Coverage Of Personal Accident Insurance Scheme And Exclusions Of Claim
Personal accident insurance is a type of insurance policy that provides financial coverage to the insured person in the event of an accident resulting in bodily injury, disability or death. It is designed to provide financial support to the policyholder and their dependents in case of any unfortunate event. However, like any other insurance policy, personal accident insurance also has certain exclusions and limitations that must be understood by the policyholder before purchasing the policy.
Types of Personal Accident Insurance
There are generally two types of personal injury insurance: Individual Personal Accident Insurance and Group Personal Accident Insurance.
Individual Accident Insurance: This insurance is for individuals, and offers greater coverage than the group type. This insurance covers death from an accident as well as short- and long-term disability caused by accidents.
Personal Accident Insurance for Groups: Employers provide this type of insurance to their employees. These plans provide basic coverage but do not offer the same benefits as a standalone policy.
Coverage of Personal Accident Insurance Scheme:
The coverage of personal accident insurance policy may vary depending on the insurer and the type of policy. However, some of the common coverage options include:
Accidental Death: This coverage provides a lump sum amount to the nominee in case of the policyholder’s death due to an accident.
Permanent Total Disablement: This coverage provides a lump sum amount to the policyholder in case of permanent total disability due to an accident. Total disability is when the policyholder is unable to perform any work or activity due to the accident.
Permanent Partial Disablement: This coverage provides a lump sum amount to the policyholder in case of permanent partial disability due to an accident. Partial disability is when the policyholder is able to perform some work or activity but not all due to the accident.
Temporary Total Disablement: This coverage provides a weekly or monthly payment to the policyholder in case of temporary total disability due to an accident. Temporary disability is when the policyholder is unable to perform any work or activity for a limited period of time due to the accident.
Medical Expenses: This coverage provides reimbursement of medical expenses incurred by the policyholder due to an accident.
Education Fund: This coverage provides financial support to the policyholder’s children for their education in case of the policyholder’s death or permanent total disability due to an accident.
Coverage Of Personal Accident Insurance Scheme And Exclusions Of Claim
Exclusions of Personal Accident Insurance Policy:
Personal Accident Insurance is a type of insurance policy that provides financial protection to an individual or their beneficiaries in the event of an accidental injury, disability, or death. The policy covers various risks, such as accidental death, permanent or partial disability, dismemberment, and medical expenses.
However, like any insurance policy, Personal Accident Insurance has exclusions, which are specific circumstances or events that are not covered by the policy. Understanding these exclusions is crucial for policyholders to know what they can expect from their insurance coverage and avoid any unexpected financial losses.
The following are some of the common exclusions of Personal Accident Insurance Policy:
Pre-existing conditions: Personal Accident Insurance policies generally do not cover any injury or disability resulting from a pre-existing medical condition. It is essential to declare all pre-existing medical conditions when purchasing the policy to avoid any disputes in the future.
Intentional self-harm: The policy does not cover any injury, disability, or death resulting from intentional self-harm or suicide.
Drug or alcohol abuse: Any injury, disability, or death resulting from the consumption of drugs or alcohol is not covered by Personal Accident Insurance.
War or terrorism: Personal Accident Insurance does not cover any injury, disability, or death resulting from war, terrorism, or any act of violence.
Hazardous activities: The policy excludes injuries, disabilities, or death resulting from participating in hazardous activities such as skydiving, bungee jumping, racing, or any other extreme sport.
Criminal activities: Any injury, disability, or death resulting from criminal activities, such as theft, assault, or murder, is not covered by the policy.
Professional sports: Personal Accident Insurance does not cover injuries, disabilities, or death resulting from participating in professional sports or any high-risk activity associated with the sport.
Pregnancy or childbirth: Any injury or disability resulting from pregnancy or childbirth is not covered under Personal Accident Insurance.
Mental illness: The policy does not cover any injury, disability, or death resulting from mental illness, such as depression or anxiety.
Injuries sustained while driving under the influence: Any injury, disability, or death resulting from driving under the influence of drugs or alcohol is not covered under Personal Accident Insurance.
It is essential to read and understand the policy’s terms and conditions before purchasing Personal Accident Insurance. Any doubts or queries should be clarified with the insurer or insurance agent. It is also crucial to declare any pre-existing medical conditions or hazardous activities to avoid any disputes during the claim settlement process.
India: Companies offering Personal Accident Insurance
In India, several insurance companies offer personal accident insurance to provide financial protection in the event of accidental injuries or disabilities. Some notable companies offering personal accident insurance in India include:
ICICI Lombard General Insurance: ICICI Lombard offers personal accident insurance plans that cover accidental death, permanent total disability, and permanent partial disability.
HDFC ERGO General Insurance: HDFC ERGO provides personal accident insurance that offers comprehensive coverage against accidental death, disability, and accidental hospitalization expenses.
Bajaj Allianz General Insurance: Bajaj Allianz offers personal accident insurance policies with various options for coverage, including accidental death, permanent total disability, and temporary total disability benefits.
Reliance General Insurance: Reliance General provides personal accident insurance plans that offer financial protection against accidental death and disability.
Tata AIG General Insurance: Tata AIG offers personal accident insurance coverage that includes accidental death, permanent total disability, and weekly benefits for temporary total disability.
New India Assurance: New India Assurance offers personal accident insurance policies with coverage for accidental death, permanent total disability, and permanent partial disability.
Oriental Insurance: Oriental Insurance provides personal accident insurance with benefits for accidental death, permanent total disability, and hospitalization expenses due to an accident.
United India Insurance: United India offers personal accident insurance plans that cover accidental death, permanent total disability, and partial disability due to an accident.
National Insurance: National Insurance provides personal accident insurance with coverage for accidental death, permanent total disability, and hospitalization expenses arising from an accident.
IFFCO Tokio General Insurance: IFFCO Tokio offers personal accident insurance plans with comprehensive coverage for accidental death, disability, and hospitalization benefits.
When considering personal accident insurance, it is essential to compare the coverage, features, and premiums offered by different insurance companies. Additionally, read the policy terms and conditions carefully to understand the scope of coverage and any exclusions that may apply. Choose a policy that aligns with your specific needs and provides adequate financial protection in case of an unforeseen accident.
In conclusion
Personal Accident Insurance is an essential type of insurance policy that provides financial protection to individuals in the event of an accidental injury, disability, or death. However, it is crucial to understand the policy’s exclusions to avoid any unexpected financial losses.
FAQs
Q1. Does a personal insurance plan provide global coverage?
Yes, personal accident insurance provides global coverage.
Q2. Do I need a personal insurance plan if I work at a desk?
Even though there is a low risk of a desk job, unexpected events can happen so it is better to be prepared.
Q3. Do I have to take a medical exam to be eligible for personal accident insurance?
No. There is no need to go for any medical test to purchase a personal accident plan.
Q4. Is there an educational benefit in personal accident coverage?
Yes, there are companies such as SBI General, ICICILombard, and Reliance General that offer Education Funds.
Q5. If someone dies from a disease, does the family get the death benefit under the personal injury cover?
The policy does not cover death due to other causes than accidents.
Q6. Can I cancel my policy during the policy period?
Yes. There is a 15-day free-look period that usually begins at the beginning of the policy. During this time, one can cancel the policy and any premium paid will be refunded. This free-look period does not allow for claims.