Personal Accident Insurance

 

What is personal accident insurance?

Personal accident insurance financially covers the insured person against uncertainties such as death, injuries, and partial/complete disabilities arising due to an unfortunate accident. In case of death, the policyholder’s nominee gets the assured sum.

Road Accident Statistics in India

According to the official data released by govt (ministry of road transport and highways), 1.55 lakh people lost their lives in road accidents in India in the year 2021, and over 3.7 lakh were injured in road crash accidents in that year.

Features of personal accident insurance policy

Types of Personal Accident Insurance Policy

• Individual Accident Insurance

As its name suggests, an individual accident insurance policy guards you against accidental damage such as injuries, disabilities, or death.

• Group Accident Insurance

Unlike an individual accident insurance plan, a group accident insurance is usually taken by employers or associations to cover a group of individuals. Depending on the size of the group, some insurers may even provide discounted premiums, thus making it a low cost benefit that employers or organisations offer to their members. However, the features and benefits of group insurance are usually less than those of an individual insurance policy .

Accidental Insurance Coverage

1. Accidental Death Cover

An accident can damage you and your family, both emotionally as well as financially, especially in case of fatal injuries. In such cases, the entire assured sum gets paid to the nominee.

2. Permanent/Total Disability Cover

If an accident, unfortunately, results in a permanent disability or a lifelong total impairment like loss of limbs, then a specified part of the sum insured will be paid to the policyholder.

3. Permanent Partial Disability Cover

In case the bodily injuries due to an accident result in partial but permanent disabilities, then a particular percentage of the sum assured gets paid to the policyholder.

4. Temporary Total Disability

If the insured meets with a temporary total disability due to which he/she gets bedridden, then the insurer shall provide a monthly or weekly allowance to compensate for the loss of income. This income can be utilised by the insured to cover household expenses or pay any pending EMIs.

Benefits of personal accident insurance policy

Having a personal accident insurance plan offers the following list of benefits:

• Helps in savings

It provides financial coverage against treatment expenses related to accident-related injuries, thus saving a lot of your money.

• Protects your family

Personal accident insurance also offers death cover to protect the financial future of the insured.

• Provides coverage for medical expenses

The insurance covers the medical bills related to injuries, disabilities, etc., caused by the accident.

• Provides a daily cash benefit

Many insurers also offer a daily cash allowance such as Rs. 1,000 or Rs 2,000 for a particular period, like a week or month during hospitalisation.

• Provides coverage for dependent children

Accident insurance policies also usually cover the education and medical expenses of the policyholder’s dependent children. They get a particular compensation amount in case the insured either suffers permanent disability or unfortunately dies after the accident.

• Provides disability cover

Insured persons can get the benefit of receiving the policy sum insured, or even a higher amount than that, in case of the policyholder’s permanent disability.

• Cumulative bonus benefit

Receive a cumulative bonus ranging from 10%-50% in the case of a claim-free year.

• Speedy claim processing

Quickly get your claims settled as soon as a few working days after the fulfilment of all formalities.

What's covered and what's not covered in a personal accident insurance plan?

Let us dig deeper to understand what all aspects are usually covered and what all are excluded from personal accident insurance policy:

Who can get a personal accident insurance policy?

Here’s the list of basic eligibility criteria that you need to fulfil for purchasing a personal accident insurance plan:

• Minimum age to buy this policy is usually 18 years, while the maximum age can vary across different insurers.
• The applicant should not have any pre-existing disease, such as diabetes, heart stroke, cancer, etc, that may likely become the cause of accidents.
• The applicant needs to provide honest and accurate information about their occupation as well as the nature of work, as this may affect their premium amount if the occupation or job profile seems risky and prone to accidents.

Why Choose Personal Accident Insurance?

It takes a single unfortunate accident to cause a minor or major injury or even permanent disability or death. In any of these cases, you and your family are likely to be left financially vulnerable due to the big hospitalisation bills that would come with such accidents. That is exactly where having a personal accident insurance policy can financially help you cover such accident-related expenses in the form of a lump sum amount and a steady income.

Why should you buy personal accident insurance?

Difference Between Accidental Insurance & Life Insurance

• Death Cover

A personal accident insurance plan offers an assured sum in case of the death of the policyholder. On the other hand, a life insurance policy offers financial cover irrespective of the death’s reason, except in a few cases like suicide.

• Death Coverage Condition

Life insurance offers death benefits if the policyholder dies a few months or years after the disease/illness. But in the case of an accidental insurance plan, the death cover is offered even if the policyholder dies instantly or within a specific time period after the accident.

• Plan Options

There are many insurance plans that provide different types of covers, such as death cover, child insurance plans, retirement plans, etc. But an accident insurance plan specifically offers cover against injuries, disabilities or death due to an accident only.

• Partial Disability Cover

In case an accident causes some injury that results in either partial loss of limb or sight or other organs, it is likely to be covered under the personal accident insurance policy. Whereas in the case of a life insurance plan, partial disabilities might not be covered.

Life Insurance Policy VS Accidental Insurance Policy Comparison Table

Differences Between Accidental Insurance and Critical Illness Insurance

Difference Between Personal Accident Insurance & Term Insurance

A personal accident insurance plan only offers financial support in case of injury, death or disabilities caused by an unfortunate accident. However, a term life insurance plan offers financial cover against the death of a policyholder due to both natural and accidental reasons, barring a few, such as suicide.

What's the price of accident insurance?

The price of accident insurance, i.e. the premium you pay for the policy, depends on multiple factors such as the type of plan chosen, your age, occupation, medical history, etc.

How much accident insurance do I really need?

Generally, it is advised to opt for a personal accident cover amounting to 100 times your monthly income. This would assist in adequately covering the policyholder's financial obligations, such as children's education, loan EMIs, household expenses, etc.

How do you file a claim on your personal accident insurance?

There are two ways of raising a claim against a personal accident insurance policy:

• Cashless claim process

Step 1: Quickly inform your insurance company within stipulated time of getting hospitalised

Step 2: Share your insurance policy details and valid ID proof at the network hospital's insurance claim desk

Step 3: Submit all the details in the pre-authorisation form at the hospital

Step 4: Fill up a request form on the insurer’s official portal to inform the insurer

Step 5: Your insurance provider might take some time to review the application and inform you of acceptance or rejection and will communicate accordingly

Step 6: If available then you can check the status of the claim online

• Reimbursement claim process

Step 1: Inform the insurance company within the stipulated timeline of your insurance provider for hospitalisation to claim reimbursement

Step 2: As per the norms of your insurance provider please submit all the required documents within stipulated timelines of being discharged

Step 3: The insurance provider will either accept or reject your claim after reviewing the submitted documents

Step 4: If your claim is approved, the insurer shall process the claim amount

Step 5: If your personal accidental insurance claim request is rejected, you shall receive a communication from your insurance provider

Additional Benefits of Personal Accident Insurance Policy

1. Hospital Daily Cash

Some personal accident insurers offer a daily cash allowance such as Rs. 1,000 or Rs 2,000 for a particular period, like a week or month during hospitalisation.

2. Ambulance Expenses

Compensation is provided for ambulance expenses incurred for carrying the insured to the hospital after the accident.

3. Returning the body of someone who has died

If the policyholder dies due to the accident, the nominee receives compensation for the expenses incurred for repatriation as well as transportation of the policyholder’s mortal remains from the accident site to either the hospital, home or even the cremation place. Compensation is likely to be also provided for the expenses incurred on cremation related religious ceremonies.

4. Broken Bones

If the insured suffers fractured bones or any other bone damage, a fixed compensation gets paid under the personal accident policy.

5. Burns

Compensation can also be provided for burns caused by an accident.

6. Family Transportation Allowance

This allowance is applicable when the hospital is far from the insured's place of residence. In such cases, the actual transportation cost which was incurred by the immediate family members to reach the policyholder also gets compensated. However, the total reimbursement payable shall be subject to the amount specified in the insurance policy.

7. Education Advantage

If the policyholder unexpectedly dies due to the accident, the insurer usually covers the cost of his/her dependent children's education up to a specified limit.

8. Loan Protector

In case the policyholder dies or suffers lifelong disabilities, a lump sum amount, upto a specified limit as per the policy, gets paid to handle the ongoing loan EMIs.

9. Home Alteration and Vehicle Modification Benefits

Also known as adaptation allowance, some insurers may offer home alteration or vehicle modification benefits in case of permanent total disability or dismemberment due to the accident. This covers the money spent to modify one's house and/or vehicle due to the disability.

Tax Benefits under a Personal Accident Policy

Section 80D of the Income Tax Act^* does not provide any tax benefits for premiums paid towards personal accident insurance policy. However, it is important to keep in mind that the primary reason for buying such insurance is the financial coverage it offers, not the tax benefits.

How can personal accident insurance benefit you?

An unfortunate accident can any day cause you a minor or major injury, or even permanent disability or worse, death. In all such cases, you, as well as your family, may be left financially vulnerable due to the big hospitalisation bills that would come with such accidents. Besides a lump sum cover, accident insurance would also take care of accident related expenses. It may also cover the education expenses of the policyholder's dependent children, loan EMIs (if any), and offer some allowance if the policyholder suffers from a permanent disability.

FAQs on Personal Accident Insurance

Q. What is a personal accident insurance policy?

Personal accident insurance financially covers the insured person against uncertainties such as death, injuries, partial/complete disabilities arising due to an unfortunate accident. In case of death, the policyholder’s nominee gets the assured sum.

Q. What does personal accident cover?

A personal accident insurance plan offers financial support in case of injury, death or disabilities caused by an unfortunate accident. Besides a lump sum cover, accident insurance would also take care of accident related expenses. It also usually covers the education expenses of the policyholder's dependent children, loan EMIs (if any), and also offers some allowance if the policyholder suffers from a permanent disability.

Q. What all is not covered in personal accidents?

Personal accident insurance usually does not cover some instances such as natural death, suicide, pregnancy, childbirth, pre-existing diseases and disabilities, participation in military, naval, air force, or adventurous/sports activities, etc.

Q. How to claim PA cover?

There are two ways of raising a claim against personal accident insurance policy, either through cashless claim procedure or through reimbursement.

Q. What kind of documentation is required for PA cover?

If you're filing a claim for accidental death or injury, you'll need to submit documents such as a post-mortem report, death certificate, FIR report, medicine bills and medical certificate.