Group Personal Accident Insurance

Group Personal Accident Insurance- FAQs

• Q: What is Group Personal Accident Plan?

  Ans: Group personal accident insurance is a comprehensive policy that is offered to large as well as small groups like employees, bank customers, colleges and corporate offices. The plans are customizable irrespective of the size of the group and match the requirements of the group members.

• Q: Can I Avail Tax Benefits of Group Personal Accident Insurance?

  Ans: Unlike health or life insurance, which provides you with a tax benefit for the annual premium paid, Group Personal Accident plan don’t have any tax benefit for the insured.

• Q: What are the factors that determine the premium?

  Ans: The factors that are taken into account while deciding the premium include exposure to risk, employment category etc. However, age and income are the secondary factors here.

• Q: What is not covered by Group Personal Accident Policy?

  Ans: The exclusions of Group Personal Accident policy may vary insurer to insurer. The policyholder may find a comprehensive list of exclusions in the official wordings of the policy at the time of buying a plan. However, below conditions are not covered by this plan:

  1. Intentional injury or intentional negligence

  2. Injuries that happen while being under the influence of drug or alcohol

  3. AIDS/HIV/STDs are not covered

  4. Accidental injury happens while the insured is riding a two-wheeler with an engine capacity of over 150cc.

  5. Injury due to participation in any adventitious sport.

  6. Any claim arising out of past illnesses

  7. No claim will be entertained for pregnancy or childbirth

• Q: What are the additional benefits offered by Group Personal Accident plan

  Ans: The additional coverage offered by group personal accident plan includes:

  1. Educational allowance in case of accidental death of the insured

  2. Family transportation

  3. Modification allowance

  4. Repatriation of mortal remains.

  However, these benefits may differ insurer to insurer.

• Q: I often travel to different countries for business and at times for leisure. What if I meet with an accident outside India?

  Ans: You can be assured as group accident policy offers coverage worldwide. The insurer will pay for the expenses incurred on an accident met when abroad.

• Q: I already have a health and life insurance cover. Do I need Group Accident Insurance?

  Ans: While life insurance offers death coverage to the family in case of an accidental demise of the insured, health insurance provides a comprehensive financial net during a medical emergency by covering pre and post hospitalisation expenses. Accidental cover, on the other hand, insures you against financial risk that could occur due to accidental permanent disability or loss of income in case of a death of the earning member. The policy strengthens your financial portfolio in case of a monetary hardship.

• Q: Would I need to pay a premium for availing the benefits of group personal accident plan?

  Ans: As the name suggests, group personal accident insurance is offered by the employer under the employees’ benefit scheme. This is a group plan and the premium is paid by the employer only.

• Q: What are the benefits offered under a group personal accident cover?

  Ans: Usually, group personal accident insurance covers accidental injury, disability of all types including permanent pertial disability (PPD), permanent total disability (PTD), temporary total disability and death. Some insurers also offer additional benefits such as ambulance changes, loss of income, educational grant, transportation of mortal remains, coverage for broken bones etc.

• Q: Will the members of a group personal accident cover need a pre-policy medical test?

  Ans: As this plan is not associated with any health conditions and only offers coverage to the uncertain conditions, no medical pre-policy test is required for availing it.

• Q: Can I claim for the tax benefit for paying the premiums towards Group Personal Accident cover?

  Ans: Only an employer can avail the tax benefit earned out of the premiums paid towards group personal accident insurance.

• Q: What are the benefits to be availed by the employer under a group personal accident cover?

  Ans: Employees are the most important asset of an organisation and the employers has to perform certain responsibilities to retain them. Among the various perks, group personal accident cover comes under the employee benefit schemes where the employees are cover for accidental injury and death. However, the policy also benefits the employers up to a certain limit:

  1. Employers are spared from taking a financial burden in case of an accidental emergency, as the insurance company pays the compensation.

  2. Employers are spared the financial burden of paying their employees in case of an accidental death or disability as the policy pays the necessary compensation.

  3. The amount pay towards the premium can be presented as business expenses against which the employer can claim tax benefit under Income Tax Act.

  4. By offering perks of this type, the employer can remain in the good books of its employer and can keep them motivated for going those extra miles. This reflects in their productivity as well and improves profit.

• Q: If I am covered by Group Personal Accident cover, will my family be covered as well?

  Ans: No, employers group personal accident cover taken for the employees can’t be extended to the families of the insured.

• Q: What are the main exclusions of Group Personal Accident cover?

  Ans: The policy doesn’t cover certain conditions which are called policy exclusions. The list of exclusions under a group personal accident cover include the death or disability due to

  1. War, riots, invasion, nuclear weapon, hostilities, civil war etc.

  2. Radioactive contamination

  3. Travelling in an aircraft other than as a normal fare paying passenger

  4. Participation in dangerous activities or adventure sports

  5. Self-inflicted injuries, suicide, attempt to suicide

  6. Get injured and disabled while participating in the operations of Air Force, Navy or Army

  7. Terrorist activities

  8. Pregnancy related and childbirth

  9. Criminal acts

  10. Accident happens while driving under the influence of alcohol, drugs or other such substances

• Q: Will the member of a group personal accident avail the sum insured in case of loss of employment due to an accidental disability?

  Ans: The insurer doesn’t offer the full sum insured in case of loss of employment due to an accident. However, a pre-defined percentage subject to a maximum limit is paid in such a case. However, this is an additional benefits, which is not common in all group personal accident plans offered by different insurers.

• Q: Does Group Personal Accident Insurance cover all types of injuries?

  Ans: No, it only covers accidental injury/death. Death caused due to an illness or natural death is not covered. Likewise injury due to suicide, attempt to suicide, accidents due to consumption of alcohol or drugs are exluded form the coverage list.

• Q: What are Permanent Disability clauses in Group Personal Accident?

  Ans: Permanent Total disablement includes-

  1. Loss of sight both eyes

  2. loss of both hands

  3. Loss of both feet

  4. loss of one hand and one foot

  5. loss of one eye and one hand or foot

  6. Paralysis due to an accident leading to permanent disability

• Q: Permanent Partial disablement

  Ans: Loss of one eye/ one foot/ one hand/ one finger/one toe/loss of hearing etc. are termed as permanent partial disablement.

  Q: What is the payable compensation under Group Personal Accident?

  Ans: The compensation under a group personal accident cover is decided based on the sum insured chosen. However, in case of death or permanent total disability, compensation is offered up to 100% sum insured. While in case of permanent partial disability, the compensation is as mentioned in your policy document.

• Q: How to claim group personal accident insurance?

  Ans: If a claim arises, the insured should intimate the employer/HR about the accident. The employer will further intimate the insurance company.

• Q: What are the documents required to claim Group Personal Accident cover?

  Ans: In order to claim, the following documents are required:

  1. Claim Form

  2. Medical Certificate from attending doctor

  3. Copies of medical reports

  4. Leave certificate from employer

  5. RTGS/bank details for transfer of claim amount

  If it is a death case, following documents are also required:

  1. Death Certificate

  2. Post mortem report

  3. PF nominee details

  4. RTGS details of nominee

  5. Police FIR (both case)

• Q: I am a housewife and spend majority of the time at home. Do I also need a personal accident insurance?

  Ans: Doesn’t matter whether you are  a working professional or homemaker, probability of accidental loss is always there. But getting intimidated is not the solution but being prepared financially is. You can opt for an individual personal accident cover or health insurance where medical expenses will be covered.

• Q: I usually travel frequently due to business work or at times for holidays. What if I meet with an accident and hospitalised?

  Ans: You can rest assured for such kind of incidents financially as your group personal accident cover will pay for the expenses incurred towards treatment, if the policy has worldwide coverage option.

• Q: Do I need to pay a higher premium to avail Group Personal Accident Cover?

  Ans: Usually, the premium is paid by the employer as it is an employer owned policy. The premium is decided based on the size of the group and the sum insured chosen. The employee doesn’t require paying the premiums to avail this cover.

• Q: I have a family to look after. Does Personal Accident Insurance cover death?

  Ans: Yes, personal accident insurance covers death, provided it is not natural. You’ll need to mention the name of the beneficieary in the policy document. The death benefit will be paid to the nominee in case of your accidental demise.

• Q: If someone dies of stroke, will his family get the compensation?

  Ans: As this policy only covers accidental death and injury, no claim can be made if the insured dies of stroke.

• Q: Who can buy this policy?

  Ans: This policy is especially designed for the employees above 18 years.

• Q: What is scope of cover under a Group Personal Accidental cover?

  Ans: A group personal accidental cover is an employer owned policy where the policy benefits are extended to a group of people within the organisation. The scope of policy is give for accidental injury including permanent total and partial disability, temporary total disability, accidental death, loss of income, educational grant to the children in case of death of the insured etc. However, the scope of cover may vary from insurer to insurer.

• Q: Can I avail the policy benefits in case of a natural death?

  Ans: Group personal accidental benefits can’t be availed in case of a natural death. The policy is only applicable in case of accidental injury and death

• Q: Does this policy cover minor injuries as well?

  Ans: No, it doesn’t. Only accidents leading to disability or death is covered by Group Personal accident cover.

• Q: Is there any territorial restriction is applicable while availing the plan?

  Ans: No, the policy coverage can be extended worldwide; however, claims are to be paid in Indian currency only.

• Q: If a plane crashes while travelling is it covered?

  Ans: Yes, as it is an accident and it is covered.