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Personal Accident Insurance

Personal accident insurance plan provides coverage in case of a road accident, accidental death and disability. It provides income replacement in case the policyholder can’t work due to any disability. This cover provides comprehensive insurance coverage to the policyholder.

As per a survey conducted in 2016 by Transport Research wing under Ministry of Road Transport & Highways, Government of India, more people die due to road accidents as compared to deadly diseases like cancer. India tops the list of the highest number of deaths due to road accidents. In such a scenario, owning an accident insurance policy is a must.

If you meet with an accident and you succumb to the injuries, your life insurance policy will be helpful in providing financial assistance to your family. Even, if you own a best health insurance plan, it will cover hospitalisation expenses. But, what if the accident results in a permanent or temporary disability that restrains you from performing daily activities? The situation becomes worse if you’re the sole bread-winner of the family. How will your family survive without income?

Here is where a personal protect cover comes into the picture.

Benefits of Buying a Personal Accident Insurance Policy In India

The benefits of buying an Accident Insurance policy are:

  • Accidental Death Compensation: The nominee of policyholder gets compensation in case of insured’s accidental death. This compensation varies from Rs.5 Lakh to Rs.1 Crore. Hence insured’s family of the gets much-needed financial security.
  • Extensive Financial Protection in the Situation of Permanent Total Disability: An accident can cause permanent disability. However, having an accidental insurance policy provides cover against such situations. The policyholder has to pay a pre-decided premium as per the opted sum assured. Most of the policies cover the loss of speech, hearing loss from both the ears or loss of vision in both eyes.
  • Benefits of Transportation: In case the policyholder is hospitalized far away from his/her home, some insurance policies provide transportation benefits to the insured’s family.
  •  Covers Permanent Partial Disability: If a policyholder is partially disabled like such as loss of hearing in one ear or loss of vision of one eye or amputation one finger or one hand, the insurance policy provides compensation for the same.
  • Additional Benefits: Some personal accidental insurance policies also provide various additional benefits like the benefit of employment or education or funeral expenses etc.

Best Personal Accident Insurance Plans

Plan Name Entry Age Plan Tenure Sum Insured (Rs.) Benefits Offered
Apollo Munich Individual Personal Accident Insurance Premium Plan

Minimum: 91 days

Maximum: 69 years

1 year
  • 5 lakh-5 crore
  • Up to 5,00,000 (up to 70 years)
  • Accidental death benefits
  • Lump sum amount payable towards Permanent Total Disability
  • Permanent Partial Disability cover
  • Emergency ambulance expenses
  • Expenses incurred for transportation of mortal remains
  • 50% of sum insured is paid towards the education of the dependent children
  • Transportation costs of imported medicines
  • Lump sum amount for treatment towards broken bone due to an accident
  • Expenses incurred in the modification of insured vehicle/residence
  • Accidental hospitalisation/in-patient hospitalisation
Standard plan

Minimum: 91 days

Maximum: 69 years

1 year 1 lakh-5 lakh
Bharti AXA Smart Individual 18-70 years 1 year 10 lakh/20 lakh/ 30 lakh
  • Coverage for accidental death
  • Disability
  • Permanent partial disability
  • Advantage of double indemnity
  • Hospital cash
  • Lifelong renewability
  • Portability benefit at the time of renewal
  • Free-look and grace period
  • 5% to 50% of increment on sum insured for every claim-free year
  • Transportation expense of mortal remains
  • Funeral expense
  • Accidental medical costs
  • Educational assistance to the dependent child
Religare Secure Personal Accident Insurance 24-70 years

Children-from 91 days

1/2/3 10 lakh-50 lakh
  • Accidental death cover up to the sum insured
  • Permanent total disability cover
  • Permanent partial disability
  • Permanent partial disability improvement (only by Plan Secure 2 and Secure 3)

Fractures-

  1. Secure 1: up to Rs.                        50,000
  2. Secure 2: up to Rs.                     1,00,000
  3. Secure 3: up to Rs. 2,00,000
  • Child education up to 10% of sum insured
  • Repatriation of mortal remains, burn, mobility cover common carrier mishap cover, accidental hospitalisation etc.
Bajaj Allianz Premium Personal Guard Plan 18 years-65 years

Children from 5 years to 21 years

1 year 10lakh/15lakh/20lakh/25lakh
  • Accidental hospitalisation expenses
  • Hospital confinement allowance from Rs.1000-2500
  • No Claim Bonus 10% of sum insured
  • Death cover
  • Permanent total disability
  • Permanent partial disability
  • Rs. 5,000 towards education allowance of the children in case of the death of the insured
  • Temporary total disability
  • Expenses incurred for transporting mortal remains
HDFC Ergo Personal Accident Insurance Anyone below 65 years 1 year 2.5lakh/5lakh/7.5lakh/10lakh

/15lakh

  • Accidental death
  • Permanent total disability
  • Broken bones coverage for elderly people up to the age of 70 years
  • Burns
  • Hospital cash
  • Ambulance fee
  • 100% coverage for spouse under family plan
Star Health Accident Care Individual Insurance 18-70 years

Children from 5 months-25 years

1 year 5 lakh/10 lakh/15 lakh
  • Accidental death-100% of sum insured
  • Permanent total disability
  • Permanent partial disability
  • Temporary total disability
  • Free-look period of 15 days to cancel the policy
  • Renewal grace period of 30 days
Oriental Janata Personal Accident Policy 10-80 years 1 year 25000-5,00,000
  • Permanent and total disability due to an accident
  • Accidental death
  • Loss of sight of both the eyes or loss of use of two hands or feet
  • Total loss of sight of one eye or loss of use of one hand or foot
Reliance Personal Accident Policy 5-70 years 1 year 20 lakh
  • Complete coverage for accidental death
  • Permanent disability cover
  • Permanent partial disability
  • Transportation expenses of mortal remains up to Rs. 2500
  •  Worldwide coverage
  • Medical expenses cover
  • Off-duty and on-duty cover
  •  5% increase of sum insured for every claim-free year
  • Educational expenses or two dependent children in case of the demise of the insured
New India Personal Accident Policy 5 years -70 years
  •  Accidental injuries
  • Death benefit
  • Permanent total disability
  • Permanent Partial disability
  • Temporary total disability
  • Transportation expenses of mortal remains
  • Education grant up to 10% of SI if the insured has one child with the age below than 25 years
  • Maximum of Rs.50,000 if the insured has more than one child, below the age of 15 years.
  • Cumulative bonus of 5%
  • Worldwide coverage
  • Hospital expenses

 

Types of Personal Accident Health Insurance policies

The various types of Personal Accident Insurance are:

    1. Individual Accident Insurance Policy: This policy covers an individual in case of an accident. If the accident causes any bodily injury, permanent total disability, temporary total disability, partial disability, the insurance company will provide compensation for the same. In case of death, the compensation up to the sum insured is offered.The premium for individual accident insurance is computed on the basis of the insured’s age, coverage opted, location etc.
    2.  Group Accident Insurance Policy: This policy is designed for a group of people belonging to the same organisation. It is purchased by the employer for the employees. This policy is very cost-effective, as the premium is paid by the employer only. The premium for group personal accident insurance is computed based on the group size and the coverage opted for. However, it might not be as comprehensive as an individual one.

Personal Accident Insurance: Inclusions

Personal accident insurance offers a variety of coverage to protect your finances. Here is the basic insurance coverage:

Accidental Death 100% coverage or sum assured is offered in case of insured’s death due to an accident. With this benefit, the policyholder can secure the financial future of the family in case of any demise.
Loss of Two Eyes or Two Limbs Due to an accident, if the insured losses both limbs or both eyes then the insurance company will provide 100% coverage.
Loss of one limb or one eye If the insured meets with an accident that results in the loss of one limb or loss of an eye, 50% of the sum assured is paid by the insurance company.
Permanent Total Disability If an accident results in total disability, due to which the insured person is unable to earn the income, the insurance company provides the entire opted sum assured for survival.
Permanent Partial Disability In case of permanent partial disability due to an accident, i.e. loss of toes, loss of hearing ability, loss fingers etc., pre-decided insurance coverage is provided.
Temporary Disability It compensates the insured against any temporary disability in case of permanent partial disability due to an accident that makes the person unable to work for a certain time.

Personal Accident Insurance: Exclusions

While personal accident policy offers wide coverage, the following are the situations that are not covered.

Self-inflicted Injury Any injury with the intention to harm or damage to self-such as attempted suicide, suicide, involvement in criminal activities, riots, civil commotion, non-compliance etc.
Consumption of Intoxicants Any injury caused due to driving under the influence of alcohol, drugs or other such substances.
Participation in Adventure Sports Any injury caused due to participation in adventurous activities, adventurous sports etc.
Outdated Claims Any claim that is filed after the end of claim filing period.
Pre-existing Injury Pre-existing injuries, infections and illnesses caused due to childbirth.

Additional Coverage Offered by Personal Accident Insurance Policy

Apart from the basic coverage, the personal accident policy also provides the additional coverage:

  • Daily Cash Allowance in Case of Hospitalization:A daily cash allowance is paid to the policyholder for buying the medicines for the However, this facility is provided for a certain number of days mentioned in the policy’s terms and conditions.
  • Expenses of Ambulance: The incurred ambulance expenses will be reimbursed.
  • Burns:Some accidental insurance plans also provide a pre-decided percentage of sum assured for the burn treatment.
  • Broken Bones:  In case of fracture or broken bones due to an accident, compensation is provided by the insurance provider.
  • Transportation of Mortal Remains: In case of demise of the insured, the insurance provider reimburses the incurred expenses for transportation of the mortal remains. Some policies also cover funeral expenses.
  • Allowance for Education:In case of sudden demise of the policyholder, the education expenses of the insured’s dependent children are covered up to a certain limit.

How to File Personal Accident Insurance Claim?

The claim process must be followed step-by-step. In order to experience a smooth claim process, one must understand the entire process and file the claim accordingly.

Step 1- Intimate the Insurer

The first thing to do after an accident is intimating the insurance company as soon as possible.

Step 2- Duly Fill the Claim Form

The next step is to duly file the claim and attach necessary documents. Keep the below information handy at the time of filing the claim:

  • The contact number of the applicant
  • Policy number
  • Date and time of the incident
  • Name and contact number of the injured person or the insured
  • Location where the incident occurred
  • A brief on the accident mentioning where and how it took place, with all the relevant details.
  • Provide the extent of loss due to the accident

Make sure your family members know about all related information of the policy so that they don’t face any problem dealing with these in your absence.

 Documents Required to File Death Claim

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

Step 3- Submit the Claim

The next step is to submit the claim form.

Note- Make sure your family members know about all the policy related information so that they don’t face any problem filing the claim.

Personal Accident Insurance Plans – Some Facts

  • Best accident insurance plans successfully bridge the gap in a person’s insurance portfolio occurring due to unforeseen demise or disability due to an accident. However, one must not ignore the fact that even IRDA-approved accident insurance plans in India don’t cover the policyholder for any condition that arises out of natural illness or other such causes. To cover this, the insured should opt for add-on cover or critical illness insurance plan.
  • The maximum amount payable by the insured may vary insurer to insurer. Also, sub-limits may exist in the plan. One should consider this clause and if the amount seems to meet his/her insurance needs, then she/he can opt for an add-on disability rider to boost the insurance cover.
  • Hold on… the only catch is that these rider insurance plans only cover permanent total disability but not impairment. So, consider the limitations.

Some Additional Information

 

Premium

Premium is the amount that the policyholder has to pay in order to avail the policy benefits. With the help of personal accident health insurance premium calculator, you can calculate the insurance by filing up the required information.

Usually, the insurer categorises individuals into 3 risk groups. On the basis of risk exposure, the premium is calculated. The groups are as given below:

Risk Group I Risk Group II Risk Group III
Persons with a sedentary occupation or those who are less exposed to risks. Doctors, lawyers, bankers, accountants etc. come under this group. This group caters to the people who perform outdoor tasks and are also exposed to higher risk factors. Engineers, chauffeurs, builders, contractors etc. are included in this group. Those who come under this group have hazardous occupations with a high level of risk. Those who work in mines, circus performers, electrical workers, racers etc. come under this group.

Most people don’t know much about personal accident cover. They think having health insurance or life insurance is enough. Personal accident insurance is a necessary insurance product that ensures peace of mind amidst uncertainty. However, before zeroing on one, compare various personal accident insurance plans online.

Personal Accident Insurance FAQs

 

Q: Why should I buy personal accident insurance, if I have life and health insurance covers?

Ans: A life insurance plan provides death benefits to the nominee of the insured in case he/she passes away. A health insurance plan compensates and/or reimburses in case of hospitalization or other medical expenses.

However, a personal accident insurance, on the other hand, protects an insured against financial risks that could arise because of permanent total or partial disability due to an accident or accidental death of the insured. In this way, this policy is necessary to strengthen the financial portfolio of an insured and provide financial security to his/her entire family against any unforeseen situations.

Q: Should I need to pay higher premiums for personal accident insurance?

Ans: No, the premiums are not that high for personal accident insurance policies. For example, if you opt for an accidental insurance policy of Rs.5 lakh with the duration of 1 year, then the premium that you need to pay for the same is somewhere near Rs.610.

Q: Would a personal accident insurance policy cover my hospitalization expenses, if I meet with an accident?

Ans: You can avail of this optional feature by paying the extra premium. Usually, a hospitalization after an accident covers reimbursement against hospitalization medical expenses and sometimes daily cash cover is also given to you during the hospitalization.

Q: I travel overseas very often sometimes it is for work and sometimes it is for leisure. What will happen, if I meet with an accident outside the country? Do personal accident insurance policies cover accidents outside India?

Ans: Yes, most of the personal accident insurance policies provide worldwide coverage. In this way, you will get the reimbursement or your claim will be paid even if you are outside India and met with an accident there.

Q: I am a housewife who spends most of her time at home. Do I as well need personal accident insurance?

Ans:  Accidents can happen to anyone and at any time. Accidents due to natural calamities, motor accident, or rail accident, etc. can occur to anybody. Therefore, opting for a personal accident insurance is useful for all.

Q: What are the eligibility criteria to purchase personal accident insurance?

Ans: A child above the age of 5 years and an adult up to the age of 65 years are eligible to purchase a personal accident insurance plan.

Q: Please provide the list of documents required to file a claim of personal accident insurance?

Ans: The list of documents required in the claim process:

  • Temporary Total Disablement:
    • Claim form
    • Doctor’s medical certificate
    • Approved leave from the employer of the insured
    • Discharge summary
  • Permanent Total Disablement and Permanent Partial Disablement
    • Claim form
    • Certificate from the doctor mentioning the disability
    • Medical tests
  • Death Claim:
    • Post-mortem report and FIR
    • Death certificate
  • Medical Expenses:
    • Bills of the hospitalization
    • Medicine prescription
    • Discharge summary

Q: Does the personal accident insurance cover death?

Ans: Yes, and for the same, all one needs to do is to mention the name of the nominee on the policy document. The sum insured will be paid to the nominee in case of accidental death.