BFSI

Personal-Accident Plans by Standalone Insurers

Not taking any chances

So, a personal-accident policy insures you against death, permanent total disability, permanent partial disability and temporary disability in case of an accident. What does it not cover then? Any insurance policy will have its inclusions and exclusions, and it’s always advisable to be aware of these. An accident is called an accident precisely because it happens unannounced and it’s best that we are prepared to meet the consequence thereof as best as we can, not the least being the financial consequences. Thus, if we are getting an insurance policy specific to accidents, we should opt for one that works for us in terms of coverage, additional cover options, premium, sum insured, etc. This report is an attempt to put together information that will help you in understanding the various aspects of such a cover and also compares six personalaccident plans by standalone insurers on relevant parameters.

We chose the six insurance plans based on consumer feedback and product structure. The parameters on which we have compared them include maximum and minimum sum insured, minimum and maximum

entry age, coverage of permanent total disablement, permanent partial disablement and temporary total disablement, ambulance charges, coverage of transportation of mortal remains, coverage of funeral expenses, number of plans, and availability of education fund.

We gave the highest weightage (20 points) to consumer feedback, which helped in determining the quality of services as well as the most important and beneficial variables. These variables have a direct bearing on the product structure. Our questionnaire covering various features of the plans received responses from a cross-section of product users. Based on these responses we assigned points on the quality of services and these combined with the points based on product analysis helped us arrive at the ‘best buy’ for consumers.

Apart from accidental death, accidental permanent disability, accidental permanent partial disability, and accidental temporary disability, the general inclusions cover medical reimbursements for health complications that have arisen from an accident.

The following are among the most common exclusions in a personal-accident insurance policy cover: • Suicide • Self-inflicted injuries • Accidents under the influence of liquor and drugs • Any pre-existing condition or infirmity • Accidents due to participation in hazardous sports or activities (deep-sea diving; working in mines, circus, etc.; army/navy/air force personnel and policemen whilst • on duty; and so on) • War situations, mental disorders, pregnancy/ childbirth

These are only illustrative and not exhaustive. Take adequate care to read about the exclusions, understand the implications, and take an informed decision.

Additional Benefits (at no cost to premium)

There is no standardised format since policies differ across insurance companies. At the same time, there are additional benefits that can be built into the policy and offered to the policy seeker. These may include: Education grant to children (limited to two children) Transportation expenses of mortal remains, subject to cap Purchase of blood Funeral expenses Domestic road ambulance Mobility cover (prosthetic/artificial devices and/or orthopaedic braces to enable the mobility of the insured), subject to cap

Rider Benefits (at a cost to premium)

The following may be opted for by the insured on payment of additional premium: Travel expenses of 1 relative (subject to cap) Transportation of imported medicines Repatriation benefit Burn injuries Fracture expenses Reconstructive surgery Home/Vehicle-modification expenses

Procedure for Claim Filing

• Intimate your insurer within seven days of the accident. • Submit completed claim form. • Submit all the required documents within 30 days, including the first information report (FIR), attested medico-legal certificate, papers containing admission/discharge and bills (if claiming for reimbursement), and income proof/ITR copy. • In case of temporary disability, in addition to the medical certificate, the insurer will also need an ‘absent from work’ certificate from the employer.