Principle Exclusions of Personal Accident Policy in General Insurance

Elisions of Rationale in Personal Accident Policy of General Insurance...

The personal accident policy of General insurance facilitates reparation in the consequence of insured suffering from physical damage due to injures merely and candidly from an accident or mishap reasoned by ferocity, can visual perceived and extraneous ways, ensuing into death, entire permanent incapacitation, partly permanent incapacitation, or entire temporary impairment concordant with rationale elisions.

The personal accident insurance is international. Nevertheless, the claims are solely payable in Indian currency. The personal accident policy is accounted to definite exceptions.

 Principle Exclusions of Personal Accident Policy

• Deliberate self physical harm or damage, self killing intentionally or effort to do it, common ailment, or permanent mental disorder is not covered under personal accident policy. 
• In case insured is female death or incapacitation ensuing from maternity or during delivery of child is not covered and insurer is not subject to any legal claims.
• Policy is not covered if the insured constitutes infracting law with felonious purport.
• Engrossing in air travel activities otherwise journeying as veritable passenger (in a punctually licensed standard kind of air craft) global wide.
• Any defrayment surpassing the capital during the policy time period.
• In case the insured is under the effect of narcotics or elating substances like alcoholic beverages the claim is invalid.
• War and denoted peril are excluded in personal accident policy.
• Destruction due to nuclear threats is not liable.
• With any military force serving on duty.
• Slews of atypical menaces are exhibited in air travel and riding in a balloon. (Surety may be organized at additional premium virtues of each state)

Personal Accident Insurance Policy Terms and Conditions

The purpose of Personal Accident Insurance is to pay fixed compensation for death or disablement resulting from accidental bodily injury.  The policy forms and rating system used by the companies, though not uniform follow more or less similar approach with minor variations.

Terms and Conditions of  Personal Accident Insurance

1. The insured person must be give the written notice of claims with full particulars to the insurance company immediately.
2. In case of death written notice must, unless reasonable cause is shown, be so given before internment or cremation and in any case, within one calender month after the death.
3. In the event of loss of sight or amputation of limbs, written notice thereof must be within one calender month after such loss of sight or amputation.
4. Proof of claim satisfactory to the company shall be furnished.
5. In the event of the death, to make a post mortem examination of the body of the insured.
6. Any medical or other agent of the company shall be allowed to examine the person of the insured on the occasion of any alleged injury or disablement and as may reasonably be required.
7. A post mortem examination report, if necessary, be furnished within the space of fourteen days after demand in writing.
8. In the event of a loss of sight the insured shall undergo at the insured's expense such operation or treatment as the company may reasonably deem desirable.
9. In the case of claim by death or permanent total or permanent partial disablement, all sums payable hereunder shall be only on the delivery of this policy for cancellation and discharge and in the case of a temporary total disablement only upon termination as such disablement.
10. No sum payable under this policy shall carry interest.

Benefits of Personal Accident Policy in General Insurance

The Personal Aaccident Policy covers caused by any accident death/ loss of two limbs/tow eyes or one limb and and eye, permanent total disablement from injuries and permanent partial disablement.  In the personal accident policy covers some other benefits to the insured person.

The extensions of the personal accident insurance policy benefits are as given below

(a) Medical Benefits extension

This medical benefits cover extended on payment of extra premium by the insured person at the time of taking insurance policy.  This extension is available by loading the premium either by 10% or by 25% and the benefit available is reimbursement of medical expenses.

(b) War and Allied risks

War and allied risks are generally exception under the personal accident policy.  But in respect of Indian personnel/ experts working in foreign countries on civilian duties this exception may be deleted on payment of additional premium as under.

(c) Weekly Medical benefits

The special benefits have in personal accident policy.  The weekly compensation under personal accident policy (Table III) shall not exceed 1% of sum insured up to 104 weeks.  The maximum weekly medical benefits ate not to exceed Rs. 5000/-.

Circumstances	Chargeable Additional Premium
During normal times	50% of premium
During in disturbance times	150% of premium

(d) Cumulative bonus

Benefits under personal accident policy will earn the cumulative bonus @5% per but not exceeding 50% of the capital sum insured.  The earned cumulative bonus will be lost if the policy is renewed after 30 days from the date of expiry.

(e) Family discount

I the insured opts to cover his/her husband/wife/dependent children/dependent parents under the policy, 5% discount is allowed on the total premium.

(f) Carriage of dead body

The personal accident policy covers carriage of dead body to place of residence subject to a maximum of 2% of capital sum insured or Rs. 1000/- which ever is less.

(g) Education fund benefit

• In the case of death or permanent total disablement of insured person under personal accident insurance policy
• If the insured has one dependent child below the age of 23 years, an amount equal to 10% of the capital sum insured subject to maximum of Rs. 5000/-
• If the insured has two dependent children below the age of 23 years, an amount equal to 10% of the capital sum insured subject to maximum of Rs. 10000/-

These are all extension benefits in Personal Accident Insurance Policy, where this personal accident insurance cover providing in general insurance sector is very important in present scenario.

Compensation Table of Personal Accident Policy in General Insurance

General Insurance industry has devised an insurance cover, known as the Personal Accident Insurance policy for employees as a service benefit or otherwise to induce a sense of security amongst them.

The policy covers the risk of accidental death and /or disablement and the Scope of Cover is world wide. The policy provides compensation in the event of insured sustaining injuries solely or directly from an accident resulting death, permanent total disablement, permanent partial disablement or temporary total disablement.

The policy have separate type of  covers which is insured option and the covers classified given in below mentioned tables

Table -  I

The personal accident policy table-I covers Death only /Loss of two limbs/two eyes or one limb and one eye or loss of one limb or one eye.

Table II

The personal accident insurance covers in table II Permanent Partial Disablement to the insured person.

Table III

The personal accident insurance covers in table III temporary total disablement at 1% of capital sum insured up to 104 weeks.

Personal Accident Insurance Policy Compensation Table

Benefit	Description	Amount of Compensation
1	Death	100% sum insured(capital sum insured)
2	Loss of tow limbs, two eyes or one limb and one eye	100% sum insured
3	Loss or one limb or one eye	50% sum insured
4	Permanent total disablement from injuries other than those named above	100% sum insured
5	Permanent partial disablement	Disable percentage of sum insured
6	Temporary total disablement	1% sum insured(max Rs. 5000/- per week from all policies taken together) maximum up to 104 weeks.

Personal Accident Insurance Policy - Scope Of Cover - General Insurance

The Personal Accident Insurance Policy in General Insurance is to induce a sense of security amongst them, and this policy covers the risk of accidental death and/or permanent or partial disablement of insured person.

The policy provides compensation to the insured got injuries directly from an accident caused by violence, visible and external resulting into death, permanent total disablement, permanent partial disablement or temporary total disablement.

Sum Insured

Personal Accident Insurance Policy in General Insurance covers in world wide and it give coverage starts from 5 lacks to 50 lacks. The free looks up period is 15 days and 5% bonus to claim free year which is maximum 50%.  The family discount is allowed 10% and no health check up required for policy issuance.

The total sum insured should not exceed 72 times the monthly income of insured from direct employment of the insured. The sum insured will be equivalent to 50% of the insured or Rs. 3lacks whichever is less.  In case of children 25% of the capital sum insured should be offered.

Cumulative Bonus:   

Benefits under Personal Accident Insurance Policy in General Insurance will earn cumulative bonus is 5% percent but not exceeding  the 50% of the capital sum insured.  The earned cumulative bonus will be lost if the the policy is renewed after 30 days from the date of expiry.

Family Discount

The sum insured opts to cover his/her husband/wife/dependent parents/dependents children under the policy is 5% discount is allowed on the total premium.

Age limit
The personal accident insurance cover is restricted to persons between the ages of 5 to 70 years for both male and female.  Cover beyond these age limits can be had at a higher rates of premium as below

• The persons above 70-75 years can be covered  by charging a loading of 10%.
• The persons above 75-80years can be covered by charging a loading of 20%.
• The age of above 80 years can be coverage depends  on insurance comapanies internal decision.

In Personal Accident Insurance Policy in General Insurance, the risk is classified  into three groups. This groups are divided about their occupation. These are given below

1. Normal Risk: Persons working as Doctors, Accountants, Architects, Engineers, Teachers, Bankers,  engaged in administrative work, shopkeepers, shops which are not used machinery and similar this type of occupations.
2. Medium Risk:Persons working as  Builders, contractors, engineers engaged in superintending construction functions only, veterinary doctors and drivers to private motor cars and light motor vehicle and persons similar this type of occupations.
3. Heavy Risk: Persons working in under ground mines, explosives, magazines, workers involved in electrical installation with high tension supply, jockeys.  Circus person, person engaged in activities like racing on wheels or horse back, big game hunting, mountaineering, winter sports, skying, ice skating, Ballooning, hang gliding, River rafting, polo rafting, polo playing like this type of similar hazards.