BFSI

Per­sonal-Ac­ci­dent Plans by Stand­alone In­sur­ers

Consumer Voice - - Contents - SubasTi­wari&GopalRav­iKu­mar

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.

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