If a person sustains an injury that converts into a permanent total disability within 12 months of the date of the accident, the insurance company will pay the sum insured as mentioned in the pocket insurance. Permanent total disability means; a) Loss of sight in both eyes. (b) Loss of ability to use one or both hands or feet (c) Loss of limbs (d) Loss of sight in one eye and loss of limbs or the ability to use one hand or foot. A lifestyle modification benefit of 2% of the sum insured will be paid out along with the benefit for permanent total disability under this top-up insurance.

Permanent partial disability under wallet insurance includes compensation based on the information below; (a) Hearing of both ears – 75% (b) An arm at the shoulder joint – 70% (c) A leg above mid-thigh – 70% (d) An arm above the elbow joint – 60% (e) A leg up to mid-thigh – 60% (f) A hand at the wrist – 55% (g) A leg up to beneath the knee – 50% (h) An eye – 50% (i) A foot at the ankle – 40% (j) Hearing of one ear – 30% (k) A thumb – 20% (l) An index finger – 10% (m) Sense of smell – 10% (n) Sense of taste – 5% (o) Any other finger – 5% (p) A large toe – 5% (q) Any other toe – 2%. In case the sachet insurance policyholder has suffered more than one form of partial disability, then the total pay-out will not exceed the total sum insured under the policy.

In case the insured is hospitalized due to an accident or some form of injury, the pocket insurance will cover the following in-patient medical expenses; (a) Room rent and boarding (b) Nursing (c) ICU charges (d) Doctor’s consultation (e) Anaesthesia, blood, oxygen, OT charges, surgical appliance charges (f) Medicines and consumable charges (g) Diagnostic procedure charges (h) Prosthetic device charges (i) Physiotherapy. However, the hospitalization needs to be recommended by a doctor or medical practitioner for the capsule insurance to cover it.

The air ambulance cover pays expenses for transportation of the insures by airplane or helicopter from the place of accident to the nearest hospital. The lower of actual expenses incurred or the amount mentioned in the top-up insurance will be reimbursed.

A hospital cash benefit cover under a pocket insurance pays a defined benefit for each day that the policyholder is hospitalized. This benefit is only payable in case the hospitalization is for more than 24 hours. This benefit can be availed for a maximum of 60 days per policy period. This benefit does not cover hospitalization due to any pre-existing injuries, any treatment that is not scientifically recognized, any treatment not advised by a medical practitioner, any other procedure not undertaken as a part of the accident treatment. This benefit is only available for treatment in India.

In case a policyholder is not able to perform his duties at his place of employment or business because of a disability caused due to an accident, the top-up insurance will pay a weekly benefit of Rs. 1,000 per week.

The road ambulance cover provides reimbursement of actual ambulance expenses incurred to transport the insured from the place of accident to the hospital. The ambulance service can be provided by a healthcare provider or an ambulance service. This cover also includes reimbursement of healthcare services provided inside the ambulance up to the specified limit.

This easy on pocket sachet insurance will reimburse travel expenses for a family member of the policyholder in case the policyholder sustains an accident outside his usual place of residence. This travel expense benefit is limited to economy class transportation by the most common mode of transport to reach that place.