FAQ on Personal Accident

What is the meaning of "Personal Accident" in legal insurance terminology?

Personal Accident is defined as an accident due to external, violent and visible means in legal insurance terminology.


What does 'External' mean with regards to personal accident insurance policies?

With reference to personal accident insurance policies, 'External' is any impact that is outward and on the exterior. Internal impact like diseases and natural causes of sickness or heart attack is not covered under this policy.


What does 'violent' mean with reference to personal accident policies?

The force of the impact that caused injury in relation to the compensation claimed can be termed as 'violent' when referring to personal accident policies


What does 'visible' signify with reference to personal accident policies?

With respect to personal accident policies, 'visible' is denoted by the result of the impact, which caused the injury. The injury must be either physically or clinically visible.


What is Permanent Total Disablement(PTD)?

Permanent Total Disablement refers to the absolute disability of an injured person after which he or she cannot engage in any employment or occupation of any description on a permanent basis.


What does 'Loss of limbs' mean with reference to Permanent Total Disablement (PTD)?

An actual loss by physical separation of the hand/s and/or leg/s, clearly discernible as loss of hand up to the wrist and/or foot up to the ankle can be classified as a 'Loss of limbs' while referring to Permanent Total Disablement.


What does 'Loss of eye/s' mean with reference to Permanent Total Disablement?

An actual loss of sight of eye and/or eyes can be classified as a 'Loss of eye/s' while referring to Permanent Total Disablement.



What is Temporary Total Disablement?

Any accidental injury that is the sole and/or direct cause of total, yet temporary disablement as long as the injured person is totally and completely unable to engage in any employment or occupation of any description can be termed as Temporary Total Disablement.



What is "Cumulative Bonus"?

The compensation payable for the death, loss of limb/s or sight or permanent total disablement is normally increased by 5 percent of the Capital Sum Insured for every completed year of insurance.

This compensation payable in event of any of the abovementioned medical contingencies is known as Cumulative Bonus.

However, the cumulative bonus is subject to a amount that can never exceed 50 percent of the Capital Sum Insured.



What compensation is provided under the Individual Personal Accident Policy?

Under the Individual Personal Accident Policy:

• If the accident results in death, the full Capital Sum Insured must be paid to the Insured’s beneficiaries.
• In the accident results in permanent disablement that involves the total loss of both eyes or two limbs or one eye and one limb, the full Capital Sum Insured is payable.
• In case the accident results in loss of one eye and one limb, then only 50 percent of the Capital Sum Insured will be paid.
• In case the accident results in partial disablement of certain parts of the insured’s body, only a specified percentage of the Capital Sum Insured will be paid.
• In case there is disablement excluding injuries that are not visible or verifiable through medical tests like sprains, muscular spasms, etc All the benefits listed above have to be paid PLUS 1 percent of the Capital Sum Insured subject to a maximum of Rs.3000 per week over the Capital Sum Insured. However the total period of compensation will not exceed 104 weeks or 2 years approximately.

What is the scope of cover under Personal Accident policy ?

The personal accident policy covers death, permanent total and partial disablement and temporary total disablement as selected by the client. The policy also offers cover in case of accidental death - the reimbursement of funeral expenses. It can also be extended to cover medical expenses arising out of accident up to 20 percent of the claim amount subject to maximum of 10 percent of the amount of insurance.



What are the parameters for granting the cover under Personal Accident Policy ?

Occupation, income, age and general health are the main parameters for granting Personal Accident cover. Insurance cover is granted up to 3 years to 5 years annual income of the person.



Can non-earning people take Personal Accident insurance ?

Non-earning members can also take Personal Accident insurance but for a smaller amount like Rs.50,000/- for the spouse and Rs.25,000/- for the children.



Is there any income tax benefit for premium paid under Personal Accident insurance ?

There is NO income tax benefit available against premium paid for Personal Accident insurance.