An accident is an uncertain unplanned event. It just happens. However it can be quite costly. Medical costs are very high these days as well as quality time lost due to not being able to attend office.
A personal accident policy available at a nominal rate helps you to bear the expensive medical treatment caused due to an accident.
We all in our day-to-day life are exposed to risk of accidents. It is a known fact that despite all possible precautions accidents do occur. Accident may occur while walking, driving or even in the house due to fall from stairs or in the bathroom etc. This may result into disablement or loss of limbs or sometimes-even death. Knowing the fact one’s endeavor that he/she or his/her dependents get adequate compensation in the events of disablement or death.
To cater the need the general insurance industry has devised an insurance cover known as the Personal Accident insurance. The policy covers the risks of accidental death and/or disablement and the cover is worldwide. The policy provides compensation in the event of insured sustaining injuries, solely and directly from an accident caused by violence, visible and permanent total disablement, permanent partial disablement or temporary total disablement.
Accountants, Doctors, Lawyers, Architects, Consulting Engineers, Teachers, Bankers, Persons engaged in Administrative, Secretarial and managerial functions, Shopkeepers, Shop Assistants not using machinery, Commercial travelers and persons engaged in occupations of similar hazards
Persons working in underground mines, explosives, workers involved in electrical installation with high intensity power supply. Jockeys, Circus personnel, Persons engaged in activities like racing on wheels or horsebacks, mountaineering, winter sports, Skiing, ice hockey etc persons engaged in occupations of similar hazards.
Being insured against death is not sufficient: a disability caused by accidents sometimes doesn’t allow you to work. Even if the disability is temporary, you still need a cover to meet financial obligation during hospitalization. It is here that personal accident policies come in handy.
These accident policies provide cover for groups too. In case of group accidental policies, the insurer gives marginal discounts on premiums.
Defined as permanent loss of use of any two limbs, or permanent and complete loss of sight in both eyes or injuries that render the insured incapable of earning an income from the date of the accident onwards from any work, occupation or profession (commensurate with his educational qualifications, training and experience).
Defined as permanent loss of any body part, one eye, one limb or one finger or a toe or injuries that render the insured incapable of earning an income. While the loss may be permanent, its effects on the insured and on his life are partial.
Defined as temporary loss in any form that may render a person immobile or affect his earning capacity from the time of the accident. In other words, a fracture in the arm or leg that keeps you from work qualifies: you may be mobile but the injury may not support your ability to work.
The sight of one eye, or of the actual loss by physical separation of one entire hand or of one entire foot, fifty percent (50%) of the Capital Sum Insured stated in the schedule
Total and irrecoverable loss of use of a hand or a foot without physical separation, fifty percent (50%) of the Capital Sum Insured cited in the Schedule
‘Physical Separation’ means amputation at or above the wrist and/that of the foot at or above the ankle respectively.
Compensation payable under sub-clause (f) shall not be payable for more than 100 weeks in respect to a person’s injury calculated from the date of commencement of disablement and shall not exceed the capital sum insured.
Payment under this sub-clause (f) shall not be made until the total amount of compensation is ascertained and agreed upon.
Note : If any such injury as mentioned above shall result in the inability to remain gainfully employed, then the Capital Sum Insured payable will be 100%.
In case of the death of the insured arising out of terrorism or acts of terrorism within the policy period, the nominee (mentioned in the policy) is compensated with the sum Insured. The Company shall also pay compensation against permanent and total loss of limbs, sight etc. (of the insured) arising out of terrorism or acts of terrorism.
Insurance under this policy shall not extend to cover death or disablement resulting directly or indirectly caused by, contributed to/or aggravated or prolonged by child birth or pregnancy or any consequence thereof. Insurers broadly put disability into three categories.
The cover provided under Personal Accident Policy is worldwide. However the claims are payable only in Indian Rupees (If the policy is taken in India)
Normally the cover is restricted to persons between the age of 5 to 70 years for both male and female. Cover beyond these age limits can be had at higher rates of premium as under.
Renewal of the policy above 70years of age but up to 80years is subject to loading of 5%on the premium. Fresh proposal above 70years but below 80years is subject to a loading of 10% on the premium. No medical examination is to be insisted for a and b.
A policy can be extended on payment of extra premium to cover medical expenses incurred by the insured in connection with injury, provided the claim for the injury is admissible under the policy. The extension is available by loading the premium either by 10% or by 25% and the benefit available is reimbursement of Medical expenses
War and allied risks are exceptions under the policy. But in respect of Indian personnel/Experts working in foreign countries on Civilian duties ‘this exception may be deleted on payment of additional premium.
Effective from April 10, 1989, a new clause called Children’s’ Education Fund has been incorporated under the PA policy. Under this clause :
If the insured person has one dependent child below the age of 23 years, an amount equal to 10% of the CSI subject to a maximum of Rs 5,000.
Mr. C S Sudheer is the founder and CEO of IndianMoney.com – India’s largest Financial Education Company. He started his career with ICICI Prudential Life Insurance and later on worked with Howden India. After his brief stint in Howden India, he moved on and incorporated Suvision Holdings Pvt Ltd which is the sole promoter of IndianMoney.com. He aims to build a nation that is financially literate with investment savvy citizens.
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