GROUP PERSONAL ACCIDENT

GROUP PERSONAL ACCIDENT


BASIC

This product has been developed to provide economical coverage to participants. Under this cover if any person covered dies due to accidental means within ninety (90) days of such accident and sustained injuries are solely and independently caused by external, violent and purely accidental means, compensation will be paid to the Participant for benefit of his/her beneficiaries.


The sum covered would either be a fixed amount for everyone, or determined according to some agreed category. Most employers tend to link amount of coverage with employees designation or salary, whereas organizations would normally provide equal amount irrespective of membership status. The cover is provided without ascertaining the state of each person’s health condition up to certain amount of sum covered (free-cover limit), beyond which he/she will be medically examined.

Admissible Ages and Terms

The minimum and maximum ages at entry are 18 years and 64 years.

Benefits Payable on Death During Coverage

In case of accidental death of the person covered during the covered period, the Sum Covered will be payable to the employer/ participant.

Minimum and Maximum Sum Covered

The minimum acceptable Sum Covered will be Rs. 100,000. The maximum Sum Covered is subject to the non medical and company underwriting limits.

Supplementary Benefits (Optional)

(a) Accidental Disability Benefits

Under Accidental Disability if any person covered sustains bodily injuries effected solely through external, violent and purely accidental means, and within ninety (90) days after such injuries are incurred, shall suffer losses, compensation will be paid to the Participant for the benefit of the person covered as per the following schedules:

Permanent Total Disability

If a covered member sustains bodily injuries and suffers losses which are ‘permanent and total’ the following compensation will be paid to the Participant for the benefit of the covered member:

Description of Injuries Compensation
( % of Sum Covered )
Loss of both hands or amputation at higher sides 100%
Loss of hand and a foot 100%
Double amputation through leg or thigh amputation through leg or thigh on one side and loss of other foot 100%
Loss of sight to such an extent as to render the claimant unable to perform any work for which eye-sight is essential 100%
Very severe facial disfigurement 100%
Absolute deafness 100%
Permanent Partial Disability

If a person covered sustains bodily injuries and suffers losses which are ‘permanent and partial’ compensation will be paid to the Participant for the benefit of the person covered a scheduled percentage of sum covered (subject to degree of disablement), varying from 1% to 90%.

Temporary Total Disability

If a person covered sustains bodily injuries which are ‘temporary and total’, compensation will be paid to the Participant for the benefit of the person covered for the loss of wages in terms of fortnightly payments of an agreed amount until he/she resumes work subject to a limit of 1 (one) year.

(b) Accidental Hospitalization Benefit

Under Accidental Hospitalization if any person covered suffers an injury due to accident and is hospitalized, medical expenses (on reimbursement basis) up to an agreed limit will be paid to the Participant for the benefit of the person covered.

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