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We all in our day-to-day life are exposed to risk of accidents. It is a known fact
that despite all possible precautions accidents do occur. Accident may occur while
walking, driving or even in the house due to fall from stairs or in the bathroom
etc. This may result into disablement or loss of limbs or sometimes-even death.
Knowing the fact one�s endeavor that he/she or his/her dependents get adequate
compensation in the events of disablement or death.
To cater the need the general insurance industry has devised an insurance cover
known as the Personal Accident insurance. The policy covers the risks of
accidental death and/or disablement and the cover is worldwide. The policy
provides compensation in the event of insured sustaining injuries, solely and
directly from an accident caused by violence, visible and permanent total
disablement, permanent partial disablement or temporary total disablement.
1. Normal Risk
Accountants, Doctors, Lawyers, Architects, Consulting Engineers, Teachers,
Bankers, Persons engaged in Administrative, Secretarial and managerial functions,
Shopkeepers, Shop Assistants not using machinery, Commercial travelers and persons
engaged in occupations of similar hazards
2. Heavy Risks
Persons working in underground mines, explosives, workers involved in electrical
installation with high intensity power supply. Jockeys, Circus personnel, Persons
engaged in activities like racing on wheels or horsebacks, mountaineering, winter
sports, Skiing, ice hockey etc persons engaged in occupations of similar hazards.
These accident policies provide cover for groups too. In case of group accidental
policies, the insurer gives marginal discounts on premiums.
Permanent partial disability: Defined as permanent loss of any body part, one eye,
one limb or one finger or a toe or injuries that render the insured incapable of
earning an income. While the loss may be permanent, its effects on the insured and
on his life are partial.
Temporary total disability: Defined as temporary loss in any form that may render
a person immobile or affect his earning capacity from the time of the accident. In
other words, a fracture in the arm or leg that keeps you from work qualifies: you
may be mobile but the injury may not support your ability to work.
Permanent Partial Disablement: The sight of one eye, or of the actual loss by
physical separation of one entire hand or of one entire foot, fifty percent (50%)
of the Capital Sum Insured stated in the schedule
Total and irrecoverable loss of use of a hand or a foot without physical
separation, fifty percent (50%) of the Capital Sum Insured cited in the Schedule
*** �Physical Separation� means amputation at or above the wrist and/that of the
foot at or above the ankle respectively.
Permanent Total Disablement: At any time during the currency of the policy, the
insured sustains any bodily injury resulting solely and directly from accident
caused by external violent and visible means.
1. If such injury, within 12 months of its occurrence, be the sole and direct
cause of the death of the insured, the capital sum insured as stated in the
schedule.
2. If such injury within 12 months of its occurrence be the sole and direct
cause of the total and irrecoverable loss of:
3. If such injury within 12 months of its occurrence be the sole and direct
cause of the total and irrecoverable loss of:
* Sight in one eye or actual loss by physical separation of one entire hand or
one entire foot- 50% of the capital sum insured stated in the schedule of the
policy.
* Total and irrecoverable loss of use of a hand or a foot without physical
separation - 50 per cent of the capital sum insured.
5. If such injury shall within 12 months of its occurrence be the sole and
direct cause of the total and irrecoverable loss of use of or the actual loss by
physical separation of the following, then the percentage of the capital sum
insured as indicated below, shall be payable. This benefit is called permanent
partial disablement benefit.
6 . If such injury shall be the sole and direct cause of temporary total
disablement, then so long as the insured shall be totally disabled from engaging
in any employment or occupation of any description whatsoever- a sum at the rate
of one per cent of capital sum insured per week but not exceeding Rs 3,000/- per
week. This benefit is known as temporary total disablement benefit.
Compensation payable under sub-clause (f) shall not be payable for more than 100
weeks in respect to a person�s injury calculated from the date of commencement of
disablement and shall not exceed the capital sum insured.
Payment under this sub-clause (f) shall not be made until the total amount of
compensation is ascertained and agreed upon.
Note: If any such injury as mentioned above shall result in the inability to
remain gainfully employed, then the Capital Sum Insured payable will be 100%.
Exclusions:
There is some exclusion in the Personal Accident Policy:
Territorial Limits
The cover provided under Personal Accident Policy is worldwide. However the claims
are payable only in Indian Rupees (If the policy is taken in India)
Renewal of the policy above 70years of age but up to 80years is subject to loading
of 5%on the premium. Fresh proposal above 70years but below 80years is subject to
a loading of 10% on the premium. No medical examination is to be insisted for a
and b.
* If the insured person has one dependent child below the age of 23 years, an
amount equal to 10% of the CSI subject to a maximum of Rs 5,000.
* If the insured person has more than one dependent child below the age of 23
years, an amount equal to 10 per cent of the CSI subject to a maximum of Rs
l0,000.