Royal Sundaram Personal Accident Insurance
Life is full of uncertainty and nobody knows when a Crisis and accidents can happen,
Read More
It can wreak havoc both financially and emotionally. A loss of life or a partial loss of sight or physical disability is not an easy thing to cope with. We cannot predict what’s going to happen next, but can always plan our future well by buying a Personal accident plan.
Royal Sundaram Personal Accident plan is designed to assure financial stability in such unfortunate cases and covers death, physical injuries and bodily burns. The plan affirms to stand out with the plan holder and help them cope with the sudden financial burden. Not only this, but the plan benefits ensures to bring life back on track by providing a strong cover and protection
The salient features of personal accident insurance plan are
- On spot plan issuance without any medical test.
- 24X7, worldwide cover and large span of network hospitals
- High sum insured amount to the quantum of Rs.10 Lakh without income proof.
- Online platform on Insta-renew to renew plan anytime, anywhere,
- Dedicated Customer Services Helpline - 1860 425 0000.
- Online chat facility with the plan expert for any query or concern.
- Simple and hassle free ISO certified Claims process.
- Single plan to cover entire family including spouse and children.
- Plan cover available for 1 year.
- Accidental deaths cover in the event of death of the insured due to an accident wherein the entire Sum Insured will be paid to the nominee.
- Compensation of entire sum insured in cases of Permanent Total Disability of the person due to an accident.
- In the event of Permanent Partial Disability recompense is paid in proportion to the disability occurred. Weekly benefit in the case of Temporary Total Disablement resulting in home confinement up to 104 weeks.
- Benefit Cover for expenses incurred towards Accident Hospitalization resulting in claim for Death / Disablement.
- A sum of Rs. 5000 towards transportation of the mortal remains to residence. Paid to the nominee
- Education Grant of up to Rs. 5000 per child (for up to 2 children is paid in case of death or permanent total disability.
- Discount of up to 10% on insuring 3 or more family members.
- For claim-free year and subject to successful renewal of plan without any break , , the benefit under Death and Permanent Total Disablement coverage will be increased by 5%, up to a maximum of 25%
Plan Eligibility
- Resident Individual between the age group of 5 - 65 years are eligible for plan .
- Coverage of Self is mandatory.
- Coverage is available for self, spouse and dependent children.
- Life Long Renewals for self and spouse & Up-to 21 years for dependent children.
Sum Insured and Premium Payable for accident plans
- For individual plans the sum insured offered is Rs. 5 Lakhs to Rs.75 Lakhs .
- For Family plan the Sum Insured shall be available as under:
1) Primary Insured: 100% of the Sum Insured.
2) Spouse: 50% of the Sum Insured.
3) Child: 25% of the Sum Insured per child.
Plan Coverage
|
Plan Sum Insured
|
Accidental Death
|
500000
|
1000000
|
1500000
|
Permanent Total Disablement
|
500000
|
1000000
|
1500000
|
Permanent Partial Disablement
|
500000
|
1000000
|
1500000
|
Temporary Total Disablement (Weekly Benefit 3000 x 104 weeks)
|
312000
|
312000
|
312000
|
Education Grant
|
10000
|
10000
|
10000
|
Transportation of Mortal Remains
|
5000
|
5000
|
5000
|
Premium Table
|
500000
|
1000000
|
1500000
|
Premium for Self plan (in Rs.)
|
758
|
1517
|
2275
|
Premium for Spouse in family plan(in Rs.)
|
378
|
759
|
1138
|
Premium for Child in family plan(in Rs.)
|
189
|
380
|
569
|
Coverage
|
Sum Insured
|
Accidental Death
|
2000000
|
2500000
|
4000000
|
5000000
|
7500000
|
Permanent Total Disablement
|
2000000
|
2500000
|
4000000
|
5000000
|
7500000
|
Permanent Partial Disablement
|
2000000
|
2500000
|
4000000
|
5000000
|
7500000
|
Temporary Total Disablement (Weekly Benefit - 5000/10000* x 104)
|
520000
|
520000
|
1040000
|
1040000
|
1040000
|
MEDICAL EXP - ACCIDENT HOSPITALISATION
|
200000
|
250000
|
400000
|
500000
|
750000
|
Education Grant
|
10000
|
10000
|
10000
|
10000
|
10000
|
Transportation of Mortal Remains
|
5000
|
5000
|
5000
|
5000
|
5000
|
Premium Table
|
2000000
|
2500000
|
4000000
|
5000000
|
7500000
|
Premium for Self (in Rs.)
|
4011
|
5015
|
11169
|
13961
|
20942
|
Premium for Spouse (in Rs.)
|
2005
|
2508
|
5584
|
6981
|
6981
|
Premium for Child (in Rs.)
|
1003
|
1254
|
2792
|
2792
|
2792
|
- Rs.10000/-weekly benefit applicable only for plan Sum Insured Rs.40 to Rs.75 lacs.
- Plan for Sum Insured Rs.40 to Rs.75 lacs shall be provided only on receipt of proposal form and income proof.
- The maximum Sum Insured for Spouse is restricted to Rs.25 lacs and for children restricted to Rs.10 lacs for Sum Insured plans Rs.50 & Rs.75 lacs.TTD applicable for earning member only.
- Education Grant payable in case Death or Disablement (PTD) of Self or Spouse only.
Plan Benefits
- Sum insured as opted at the time of enrollment in plan shall be paid in the event of death caused due to any bodily injury within 12 months post sustaining the injury.
- For any Permanent Total Disablement, the insured shall be eligible for the capital sum insured chosen by the proposer of the plan.
- For Permanent Partial Disablement sustained in the event of accident, the insured shall be paid fifty percent (50%) of the capital sum insured chosen by the proposer of the plan.
- For the loss of employment as a direct consequence thereof immediately permanently totally and absolutely in case of an accident, a lump sum equal to hundred percent (100%) of the Capital Sun insured will be covered in the plan.
- In the event of Death of the insured person due to accident outside her/his residence the expenses incurred for transportation of insured’s dead body to the place of residence subject to a maximum of 2% of capital sum insured or Rs 5000/- whichever is less.
- Payment of compensation towards Education Fund for the dependent children of the insured as 10% of the CSI subject to a maximum of Rs.5,000/- for one dependent child and for more than one dependent children the payment shall be equal to 10% of CSI subject to a maximum of Rs.10,000/-
- Additional coverage for medical expenses available on payment of extra premium.
- The medical benefits are in addition to benefits provided under the plan.
- For the loss of employment due to temporary total disablement (TTD) as a result any injury , a sum at the rate of one percentage (1%) of the Capital Sum Insured stated in the Schedule hereto per week but in any case not exceeding Rs.3000/- per week in all, under all Plans shall be paid till the time the Insured Person shall be totally disabled from engaging in any employment or occupation of any description whatsoever.
- Accidental Death coverage in the event of death of the insured due to an accident within the plan period, Sum Insured is paid to the nominee as mentioned in the plan.
- Permanent Total Disability coverage for protection against any accidental injury, causing the insured Permanent Total Disability for 12 consecutive months. The compensation for such cases shall be paid proportionally as per table below.
Benefits
|
Percentage of Capital Sum Insured
|
Loss of sight of both eyes
|
100%
|
Loss of two entire hands or two entire feet
|
100%
|
Loss of one entire hand and one entire foot
|
100%
|
Loss of sight of one eye and such loss of one entire foot, or hand
|
100%
|
Complete loss of hearing of both ears & complete loss of speech
|
100%
|
Complete loss of hearing of both ears or complete loss of speech and loss of one limb or loss of sight of one eye
|
100%
|
- Permanent Partial Disability is covered for the cases where any accidental injury has resulted in Permanent Partial Disability for 12 consecutive months to the insured. The compensation shall be paid proportionally as per table below.
Benefits
|
Percentage of Principal Sum
|
Loss of toes: all
|
20%
|
Great: both phalanges
|
05%
|
Great: one phalanx
|
02%
|
Other than great, if more than one toe lost, each
|
02%
|
Loss of hearing - both ears
|
60%
|
Loss of hearing - one ear
|
30%
|
Loss of speech
|
60%
|
Loss of four fingers and thumb of one hand
|
40%
|
Loss of four fingers
|
35%
|
Loss of thumb: both phalanges one phalanx
|
25% 10%
|
Loss of index finger - three phalanges or two phalanges or one phalanx
|
10%
|
Loss of middle finger - three phalanges or two phalanges or one phalanx
|
06%
|
Loss of ring finger - three phalanges or two phalanges or one phalanx
|
05%
|
Loss of little finger - three phalanges or two phalanges or one phalanx
|
04%
|
Loss of metacarpals - first or second, third, fourth or fifth
|
03%
|
Sense of smell
|
10%
|
Sense of taste
|
05%
|
Sight of one eye
|
50%
|
One hand One foot
|
50% 50%
|
Exclusion under the plan
- The Plan does not provide benefit for any death, disability, expense or loss incurred in result of any injury attributable directly or indirectly to the following:
- Intentionally self-inflicted injury, suicide or any attempt thereat while sane or insane
- Injury or Disease directly or indirectly caused by or contributed by ionizing radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from burning nuclear fuel.
- Injury or Disease directly or indirectly caused by or contributed by the radioactive, toxic, explosive or other dangerous properties of any explosive nuclear equipment or any part of that equipment;
- War, invasion, act of foreign enemy, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection, mutiny, military or usurped power, seizure, capture, arrests, restraints and detainment of all kings, princes, and people of whatsoever nation condition or quality, terrorism
- The Insured Person’s participation in naval, military or air force operations whether in the form of military exercises or war games or actual engagement with the enemy with foreign or domestic;
- Loss sustained or contracted in consequence of the Insured being under the influence of alcohol or drugs unless administered on the advice of a physician and as mentioned in various plans.
- Any loss of which a contributing cause was the Insured’s actual or attempted commission of, or willful participation in, an illegal act or any violation or attempted violation of the law or resistance to arrest;
- Any loss sustained whilst engaging in aviation or ballooning, whilst mounting into, dismounting from or travelling in any balloon or aircraft other than as a passenger (fare paying otherwise) in any duly licensed standard type of aircraft anywhere in the world;
- Any opportunistic infection and/or malignant neoplasm, if at the time of the accident or sickness the Insured had an Acquired Immune Deficiency Syndrome (AIDS) or having an antibody positive blood test to HIV (Human Immune-deficiency Virus). Opportunistic infection shall include but will not be limited to pneumosystis carinii pneumonia, organism of Kaposi’s Sarcoma, central nervous system lymphoma, and/other malignancies now known or which become known as causes of death in the presence of Acquired Immune Deficiency Syndrome;
- Any loss sustained while the Insured is participating in contests of speed using a motorized vehicle or bicycle and/or hunting and/or skiing and/or skydiving and/or gliding and/or mounteering and/or winter sports;
- Any loss resulting directly or indirectly from or, contributed or aggravated or prolonged by childbirth or from pregnancy.
- Loss caused directly or indirectly, wholly or partly by: a. bacterial infections (except pyogenic infections which shall occur through an accidental cut or wound) or any other kind of disease;
- Medical or surgical treatment except as may be necessary solely as a result of Injury;
Claims Procedure
In any of the event as covered under the scope of plan benefits, an immediate notice of occurrence or commencement of loss shall be done. Apart from this duly filled Claim Form with written evidence of loss must be furnished within thirty (30) days after the date of such loss. Upon acceptance of the offer of claim settlement by the Insured, the claim amount will be settled by the Company within 7 days from the date of acceptance of the offer by the Insured. In case of delay in the payment, the Company shall be liable to pay interest at the rates stipulated by IRDA from time to time. Claim documents may be submitted to local Royal Sundaram Offices address of which can be obtained by calling our Toll Number 1860 425 0000
Documents required for Claims
(a) Documents to Disablement Claims
i. Permanent Total or Partial Disablement
- Duly filled in Claim form
- Disability Certificate issued by attending physician
- Accident report
- FIR/MLC copy
- Hospital Records
- News Paper cuttings if any and any other relevant records
- English Translation of vernacular documents
- Latest IT return to show Proof of annual income
- Any other document as may be required by the Company
ii. Temporary Total Disablement
- All documents listed above along with
- Leave Certificate issued by employer
- Salary Certificate
(b) Documents for Death Claim
- Duly filled in claim form
- Original Death Certificate
- Post Mortem Report
- Inquest report
- Accident report
- FIR/MLC copy
- Hospital records
- News Paper cuttings if any and any other relevant records
- Chemical Analysis Report if available
- English Translation of vernacular documents
- Latest IT return to show Proof of annual income
- Succession Order/legal heir certificate/legal documents to establish identification of legal heir in the absence of nomination under the plan
- Any other document as may be required by the Company
(c) Accident Hospitalization Claim
- Discharge summary
- Original Hospital Bills
- Advance and final receipts (All receipts shall be numbered,signed and stamped)
- Prescriptions for medicines
- Diagnostic Test Reports, X Ray, Scan, ECG and other films (including doctor’s advice demanding such tests)
- Cash memos/bills for medicines purchased from outside
(c) EducationGrant
- School Identity Card or Certificate from the educational institution
- Age-proof of the child in respect of whom this benefit is claimed.
Royal Sundaram Personal Accident Insurance- FAQs
1. How to pay a premium? What are the modes of payment available?
The Royal Sundaram General Insurance Co. Limited offers 2 modes of premium payment namely:
- Cash payment at the branch
- Online Payment
For the online payment mode, the policyholder can pay via;
- Credit Card
- Debit Card
- Net banking
2. How can I check policy status for Royal Sundaram personal accident insurance?
If you a registred user, simply log into the website with your email id and password.
3. What is the policy renewal process for Royal Sundaram personal accident insurance?
You can renew the policy online
Step1: Enter your Ploicy Number and Date of Expiry into e-portal
Step2: Calculate the premium
Step3: Select the payment option –Net Banking or Debit/Credit Card to pay
Step4: Upon successful payment completion print/save the premium deposit receipt
4. What is the company’s process to settle claim for Royal Sundaram personal accident insurance?
For the claim you can intimate the company by filling a form online.
You can email: customer.services@royalsundaram[dot]in
Royal Sundaram General Insurance Co. Limited guarantees to settle the claims in 2 days, if all the documents are in order and no discrepancy is found.
5. What is the policy cancellation process for Royal Sundaram personal accident insurance?
You can visit the nearest branch with your policy documents and submit at the service counter. Once the process is complete the refund will be directly debited in your bank.