Wednesday, 4 December 2013

What is Personal Accidental Insurance? (Explained with some common FAQ’s)

Before beginning we will like to say that in TRUE sense if any policy is to be called as complete insurance policy then it is  this policy.

In simple words any incident causing injury to a person which are resulting solely and directly from an accident caused by EXTERNAL  & VISIBLE means , resulting into death or disablement of a person is covered under this insurance.

Beside common Rail, Road or Air Accident this insurance generally also include incidents like:
  1. Injuries due to any collision or even a simple fall down.
  2. Incident of injury due to fire, “say in as” bursting of cracker or any explosive material.
  3. Also, Injury and burns caused due to chemical reaction etc.
  4. Even A Snake-Bite, Dog Bite causing injuries etc.
  5. Drowning in Water, Gas Poisoning & Electrical Shock are even included.
Above are just some illustrative and not an exhaustive list of type of accidents, but any of these kind of accident need to result in death or disablement of person either permanent or temporary, then only one can claim insurance as per the policy offered by insurance company.

Refer Table for getting some more clarification and understanding on practical basis with some FAQ
(This premium chart is just taken for illustrative purpose only)

Ø  What will be Sum Insured offered to person whose  monthly income is 40,000 and what will be the premium he has to pay?
Let us Consider this Person fall Under GROUP 1 and wants to opt for Plan II
The person can opt for Maximum Sum Insured of 40,000 x 120 times = 48,00,000 (ie 48 Lakh)
As person is from Group 1 the premium which he has to pay for 48,00,000 will be 48 x 90 = 4,320.
However if person want to opt only for lesser value say 30,00,000 charges will be 30 X 90 = 2,700. 
He can opt for any amount less than 48 Lakh but not more than this amount.

Similarly,Say if this person was in Group 2 premium for 48 lakh will be 48 x 146 = 7,008

And if he want to opt for lesser value say 30 lakh again, charges will be 30 X 146 = 4,380

If person is a business man or is getting fixed remuneration his monthly income will be derived according to yearly returns he files or amount gets from his business income and value will be counted accordingly.

Ø  What are classification of Plan & Group, are there any exclusion for this policy ?
Yes, There are exclusion under this policy, similar like other policy Pre Existing Injuries are not considered. Injuries caused or leading to consumption of illegal Drugs or are under influence of liquor etc….., Even incident occurred due to suicidal attempts are not considered.
Also incident caused due to participation in hazardous activities and even sports are not included such as (Car & bike Racing, Jockey etc etc…) For classification refer below picture for understanding the option of Plan & Group.

Ø  Who all can opt or can get this  Accidental Insurance Cover ?
Any person can opt for this policy who generates income from legal source and fall in particular age group and is of sound mind. We see company even offer this to child under Family Group Policy even in some cases only.

Ø  What is difference between Permanent and Temporary Disablement?
Total Loss or unusable state of eyesight, Both Hands, Both Legs limbs, will be considered as permanent disablement and loss of one hand or leg will be consider as permanent partial disablement.
Similarly person getting attack of paralysis (Lakava) and not cureable will be considered as permanent disablement. However if it is curable and person can be cured with in specified period of time it will be considered as temporary disablement. (even person due to accident is out of work, and just cannot go to work due to major facture and injuries will be considered as temporary disablement)

Permanent, Partial & Temporary Disablement Insurance claim is selected and granted by the insurance companies based on the underwriting norms already specified by them and this also has to be declared by the treating doctor and proved on medical grounds.

Ø  Does this policy cover medical expenses incurred due to accident?
Yes you can avail this facility, on payment of additional premium for medical expenses reimbursement to be claimed. Generally 10 to 20% of premium is charged more with particular limitation of expenses to be claimed under same policy.

Ø  Are even the accident caused in Overseas included?
Yes, Claim can be made and will be paid irrespective of place of occurrence but will  be paid in India only. Based on all the document required which are to be provided upto to satisfaction of the company.

Ø  What is the compensation given in  the event of the incident causing TTD ?
In the event of an accidental injury resulting in temporary total disablement ( or in a state yet to be confirmed by the attending physician is PTD )the insured shall be entitled to various  compensation eg: @ 1% of sum insured per week subject to a maximum of weeks mentioned in policy which has certain limitation generally Rs.5,000/- per week, which differ from company to company.

Ø  What if accident occurs and injury is serious where incident such as one hands fingers are only lost which does not come under PDT or TTD?
Very Good point, there can be en-number of such incident where disablement is very serious, in such case certain %age of sum insured (say 5% to 10% will be given as claim) which are already specified in policy documents.

Ø  What if the person is hospitalized and later  death occurs after 4 months?
This is most important point, any Death which occurs within duration of 12 months is entitled to get claim amount where intimation are provided to the company regarding the incident date and is recorded with insurance company and policy is into force either same or renewed.

Believe it Guys this is one of the policy one must have to make your INSURANCE PROTFOLIO complete.  It is specifically recommended to young people who do travel or have taken liabilities on them. This policy rank No 2. among the MUST SEVEN POLICY bought by an individual.

As this policy is cheap and there is very less to earn people giving services in this field do not advocate such policy and even people do some time ignore such important recommendation. If you have any question or query do feel free to call, Comments are always welcome too….