Personal Accident Insurance – Part 2

2016-06-30 20:02:00 UTC

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In part 1 of the series, we looked at the basics of Personal accident insurance policy as well as the riders to obtain a suitable cover. Here we look at other aspects like how to get PA insurance cover, general procedure for a claim, etc.

What does Personal Accident Insurance cover?

Any death, disability or dismemberment caused accidentally is included. The following are some examples:

  • Road accidents
  • Death from falling
  • Drowning when you go for a swim in a pool or a beach
  • Floods, Earthquake, fire or any other similar act of God
  • Death due to electric shock
  • Death due to animal attack

The above are for standalone policies; PA add-ons(AKA riders) don’t cover partial disability or hospitalization as already mentioned in part 1

Are there any exclusions in PA cover?

Below are some common exclusions.

  • War, invasion, act of foreign enemy, hostilities and civil war
  • Suicide, attempted suicide or self-inflicted injury
  • Childbirth or pregnancy related complications
  • Whilst engaging in Adventure sports, mountain climbing, Para gliding, flying, etc.
  • Accidental death or disability caused by insanity, HIV, etc
  • Accident occurring under the influence of intoxicating liquor or drugs

Can you add an Accidental Death Benefit Rider (ADBR) to an existing term life policy?

Most insurers will allow you to add ADBR anytime, as long as the base policy is in force. Therefore, even if you have already bought a term insurance plan, it is possible to get the ADBR cover. As with all riders, ADBR cannot be bought standalone.

What do you need to do In the event of Accidental injuries?

Notify your insurer all particulars of the accident and submit a duly completed claim form along with the documents below:

  • Medical Certificate about the nature of accident and extent of injuries
  • Medical Examination Report
  • Details of medical treatment or first aid received
  • Certificate from the employer to confirm absence from work
  • Fitness certificate

What do you need to do In the event of Accidental death?

In the event of an Accidental death, the following documents are to be furnished to the insurer by the nominee as proof of accidental death:

  • Police Report
  • Post-mortem Report
  • Panchnama
  • Medical examination Report
  • Death Certificate
  • Original Policy

Is medical checkup required to acquire a PA insurance cover?

Generally no medical test or examination is required to get a Personal Accident insurance cover but certain occupations may be exceptions.

Can unemployed individuals get a Personal Accident Insurance cover ?

Evidence of employment and income such as Income Tax Return and salary slip , etc are required to make claims and therefore it’s not possible for unemployed individuals to acquire this cover.

Can an individual cover his dependents (kids and spouse ) under Personal Accident insurance cover?

Children and spouse are eligible for this cover and you can include them in your PA cover and choose a Family Package cover. However, insurers generally offer only a fraction of the sum assured as cover for dependents typically 25% and 50% of sum assured for kids and spouse respectively. However, this is only possible in a standalone policy.

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