Accidents can happen to anyone. Why be always plagued by the worry of hospital bills? An accident insurance policy can take away a lot of your headache and though you would need to exercise all caution so that accidents don’t happen, you will be free from the nagging small voice that keeps asking you that what if you get hospitalized without any fault of yours.
Accident insurance policy: terms and conditions
Sum assured
Sum assured amount is the maximum amount payable in case of an accident. A percentage of the assured amount is paid to the insured or beneficiary as per stipulations of the policy with regards to the type of criticality. For a yearly premium of Rs 1250-Rs1500 a Rs 10+ lakh personal accident cover can be availed.
Coverage
A personal accident policy can cover for disability, death, employment loss, child education, hospital expenses and a number of other conditions related to the accident. Accident policy covers policy members for accidents at home, workplace, on road, on vehicle and all other places and situations.
Policy members
Policyholder is the person who purchases the personal accident insurance. Policyholder can include family members like spouse and children under the personal accident plan. All members covered under personal accident plan are the policy members.
Premium
A nominal periodic amount, also called premium, is charged by the insurance company to provide accident cover to the policyholder and policy members.
Premium frequency
The premium can be payable yearly, semi-annually, quarterly or even monthly.
Tenure
Most personal accident policies are a short term of one or two years. Long term personal accident plans can be up to five years tenure.
Renewal
In order to remain effective after the tenure, personal accident policy needs to be renewed sufficiently early, say before 20 days, before the tenure expires.
Free look period
Policy free look period is the period of fifteen days or one month after the subscriber is issued the policy document. During this period the policyholder can go through the terms and conditions of the document and cancel the policy if not satisfied. After the free look period policyholder has no claims over premium reimbursements for cancelling or discontinuing the policy.
Accident insurance policy: Benefits
Cashless hospitalization
The insurance company provides cashless treatment access at networked hospitals. In case of accident policyholder/member can get admitted at any networked hospital. The bill is directly settled between the hospital and insurance company.
Post-hospitalization cover
Post-treatment at the hospital many days may be required to be spent at home to recover completely. Personal accident cover plan takes care of the post-hospitalization recovery expenses.
Cover for child education
If the accident has been severe such as to incapacitate policyholder to support dependent children then child education cover expenses can be claimed from the insurance company.
Cover for employment loss
In case the policyholder is unable to continue employment after meeting with an accident then the insurance company will pay for employment loss.
Death benefit
Should the demise of policyholder occur in an accident, then the beneficiary of the policy can claim death benefit from the insurance company.
Disability benefit
The insurance company is liable to pay the partial or whole sum assured amount in case of disability. The partial sum assured amount as per stipulated percentages can be claimed for partial/temporary disability. For permanent or total disability 100% sum assured can be claimed.
Premium waiver benefit
The insurance company can waive the entire premium if an accident leads to employment loss and incapacity.
Renewal benefit
Insurance company offers discounts in premium and or more cover benefits if the policy is renewed with the company after tenure expiry.
No claims benefits
NCB benefits can be up to 50 % for no claims during previous policy tenures.
Accident insurance policy: Exclusions
In several cases the insurance company may not honor the claims, these can be:
- Accident due to negligence
- Accident beyond scope of geographical coverage
- Participation in high-risk activities
(Like adventure sports)
- Policy not being in force
- Accident due to committing an illegal/criminal act
Health insurance plans and personal accident plans
Many people may have a false notion that if they take up a health insurance plan, personal accident cover is automatically included. Several health insurance plans may offer personal accident cover benefit as a rider if subscriber opts for the same.
