The Personal Accident Insurance Policy In India is comprehensive financial protection to provide individuals with protection against accidental death, bodily injuries resulting from accidents, and both partial and total disabilities, whether permanent or temporary. In the unfortunate event of the policyholder's accidental death, the nominee will receive 100% compensation from the insurer. In addition to
accidental disability, there are other types of compensation available for loss of eyesight, limbs, speech, etc.
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What is a Personal Accident Insurance Policy?
A personal accident insurance policy is designed to provide financial compensation to the insured in the event of an accident that results in injury, disability, or death. It acts as a protection, offering a lump-sum payout or reimbursement of medical expenses incurred due to the accident. Unlike health insurance, which covers illness and medical costs broadly, personal accident insurance specifically targets unforeseen events causing physical harm. Coverage can extend from minor incidents to more severe cases involving permanent disability or accidental death.
Best Personal Accident Insurance Policy In India
Here we have provided the best personal accident insurance policy in India that you should look for before making a buying decision.
Insurer
Plan Name
Age (in years)
Coverage Amount (in Rs)
Aditya Birla Capital
Activ Assure Personal Accident Plan
5-65 years
Up to 12 times an earning member’s annual gross income
Road safety in India has always been a significant concern due to the high frequency of accidents caused by these incidents. Here is an insight into some statistics about road accidents in India.
Daily Incidence
The data indicates that daily, approximately 1,214 road accidents occur across various regions of India. This suggests that road accidents are not isolated incidents but rather a consistent threat to life and property.
2017 Report
The Ministry of Road Transport and Highways (MoRTH) reported that in the year 2017 alone, there were 464,000 (4.64 lakh) accidents. This alarming number underscores the need for improved road safety measures and regulations.
Rising Trend
An increase of 1.68% in the number of accidents was reported in 2018 compared to the previous year. This rising trend is a cause for concern and calls for action to reverse these statistics.
Benefits of Personal Accident Insurance Policy In India
Here are the benefits of a personal accident insurance policy in India that you should look for before deciding to buy a personal accident insurance policy in India.
Dismemberment Cover
Most Personal Accident Insurance policies include provisions for dismemberment benefits resulting from accidents. In the unfortunate event of such incidents, insurers determine specific percentages or ratios to facilitate benefit payouts to the policyholder.
Coverage for Burns
Some policies offer optional extra coverage for burns, addressing potential dismemberment or death caused by burns. The policy reimburses the cost of treatment following hospitalization, easing the financial burden on the insured.
Reimbursement of Hospitalization Expenses
Personal Accident Insurance extends coverage by reimbursing various hospitalization expenses. This includes medical costs, room rent charges, doctor's consultation fees, and expenses related to medical tests.
Reimbursement of Transportation Expenses
Personal Accident Insurance policies often include coverage for transporting the mortal remains of the insured person.
Daily Allowance
Certain insurance providers go a step further by offering a daily cash allowance to cover expenses arising from hospitalization. Policyholders can receive this allowance for a specified duration, typically up to 30 or 45 days of hospitalization.
Education Grants
Depending on the insurer, policyholders may qualify for education grants. This additional payout is designed to assist in paying tuition fees for dependent children. Many insurance companies recognize the importance of education grants as a common benefit within Personal Accident Insurance Policy.
Reimbursement of Transportation Expenses
Personal Accident Insurance policies often include coverage for transporting the mortal remains of the insured person.
What is Covered in a Personal Accident Insurance Policy?
A Personal Accident Insurance Policy is designed to provide financial assistance in the unfortunate event of an accident that leads to injuries or death. Although coverages can vary across different insurers and policies, the following are generally included in a Personal Accident Insurance Policy.
Accidental Death
In the unfortunate event that the policyholder passes away as a result of an accident, the insurance company provides a lump-sum compensation to the nominee or the family of the deceased.
Permanent Total Disability
If an accident leads to a permanent total disability, such as the loss of both legs or arms, the person insured can be eligible for a lump sum payout to help cope with the financial implications of this new reality.
Permanent Partial Disability
Some accidents may result in permanent partial disability, which could entail the loss of a limb, loss of hearing in one ear, or the loss of toes. In such a case, the plan typically pays out a percentage of the sum assured, depending on the severity of the disability.
Accidental Dismemberment
This benefit is specifically related to the loss of, or the permanent loss of use of, certain body parts as a direct result of an accident. Compensation is based on a predetermined schedule for the type of dismemberment.
Medical Expenses / Hospitalization Charges
Following an accident, a Personal Accident Insurance Policy covers medical bills, treatment costs, and hospitalization charges, thereby easing the financial burden on the injured and their families.
Child Education Support
Some policies include a benefit that provides financial support for the education of the policyholder's children if the policyholder suffers accidental death or permanent total disability.
Life Support Benefit
If the policyholder is put on life support as a result of an accident, the policy may pay out a daily or lump sum amount to assist with the associated costs.
Burns, Broken Bones, and Ambulance
Some plans may offer specific coverages for the treatment of burns, fractures, and the costs associated with ambulance services needed as a result of an accident.
Daily Allowance
If an accident leads to hospitalization, the insurance can provide a daily cash allowance to help offset the loss of income during the period of recovery.
What is Not Covered in a Personal Accident Insurance Policy?
Buying a Personal Accident Insurance Policy is a way to ensure that you or your loved ones have some level of protection against the unexpected financial burden that an accident can cause. However, it’s important to note that such insurance plans typically do not cover all types of accidents or incidents.
Below is a brief overview of some of the most common exclusions:
Natural Death
Personal accident insurance policy does not cover natural death, as it is meant to provide coverage primarily for accidents that lead to injury or death.
Pre-existing Disability or Injury
If the insured individual has a pre-existing disability or injury, the policy usually does not cover events or complications.
Childbirth or Pregnancy-Related Issues
These policies do not cover any accidents or complications associated with pregnancy, childbirth, or related medical conditions.
Suicide or Self-Injuries
Any intentional self-harm, including injuries resulting from a suicide attempt, is not covered by standard personal accident insurance policies.
Non-Allopathic Treatments
Treatments that fall outside mainstream Western medicine, like homeopathy, ayurveda, acupuncture, etc., are typically not covered by these insurance plans.
Influence of Intoxicants
Accidents that occur while the insured is under the influence of drugs, alcohol, or other intoxicants are excluded.
Committing a Criminal Act or Involvement in War Activities
Any injuries or deaths that occur as a direct result of the insured person participating in illegal activities or war (declared or not) are not covered.
Suffering from a Mental Disorder
Typically, accidents related to or as a direct consequence of mental disorders are excluded from coverage.
Participating in Naval, Military, or Air Force Service
If the insured is involved in the armed forces and encounters an accident as part of their service, it is generally not covered by personal accident policies, as these are high-risk, specialized activities.
Adventurous or Sports Activities
Those who engage in extreme sports or adventurous activities (like bungee jumping, mountaineering, racing, etc.) may not be covered for accidents occurring during such activities as they are typically considered high-risk.
Tax Benefits of Personal Accident Insurance Policy In India
As of now, under the Income Tax Act 1961, premiums paid for personal accident insurance do not qualify for tax deductions or exemptions under Section 80D or any other section that covers health insurance. Section 80D is primarily focused on premiums paid for medical insurance, which covers expenses relating to hospitalization and related medical expenses. It also includes health check-ups and preventative health care for self, spouse, dependent children, and parents, with deduction limits that vary depending on the age of the insured persons.
Note: Tax benefits may be subject to variation as a result of changes in tax laws.
Types of Personal Accident Insurance Policy In India
A personal accident insurance policy is designed to provide financial protection to individuals or groups in the event of an accident leading to injury, disability, or death. Below are the details about two types of personal accident insurance policies.
Individual Personal Accident Insurance
This type of policy provides coverage to a person. It is purchased by the person and the benefits under the policy apply only to the insured individual. The policy provides compensation if the policyholder suffers an injury, disability, or death due to an accident.
Death Benefit
In case the policyholder dies as a result of an accident, a predetermined sum is paid to the nominee.
Permanent Total Disability Benefit
If the insured person suffers from permanent and total disability, such as loss of limbs or sight, a lump sum is paid.
Permanent Partial Disability Benefit
In case of partial disability like the loss of a finger or toe, a percentage of the total sum insured will be paid depending on the extent of the disability.
Temporary Total Disability Benefit
If the insured is temporarily unable to work due to an accident, the policy may provide weekly payments to compensate for lost income.
Medical Expense Reimbursement
The policy may also reimburse actual medical expenses incurred due to an accident, subject to the policy's terms and conditions
Group Accident Insurance
This type of policy is often purchased by employers to provide coverage for their employees as a group. The employer is the policyholder, and the employees are the insured members. Group accident insurance typically offers similar benefits as individual accident policies, such as:
Death Benefit
In the unfortunate event of an employee's death due to an accident, the nominee receives the death benefit.
Disability Benefits
Both total and partial disabilities are covered, with payments varying based on the severity of the disability.
Medical Expense Coverage
It may offer reimbursement of medical expenses for injuries directly caused by accidents.
Ancillary Benefits
Some group policies include benefits like education funds for children of deceased employees, adjustment allowances, and funeral expenses.
Difference Between Accidental Insurance & Life Insurance
While both accidental insurance and life insurance aim to provide financial protection, they differ significantly in their coverage and conditions. Understanding the distinctions between these two types of insurance is crucial for individuals seeking appropriate coverage. Below are the key differences.
Parameters
Accidental Insurance
Life Insurance
Death Cover
Compensates for accidental death, covering instances when the policyholder loses their life due to accidental damage or injuries.
Offers financial benefits for any cause of death, excluding suicide attempts. The death benefit is payable for the policyholder's demise due to illness, accident, or other reasons.
Death Coverage Condition
Provides death coverage within a specified time frame (usually 180 days) following an accident, contingent on the accident as the primary cause.
Extends death coverage beyond illness, regardless of the cause or timing of death, excluding specific accidents.
Plan Options
Primarily covers losses or damages from accidents, with a focus limited to accidental events. It does not provide the diverse plan options associated with life insurance.
Offers a comprehensive approach to financial protection with a wide range of plan options, including retirement solutions, death cover, and long or short-term financial investment goals.
Partial Disability Cover
Specifically covers partial disabilities, like the loss of a limb or sight resulting from accidental injuries, ensuring financial support for policyholders facing such challenges.
Primarily focuses on the death benefit and generally does not cover partial disabilities resulting from accidents.
Difference Between Accidental Insurance and Critical Illness Insurance
Accidental Insurance and Critical Illness Insurance are two different types of insurance policies that offer protection against different risks. Here's a breakdown of their key differences.
Parameter
Accidental Insurance
Critical Illness Insurance
Importance
Provides compensation for accidental injuries and disabilities
Provides financial support for treatment of critical illnesses
Why Should You Buy a Personal Accident Insurance Policy In India?
Buying a personal accident insurance policy in India is an important step in protecting your financial stability and securing peace of mind for yourself and your loved ones. Here are several reasons why you should consider buying a personal accident insurance policy in India.
Financial Protection: A personal accident insurance policy ensures that in case of an accident that results in injury, disability, or death, you or your beneficiaries will receive financial compensation. This benefit can help cover medical expenses, hospitalization costs, and loss of income due to temporary or permanent disability.
Compensation for Disability: Accidents can sometimes lead to partial or total disability that has a significant impact on your ability to work and earn a living. Personal accident insurance provides payouts for different levels of disability, ensuring that you have financial support if you're no longer able to maintain your previous standard of work or income.
Support for Dependents: In the unfortunate event of an accident resulting in death, a personal accident insurance policy provides a sum to the policyholder's dependents or beneficiaries. This sum can help support them financially and ensure that their standard of living is not drastically affected by the loss of income.
Affordability: Personal accident insurance policies are typically affordable, especially when considering the level of coverage they offer. Since these policies are focused on accidents, they do not cover illnesses, which helps to keep the premiums relatively low.
No Medical Examinations Required: Most personal accident insurance policies do not require a medical examination for enrollment, making the process quick and hassle-free. This is an advantage over other types of insurance that might demand comprehensive medical checks before approval.
Coverage for Hospitalization: Some personal accident policies extend coverage to include hospitalization expenses due to accidents. This additional benefit can alleviate the financial burden associated with prolonged hospital stays and treatments.
Eligibility Criteria to Buy a Personal Accident Insurance Policy In India
When considering the purchase of a personal accident insurance policy in India, individuals must meet certain eligibility criteria set by insurance providers. Here are common eligibility criteria to cover when buying a personal accident insurance policy in India.
Age Limit
The minimum age requirement is often around 18 years, while the maximum age may vary but is commonly capped at 65 or 70 years.
Income Criteria
Some insurance policies may have income criteria to assess the financial capacity of the applicant.
Occupation and Profession
Insurance companies may have restrictions or specific terms for individuals engaged in hazardous occupations, such as those involving heavy machinery, construction, or high-risk activities.
Health Status
While personal accident insurance policies generally do not require a medical examination, the applicant's overall health may be a factor. Pre-existing medical conditions or disabilities may impact the eligibility or terms of coverage.
Documents Required to Buy a Personal Accident Insurance Policy In India
The documents required to buy a personal accident insurance policy in India may vary depending on the insurance company and the specific plan you choose. However, some general documents are commonly required across most insurers:
Proposal Form: This form is provided by the insurance company and requires details about the person seeking coverage, including your Name, Date of birth, Gender, Occupation, Address, Contact information, and Medical history.
KYC documents: These documents verify your identity and address, and may include a PAN card, Aadhaar card, Driving license, Voter ID card, Passport, and Bank statement.
Proof of income: This is required if the chosen policy coverage is based on your income. Some acceptable documents include Salary slips, Income tax returns, and Bank statements.
Medical certificate: In some cases, especially if you have pre-existing medical conditions, the insurance company may require a medical certificate from a registered doctor.
Occupation proof: This document is necessary if your occupation falls in a high-risk category. Some acceptable documents include a Salary certificate, Employment letter, or Business registration certificate.
Why Buy a Personal Accident Insurance Policy In India from Okbima?
There are so many reasons to buy a personal accident insurance policy in India from Okbima that are mentioned below.
Wide Range of Options
Okbima is known for offering a diverse range of insurance products from various insurers. This provides customers with the flexibility to compare policies from different companies and choose the one that best fits their needs.
Ease of Comparison
Okbima's online platform allows users to compare different personal accident insurance policies quickly and easily. This comparison helps individuals make informed decisions based on coverage, premium rates, and other relevant features.
Transparent Information
Okbima provides detailed and transparent information about the features, terms, and conditions of each policy. This transparency helps customers understand what they are purchasing and ensures that they make well-informed decisions.
Online Convenience
Buying insurance through Okbima is a convenient online process. Customers can explore, compare, and buy policies from the comfort of their homes, eliminating the need for physical visits to insurance offices.
Expert Advice
Okbima's platform offers expert advice and assistance to help customers understand their insurance needs and guide them in selecting a suitable personal accident insurance policy.
Claim Assistance
In the event of a claim, Okbima may assist policyholders in the claims process, providing guidance and facilitating communication between the insured and the insurance company.
Documents Required to Renew Personal Accident Insurance Policy In India
The documents required to renew your personal accident insurance policy in India may vary depending on your insurance company and the specific plan you have. However, some general documents are commonly required across most insurers that are mentioned below.
Renewal form: Most insurance companies will send you a renewal form along with your renewal notice. This form will typically ask for your personal information, contact details, and confirmation of your policy details.
Proof of premium payment: You will need to provide proof of your premium payment, which can be a copy of your bank statement, cheque, or online payment confirmation.
Updated KYC documents: If your KYC (Know Your Customer) information has changed since you purchased the policy, you may need to provide updated documents such as your PAN card, Aadhaar card, or driver's license.
Claim history: If you have made any claims during the previous policy period, you may need to provide information about the claims. This may include claim forms, medical reports, and discharge certificates.
Medical declaration: In some cases, you may be required to fill out a medical declaration form, especially if your health has changed significantly since you purchased the policy.
How to Renew Personal Accident Insurance Policy From Okbima?
Renewing a Personal Accident Insurance Policy from Okbima is an easy process and requires less documentation. To renew your commercial vehicle insurance, contact our team of experts to buy the best plan at an affordable price.
Documents Required to Claim for Personal Accident Insurance Policy In India
The documents required to claim for a personal accident insurance policy in India can vary depending on the insurance company, the type of claim (accidental death, disability, etc.), and the specific circumstances of the accident.
However, some common documents that are generally required across most insurers:
Duly filled claim form
This form is usually provided by the insurance company and requires details about the policyholder, the accident, and the claim being made
Policy document
You will need to submit a copy of your insurance policy document to verify your coverage and benefits.
FIR copy
In case of accidental death or serious injuries, an FIR copy is mandatory to be submitted.
Medical certificate
A detailed medical certificate from the treating doctor is essential, outlining the nature of injuries, treatment received, and prognosis.
Hospital bills and discharge certificate
If you were hospitalized due to the accident, provide copies of all hospital bills, discharge certificates, and any other medical reports.
Death certificate
In the unfortunate event of death, a certified copy of the death certificate is mandatory.
Proof of income
If your claim is for loss of income due to disability, you may need to provide proof of your income, such as salary slips or tax returns.
Identity proof
You will need to submit identity proofs for yourself and any beneficiaries.
How to File a Claim for a Personal Accident Insurance Policy In India?
Filing a claim for a personal accident insurance policy in India is a time-consuming task. Below we have mentioned the easy steps to claim the cashless process and reimbursement process.
Cashless Claim Process
Step1: If you encounter an accident and need to avail yourself of cashless claim benefits, Contact your insurance provider, and Inform them about the incident.
Step2: Provide required details, including your policy number, date and time of the accident, location, and a brief description of the incident.
Step3: For cashless claims, identify the network hospitals affiliated with your insurance provider. These hospitals have a direct tie-up with the insurer, facilitating a smoother and quicker cashless claim process.
Step4: Choose a network hospital for treatment and fill in the pre-authorization form, and the hospital will then contact the insurance provider for approval.
Step5: The insurance provider reviews the pre-authorization request and approves the claim if it meets the policy terms. Once approved, the hospital can proceed with the necessary medical treatment without requiring direct payment from the insured.
Step6: After receiving treatment, ensure that the hospital sends the final bill and medical records to the insurance provider for reconciliation. Any additional expenses beyond the approved amount may need to be settled separately.
Step7: Upon verification of documents, the insurance company settles the approved amount directly with the hospital. The insured person does not have to pay for the expenses covered.
Reimbursement Claim Process
Often, health insurance plans in India are limited to citizens or residents of a specific country. Insurance providers usually require individuals to provide proof of nationality or residency to be eligible for coverage.
Step1: In case of non-network hospitalization or if you choose to pay for the medical expenses yourself, inform the insurance provider about the accident and your intention to file a reimbursement claim.
Step2: Visit the hospital of your choice and undergo the necessary medical treatment. Retain all bills, medical reports, and receipts related to the treatment and expenses incurred.
Step3: Complete the claim form and attach all relevant documents, including medical bills, prescriptions, and diagnostic reports.
Step4: Submit the completed claim form along with the required documents to the insurance provider within the stipulated time frame mentioned in the policy terms.
Step5: The insurance company will assess the claim, verifying the submitted documents and ensuring they align with the policy terms and conditions.
Step6: Upon successful verification, the insurance provider approves the reimbursement claim, and disburses to the insured's bank account.
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FAQs About Personal Accident Insurance
Accident insurance costs vary based on factors like coverage, age, and health. Get personalized quotes to determine the premium that suits your needs.
Sufficient accidental insurance coverage depends on factors like lifestyle, income, and medical expenses. Identify your needs and consult experts for personalized advice.
Personal accident insurance provides financial security by covering medical expenses and offering benefits in the event of disability or death due to accidents.
Adequate coverage considers medical costs, income protection, and potential expenses. Identify your lifestyle and responsibilities to determine the appropriate coverage for your needs.
Yes, accident insurance is beneficial for covering medical bills, lost income, and other expenses resulting from accidents, providing financial protection and peace of mind.
Yes, You can claim benefits from multiple personal accident insurance policies to cover different aspects of an accident-related loss. Check policy terms for details.
Personal accident insurance complements health insurance by offering additional coverage for disability, death, and specific accident-related expenses not covered by health insurance.
Some policies allow coverage for family members, including parents. Check with your insurance provider for specific details on including parents in your personal accident policy.
To claim personal accident insurance after an accident, contact your insurer promptly. Follow their claim process, providing the necessary documents and details for a smooth claim settlement.
In case of accidental death, personal accident insurance provides a lump sum amount to the nominee, offering financial support during a challenging time.
Claim periods vary, but insurers typically require notification within a specific timeframe, often within 30 days of the accident. Report the incidents to ensure a seamless claim process.
While not mandatory, personal accident cover for bikes is advisable. It provides financial protection in case of accidents, covering medical expenses and offering additional benefits.
No, personal accident insurance and worker's compensation differ. Personal accident insurance is individual coverage, while worker's compensation is employer-provided, specifically for work-related injuries.
Generally, accidents in company vehicles may impact personal insurance rates. Consult your insurance provider to understand specific implications and reporting requirements.
GST applicability on personal accident insurance varies. Consult your insurer or tax advisor for accurate information regarding GST claims on your policy.
Yes, you can purchase multiple personal accident insurance policies to enhance coverage. However, ensure you understand the terms and conditions of each policy.
The coverage for heart attacks may vary, some policies may cover accidental heart attacks, while others may not. So, review policy terms or consult your insurer for clarification.
No, personal accident insurance is not mandatory, but personal accident insurance is highly recommended for financial protection in case of accidents.
Personal accident coverage on car insurance provides additional protection for occupants. Identify your needs and consider adding this coverage for enhanced security.
Personal accident coverage isn't mandatory with term insurance, but it offers additional protection against accidental injuries. Identify your needs for comprehensive risk management.
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