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Presentation on ACCIDENT CARE - PowerPoint PPT Presentation

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Presentation on ACCIDENT CARE. ACCIDENT. ?. Accident Means. Not only Road/Rail or Travel accidents but also includes Accidental Fall Electric Shock Snake Bite Drowning in Water. Covers. Accidental Death Disablement. Age Limits.

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Presentation on accident care

Presentation on


Accident means
Accident Means

Not only Road/Rail or Travel accidents but also includes

  • Accidental Fall

  • Electric Shock

  • Snake Bite

  • Drowning in Water


  • Accidental Death

  • Disablement

Age limits
Age Limits

  • Available for Persons aged between 18 years and 70 years.

  • Children from 3 years can be covered under family package when atleast any one of the parents are covered.

Table i accidental death
Table I : Accidental Death

  • Covers Death of the Insured Person

  • Death occurring within 12 Months from the date of Accident

  • Compensation payable is 100% of Capital Sum Insured

Table ii accidental death ptd ppd
Table II : Accidental Death + PTD + PPD

  • Death Cover - As per Table I

  • Disablement cover

  • The disablement should occur within 12 Calendar months from the date of the Accident

  • The disablement is confirmed and claimed for, prior to the expiry of a period of 60 days since occurrence of the disablement

Table iii accidental death ptd ppd ttd
Table IIIAccidental Death+PTD+PPD+TTD

  • Death Cover - As per Table I

  • Death+PTD+PPD Cover- As per Table II

  • TTD Cover

  • Weekly compensation @ 1% of the Sum Insured not exceeding Rs. 5000 per week

Capital sum insured maximum limit
Capital Sum Insured Maximum Limit

  • TABLE I - 75 Times of monthly income

  • TABLE II - 60 Times of monthly income

  • TABLE III - 24 Times of monthly income

    (Table III cover can be given only with the approval of Corporate Office)

Premium rating
Premium Rating

Note: Rate provided is “Per Mille” i.e., Per Thousand

Additional benefits
Additional Benefits

  • Educational Grant – Rs.5000 per Child below 18 years maximum Rs.10000

  • Transportation of Mortal Remains – Rs.3000 if Accident outside the place of Residence

  • Travel Expenses for Relative – Actual TravelExpenses, maximum of Rs.1000 (Relative means spouse, children, parents, siblings or in-laws)

Group discount
Group Discount

Group Discount Applicable to Accident Care (Group) Policies

Medical expenses extension
Medical Expenses Extension



    25% of valid claim under P.A. or the Actual Medical Expenses incurred because of Accident, which ever is less subject to a maximum of 10% of Capital Sum Insured.

Restricted cover
Restricted Cover

  • On-duty cover : @75% of Applicable Premium

  • Off-duty Cover : @50% of Applicable Premium

Cumulative bonus
Cumulative Bonus

  • Applicable for Death and PTD cover only.

  • 5 % increase in Capital Sum Insured for every claim free year.

  • Maximum 50 %.

Transfer of policy
Transfer of Policy

Documents required for granting Cumulative Bonus

(a) Renewal Notice with Cumulative Bonus details

  • Cumulative Bonus as shown in the Renewal Notice is given

    (b) No Renewal Notice or Renewal Notice without Cumulative Bonus details

  • Cumulative Bonus as shown in the Previous Policy is given

  • If a declaration stating No Claim under the expiring policy is obtained from the insured, eligible Cumulative Bonus will be given

    Note: To obtain the above mentioned benefits there should be a

    continuous renewal without break.

Major exclusions
Major Exclusions

Any Claim,

  • In Respect of Pre Existing Conditions.

  • If the Insured acts against the advice of the Physician.

  • Whilst under the influence of intoxicating liquor or drugs.

  • Arising out of mental diseases, suicide or attempted suicide, self inflicted injuries or sexually transmitted conditions, anxiety, etc.

  • Due to participation in hazardous sport / activities.

  • By persons who are physically and mentally challenged unless specifically agreed and endorsed in the policy.

    Note: For a detailed list kindly refer the policy conditions.

Claims procedure
Claims Procedure

Document to be submitted in case of Death Claims

  • Completed Claim form

  • Death certificate, Panchanama

  • FIR, wherever applicable

  • Postmortem report

  • In the absence of assignment, Legal Heir ship Certificate/Succession Certificate / Will duly probated

  • Original Policy, if issued for Individual

  • Coroner’s Report/Police Inquest Report

Claims procedure contd
Claims Procedure (Contd.)

Document to be submitted in case of Disablement Claims

  • Original Policy

  • Disability Certificate from the attending Doctor confirming the %age of disability.

  • Photo of the person indicating the disability.

  • Completed claim form

  • FIR, Wherever applicable

  • Employer’s Certificate for the period of absence from duty (for TTD Claims)