GROUP PERSONAL ACCIDENT
BASIC
This product has been developed to provide economical coverage to participants. Under this cover if any person covered dies due
to accidental means within ninety (90) days of such accident and sustained injuries are solely and independently caused by
external, violent and purely accidental means, compensation will be paid to the Participant for benefit of his/her beneficiaries.
The sum covered would either be a fixed amount for everyone, or determined according to some agreed category. Most employers tend to
link amount of coverage with employees designation or salary, whereas organizations would normally provide equal amount irrespective of
membership status. The cover is provided without ascertaining the state of each person’s health condition up to certain amount of sum
covered (free-cover limit), beyond which he/she will be medically examined.
Admissible Ages and Terms
The minimum and maximum ages at entry are 18 years and 64 years.
Benefits Payable on Death During Coverage
In case of accidental death of the person covered during the covered period, the Sum Covered will be payable to the employer/
participant.
Minimum and Maximum Sum Covered
The minimum acceptable Sum Covered will be Rs. 100,000. The maximum Sum Covered is subject to the non medical and company
underwriting limits.
Supplementary Benefits (Optional)
(a) Accidental Disability Benefits
Under Accidental Disability if any person covered sustains bodily injuries effected solely through external, violent and
purely accidental means, and within ninety (90) days after such injuries are incurred, shall suffer losses, compensation will be
paid to the Participant for the benefit of the person covered as per the following schedules:
Permanent Total Disability
If a covered member sustains bodily injuries and suffers losses which are ‘permanent and total’ the following compensation will
be paid to the Participant for the benefit of the covered member:
Description of Injuries |
Compensation ( % of Sum Covered ) |
Loss of both hands or amputation at higher sides |
100% |
Loss of hand and a foot |
100% |
Double amputation through leg or thigh amputation through leg or thigh on one side and loss of other foot |
100% |
Loss of sight to such an extent as to render the claimant unable to perform any work for which eye-sight is essential |
100% |
Very severe facial disfigurement |
100% |
Absolute deafness |
100% |
Permanent Partial Disability
If a person covered sustains bodily injuries and suffers losses which are ‘permanent and partial’ compensation will be paid to the
Participant for the benefit of the person covered a scheduled percentage of sum covered (subject to degree of disablement), varying
from 1% to 90%.
Temporary Total Disability
If a person covered sustains bodily injuries which are ‘temporary and total’, compensation will be paid to the Participant for
the benefit of the person covered for the loss of wages in terms of fortnightly payments of an agreed amount until he/she resumes
work subject to a limit of 1 (one) year.
(b) Accidental Hospitalization Benefit
Under Accidental Hospitalization if any person covered suffers an injury due to accident and is hospitalized, medical expenses
(on reimbursement basis) up to an agreed limit will be paid to the Participant for the benefit of the person covered.