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.
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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:
- Injuries due to any collision or even a simple
fall down.
- Incident of injury due to fire, “say in as” bursting
of cracker or any explosive material.
- Also, Injury and burns caused due to chemical
reaction etc.
- Even A Snake-Bite, Dog Bite causing injuries
etc.
- 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)
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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….