Bharti AXA Group Personal Accident Insurance
Bharti AXA Smart Group Personal Accident Insurance policy provides insurance coverage to employees of an organization or members of a group against any physical loss that is caused because of disability or accidental death arising because of an accidental injury. The policy pays compensation for any disablement or accidental death that happens anywhere across the globe.
This policy can be issued to a group of people and can either be provided by the employer to its employees or by an institution, club, or society to its members.
Bharti AXA Smart Group Personal Accident Insurance Policy – Inclusions
Mentioned below are the basic coverage offered by the group personal accident insurance policy. A policyholder can opt for any one or all four benefits under this plan:
- Accidental Death: Under this compensation upon the death of policyholder caused by bodily injury due to accident, external, violent, and visible means that result in death within one year of occurrence of such an event. The compensation under this plan is limited to the sum insured. However, other benefits that are offered under this section are:
- Funeral Expenses: The policy pays for the expenses incurred in the funeral.
- Transportation of Mortal Remains A specific percentage of the sum insured as selected by the policyholder towards all the expenses incurred for transporting the dead body of insured from the place of accident to his/her resident. This benefit is payable only when the death claim is admissible in the policy.
- Children’s Education Grant: A grant of Rs. 10,000 is paid for every dependent child, However, the maximum amount that is payable under this advantage is limited to Rs. 20,000, in case of more than one child.
- Permanent Partial Disablement: Under this, compensation is paid that is up to the limit that is opted by the policyholder for bodily injuries caused because of violent, accidental, and visible means that result in Permanent Partial Disablement within one year of occurrence of such event.
- Permanent Total Disablement: Under this, compensation is paid that is up to the limit that is opted by the policyholder for bodily injuries caused due to violent, accidental, visible, and external means that result in Permanent Total Disablement. These permanent total disablements have to be caused by an accident without any hope of improvement that has permanently and disabled and prevented the policyholder from any occupation or business of any type. Or if the policyholder has no occupation or business from attending to his/her normal and usual duties to earn a livelihood.
- Temporary Total Disablement: Under this section, compensation is paid for any bodily injury that is caused because of an accident, external, violent, and visible means that has resulted in Temporary Total Disablement. These injuries have to be directly, solely, and disabled an insured and prevent him/her from attending any kind of occupation or business temporarily. The compensation has to be paid for a temporary period during which the insured has suffered from total disablement because of accidental bodily injury. The payable compensation is limited to the amount that is opted by the policyholder.
Additional Benefits/ Add-On Covers
An insured can avail of the additional benefits or add-on covers by paying an additional premium. With the below-mentioned additional covers, a policyholder can ask for some add-on requirements for its group of people as the Bharti AXA Smart Group Personal Accident Insurance policy can be tailor-made.
- Daily-Cash Allowance by Hospital: Under this benefit payment of fixed allowance every day during treatment in hospitalization followed by an accidental bodily injury due to an accident, external, violent, and visible means is paid, if the hospitalization exceeds the mentioned number of days. The allowance rate and the maximum number of days for which the allowance is paid and the minimum days of hospitalization qualifies for payment of this add-on cover has to be selected by the insured.
- Double Benefit in Case of Permanent Total Disablement or Death Benefit: Under this benefit facility of double benefit, which is 200% of the sum insured, in case of Permanent Total Disablement or Death because of an accident due to traveling as a passenger in public transport is paid.
- Accidental Medical Expenses: Under this additional benefit reimbursement of actual medical expenses incurred after medical treatment of bodily injury that is caused by an external and visible means, accidental or violent reasons is paid. The reimbursement limit under this advantage has to be opted by the policyholder and should be mentioned in this policy’s schedule.
- Broken Bones: Under this add-on cover, the compensation is paid, when an injury results in a complete break of bone within one year of the accident. Here the broken bone refers to the complete break of a bone and this should not include any kind of fracture. The compensation has to be a Sum Insured that is opted by a policyholder under Broken Bones Benefit. The sum insured in this case has to be as mentioned in the policy.
- Legal Expense: This additional cover pays for the legal expenses and costs that are incurred concerning a Company by insured or by the legal representative of the policyholder against the claims made for compensation of disablement or death arising out of an accidental bodily injury during the period of the policy.
- Maximum Liability Under this Policy: The maximum liability under this policy when a policyholder claims for death is limited to 100% of the mentioned Sum Insured that opts for the death benefit. However, any amount that is payable as Additional Benefits except for the benefits that are paid for broken bones is payable in addition to the aforementioned compensation. If a policyholder opts for double benefit cover, the total compensation, in that case, is limited to 200% of the Capital Sum Insured including the additional benefits, if any, that are payable under Daily Cash Allowance in Hospital, Legal expenses, Medical Expenses benefits when these additional benefits have opted.
Bharti AXA Smart Group Personal Accident Insurance Policy – Exclusions
The major exclusions of this policy are:
- Death or disablement because of aggravated or prolonged by childbirth or during pregnancy or as a result of these.
- Pre-existing accidental injury and existing disabilities are not covered.
- Weekly compensation payment until the total amount is agreed or ascertained.
- Permanent disability or accidental death incurred because of mental disorder or consciousness disturbance, fits, strokes, or convulsions that affect the whole body and create pathological disturbances because of mental reaction for the same.
- Permanent disability or accidental death caused by radiations, curative measures, poisoning, infection, except when they arise due to an accident.
- A claim that is made with respect of permanent disablement or accidental death of the policyholder:
- From suicide, intentional self-injury, or suicide attempt.
- Commits self-exposure to unrequired perils except for the ones for saving human lives.
- Under the influence of alcohol, liquor, or other intoxicants.
- Indirectly or directly caused by AIDS, venereal disease, or insanity.
- If he/she commits any breach of law or participates in any riot, crime, civil commotion, or misdemeanor.
- Any consequential damage or loss expenses or cost of any nature.
- Permanent disablement or death because of accidental injury that arises out of or indirectly or directly connected with war, the act of a foreign enemy, invasion, hostilities, terrorism, rebellion, civil war, insurrection, revolution, military, mutiny, seizure, ensured power, capture, restraints, arrests, mutiny, mutiny, capture arrests, etc.
Bharti AXA Smart Group Personal Accident Insurance Policy – Claim Process
A policyholder has to follow the below steps to claim Bharti AXA Smart Group Personal Accident Insurance Policy:
- Claim Submission: A policyholder or his/her legal representative should have to get in touch with the company through any of the following means:
- Website: bharti-axa.co[dot]in
- Toll-Free Number: 1800 – 103 – 2292
- Courier: Can be sent to any of the branch offices or corporate office of Bharti AXA.
- For senior citizens, any concerns related to the claim can directly be addressed to the channel made for Senior Citizens.
- The policyholder can as well approach the grievance cell available at any of the branches of the company with the policy details from Monday to Friday during working hours.
- Claim Documents: The policyholder has to provide the following documents while filing a claim:
- In case of accidental death claims:
- Death certificate
- Claim form
- FIR from police authorities
- Post mortem report and
- Any other documents that are needed
- In the case of disablement claims:
- Claim form
- Medical certificate issued by attending doctor for the injury that indicates the disablement extend.
- FIR provided by the police authorities (if required)
- Medical reports provided by the hospital
- Any other required documents
- On receiving all the needed documents, the settlement offer is made within 30 days. Payment of claim amount is made within seven days after receiving the acceptance in response to offering the settlement.
- In case of accidental death claims:
Cancellation Process for Bharti AXA Smart Group Personal Accident Policy
The Bharti AXA Insurance Company can cancel the insurance policy by giving the notice of seven days through Registered Post to the policyholder at his/her post address that was the last known. The company can exercise its rights to cancel the policy only in case of non-cooperation of the policyholder in implementing the terms and conditions of the insurance policy, fraud, misrepresentation, non-disclosure of the necessary information in such cases the policy has to be canceled and no premium will be refunded.
The insured can as well give a notice period of seven days in writing to Bharti AXA for canceling the policy and in that case, the company has to cancel the policy from the date it has received the notice. The company will retain the premium of the policy for the period during which this policy has remained in force at the short period scales of the company. Provided that the refund upon policy cancellation by the policyholder has to be made only when no claim has been incurred up to the cancellation date of the policy.
Short Period Scale Table
The premium that has to be Charged (% of the Annual Rate)
Up to 1 month
Up to 3 months
Up to 6 months
More than six months
Complete annual rate
Bharti AXA Group Personal Accident Insurance - FAQs
Ans: The company can apply additional loading over the premium of the policy at the time of renewal as per the claim experience.
- Any revision or modification in the insurance policy is done after getting approval from IRDAI and this shall be intimated to the policyholder at least three months before.
- The premium while renewal of the group insurance policy is not changed unless the company has revised the premium after obtaining due approval from the Insurance Regulatory and Development Authority of India. The premium will be changed only when there is a change in the policy or change in Sum Insured.
Ans: The minimum entry age for this policy is 18 years, it is easily renewable up to the age of 75 years. A policyholder can cover his/her dependent children till they become 23 years old.
Ans: Under this policy, a policyholder gets 15 days from the date he/she receives the documents of this policy for reviewing its terms and conditions. If the policyholder has some objections related to any terms and conditions of the policy, he/she can cancel the policy by providing the reason for the same. In such a case, the premium will be given back after making adjustments in the amount spent on the medical check-up of the policyholder, proportionate risk premium, and stamp duty charges. The policy can be canceled only when the policyholder has not made any claims in the policy. This period of 15 days is called the free-look period and it is not provided while the policy is renewed.