Group Personal Accident

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What are the different types of Disabilities covered under a Group Personal Accident Plan?

Group personal accident insurance plans cover diverse types of disabilities. The disabilities caused by accidents are classified under the following three sections for determining compensation:

  1. Permanent Total Disablement (PTD)
  2. Permanent Partial Disablement (PPD)
  3. Temporary Total Disablement (TTD)

Permanent total disablement refers to the permanent loss of functionality. For example, if both legs and arms are severed or both eyes turn blind. This must last more than 365 days to be considered permanent arms or feet from the body, loss of eyesight or hearing without recourse.

Permanent Partial Disablement refers to the partial loss of functionality without the chance of recovery or treatment. For example, if one leg or eye are damaged and not impairable within 1 year

Read More: What is group personal accident insurance?

There, the insurer pays a weekly benefit instead of a one-time lumpsum amount.

Since the disablement is considered for a limited time, the insurer may apply a limit on the maximum period for which the benefit is payable. This limit depends on the percentage of the sum insured (S.I.) payable with each instalment. The insurer will pay only up to the maximum S.I. Under the plan. A few examples illustrating the types of disabilities are given below.

Case: 1

As a senior accountant, Radha Sharma was working in K.J Jewellers for the last ten years. When her retirement was a few years away, destiny played its game.

One day, when she was coming back from the office, her car collided with a truck coming from the other side. The impact of the collision was so severe that the truck driver died on the spot and Radha suffered grave injuries. Some passersby took her to a hospital where doctors operated on her immediately. Though her life was saved, the doctors had to amputate her right hand and both legs.

All her medical expenses were covered under group personal accident insurance policy offered by K.J Jewellers. As she became permanently total disabled, the insurer not only covered medical expenses incurred on the treatment of Radha but also paid a lump-sum amount (on the basis of her salary) to deal with the loss of income. As she also lost her earning ability, the lump sum amount helped in dealing with costs such as expenses and EMI’s.

Case: 2

It was the fateful day of December in 2015 when Ram Sharan’s hand gloves caught between the machine while working in the clothing mill in Gujarat. His co-workers took him to a hospital, where the doctors had to cut a portion of his right thumb which got severely damaged in the accident.

Doctors kept him under observation and discharged him after a week.

Ram Saran’s employer had covered him in a group personal accident insurance policy. Considering the case as a permanent partial disability, the insurer agreed to cover medical expenses and also paid a lump sum amount to Ram as per his salary. His partial disability was permanent which affected his earning capacity, and he had to find a new job as per his current state.

The insurer’s lump sum amount provided much-needed relief to the family.

Case: 3

Vijay Saran was traveling to Pune on an official trip when his car brakes failed and hit stationary mini truck. As Vijay’s car had airbags, they opened as soon as the car hit the truck. Thankfully, these airbags saved his life, however, he sustained some injuries and was being taken to a nearby hospital by passersby.

Read More: How the claim is processed under group personal accident insurance?

Though doctors declared him out of danger, he was in shock and lost sensation in both his hands and feet. As per the doctors attending him, “Due to the accident, Vijay is under shock because of which, movement in some of his body parts is restricted. His condition will improve with time and eventually he will start working normally as he would have before the accident.”

In this case, Vijay’s employer was covering him under a group personal accident insurance policy. Though he was disabled, it was temporary, and therefore, instead of paying a lump-sum amount, the insurer paid weekly benefits as per the sum insured for six months. The insurer asked for his salary certificate to decide the amount to be paid to Vijay as weekly compensation.

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What are the different types of Disabilities covered under a Group Personal Accident Plan?

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