What is Personal Accident Insurance?

Personal accident insurance is a policy which covers emergency medical costs incurred to treat injuries sustained during an accident. In addition to bodily injuries, such an insurance plan also covers permanent total or partial disabilities, temporary total or partial disabilities, and even death arising from an accident. There are two different types of personal accident insurance available, namely individual personal accident cover and group personal accident cover. These policies also provide coverage for accidents that occur while travelling by road, air, and rail. However, a personal accident insurance plan does not cover injuries or death arising due to war, voluntary actions, or when the policyholder is under the influence of drugs or intoxicants. 

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What is Personal Accident Insurance and Coverage

Personal accident insurance is a type of insurance policy that provides coverage for medical costs arising from injuries due to accidents.

Apart from covering the medical cost of treatment for injuries, this plan also provides a predetermined amount of money for the following:

  • Permanent total or partial disabilities,

  • Temporary total or partial disabilities,

  • Death

Let’s take a closer look at the details of the policy below.

Types of Personal Accident Insurance

There are many types of personal accident covers in health insurance that you can opt for. Some of the best plans to go with are as below:

Individual Personal Accident Cover

The individual personal accident policy secures you in the event of an accident. Such an insurance plan covers accidental injuries sustained by the policyholder, such as loss of sight or limbs, disabilities, or even death.

Group Personal Accident Cover

The group personal accident insurance plan safeguards a group of people covered under the policy. Organisations purchase such coverage to cover their employees against the risk of accidents. Thus, employees can get personal accident cover at affordable premiums.

Child Personal Accident Cover

Children are often prone to unforeseen accidents. The child personal accident cover ensures that your child is adequately protected against such injuries and accidents. The plan offers a high insurance amount and covers permanent partial disabilities and related medical expenses. 

Note: Self-inflicted injuries are not covered.

Personal Accident and Accidental Hospitalisation Cover

The personal accident and accidental hospitalisation plan cover expenses incurred due to accidental death, accidental hospitalisation, parental benefit, permanent total disability, child care, and lifestyle modification. This travel insurance policy helps to minimise the impact of unforeseen adverse situations.

Accidental Cover with Child Care

Ensuring the well-being of children is one of the most challenging responsibilities of any parent. The accidental cover with child care offers much-needed financial cushion during an unforeseen situation. This plan takes care of permanent partial disability, permanent total disability, temporary total disability, parental care and child care coverage, and even death.

Lifestyle Modification with Personal Accidental Cover

Accidents can happen anywhere and everywhere. Life modification with personal accidental cover helps modify your assets to reduce the impact of any personal accident- all at a  low premium!

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Best Personal Accident Insurance Plans 

Let’s take a look at the personal accident insurance plans on Bajaj Markets: 

Plans Available

Premiums Starting At* 

Check Plans

Bajaj Allianz Personal Accident Insurance 

₹3,200

Care Personal Accident Insurance 

₹4,472

Aditya Birla Activ Secure Personal Accident  

₹4,472

Child Personal Accident Cover

₹322

Personal Accident & Accidental Hospitalisation Cover

₹589

Accidental Cover with Child Care

₹693

Life Modification with Personal Accidental Cover

₹744

Disclaimer: All premium rates are indicative. The actual premium might change depending on numerous factors.

Major Inclusions and Exclusions under Personal Accident Insurance 

Let’s take a look at the inclusions and exclusions under the personal accident insurance plan:

Inclusions

Exclusions

Death due to accident

Death due to natural causes

Permanent total/partial disability 

Pre-existing disabilities or injuries 

Dismemberment due to accident 

Pregnancy and childbirth 

Medical coverage for hospitalisation charges 

Suicide/self-harm 

Academic support for children 

Non-allopathic medicine/treatments 

Coverage for life support 

Medical issues due to the use of drugs/alcohol 

Burns and fractures

Injuries caused due to being involved in criminal or illegal activity 

Daily cash allowance and ambulance coverage

Injuries caused due to being involved in the military/navy/airforce or adventure sports 

Why Do You Need Personal Accident Insurance?

You may need personal accident insurance for the following important reasons: 

Financially Secures Against Accidents

The chances of suffering from multiple injuries or disabilities are higher during an accident. Such an unfortunate mishap can lead to loss of limbs or sight, permanent or temporary disability, and even death. The last thing you would want to worry about in such a situation is healthcare expenses, which is why personal accident insurance is a must-have.

Offers Wider Coverage

Personal accident health insurance offers comprehensive coverage. Apart from death resulting from the mishap, it also includes other circumstances such as temporary or permanent disability and partial or total disability. You can always fall back onto your insurance plan no matter what!

Provides Cost-Effective Premiums

Premiums charged for personal accident cover are affordable when considering the benefits. When compared to other plans, not only can you get lump sum payouts but also extensive coverage at an affordable cost!

Features and Benefits of Personal Accident Insurance 

Listed below are the main features and advantages that come with personal accident insurance: 

Secures Education Expenses

The dependent children will receive a lump sum benefit in case of permanent disability or death of the insured due to an accident. This amount can be used to cover the education costs of the children.

Covers Funeral Costs

The personal accident insurance policy also covers the expenses incurred while arranging the funeral of the insured. Thus, the dependents can have a dignified funeral for the deceased policyholder without worrying about their finances.

Ensures Medical Care

In case the policyholder endures any accidental injuries, the policy covers the cost of hospitalisation and treatment. So, you can focus on recovering from your injuries by getting the best medical care!

Burns & Broken Bones

Any accidental burns, fractures, or bone damage experienced by the policyholder due to the accident is covered under the policy.

Repatriation of Mortal Remains

The expenses incurred on transporting the mortal remains of the policyholder from the site of the accident to the hospital or their home are also covered under the insurance plan. 

Covers Ambulance Charges

The insurance provider shall reimburse the cost of getting an ambulance for the insured.

Pays for Travel Expenses

If the hospital is far from your residence, the personal accident insurance cover shall pay for the actual travel cost. This benefit is available to the immediate family members of the policyholder.

Offers Hospital Daily Cash

Depending on your personal accident policy, the insurance provider shall payout a fixed amount in case of hospitalisation to manage other medical expenses. 

How Much Does Personal Accidental Insurance Cost

The premium of the accident insurance policy depends on various factors such as your age, occupation, medical history, etc. Thus, the cost of personal accident cover may vary from one insurance provider to another. But, it is recommended to avoid compromising on the coverage for a lower premium quote. 

How Much Personal Accident Insurance Coverage is Sufficient

While estimating the coverage for your personal accident health insurance plan, you must understand your dependents' requirements. In the event of permanent disability or death, the sum insured must be sufficient to secure your family's financial needs. As a thumb rule, many recommend that the insurance policy coverage amount should be 8-10 times your annual income. This can easily safeguard the financial requirements of your loved ones without having to depend financially on others. 

The best option is to go for cost-effective Pocket Insurance and Subscriptions. These plans not only ease the financial burden with their affordable premium rates but also extend significant monetary aid during any crisis. Plans like natural disaster cover, child personal accident cover, cancer cover, etc., come at an affordable premium with a high insurance amount.

How to Raise a Personal Accident Insurance Claim

In the event that you have to utilise your personal accident insurance, you should be aware of the claim settlement process. 

For Cashless Claims 

Follow these given steps to apply for a cashless claim:

 

Step 1: Locate a nearby network hospital associated with your insurance company.

 

Step 2: Inform your insurance provider or company regarding the claim at the earliest, ideally within a 48-hour span of hospitalisation (during an emergency) and at least 3 days prior to admission (for planned hospitalisation).

 

Step 3: Provide your cashless card or policy number at the hospital to get admitted.

 

Step 4: Fill out the pre-authorisation form available at the hospital desk and submit it along with relevant documents. 

 

Step 5: You will receive updates on the decision or approval from the insurer via SMS and email within 2 hours.

 

Step 6: You can even remain updated about the status of the claim online and get cashless treatment once all the necessary formalities have been complied with.

 

For Reimbursement Claims 

You can follow the given instructions to apply for a reimbursement claim:

 

Step 1: Make sure you inform the insurer about the claim as soon as possible, within 48 hours at the most.

 

Step 2: Seek treatment at a hospital of your choice, pay the bill, and maintain the original receipts.

 

Step 3: Raise a reimbursement claim by 15 days from the day of discharge and submit the supporting documents to the insurance provider.

 

Step 4: The insurer shall verify the details and ask for any information per your policy's requirements.

 

Step 5: If the insurance claim satisfies all the terms and conditions of your policy, the insurer shall compensate for the medical expenses incurred, and the reimbursement sum will be credited to your bank account.

Documents Required to Claim under Personal Accident Insurance 

You may have to submit the following documents when claiming an accident insurance policy: 

 

  • Original insurance policy document

  • Death certificate of the policyholder, in case of death

  • Proof of identity

  • Proof of age

  • Medical certificate, as proof of death of the insured

  • Discharge form

  • Post-mortem report

  • Hospital records

  • Police FIR

  • Medical bills and receipts

Tax Implications Under a Personal Accident Policy

Section 80D of the Income Tax Act (1961) does not have any provisions for tax benefits for an accident insurance policy. However, the lack of tax benefits should not deter you from purchasing personal accident insurance. The main purpose of buying this policy is financial security and safety for you and your family, as well as coverage against various kinds of medical costs and disabilities caused due to accidents.

 

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FAQs on Personal Accident Insurance

  • ✔️What is covered under a personal accident insurance policy?

    The following aspects are covered under the personal accident insurance plan:

    • Accidental death

    • Accidental dismemberment

    • Disability

    • Medical expenses

    • Child education

    • Ambulance charges

    • Fractures

    • Daily allowance

  • ✔️What is excluded from the personal accident cover?

    The exclusions of personal accident insurance are:

    • Self-injury

    • Suicide

    • Any accident caused under the influence of alcohol or drugs

    • Alternative treatment

    • Natural death

  • ✔️What are the documents required for raising a personal accident insurance claim?

    You can keep the following documents ready while filing a personal accident insurance claim: 

    • Medical report

    • Original medical bills

    • Death certificate, in case of death

    • Post-mortem report

    • FIR 

  • ✔️What is the difference between a personal accident cover and a health insurance plan?

    A personal accident insurance plan secures you against the risk of an accident and covers the healthcare cost arising from treating the accidental injuries. Whereas, health insurance covers any medical expenses that you incur for ailments, injuries, etc. throughout the policy tenor.

  • ✔️How do I buy health insurance policies online on Bajaj MARKETS?

    You can head over to the ‘Health Insurance’ section on Bajaj Markets or download our insurance app to manage your plans.

  • ✔️Do I still require a personal accident cover if I have a health plan?

    Yes. Both these plans are quite unique and provide coverage for different conditions. Unlike a personal accident policy, health insurance will not offer a lump sum benefit in case of disablement or death of the insured.

  • ✔️Should I purchase a different personal accident cover for all my family members?

    No. The personal accident insurance plan is available as a floater policy which shall safeguard you and your dependents against unforeseen mishaps.

  • ✔️Is there an age limit for buying a personal accident cover?

    A minimum and maximum age limit might be applicable while buying a personal accident cover. But such an age limit might vary from one insurer to another.