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GROUP PERSONAL ACCIDENT INSURANCE

WHAT IS A GROUP PERSONAL ACCIDENT INSURANCE ?

Personal accident insurance covers the risk of bodily injuries arising directly from an accident that was caused by external, violent and visible means and results in death or disablement either permanent or temporary.

Group Personal Accident policy can be taken over and above a WC policy to provide extra benefit to the employees as compensation payable under WC is quite less. It is a benefits policy and cannot be a substitute for a WC policy.

WHY IT IS NECESSARY ?

Unfortunate accidents have a knack of throwing the financial footing of a whole family out of kilter for a long time and the number of people getting injured in a traffic or other accidents is staggering. Being a breadwinner of the family, an accident can create serious financial problems by ruining the comfort and security one works so hard to provide. That’s why it is important to be well prepared for all these situations. One way to secure your financial and mental outcome is to go for “Personal accident insurance”.

Accident Insurance
Accident Insurance Policy

WHO CAN BUY IT ?

It is a comprehensive cover for small as well as large companies, irrespective of the size (Big/small), it can be customized to meet the requirements of any group.

Key points:

  • Benefits the employees in case of any unforeseen event
  • Payable if the insured dies or sustains any bodily injury resulting solely and directly from accident caused by external, violent and visible means whether due to employment or otherwise
  • Will not come into force in case of occupational diseases
  • The employer can choose the sum insured which can be a multiple of the salary or a graded cover according to the designation.
  • PA is a benefits policy and not under any Act, compensations are benefits offered to the employees.
  • Not payable if the workman was under the influence of drinks/drugs or regulations i.e. negligence.

Coverage Offered ?

Accident death:-

In case of the demise after an unfortunate accident, the principal amount is paid by the insurer

Disability (Total/permanent partial):-

Insurer pays the compensation up to sum assured in case if the insured is partially/permanent disabled in an accident and continues to be so till 1 year

Reimbursement of charges

Ambulance charges:-

In case the insured is met with an accident and is taken to a facility by an ambulance, the ambulance charges are reimbursed.

Charges for transportation of mortal remains:-

Charges are reimbursed in case the body is to be transferred from accident site to the health care facility/residence/crematorium ground

Weekly compensation:-

Insurer pays a weekly compensation to the policyholder in case he/she is fully disabled for a temporary time in an accident

Compensation for broken bones:-

Policy clearly states which bones are covered, and based on that, the policyholder is given a lump sum account

Accident Insurance Claim
Accident Insurance Plans

What Is Not Covered ?

  • Pregnancy/childbirth
  • An injury caused by the influence of drugs/alcohol
  • Natural death
  • An injury caused by radioactivity
  • War/nuclear unrest

How Does The Claim Process Work ?

Claim processing is divided into 3 parts: Intimation, processing, settlement!

  • Need to inform the insured about any sustained accident
  • The claim is registered, and the insurance company send a checklist of documents that need to be submitted

In case of disability:

  • Claim form
  • Sick leave certificate by the employer
  • Police FIR
  • Related medical reports
  • Disability certificate by attending health practitioner along with a statement

In case of Death:

  • Claim form
  • Letter from HR
  • Salary Slips
  • Death certificate
  • Post-mortem report
  • Police FIR
  • In case the payment is to be made to the beneficiary: Notarized affidavit or succession certificate

After submission of the required documents, the claim is processed, it will either be:

Approved: A cheque is sent to the insured

Rejected: A rejection letter is sent out the insured/HR/Contact person

Accident Insurance Claims

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