Personal Accident Policy

 

                                           

Accidents are unpredictable, they are sudden and unforeseen. Yet re-claiming life to normalcy is the immediate need. Insurance policies cover the risk of accidents, mishaps through what is commonly known as the personal accident policy.

Policy   covers death, disablement, bodily injuries to the insured resulting solely and directly from accident caused by external violent & visible means within 12 months of its occurrence. Examples are rail/road/ air accidents, injury due to any violent collision/ fall, snakebite, burn injury, drowning, poisoning etc.

An examination of the important features of a Personal Accident Policy:

Free look period:  A period of at least 15 days from the date of receipt of the policy is allowed to the policyholder to review the terms and conditions of the policy and to return the same if not acceptable. One can cancel a policy within 15 days from the date of purchase.

Can we cancel the policy during free look period?

Yes. Free look period is a feature allowed only on the new policy and not on renewals. If the insured has not made any claim during the free look period, the insured will be entitled to the following:

A refund of the premium paid less any expenses incurred by the company on medical examination of the insured person and the stamp duty charges.

Free look period is a special feature enabled for the policyholder in order to facilitate proper understanding of the policy document, terms and conditions.

Medical expenses add-on cover: 10% of CSI or 40% of admissible claim whichever is less, on payment of 20% of basic premium, as Add-on cover.

Does the medical expenses cover pay for all medical needs?

No, the following example will elaborate further

A cement factory covered all their employees under a group personal accident policy. X was working in a cement factory and fell ill due to the strenuous nature of his work at his workplace. He was hospitalized and diagnosed with excess dehydration and treated at the local hospital. The owner of the cement factory raised a claim for medical expenses.

Insurance company rejected the claim as there was no accident to the employee and just a minor ill health. It should not be construed that a PA policy takes care of all domiciliary expenses. Only medical expenses related to an admissible claim under the policy will be paid as a claim for medical expenses.

Cumulative bonus: Compensation payable shall be increased by 5% for each completed year of Insurance, but maximum restricted to 50% of Capital Sum Insured

What is the benefit of cumulative bonus?

A had accumulated a cumulative bonus of 20 % for 4 claims free years. He had a sum insured of Rs. 5,00,000/-at the time of policy purchase. Now the sum Insured available to him if he makes a claim is Rs. 6,00,000/- So he has earned a sum insured of Rs. 1,00,000/- free of cost.

Education fund for children: These claims are paid only for death & permanent total disablement covers. This provides immediate financial assistance to the dependent children.

·        One dependent child- 10% of CSI subject to max of Rs. 5,000/-

·        More than one dependent child- 10 of CSI subject to max of Rs. 10,000/-.

 

By being aware of the terminologies and definitions of insurance covers one can make an informed choice of cover that fits into one’s budget and requirements.

 

We at Zen Insurance assist in choosing the right Insurance cover to suit your needs. Please contact us for assistance.

Disclaimer:   

Zen Insurance is an IRDAI registered broker which facilitates quick & accurate insurance broking services. We deal with only regulator approved products of insurers. We do not underwrite the products.