Group Personal Accident Insurance

Group Personal Accident Insurance is suitable for organizations/employers, who wish to ensure their employees against permanent total disablement, accidental death, loss or eyes and limbs, and permanent partial disablement.

Accidents create financial problems for the insured and dependents alike. Group personal accident insurance offers complete coverage in the event of death or disablement of the policyholder due to accidents occurring anywhere in the world.

Group personal accident insurance is a comprehensive cover that can be bought for large as well as small groups, such as bank customers, employees, schools, colleges, and corporates. Irrespective of the size of your group, you can buy customizable group personal accident cover to suit the requirements of your group members.

In addition to offering such basic benefits as accidental death and permanent partial/total disability coverage, various group accident covers offer an option to choose additional benefits for all or selected members of the group. The group personal accident cover also offers discounts on the basis of the number of members.

Why Is It Required?

Accidents not only create physical disablement (permanent or temporary) but can also come with the financial crisis for both the sufferer and his/her family. Since we all are exposed to accidents in our day to day life, and if the accident occurs with the breadwinner of the family, then the situations can be troublesome. Therefore, in the modern era where organizations are becoming more and more customer-centric, it has become important to opt for an insurance policy that provides compensation in case of an accident that has caused disablement or death.

In order to cater to such needs of the organizations, group accidental insurance policiesare introduced. These policies offer comprehensive coverage to the group of people against accidental disability and death.

Key Features of Group Accidental Insurance Policy

  • An accidental insurance policy for employees can be given to clubs, corporates, associations, institutions, and firms.
  • Some plans also provide an educational fund for dependent children of the insured in case of his/her permanent disablement or death.
  • Generally, the tenure of these policies is one year from the start date of the policy.
  • Most of the insurance providers offer a discount based on the size of the group.
  • Agroup accidental insurance policy can be renewed by following the same steps as forany other ordinary policy.

Benefits of Group Accidental Insurance Policy

The common benefits that most of the accidental insurance policies for employees offer are:

  • Accidental Death: The insurance provider pays the sum insured in case of accidental death of the insured to his/her nominee(s).
  • Permanent Partial Disability:If the employee has become partially disabled due to some injury, then sum assured ranging from 2% to 60% depending upon the policy term is paid by the employer to employee. However, the disability must be continued for 12 months.
  • Permanent Total Disability:If the employee of the insured meets with an accident that has caused permanent disability and that is continued for one month, then the compensation is given to the employee. This compensation can be up to the sum assured.
  • Educational Benefits:The insurance company pays for the cost of the education of the children in case of permanent disability or unfortunate death of the employee.
  • Charges of the Ambulance: The insurance company pays for the ambulance charges if the employee has met with an accident is required to be taken to the hospital by ambulance.
  • Weekly Benefits: If an employee is completely disabled due to an accident, then the insurance company pays weekly compensation for a temporary period.
  • Transportation of Mortal Remains: Most of the plans reimburse the cost incurred in transporting the mortal remains from the site of the accident to residence, hospital, or cremation ground.
  • Medical Reimbursement: The accidental insurance policies for employees reimburse hospitalization charges and medical expenses incurred due to accident or injury.
  • Broken Bones: The policy pays for the lump sum amount to the employee in case of damage of bones incurred due to injury or accident.

What Does It Cover?

The group personal accident insurance offers the following coverage:

  • Accident Death: If the insured succumbs to death after an accident, the insurer will pay the principal amount
  • Permanent partial/total disability: If the injury causes a partial/permanent disability to the insured which continues for a year, the insurer will pay compensation up to the sum assured.
  • Weekly Benefit: The insured is entitled to get a weekly compensation if they are fully disabled for a temporary period due to an accident.
  • Ambulance Charges: If the policyholder meets with an accident and is taken to a hospital, the policy offers reimbursement of ambulance charges.
  • Mortal remains transportation: The policy reimburses the cost incurred in moving the mortal remains from the accident site to hospital, residence or cremation ground.
  • Broken bones: A lump sum amount is paid for broken bones resulting from an accident. The policy clearly states which broken bones will be covered under the plan.

What it doesn't cover?

Usually, group personal accident insurance doesn't offer coverage in the following cases:

  • Natural death
  • Injury caused while under the influence of drugs or alcohol
  • Violation of law
  • War and nuclear perils
  • Pregnancy or childbirth
  • Ionizing radiation or radioactivity

How to Claim?

Follow the below steps to file the claim for Group Personal Accident Insurance:

  • Claim Intimation:
    • Intimate the insurance provider about the accident either by call or by email.
    • The insurance company registers the claim after receiving the intimation.
    • After registering the claim, the insurance company sends the claim form to the insured with a checklist of all the required documents.
  • Claim Processing:
    • If the received claim documents are incomplete, the policyholder is intimated via SMS, email, call, or any other mean.
    • Upon receiving all the required documents, the claim is processed as per the policy’s merit.
  • Claim Settlement:
    • After receiving all the relevant documents with a duly filled claim form, the claim is processed and the cheque is prepared and sent to the concerned insured.
    • On rejection of the claim, a rejection letter is sent to the insured/ concerned point of contact/ beneficiary/ HR of the organization by the claim settlement team.

Required Documents

We can segregate this section in two parts

Documents Required for Personal Accident - Death Claim:

The following documents are required in case of personal accident death claim:

  • Claim Form
  • Police Panchanama or Police FIR
  • Coroner’s Report or Post-mortem report
  • Death Certificate
  • When the payment is given to the beneficiary -notarized affidavit or succession certificate certifying the legal inheritor status.
  • Salary slip, and
  • A letter from the HR of the organization

Documents Required for Personal Accident - Disablement Claim

The following documents are required in case of personal accident disablement claim:

  • Claim Form
  • Police FIR in case the accident is reported to the police.
  • Pathology reports, medical papers, X-ray reports, etc. as required.
  • In case of permanent disability claims -the disability certificate given by the reputed surgeon or government/municipality office.
  • In case of permanent total disability claims - sick leave certificate provided by the employer.
  • The statement given by the attending physician.

Compare and Buy Group Personal Accident Cover at PolicyBazaar

In just a few seconds, you can compare and buy group personal accident cover at PolicyBazaar. You can compare the plans offered by different insurers and proceed to buy the plan of your choice. The premiums can be paid online and policy will be issued instantly.

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What is Group Personal Accident Plan?

Ans:

Group personal accident insurance is a comprehensive policy that is offered to large as well as small groups like employees, bank customers, colleges and corporate offices. The plans are customizable irrespective of the size of the group and match the requirements of the group members.

Can I Avail Tax Benefits of Group Personal Accident Insurance?

Ans:

Unlike health or life insurance, which provides you with a tax benefit for the annual premium paid, Group Personal Accident plan don’t have any tax benefit for the insured.

What are the factors that determine the premium?

Ans:

The factors that are taken into account while deciding the premium include exposure to risk, employment category etc. However, age and income are the secondary factors here.

What is not covered by Group Personal Accident Policy?

Ans:

The exclusions of Group Personal Accident policy may vary insurer to insurer. The policyholder may find a comprehensive list of exclusions in the official wordings of the policy at the time of buying a plan. However, below conditions are not covered by this plan:

1. Intentional injury or intentional negligence

2. Injuries that happen while being under the influence of drug or alcohol

3. AIDS/HIV/STDs are not covered

4. Accidental injury happens while the insured is riding a two-wheeler with an engine capacity of over 150cc.

5. Injury due to participation in any adventitious sport.

6. Any claim arising out of past illnesses

7. No claim will be entertained for pregnancy or childbirth

What are the additional benefits offered by Group Personal Accident plan

Ans:

The additional coverage offered by group personal accident plan includes:

1. Educational allowance in case of accidental death of the insured

2. Family transportation

3. Modification allowance

4. Repatriation of mortal remains.

However, these benefits may differ insurer to insurer.

I often travel to different countries for business and at times for leisure. What if I meet with an accident outside India?

Ans:

You can be assured as group accident policy offers coverage worldwide. The insurer will pay for the expenses incurred on an accident met when abroad.

I already have a health and life insurance cover. Do I need Group Accident Insurance?

Ans:

While life insurance offers death coverage to the family in case of an accidental demise of the insured, health insurance provides a comprehensive financial net during a medical emergency by covering pre and post hospitalisation expenses. Accidental cover, on the other hand, insures you against financial risk that could occur due to accidental permanent disability or loss of income in case of a death of the earning member. The policy strengthens your financial portfolio in case of a monetary hardship.

Would I need to pay a premium for availing the benefits of group personal accident plan?

Ans:

As the name suggests, group personal accident insurance is offered by the employer under the employees’ benefit scheme. This is a group plan and the premium is paid by the employer only.

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