Personal Accident Insurance
A personal accident cover is a Policy that covers an individual or family in the event of injuries, disability, or death caused solely by violent, accidental, external, and visible events. PA insurance provides 24-hour worldwide insurance protection. The Policy is part of a complete Health Insurance Plan for any family as in case of an accident the hospitalization expenses could be covered in a Mediclaim Policy but a loss of breadwinner to the family or loss of pay in case of him being bedridden for a few months or any permanent disability can be compensated by the PA policy. The policy helps to tide over any financial hardship that a family may face due to any of aforesaid reasons.
COVERAGES
The types of cover vary from insurance company to insurance company but it usually includes:
- Accidental death: Payment of sum insured in case of death of an insured person due to an accident
- Permanent Total Disablement (PTD): Lump sum payment of a pre-defined percentage of the sum insured basis the severity and disability caused by the accident
- Temporary Partial Disablement (PPD):Lump sum payment of pre-defined percentage of the sum insured basis the severity and disability caused by the accident Hospitalization benefits- Reimbursement of medical expenses up to a limit incurred on accidental hospitalization of the insured person Temporary
- Total Disablement (TTD): Payment to compensate for the loss of income in case the insured person is not able to work due to an accident
- Cremation Ceremony: Lump sum payment for performing the cremation ceremony
- Broken Bones:Lum sum payment of a pre-defined percentage of sum insured basis the severity of fracture caused due to an accident
- Loan Secure: Payment of outstanding principal loan amount in case of death or permanent total disability of the insured member. The outstanding principal loan amount would not include any arrears or penalties levied by the bank or financial institution
- Adventure Sports: Payment of sum insured in case of death or permanent total disability of insured member while he/she was engaged in adventure sports in a non-professional capacity and under the supervision of trained professional.
- Emergency Road Ambulance Charges: Reimbursement of expenses incurred on an ambulance used to transfer the insured person to a hospital following an accident
ELIGIBILITY
Individual Personal Accident plan covers all age brackets, from children to elderly members of the family.
| Age Eligibility Relation | Minimum Entry Age (years) | Maximum Entry Age (years) |
| Policy Holder | 18 | 69 |
| Adult Dependent | 18 | 69 |
| Child Dependent | 91 days | 25 |
*children aged between 91 days to 5 years can be covered only if either of the parents is covered under the same policy.
SUM INSURED (SI) ELIGIBILITY
| Relationship | Eligible For |
| Policyholder (salaried) | 20Xannual income Policyholder |
| Policyholder (businessman/self-employed) | 25Xannual income Non-earning |
| Non-earning spouse/dependent parents | 50% of policyholder SI; Max up to 1 Cr |
| Child dependent | 25% of policyholder SI; Max up to 25L |
| Earning spouse (salaried) | 20X annual income; max up Policyholder SI |
| Earning spouse (businessman/self-employed) | 25X annual income; max up to policyholders SI |
EXCLUSION
The policy will not compensate for any claim arising due to:
- Self-inflicted injury, suicide or attempted suicide, or abuse of intoxicants or hallucinogens including drugs and alcohol
- Participation in an actual or attempted felony, riots, or civil commotion. If engaged in adventure sport unless Adventure Sports benefit is opted by insured
- Participation or involvement in naval, military or air-force operations, any breach of law with criminal intent
- War or any act of war, the act of a foreign enemy, public defense, rebellion, revolution, insurrection, military or usurped acts, chemical, radioactive or nuclear contamination
- Pregnancy or childbirth or its complications, external congenital diseases
- HIV/AIDS, sexually transmitted diseases