Group personal accident insurance

Q1. What is Group Personal Accident Insurance?

Group Personal Accident Insurance policy provides your beneficiary with a benefit in the unfortunate event of your accidental death and disability. It covers injury or death due to accidents. It covers the following:-

1. Accidental Death:
It provides for payment of compensation on the insured person’s death caused by bodily injury arising out of accidental, violent, external and visible means and resulting in death.

2. Permanent Total Disablement:

a. Loss of 2 Limbs (both hands or both feet or one hand and one foot)
b. Loss of a Limb and an eye
c. Complete and irrecoverable loss of sight of both eyes
d. Complete and irrecoverable loss of speech &hearing of both ears
3. Permanent Partial Disablement:

a. Use of a hand or a foot without physical separation
b. Loss of speech
c. Loss of toes – all
d. Loss of toes great – both phalanges
e. Loss of toes great – one phalanx
f. Loss of toes other than great, if more than one toe lost: each
g. Loss of hearing – both ears
h. Loss of hearing – one ear
i. Loss of four fingers and thumb of one hand
j. Loss of four fingers of one hand
k. Loss of thumb – both phalanges
l. Loss of thumb – one phalanx
m. Loss of index finger – three phalanges
n. Loss of index finger – two phalanges
o. Loss of index finger – one phalanx
p. Loss of middle finger or ring finger or Little finger – three phalanges
q. Loss of middle finger or ring finger or Little finger – two phalanges
r. Loss of middle finger or ring finger or Little finger – one phalanx
s. Loss of a Limb
t. Complete and irrecoverable loss of sight of an eye
u. Each arm at the shoulder joint
v. Each arm to a point above elbow joint
w. Each arm below elbow joint
x. Each hand at the wrist
y. Each thumb
z. Each index finger
aa. Each other finger
ab. Each leg above center of the femur
ac. Each leg up to a point below the femur
ad. Each leg to a point below the knee
ae. Each leg up to the center of tibia
af. Each foot at the ankle.
ag. Each big toe
ah. Each other toe
ai. Each eye
aj. Hearing in each ear
ak. Sense of smell
al. Sense of taste

3. Temporary Total Disablement:

a. Injury to vertebral body resulting in spinal cord damage
b. Pelvis
c. Skull (excluding nose and teeth)
d. Chest (all ribs and breast bone)
e. Shoulder (collar bone and shoulder blade)
f. Arm
g. Leg
h. Vertebra – vertebral arch (excluding coccyx)
i. Wrist (collies or similar fractures)
j. Ankle (Potts or similar fracture)
k. Coccyx
l. Hand
m. Finger
n. Foot
o. Toe
p. Nasal bone

5. Accidental Medical Expenses:

Reimburses the costs of medical expenses incurred by an insured person within 12 months of the date of loss resulting from an Accident

(You can decide which of these specific risks to insure for)

Q2. What is not covered under Group Personal Accident Policy?

1. Self inflicted injury
2. Participation in a criminal act
3. Participation in a hazardous sport such as Sky Diving, Scuba Diving, Bungee jumping etc.
4. Intoxication
5. AIDS/HIV
6. Terrorism
7. War or Civil War
Q3. What the insured has to do in the event of accident?

The following documents are required to be submitted :

IN THE EVENT OF ACCIDENTAL INJURIES

1. Immediate written notice should be given to the Insurance Company with all particulars.
2. Claim from duly completed along with the following documents should be submitted.
3. Medical Certificate about the nature and extent of accident resulting injuries
4. Certificate from the employer to the effect that the Insured was on leave during the period.
5. Fitness certificate.
6. Details of treatment rendered by the attending Doctor/Hospital/Nursing home.
7. Medical Examiner’s Report.

IN THE EVENT OF ACCIDENTAL DEATH

1. Post-mortem Report.
2. F.I.R./Police Report.
3. Panchnama
4. Departmental Inquiry, if any.
5. Report of Doctor/Hospital/Nursing Home.
6. Death Certificate
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