Personal Accident Insurance

While minor accidents can indispose you temporarily, major ones can severely impact your life and well-being. A sound insurance plan to protect you from economic repercussions of having a mishap has become a necessity. The value of the human life is immeasurable, but with a view to providing some relief to the injured person or a dependent, insurance companies have devised this insurance policy. It refers to an insurance which offers compensation in the event of demise, bodily hurts, impairment or mutilation resulting from an event, such as a violent, hazardous, visible and external means. The types of events that are included in such insurance are rail, road, and air, injury because of collision or fall, burn injury, drowning etc. The policy guards your dependents (parents or family) from any economic repercussions if the unfortunate comes to pass. A person should purchase the policy that covers or provides reimbursements for all eventualities from short-term impairment to untimely demise, and safeguard the family’s future. Besides, online renewal of these plans is just a few clicks away.

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Personal Accident Insurance Plans

Insurance CompaniesPersonal Accident Insurance PlansAgeSum AssuredPolicy TermNo Claim Bonus
HDFC Ergo General InsurancePersonal Accident Plan18 – 65 years2.5 lakh – 15 lakh1 year5% for each claim free year; limited to 50% of initial sum
New India AssurancePersonal Accident Policy5 – 70 yearsN/A1 year5% for each claim free year; limited to 50% of initial sum
Royal Sundaram General InsuranceIndividual Personal Accident Policy (Death & Disablement Only)18 – 65 years5 – 75 lakhs1 year5% for each claim free year; limited to 25% of initial sum
SBI General InsuranceIndividual Personal Accident Insurance Policy18 – 65 years1 lakh – 10 lakh1 year5% for each claim free year; limited to 50% of initial sum
Max Bupa Health InsurancePersonal Accident Health Insurance18 – 65 years5 lakh – 25 lakh1 – 2 year5% for each claim free year; limited to 25% of initial sum
ICICI Lombard General InsuranceICICI Lombard Personal Protect18 – 80 years3 lakh – 25 lakh1 year/ 2 years/ 3 yearssum increased by 10 percent at renewal after each claim-free year; max up to 50 %

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types of personal accident insurance

Personal accident policy can be further divided under two sub-heads

Individual Accident Insurance:

This policy guards an individual in the event of any intentional or unintentional mishap. The incident may cause impairment, whether short-term or lifelong wounds or even demise.

Group Accident Insurance:

As the term itself suggests, it is not meant for individuals and is taken by employers for their employees. Depending on group size, discount on premium might be offered as well. It is a good incentive/ value added advantage for small organizations as it is available at low cost. However, this is a very basic plan and may not offer advantages like that of an individual plan (subject to terms of the plan). Most of IRDA approved policies include major events or cases, such as impairment, whether short-term or lifelong or even untimely demise.

Accident insurance policy can protect the policy-holder and his/her spouse from the economic concerns such as loss of income and medicinal expenditure that unexpected accidents lead to. It is essential that people understand the features, advantages and the necessity of impairment and demise insurance policies a bit more in detail. With these plans available online, the renewal is very easy.

accident coverage insurance

Coverage under Personal Accident Insurance Policy

Enjoy the following advantages under this insurance policy –

  • Accidental death: The benefits under this plan is payable if demise occurs from a mishap.
  • Accidental disability: It indicates that the policyholder is disabled either partially or wholly.
  • Accidental dismemberment: It indicates that a part of the policyholder’s body has been severed or dismembered. It means, if the policyholder loses his hand or leg or eyes in a mishap, then he would be eligible to get a claim under dismemberment.
  • Terrorism act: Injuries afflicted because of terrorist acts are also included.
  • Daily payment during hospitalization: It gives monetary relief to a patient while he undergoes cure at the hospital.

benefits personal accident insurance

Advantages of Personal Accident Insurance Policy

Pause for a moment to think, what will happen to your dependent if you become permanently disable because of a mishap (hit by a motor vehicle)? There would be no monthly or annual earnings but bank EMIs, medicinal costs, and other expenditure will keep increasing. To deal with such situation, it is important to purchase such a policy with all mandatory disclosures read carefully. To give you a better understanding, we have listed the top advantages of having insurance-

  • Family security
  • No requirement of medical tests and documentation
  • Substantial cover at lower premium
  • Worldwide coverage
  • Can be bought for individually or family
  • Easy and certified claim process
  • 24×7 support service
  • Legal and funeral expenses
  • Child education advantage
  • Double indemnity for demise/ impairment while traveling in public transport
  • Highly customized plan

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Who Should Buy Personal Accident Insurance Coverage?

Irrespective of your age, occupation and health, it is strongly advised to purchase accident insurance. In fact, you should buy this plan as soon as you start earning. It is more important for those who have taken loans, vehicle loans, and mortgages because this would offer protection towards repayment of the outstanding balance in the event of a mishap. Unlike life insurance policy, the premium of this policy will be decided by your occupation rather than age. You will be able to pay online and make sure it does not lapse. Generally, there are 3 categories under which occupational risks can be segmented-

Doctors, Machine operators, and Underground mines workers

Class 1= Low RiskClass 2= High RiskClass 3= Very High Risk
AccountantsMoney carrying employeesJournalists
LawyersBuildersPeople working in explosive industries
BankersContractorsMountaineers

How much Accidental Insurance Coverage is enough?

Although it is tough to value the human life but some yardstick is required to fix the money. The rule book says that it should be 100 times your monthly income. For example, if your current earnings are Rs 10,000 then your plan should be Rs 10, 00,000. This ensures that all possible eventualities, such as loan repayment, children’s education and marriage, regular earnings for the spouse are taken care of in the event of any lifelong impairment or even demise, provided the insurer’s liability renewed timely.

Major Inclusions and Exclusions of Personal Accident Insurance

Educating yourself about terms and conditions before you avail such a policy always works in your favor. So have a quick glance over inclusions and exclusions:

Accidental deathNatural death
Permanent total/ partial disabilityPre-existing disability or injury
Accidental dismembermentChildbirth or pregnancy
Medical expenses/ hospitalization chargesSuicide or self-injuries
Child education supportNon-allopathic treatments
Life support benefitInfluence of intoxicants
Burns, broken bones and AmbulanceCommitting a criminal act, or being involved in war activities Suffering from mental disorder
Daily allowanceParticipating in naval, military, air force, adventurous or sports activities

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accident insurance claim

How to File Accident Insurance a Claim?

To initiate claim process, one needs to inform the provider about the event within the specified time frame. You might be provided with a claim reference number. The following information is required to be submitted to the provider when intimating your claim-

  • Your contact numbers
  • Policy number
  • Date and time of accident
  • Name and contact details of insured person who is injured
  • Location of incident
  • Brief description on how the accident/ loss took place with its location details
  • Extent of loss

It is essential that these details are known to the family members or dependents (including spouse) also as an unexpected event such as demise may put them in situations where they are unaware of what to do next.

In case of Accidental death/ disablement claim, following documents are required to submit-

  • Death certificate
  • Post-mortem report
  • FIR report
  • Medical certificate
  • Medicine bills

As a necessary precaution, policyholders can ensure that these details are kept for future reference of the family members so that they are not left helpless or any advantage unclaimed in the event of an unexpected event leads to a coma or even demise.

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  • The Need for a Personal Accident Policy

    Life is uncertain. The whole idea of taking insurance is to protect oneself and one’s family from uncertainties and eventualities. A life insurance policy safeguards you against unexpected demise and a health policy includes medicinal expenditure in the event of an illness. The diseases not specified in the documents come under exclusion segment. One is likely to believe that life insurance and health insurance cover all the insurance requirements of an individual, however, this is not true. This IRDA approved plan takes care of events, such as demise and disabilities are a must.

    Accidents are undesirable, unexpected and unplanned incidents which may cause physical injury, impairment, and even demise, excluding ones resulting from any self-inflicted act. Such mishaps happen without prior intimation when one is least expecting such an event. They become stumbling blocks in leading a normal life and often compromise the ability to earn a living. Such policies are meant for such situations and plug this important gap in one’s insurance portfolio, which is not adequately covered by a life and health policy. This policy does authorize the insured to avail an extra layer of protection for his or her loved ones if they already have an insurance plan like an endowment policy.

    This policy provides financial support to the policy-holder if he or she is disabled due to an accident, irrespective of the magnitude of the mishap. These plans include the insured from impairment, demise, and dismemberment because of a mishap. Both disabilities are included, which usually affect one’s ability to earn at the same level before the accident. A life insurance policy does not typically include such circumstances. Moreover, a health policy or mediclaim only includes medicinal expenditure and does not reimburse expenditure for impairment or demise.

    The best personal accident insurance plans in India help the families and dependent members of the insured cope better with the emotional loss by providing them much needed financial support in times of need when the worst such as demise transpires. In case of impairment, the policy-holder is provided compensation for lost earnings because of an accident. It also brings peace of mind as it guards against the most unexpected events.

    Other benefits include hospitalisation, hospital bill payment, compensation of ambulance cost etc.

  • Primary Features of Personal Accident Insurance Policy

    This policy is designed to provide compensation and is applicable for accidental injury resulting in demise or impairment covering four major events:

    Accidental Death:

    In case of unexpected demise or wounds during the policy period, the entire money is paid to the nominee as mentioned in the policy document. There are certain documents that need to be shown in case of demise, and these have been shown elsewhere in the page.

    Permanent Total Disablement:

    In the unforeseen event resulting in lifelong total impairment of the insured, the advantage under this policy is paid to the insured policy-holder.

    Permanent Partial Disablement:

    In the unfortunate event of bodily injuries, resulting in permanent impairment of the insured, usually a certain percentage up to 100% of the benefit is paid to the insured person. The reimbursement total is determined by the extent of loss or impairment.

    Temporary Total Disablement:

    A payment is made if the insured suffers a mishap that may result in short-term impairment and confinement to home. A weekly payment, subject to a maximum limit, is paid to the policy-holder to tide over the short term crisis when he or she is unable to undertake work or employment for a few weeks or months, or if it leads to the lost earnings.

  • Additional Features of Personal Accident Insurance Policy

    This policy may also include the following expenditure in addition to the four primary ones mentioned above:

    Hospital Daily Cash:

    A daily cash allowance is paid to the insured for medication due to an accident. This is limited to a certain number of days specified in the terms and conditions of the policy.

    Ambulance Expenses:

    This policy reimburses the ambulance charges to ferry the insured post-accident to the hospital.

    Transportation or Repatriation of Mortal Remains:

    In the unfortunate event of demise, the nominee receives the money towards transportation of the mortal remains from the demise site to hospital, residence or cremation ground. This also includes the cost of religious ceremonies related to cremation.

    Broken Bones:

    If the bodily injuries to the insured result in fractured bones or bone damage and not in lifelong impairment or demise, a fixed compensation is payable under the policy.

    Burns:

    If such a mishap results in hospitalisation of the insured for the cure of burns, a certain percentage of the policy benefit is payable.

    Family Transportation Allowance:

    This applies when an accident results in the confinement of the principal insured to a hospital quite far (defined in terms of a specific number of kilometers) from his or her residence. In such instances, the actual transportation expenditure in lieu of cure of immediate family member on the recommendation of a medical practitioner, to reach the insured person is compensated. The total reimbursement payable is subject to a maximum amount specified in the policy.

    Education Advantage:

    In case of unexpected demise of the insured, the cost of education of dependent child is included in the policy up to a specified limit. This cost includes the amount that the insured may have paid if his demise had not occurred.

    Loan Protector:

    In the event of unexpected demise or lifelong total impairment of the insured, a lump sum amount specified in the policy schedule is paid. This helps tide over difficulties from loan repayment that would not have occurred if the demise had not come to pass.

    Adaptation Allowance (also known as Home Alteration and Vehicle Modification Benefit):

    In case permanent total impairment or dismemberment due to an unforeseen event, money has to be spent to modify one’s house and/or vehicle to make it impairment friendly. Most of IRDA approved policies offer this advantage. There is usually an upper limit to the money that is reimbursed.

  • Group Personal Accident Plan

    Many companies offer such a plan to their employees through a group cover. More often than not, such policies have a basic cover for unexpected demise or impairment and do not provide the same advantages available under a standalone policy. The rate of premium for a group policy is relatively less as insurance companies offer a discount depending on the size of the group.

    Some companies in the segment provide their unique calculators that can help their employees determine their annual payouts. A corporate group health plan also features portability of assured advantages as constituted by IRDA Act, 1999, backed by Government of India.

    An individual can opt for a like policy if he or she can afford it and if the company’s group policy is insufficient.

  • Tax Benefits Under a Personal Accident Policy

    Section 80D of the Income Tax Act 1961 does not provide any tax benefit for the premium paid for these plans that insure against any physical impairment, dismemberment or demise. However, it is important to understand that the primary reason for buying any kind of insurance is protection and safety. Insurance decisions should never be driven by tax considerations.

  • Personal Accident Plans – Final Take

    These plans are clearly successful in plugging a gap in an individual’s insurance portfolio arising from unexpected demise or impairment due to accidents. However, the truth is that even the IRDA approved best accident insurance plans (in addition to life and health insurance policies) do not consider policy-holder for impairment due to a natural illness and such causes. For these, the insured can opt for additional optional riders such as critical illness rider.

    The maximum amount payable varies from one policy to another. Also, people looking for impairment or unexpected demise advantages should consider any sub-limits that may exist in the plan. If the amounts seem inadequate for the persons under the impairment or demise policy, one can alternately purchase demise or disability rider on one’s insurance plan in addition to the maximum available cover. The catch here is that such as demise or disability rider only includes permanent total disablement and not impairment. As such, considering the limitations, this policy makes actually work out better.

InsurerPlan NameHospitalizationFamilyCoverAmbulancePTDPPDIssuance
Max Bupa Health InsuranceHealth Assurance- Personal AccidentHospi-Cash providedcovers upto 2 childrenNot coveredcovered upto 125% of Sum Assuredcovered from 25% to 100% of Sum Assurede-Policy
Bharti AXA General InsurancePersonal Accident SuperiorHospi-Cash of Rs 1000 per day for 30 L cover & upto 20% of Sum assured for 20 L and 30 L covercovers individuallyNot coveredcovered for 1.5 times of Sum Assuredcovered from 2% to 75% of the Sum AssuredInstant e-Policy
HDFC ERGO General InsuranceIndividual Personal Accident (IPA)Hospi-Cash provided  covered upto 100% of Sum Assured Instant e-Policy
ReligareSecure 1 – Personal AccidentCovered in Add-on Ridercovers individuallyNot coveredcovered from 50% to 100% of the Sum Assuredcovered from 2% to 75% of the Sum Assurede-Policy
Secure 3 – Personal AccidentCovered in Add-on Ridercovers individuallyNot coveredcovered from 50% to 100% of the Sum Assuredcovered from 2% to 75% of the Sum Assurede-Policy
Apollo Munich Health Insurance Company Ltd.IPA-StandardNot Covered Rs. 2000covered from 50% to 100% of the Sum Assuredcovered from 2% to 75% of the Sum Assurede-Policy
border-left: none>IPA-PremiumNot Covered Rs. 2000covered from 50% to 100% of the Sum Assuredcovered from 2% to 75% of the Sum Assurede-Policy
The New India Assurance Co. Ltd.E_Personal AccidentHospi-Cash of Rs.200 per day for 50 daysCovers individuallyNot coveredupto 100% of Sum Assuredupto 50% of the Sum Assurede-Policy
Liberty Videocon General Insurance Co. LtdGroup Personal AccidentHospi-Cash of Rs.500 per day for 30 daysCovers individuallyNot coveredupto 100% of Sum Assuredcovered from 2% to 70% of the Sum Assurede-Policy

What is Personal Accident Insurance?

Ans:

An insurance policy that considers expenses incurred for treatment of wounds that occurred in an unfortunate event, caused by road/air/rail collision, fire, explosion, and so forth. This insurance offers certain coverage for medical expenses and with respect to the loss of income due to an accident.

What is covered by Personal Accident Insurance?

Ans:

    1. Accidental Demise: payable to nominee, in case the policyholder dies in an accident
    2. Permanent/partial disability: the loss of income, in case of permanent/partial accidental disability
    3. Dismemberment: provider considers the loss of income, in case of dismemberment (loss of limb)

Medical Expenses: provider bears medicinal expenses incurred for treatment of injuries to the policyholder

What is not covered by Personal Accident Insurance?

Ans:

One must keep in mind the exclusions of this policy while following points are generally not included:

  1. Any pre-existing injury or disability
  2. Use of alternate medical treatments (e. Unani, Ayurvedic, Homeopathic etc)
  3. Any self-harming acts (e. Suicide or purposeful overdose)
  4. Accidents resulting from drunk driving or use of other intoxicating substances
  5. Injuries/death from illegal activities
  6. Injuries/death due to involvement in a war
  7. Injuries/death due to mental disorder
  8. During pregnancy/childbirth

What are the benefits of buying Personal Accident Insurance?

Ans:

    1. High Coverage: considerable inclusion for the policyholder
    2. No Medical Check-up Required: buying this insurance requires no medical examination
    3. Children Education Benefit: coverage is provided for children education after unexpected demise/disability resulting in lost income
    4. Lifestyle Support: financial support to the family, in case of unexpected demise/disability resulting in loss of income
    5. Death/Disability Coverage: for demise/disability due to an accident caused by public transport
    6. Coverage for Increasing Healthcare Cost: keeping an eye on increasing healthcare cost, including medical medication against inflation
    7. Group Insurance Benefit: discounted premium prices for group insurance

Plan Flexibility: coverage is offered for single and family

Do I need Person Accident Insurance?

Ans:

Life is full of risks when you are traveling to your destination. A mishap may result in several outcomes, viz. partial/permanent disability, or even demise. This insurance is recommended for anyone who travels too much not just for life support, but for financial support as well, especially in case of lost income.

What does it cover?

Ans:

This policy makes you feel free as it covers you against demise or damage caused by any unfortunate event for example accident, explosion, and terrorist attack. This insurance policy provides the full inclusion for expenditure in lieu of the medication of injuries due to any unfortunate event. It also includes the lost regular earnings due to an accident. The nominee receives the advantage in some of the cases given below:

  1. When the policyholder dies in an accident.
  2. If the policyholder is injured and becomes disabled the policy ensures the policyholder with the loss of income and also take care of regular treatment expenditure.
  3. Wounds or damage caused by the terrorist attack is also included in this policy.

If the policyholder loses any of his body parts, he or she is eligible to get a claim under dismemberment.

Why You Should Buy Personal Accident Insurance?

Ans:

Life is uncertain and it needs certain measures that can make you feel safe and secure at every point of life whether you are going on vacation or enjoying a long drive with your loved ones. Don’t worry about the financial need when you are not able to earn due to any wounds or impairment, because it includes all expenditure related to medication of policyholder and also provide financial aid if the person is not able to work for the time or lifetime due to its permanent or partial impairment respectively. It also helps to provide family security at the lowest premium with easy and quick claim process. These plans are highly customized which can be altered according to your need.

When can you Claim for the Benefits after Buying the Policy?

Ans:

You can claim the benefits of policy whenever you need it. There is no fixed time period to claim the advantage the policy-holder can claim for the benefits whenever he meets any unfortunate event like the accident.

How are Personal Accident policies different from personal guard?

Ans:

A personal guard insurance plan is the personal accident policy which covers up to the highest compensation of 125% of the total insured under the policy benefits. There is no extra premium charged for this advantage.

What are the documents needed for a claim?

Ans:

Read below to know the mandatory documents required for claiming the advantages of the policy:

a.) Temporary total disablement

  1. Claim form
  2. Medical certificate from the doctor
  3. Leave approval from the employer
  4. Discharge summary

b.) PTD & PPD

  1. Claim form
  2. Medical tests
  3. Certificate of disability from the doctor

c.) Death Claim

  1. FIR, post-mortem report
  2. Death certificate

d.) Medical Expenses

  1. Hospitalization bills
  2. Discharge summary
  3. Medicine prescription

What is the Eligibility of Personal Accident Insurance?

Ans:

Child above the age of 5 years and adult up to 65 years is eligible for this insurance plan. He or she is covered for Rs1/ basic and Rs1/-Lac wider, whereas if the person is below 65 years he or she can be included in the highest SI of Rs 1 Lac.

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