About Personal Accident Insurance

Personal Accident Insurance: Get covered against accidental death and disability with personal accident insurance. Buy the best plan at PolicyBazaar and save your medical expenses.

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Better Safe Than Sorry

Did you know that in recent years you have become more prone to accidents than you would have ever imagined? Some of these alarming statistics reveal that:

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  • According to National Crime Records Bureau (NCRB), total 4,00,517 people died of accidental deaths in 2013, a rise of 14% over the previous year.
  • According to the World Health Organization (WHO), death rate per 1,00,000 population for road traffic accident was 18.9 in 2013.
  • 1214 road accidents occur every day in India.

While minor accidents can indispose you temporarily, major accidents can severely impact your life and well-being. A sound insurance plan to protect you from financial repercussions of meeting with an accident has become a necessity. The value of human life is immeasurable, but with a view to provide some relief to the injured person or family members, insurance companies have devised personal accident insurance policy. It refers to an insurance which offers compensation in case of death, bodily injuries, total/ partial disability or mutilation resulting from an accident caused by violent, visible and external means. The types of events that are covered under accidental insurance are rail, road and air accident, injury due to collision or fall, burn injury, drowning etc.

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Child education plan gives you various benefits such as life cover, building a corpus for the child's future needs and the option of adding specific riders. Go ahead and invest in an education plan, but always compare quotes before you finally sign on the dotted line.

Personal accident policy can be further divided under two sub-heads

  • Individual Accident Policy:This policy covers an individual in the event of any accident.
  • Group Accident Policy:As the term itself suggests, it is not meant for individuals and is taken by employers for its employees. Depending on group size, discount on premium might be offered as well. It is a good incentive/ value added benefit for small organizations as it is available at low cost. However, this is a very basic cover and may not offer benefits like that of individual plan.

Accident insurance policy can protect the policyholder and his family from the financial concerns such as loss of income and medical expenses that unforeseen accidents lead to.

Coverage given under Personal Accident Insurance Policy

Buy personal accident insurance policy to enjoy following coverage-

  • Accidental death: The sum assured under this plan is payable if death occurs from an accident.
  • Accidental disability: It indicates that the policyholder is disabled either partially or wholly.
  • Accidental dismemberment: It indicates that a part of the policyholder's body has been severed or dismembered. It means, if the policyholder loses his hand or leg or eyes in an accident, then he would be eligible to get a claim under accidental dismemberment.
  • Terrorism act: Injuries afflicted due to terrorism acts are also covered.
  • Daily allowance during hospitalization: It gives monetary relief to a patient while he undergoes treatment at the hospital.

Benefits of Accident Insurance Policy

Pause for a moment to think, what will happen to your family if you become permanently disable due to an accident? There would be no earnings but bank EMIs, medical costs and other expenses will keep rising. To deal with such situation, it is important to buy a personal accident insurance policy. To give you a better understanding, we have listed the top benefits of having insurance-

  • Family security
  • No requirement of medical tests and documentation
  • Substantial cover at lower premium
  • Worldwide coverage
  • Can be bought for individually or family
  • Easy and certified claim process
  • 24x7 support service
  • Legal and funeral expenses covered
  • Child education benefit
  • Double indemnity for death/ disability while traveling in public transport
  • Highly customized plan

Who Should Buy Personal Accident Insurance Coverage?

Irrespective of your age, occupation and health, it is strongly advised to buy personal accident insurance coverage. In fact, you should buy this cover as soon as you start earning. It is more important for those who have taken personal loans, vehicle loans and mortgages because this would offer protection towards repayment of outstanding balance in case of any accident. Unlike life insurance policy, personal accident insurance premium will be decided by your occupation rather than age. Generally, there are 3 categories under which occupational risks can be segmented-

DoctorsMachine operatorsUnderground mines workers
Class 1= Low Risk Class 2= High Risk Class 3= Very High Risk
Accountants Cash carrying employees Journalists
Lawyers Builders People working in explosive industries
Bankers Contractors Mountaineers

How Much Accident Coverage is Enough?

Although it is tough to value the human life but some yardstick is required to fix the sum assured. The rule book says that it should be 100 times your monthly income. For example, if your current monthly income is Rs 10,000 then your cover should be Rs 10,00,000.

Major Inclusions and Exclusions of Accident Insurance

Educating yourself about terms and conditions before taking an insurance policy always works in your favor. So have a quick glance over what is covered and not covered under the policy.

Accidental death Natural death
Permanent total/ partial disability Pre-existing disability or injury
Accidental dismemberment Child birth or pregnancy
Medical expenses/ hospitalization charges Suicide or self injuries
Child education support Non-allopathic treatments
Life support benefit Influence of intoxicants
Burns, broken bones and Ambulance Committing a criminal act, or being involved in war activities Suffering from mental disorder
Daily allowance Participating in naval, military, air force, adventurous or sports activities

How to File Accident Insurance a Claim?

To initiate claim process, one needs to inform the insurer about the event within the time frame specified by the company. You might be provided with a claim reference number. The following information is required to be submitted to the insurer when intimating your claim-

  • Your contact numbers
  • Policy number
  • Date and time of accident
  • Name and contact details of insured person who is injured
  • Location of loss
  • Brief description on how the accident/ loss took place with its location details
  • Extent of loss

In case of Accidental death/ disability claim, following documents are required to submit-

  • Death certificate
  • Post mortem report
  • FIR report
  • Medical certificate
  • Medicine bills

How Can PolicyBazaar Help You?

Just as you care about what would happen to your loved ones after your death you should equally think how would they deal if you met with an accident or become permanently disabled or paralyzed? Prepare yourself for the unexpected situations with a right personal accident policy. We, at PolicyBazaar offer a range of personal accident insurance plans of different companies that can be tailored to the divergent needs of a client. Beyond directing you to the best insurance policies available, PolicyBazaar additionally facilitates the further steps you need to take in order to buy the plan chosen.

FAQ's

What is Health Insurance?

Ans:

The term health insurance (popularly known as Medical Insurance or Mediclaim) is a type of insurance that covers your medical expenses. Health insurance comes in handy in case of severe emergencies. Health Insurance provides a financial coverage for medical and hospitalization expenses, in case of an illness/disease or accident.

Health insurance provides for medical expenses to the insured in case of hospitalization for more than 24 hours caused due to illness or accident. Health insurance covers Medicare needed by individual or family for surgeries, nursing care, consultation fees, diagnostic tests, hospital accommodation et al. Health insurance also pays for regular checkups. The insured in return pays a specified amount called premium on an annual or biennial basis.

Why Health Insurance?

Ans:

Health insurance comes with dual benefits where you get a health cover as well as save on tax under section 80(D). With increasing risk of medical emergencies due to modern lifestyle patterns and exorbitant medical expenses, health insurance is important so that you do not compromise on a good medical treatment. Health Insurance provides protection to your family and yourself with hospitalization in best hospitals along with best medical facilities. Good medical treatment is necessary for fast recovery. This is why everyone needs health insurance.

How much cover do I need?

Ans:

Your age, lifestyle pattern, city of residence and annual income are vital parameters that help to determine the appropriate coverage required for you.

Documents required?

Ans:

Generally documents required are age proof, address proof and identity proof. Specific documents may be required in case the person needs to undergo medical tests. This can be checked on the Price quotes page.

Type of Health Insurance

Ans:

  • Individual health insurance
  • Family Floater
  • Senior Citizen Health Insurance
  • Hospitalization Insurance
  • Travel Health Insurance

What if the insurance company refuses to settle my claim and I want to file a complaint? Or I am not happy with processed claim amount.

Ans:

In order to monitor grievances and turnaround times of policyholders, IRDA has implemented the Integrated Grievance Management System (IGMS). It is a platform where policyholders can register their complaints with insurance companies first and if required, it can be escalated to IRDA Grievance Cells. You can reach IRDA Grievance Call Centre (IGCC) through-

Call - Toll free number 155255 for voice calls

Email - complaints@irda.gov.in

Can I cancel my health insurance? If yes, will I get my premium back?

Ans:

Yes, you can cancel your health insurance. A free look period of 15 days from the date of policy receipt is available to you to review terms and conditions of the policy. In case you are not satisfied with the terms of the policy, you may seek cancelation of it. In such an event, insurance company allows refund of premium paid after adjusting underwriting costs, cost of pre-acceptance medical screening, etc.

What are pre-existing diseases or conditions?

Ans:

Any health problem faced by an individual prior to seeking insurance policy is called pre-existing diseases. Insurance companies are reluctant to cover pre-existing diseases as it is a costlier affair for them.

The problem is that people with pre-existing conditions usually do not get warm welcome from insurance companies. But it should not deter you from buying a health cover even if you have a pre-existing ailment.

Every insurance company has its own conditions regarding pre-existing illness. Some insurers prefer to check a person’s entire medical history to know pre-existing condition status, while other insurers will look for medical records over the past four years. Individual health policies bring pre-existing illnesses into the ambit of coverage after the waiting period. So while choosing a policy, you should also need to compare waiting period stipulated in policies for covering pre-existing ailments.

What are the fine prints which I should know before buying health policy?

Ans:

A) Buying health insurance can be a painstaking process, so you should make sure you keep below things in mind before buying a health insurance policy-

B) What’s covered and what’s not covered in the policy= No health policy covers all diseases, so it is important to know the list of covered diseases

c) Pre-existing diseases= Be upfront about your current health state and pre-existing diseases. Concealing information may become the reason of claim rejection.

d) When does the cover start= No health insurance offers coverage from Day 1. So it is important to know when your coverage will start. If you will undergo treatment before that period, you will not be entitled to get a claim.

e) Family floater or individual policy= A family floater offers insurance coverage for the entire family under one plan and is cheaper than individual policy. However, it is crucial to check what happens if the main policyholder of the plan dies. Some policies may lapse while some won’t. Also, taking a family floater with your ageing parents would mean that most of your coverage would go in their treatment and less coverage would be available for the rest of the family.  

f) Understand the premium= Costs of healthcare services are rising exponentially. Thus, it is important to have comprehensive health coverage so that timely treatment could be made. However, before you buy a plan, it is crucial to compare costs with the total sum assured and coverage. There is no sense in taking up low priced plan if it covers very few diseases.

What are the exclusions of a health insurance policy?

Ans:

Make sure you know what is not covered by your health policy to get its optimum benefits. Following are treatments and medical expenses which do not covered by health insurance companies-

  • Any pre-existing disease that was diagnosed 48 months prior to policy issuance.
  • Any disease contracted during first 30 days of the inception of the policy, except those arising out of the accident.
  • Medical expenses incurred on AIDS.
  • Congenital disease.
  • Test/treatment related to infertility and vitro fertilization.
  • Accident in an inebriated state.
  • There are expenses like joint replacement, non-infective arthritis, etc; which are covered after completion of 2 years continuous policy.
  • Expenses attributable to self-inflicted injury, including suicide attempt or suicide.
  • Insured person committed or attempting to commit criminal or illegal activity.
  • Cost of spectacles, dental treatment and any cosmetic surgery.

Any insured person’s participation or involvement in military, air force operations, racing, scuba diving, parachuting, mountain climbing and any other dangerous activity

What are the inclusions of a health insurance policy?

Ans:

Almost all health insurance policies cover following expenses-

A) Day care treatment where 24 hours hospitalization is not required due to technology advancement.

B) Hospitalization

C) Domiciliary hospitalization where care & treatment is taken at home due to unavailability of room in the hospital or the condition of the person is critical and cannot be moved to hospital under any circumstances.

Critical illnesses like cancer, heart attack, coma, major burns, organ transplantation, etc.

What do you mean by no claim bonus?

Ans:

No claim bonus (NCB) is a discount on the base premium if no claim on the health policy is made during the policy term. This bonus is usually given in the form of a discount in premium rates or enhancement of sum insured. Some insurers also add to the sum insured at a pre-defined rate. However, more commonly NCB is offered in the form of discount on premium. NCB is quite attractive for a healthy person who has bought health insurance policy for emergency situations. He/she doesn’t need to make small claims at regular intervals and thus, he can enjoy NCB.  However, for a person who is suffering from chronic heart ailment, NCB is almost not applicable.

How can I exercise portability procedure on my current health insurance?

Ans:

Portability can be exercised only at the time of renewing a policy, not at any time during the policy term. Switching to a new insurer can be easy if you follow below simple steps.

  • A policyholder needs to send an application to port the policy to the new insurer which should reach at least 45 days prior to the last day of renewal of the current policy. Though the insurance company is free to consider a proposal even if the policyholder fails to approach them before 45 days of policy renewal, but in that case it will not be legally bound to consider your application. So, chances are high that your application will be rejected.

 

  • Once your request is received by the new insurer, he will send proposal and portability forms along with details of different products offered by it. Choose the insurance product which suits you most and fill up the proposal and portability forms and submit them to the new insurer.

 

  • After receiving both the forms, insurance company will approach your current insurer seeking details like medical history and claim history. The data will be received through a common data sharing portal developed by IRDA for all insurance companies. The current insurer will have to furnish all details about your policy within seven working days.

 

After the new insurer receives all details regarding your previous policy, he has to take a decision on underwriting your insurance application within 15 days. If the new insurer fails to abide by this duration, he will be bound to accept your application. 

What are the various riders and benefits available in a health insurance policy?

Ans:

A rider is an add-on option that can be added to a current health policy to get additional coverage. There are various riders available in health insurance sector and some of the major ones are listed below-

  • Critical illness rider= There are certain critical ailments, such as heart attack, paralysis, cancer, etc; for which hospitalization expenses are too high to be covered under a regular health insurance policy. Under critical illness rider, mostly lump sum is paid to the insured and this amount is substantial to cover massive expenses which are involved due to critical illness.

 

  • Hospital Cash= Insurer provides fixed cash on a daily basis to compensate the loss of income & meet petty expenses of the policyholder during hospital stay

 

  • Top-ups= In case there is a change in coverage needs or premium paying ability increases, it is better to opt for a top-up insurance plan than buying an individual plan. It helps in expanding the existing health insurance coverage. 

 

  • Attendant allowance= Some insurers are giving attendant allowance to accompany the insured person who is hospitalized.

 

  • Co-Payment= It is the portion of the claim that a policyholder agrees to pay in the event of a claim. For a policyholder, main benefit comes in the form of low premium. Higher the co-payment ratio, lower will be premium. A healthy individual whose chances of being hospitalized are low can consider buying a policy with a co-payment clause. 

 

  • Deductible= Also known as ‘excess’, deductible is the uninsured part of the claim amount which an insured has to pay before the insurance company takes over and pays remaining expenses as per the policy. Since the insurer shifts the small portion of risk on you, he gives you discounts on premium. Unlike co-payment, insured has to first pay his portion and then only insurer settles the remaining portion.

What is the right time to buy health policy?

Ans:

ASAP- As soon as possible is the perfect answer to this question. By buying at a younger age, you can enjoy low premium rates. Moreover, for critical illnesses and maternity, every insurer has its own waiting period. By buying it a young age means you get access to health coverage when the need actually arises. So don’t wait for any accident or a medical condition to occur before you hit a panic button and buy a health insurance policy. 

What do you mean by health card?

Ans:

It is a card that comes along with health insurance policy. Similar to the identity card, this card will allow you to avail cashless hospitalization at any network hospital.

How much does health insurance cost?

Ans:

• Buying a health policy is not an easy task. There are various factors that collectively play an important role in deciding the total cost which you need to shell out to get coverage. Young, healthy people need to pay far less for insurance cover than their old counterparts. Similarly, if you are buying an individual policy then premium would be low in comparison to a family floater plan as the latter is a comprehensive plan that covers the entire family, whereas the former covers only individual. Similarly, corporate health insurance is cheap as it is similar to buy policies in bulk. However, in individual policy, you spend more to get coverage.

• The cost of health insurance also depends upon sum insured. If you opt for a higher sum insured, your premium rates will increase. Similarly any rider attached with the plan increases its premium cost. For instance, premium rates of a basic health policy offering Rs 3 lakh sum insured to an individual aged 30 years, would vary between Rs 3000-4000/annum. But if you take a critical illness rider, you have to spend more 1500-2000/annum.

• The cost of health insurance also varies on the basis of the health condition of a person. For example, an unhealthy person who is already suffering from any pre-existing condition may need to pay higher premium in the form of loading as compared to a healthy person who doesn’t need to pay the loading charges.

• Also, in certain cases, the premium may vary from the city to city. For example, a person living in metro city may need to pay the higher premium as compared to the other person of same age and family size living in the remote area, for the same sum insured.

What are the different types of health insurance?

Ans:

There are various types of health insurance plans available in the market and some of the major ones are-

  • Individual health plan It offers coverage to an individual against illnesses. There are various factors that affect the cost of health insurance premium like age of the insured, sum insured, personal health, etc. To know more about individual health plan and available options, Read more 

  • Family Floater health plan With this policy, you can cover the entire family under a single plan. Here the sum insured is shared by all members of a family. It means, if a family of 5 members takes a cover of Rs 5 lakh, the entire family can claim up to Rs 5 lakh. Read more about family floater health plan.

  • Critical illness plan Insured is entitled to get payment either as a lump sum or as an indemnity, in accordance to the policy chosen. Under lump sum payment, insured is entitled to get the total sum insured irrespective of the total hospitalization cost. However, in indemnity, the company will reimburse only the hospitalization cost, provided it should be within sum insured. For instance, if your hospitalization cost is Rs 2 lakh and the policy sum insured is Rs 5 lakh, you will get Rs 5 lakh under lump sum payment plan. However, in case of indemnity plan, you will get only Rs 2 lakh. The policy offers coverage to insurer against a fixed number of serious ailments after certain survival period. It can be bought alone or as a rider on a health insurance policy. To know more about insurance plan, Read Here

 

  • Senior citizen health plan It offers coverage to protect you from health issues during old age. Many companies have devised special plans for aged people. It is important to choose a plan offering vast coverage as the probability of falling ill increases with age.

What is Convalescence benefit?

Ans:

After a long period of hospitalization, a policyholder may not be able to get back to work immediately. This means there may be a loss of income. At this point of time, he/she may need extra funds to take care of the household expenses, medicines, etc. Convalescence benefit is an additional benefit offered with health insurance to take care of such expenses.

What is cumulative bonus?

Ans:

An increase in the sum assured by a percentage for every claim free year is called cumulative bonus. It is important to renew the policy without a break to avail cumulative bonus benefit.

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