Personal Accident Insurance Premiums vary with the policyholder’s occupation rather than age.
The Insuring public is categorized as Low, Medium & High Risk categories, based on their occupation. Premium will be charged by the Insurer accordingly.
Low risk: Teachers. Lawyers, Bankers, accountants, Doctors, consulting Engineers & Persons engaged in occupations of similar nature
Medium risk: Builders, Contractors, Veterinary Doctors, Paid drivers of Light Motor vehicles Persons engaged in occupations of similar nature & not engaged in Manual Labour etc.
Persons working in Underground mines, explosives, magazines, workers engaged in installation if High Tension Electrical lines, Jockeys, Circus personnel etc.
Sum insuredIs based on:
Income from gainful employment
Age as on date of proposal.
Normally Personal Accident Insurance cover is granted up to a Sum Insured of 60 to 72 times the monthly earnings. Linking the capital sum insured to the earnings of the person is to ensure that the weekly benefits provided to the insured in the event of temporary disablement would not be disproportionate to his weekly earnings.
This Policy is available to persons between the age of 5 and 70 years (Male & Female). The age ceiling of 70 years can be relaxed subject to suitable Premium loading.
Add on covers available
Medical Expenses can be extended on payment of extra Premium if the claim is admitted under the Policy
Compensation under more than one clause for same period of disability
Any claim in the same period of insurance exceeding the capital sum insured
Death or disablement arising out of Suicide, attempted suicide etc. Pregnancy and/or childbirth
War and nuclear perils, Ionizing radiation or radioactivity
HIV / AIDS / or death due to any disease