Group Personal Accident Policy offers protection against the financial consequences of unforeseeable accidents to you and your employees/members. The Policy can also be extended to cover the dependent children/parents of your employees.
What does this Policy cover?
The Policy provides for defined benefits based on the nature of injury sustained, by insured persons, in the accident during the Policy period.
Coverage:
The Policy provides for three different options as under:
a) Basic Cover -covers against Death only
b) Wider Cover -covers against Death, Permanent Total Disablement & Permanent Partial Disablement.
c) Comprehensive Cover -covers against Death, Permanent Total Disablement, Permanent Partial Disablement & Temporary Total Disablement
NB: Comprehensive cover is not available to family members
Compensation Benefit:
The compensation benefits will depend upon the nature of injury and the Capital Sum Insured under the Policy.
For accidents resulting in Death or Permanent Total disablement, we will provide compensation equivalent to the full Capital Sum Insured.
For Permanent Partial Disablement the compensation will depend on the nature of injury and corresponding percentage of Capital Sum Insured as detailed in the ‘Table of Benefit’ under the Policy document or as per the medical advices of our appointed Medical Practitioner.
In respect of Temporary Total Disablement, we will provide compensation at 1% of Capital Sum Insured or Rs 5000/- whichever is less per week for a maximum period of 104 weeks.
Extra benefits under the Policy:
In addition to the Compensation benefit stated above, we also undertake to provide compensation in respect of the following:
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A. Transportation cost for carriage of dead body to Home including funeral charges. |
1% of Capital Sum Insured or 2,500/- (Two thousand five hundred) whichever is lower. |
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B. Cost of Clothing damaged in the Accident as described above and liability is admitted by US. |
Actual expenses subject to maximum of Rs 1000/ |
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C. Ambulance charges for transportation of Insured person to Hospital following Accident |
Actual expenses subject to maximum of Rs 1000/ |
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D. Education Fund In the event of death, permanent total disablement of the employee/member , WE will approve compensation towards Education Fund for dependent children upto the age of 25 years |
-5% (Five percent) of C.S.I Subject to a maximum of Rs. 15000/- in all
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E. Loss of Employment In the event of accident leading to loss of employment of the employee/member as a consequence of Permanent Total Disability as per the table of benefits. |
2% of CSI subject to a maximum of Rs 25000/-
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Optional Benefits available under the Policy: The Policy can be extended to cover the following by payment of additional Premium (applicable to Employees/Members only):
A) Medical Expenses Extension: Cover the medical expenses reasonably and necessarily incurred by you towards medical expenses as a result of an accident resulting in the bodily injury , death or disablement. The compensation under this extension is restricted to 40% of Personal Accident Claim or actual medical expenses whichever is less.
B) Hospital Confinement Allowance: Daily allowance of Rs 500/- per day to the actual number of days or 30 days, whichever is minimum, if the insured person (s) is hospitalized as a result of an accident resulting in the bodily injury, death or disablement.
The additional premium for this extension is Rs 300/- per person
Exclusions:
- Self-injury, suicide, venereal disease or insanity.
- Influence of intoxicating liquor or drugs.
- Death due to pregnancy or childbirth.
- Breach of law with criminal intent.
- War and nuclear group of perils.
- On duty with armed forces.
- Injury/death while participatingin adventurous sports
- Contracting any illness directly or indirectly arising from or attributable to HIV or any HIV related illness including AIDS and / or any mutant derivativeor variation of HIV or AIDS.
Documents required for settlement of claims:
- Claim form.
- Doctor’s report, bills in case of temporary/permanent disablement.
- Police report/post mortem report in case of accidental death.
- Leave certificate from employer in case of temporary disablement.
- Any other relevant document which may be required