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Personal Accident Policy

 

Personal Accident Policy

 

Salient Feature. 1

Scope of Cover and Premium Rating. 1

Risk Classification. 1

Medical Expenses. 2

Other Benefits. 2

Group Policies and Group Discount 2

Geographical Limit 2

 

Salient Feature

 

The policy compensates  individual against death, loss of limbs, loss of eyesight, permanent total disablement, permanent partial disablement and temporary total disablement, solely and directly resulting from accidental injuries.

 

 

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Scope of Cover and Premium Rating

 

Serial   Contingency and Benefit                                 Table       Benefits                   Rate (Rs.  Per mile)

  No.     Payable as % of CSI                                                         Covered            Normal   Medium      Heavy

                                                                                                                                      Risks       Risks         Risks

 

   1.        Death only - 100%                                               I                   1                  0.40         0.60            0.90

 

   2.        Loss of two limbs, two eyes 

               or one limb and one eye-100%

 

 

   3.        Loss of one limb or one eye-50%

 

 

4.            Permanent Total Disablement                        IA                 1 to 4          0.45          0.65            1.50     

           from injuries other than those

           named above (PTD-100%)

 

5.            Permanent Partial Disablement                      II                  1 to 5           0.90        1.25            1.90

           % of CSI as Detailed in the Policy

 

6.            Temporary Total Disablement                          III                 1 to 6           1.50        2.00           3.00

           1% of CSI per week up to 104 weeks

           maximum. Weekly benefits not to

          exceed Rs.5,000/-

 

 

 

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Risk Classification

 

Normal Risk:

 

Bureaucrats, Doctors, Lawyers, Accountants, Architects, Bankers, Consulting Engineers, Teachers, Persons engaged in administrative functions, persons primarily engaged in occupations of similar hazard.

 

Medium Risk:

 

Builders, Contractors, Engineers engaged in superintending functions only, Veterinary Doctors, Paid Drivers and Persons engaged in occupations of similar hazard and not engaged in manual labour.

 

All persons engaged in manual labour  (except those falling under heavy risk), cash carrying employees, Garage and Motor Mechanics, Machine Operators, Drivers of Heavy Vehicles, Professional Athletes and Sportsmen and Wood working Machinist and persons engaged in any occupations of similar hazard.

 

Heavy Risk:

 

Persons working in underground Mines, Explosive, Magazines, Workers involved in electrical installation with High-tension supply, jockeys, Circus personal, persons engaged in activities like racing on wheels or Horse back, big game hunting, Mountaineering, Winter Sports, Skiing Ice Skating, Ballooning, Hang gliding, River Rafting, Polo playing and persons engaged in occupations/activities of similar hazards.

 

 

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Medical Expenses

 

Reimbursement of medical expenses directly arising out of an accident can be covered at an additional premium of 20% of the basic premium.

 

Medical expenses reimbursable shall be 10% of C.S.I. or  40% of the admissible claim whichever is lower ( If no claim is admissible under the basic cover no medical expense shall be payable).

 

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Other Benefits

 

Expenses for carriage of dead body

 

Expenses incurred for carriage of dead body of the insured (in case of death due to accident only, to place of residence at  2% of C.S.I. subject to maximum Rs.1000/- shall be reimbursed.

 

Education Fund

 

10% of C.S.I. per dependent child subject to Rs.5000/- per child up to maximum two dependent children.

 

Cumulative Bonus

 

5% of C.S.I. per claim free year shall be added to the Capital Sum Insured subject to maximum of 50% of C.S.I.

 

 

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Group Policies and Group Discount

 

Group policies can be issued covering more than one person.

Group Discount shall be granted from 5% onwards for groups consisting above 100 persons.

 

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Geographical Limit 

 

Worldwide

 

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