Group PA Insurance


Accidents can happen…anywhere…any place…to anybody. Each one of us in our day to day life is exposed to the risk of accidents. Accidents can be by anything from travel by rail, road, water and air, or by natural calamity, terrorism, animal bite or even by slipping. Personal accident insurance is designed to provide compensation or financial assistance in case someone meets with any kind of accident.

What is Personal Accident Insurance? Personal Accident Insurance covers in the event of the person sustaining bodily injuries resulting solely and directly from an accident caused by external, violent and visible means, resulting into death or disablement (partial/total). It pays for injuries sustained, occurred anywhere in the world.

Coverage under Personal Accident Insurance:

  • Accident by Rail / Road / Water / Air
  • Injury due to terrorism
  • Injury due to natural calamities
  • Slipping from stairs or in bathroom
  • Fractures & burns
  • Injury due to drowning, poisoning, animal bite, etc;.

Important Terminology in Personal Accident Insurance:

  • Accident : When a sudden, unforeseen and unexpected event occurs with a person , caused by external, violent and visible means which results in physical injuries is called Accident. It does not include any disorders due to mental, emotional , nervousness, depression or anxiety. Any illness or disease is not considered as an accident.
  • Accidental Death : Death caused in an accident and not due to any natural cause, is termed as accidental death.
  • Permanent Total Disablement : Any accidental injury which results into loss of any two limbs, or permanent and complete loss of sight in both eyes or injuries due to which the insured incapable of earning any income which is certified by a medical specialist that the injury is of a permanent nature, then it is termed as permanent total disablement.
  • Permanent Partial Disablement : Any accidental injury which results in permanent loss of any body part, one eye, one limb or one finger or a toe and is certified by a medical specialist that the injury is of a permanent but partial in nature, then only the person is termed as permanently partially disabled. The loss may be permanent; its effects on the insured and on his life are partial.
  • Temporary Total Disablement : Any accidental injury which is not permanent in nature making an injured person completely unable to perform any job functions on a temporary basis and is certified by a medical specialist that the injury is of a temporary and is unfit to work for certain period, is termed as temporary total disablement.

Types of Personal Accident Insurance:

  • Individual : The policy can be availed by any individual for self protection.
  • Family : Any individual can take this policy for protecting his family. It covers the individual(self), spouse (wife), parents and children Spouse and children are entitled a limited cover as per the policy.

Coverage offered under a Personal Accident policy

    Table A
  • Coverage under Table B
  • Temporary Total Disablement i.e. where the insured person becomes temporarily disabled from undertaking any work as a result of an accident for e.g. fracture of legs. In such cases, a weekly payment of 1% of the capital sum insured subject to a maximum limit, is paid for the number of weeks or part thereof (maximum 100 weeks), during which the insured person is totally disabled.
    Table B
  • Coverage under Table C
  • Permanent Partial Disablement i.e. where a part of the body becomes permanently disabled due to an accident, e.g. total and irrevocable loss of use of a finger due to an accident. In such cases, a percentage of the capital sum insured as specified in the policy is paid.
    Table C
  • Coverage under Table D
  • Loss of two limbs / both eyes / one limb and one eye wherein 100% of the capital sum insured is payable.
  • Loss of one limb or one eye wherein 50% of the capital sum insured is payable.
  • Permanent Total Disablement other than above e.g. paralysis due to an accident, wherein 100% of the capital sum insured is payable.
    Table D
  • Death cover wherein 100% of the capital sum insured is payable.

This policy is designed to provide personal accident coverage to the Employees of a Firm/Company or Members of an institution/society/association/club.

COVERAGES UNDER GROUP PERSONAL ACCIDENT POLICY :

  • Accidental Death : In case accidental death, sum assured is payable to the nominee of the insured person.
  • Permanent Total / Partial Disablement : In this case , the claim payable depends upon the extent of disability and in certain % percentage terms up o 100% of the sum assured, when authenticated by qualified doctor.
  • Temporary Total Disablement : Any accidental injury which is not permanent in nature making an injured person completely unable to perform any job functions on a temporary basis and is certified by a medical specialist that the injury is of a temporary and is unfit to work for certain period, in this situation the policy holder is entitled for loss of pay as per policy terms and conditions.
  • Medical Expenses Reimbursement In accidental cases , medical expenses incurred on treatment are reimbursed as per terms and condition of the policy.

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