Overview
No matter how careful we are, there's no predicting when one will end up with a broken bone. You don't necessarily have to be a sportsperson to have bone injuries, common people trip & fall all the time & sometimes end up with fractures too. Fracture cover is a pocket-size insurance that provides a lump sum benefit depending on the body part fractured and nature of fracture. This fracture treatment insurance also provides for income loss in case of permanent partial disablement besides providing a fracture cover.
Coverages
- Option 1
- Option 2
The insured gets a Sum Insured of Rs. 50,000 in case of Permanent Partial Disability due to an accident and an additional amount of Rs. 50,000 in case of a fracture.
The insured gets a Sum Insured of Rs. 50,000 in case of Permanent Partial Disability due to an accident, an additional amount of Rs. 50,000 in case of a fracture and income replacement (in case of income loss due to disability) of Rs. 1000/week.
Exclusions
- Any Pre-existing Condition(s) and complications arising out of or resulting therefrom.
- Through suicide, attempted suicide (whether sane and insane) or intentionally self-inflicted injury or illness.
- HIV (Human Immunodeficiency Virus) and/or any HIV related illness including AIDS (Acquired Immune Deficiency Syndrome) and/or mutant derivatives or variations thereof however caused.
- No benefit would be paid under this policy unless the nature & extent of the injury is established medically with appropriate investigation reports & certified by the treating doctor.
- While engaged in any hazardous activity unless specifically insured.
- Refer to the download section for the PDF mentioning more exclusions.
Claim Process for Sachet Insurance
Filing claims was never so simple. Just follow these steps and you’re done!
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1
Register your claim online
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2
Upload documents online
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3
Claim Assessment
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4
Claim Decision
- Process
- Download
- Emergency Contact
- Claim Reimbursement
- Cancellation Process
If you meet with any Accidental Bodily Injury that may result in a claim, then as a condition precedent to our liability:
a. You or someone claiming on your behalf must inform us in writing immediately and in any event within 30 days from the date of the accident and submit all documents to us within 30 days from the date of intimation.
b. You must immediately consult a Doctor and follow the advice and treatment that he recommends.
c. You must take reasonable steps to lessen the consequence of Bodily injury.
d. You should allow examination by our medical advisors if we ask for this.
e. You or someone claiming on your behalf must promptly give us documentation and other information we ask for to investigate the claim or our obligation to make payment for it.
f. In case of your death, someone claiming on your behalf must inform us in writing immediately and send us a copy of the post mortem report (if conducted) within 30 days.
*Note: Waiver of conditions (a) and (f) may be considered in extreme cases of hardship where it is proved to Our satisfaction that under the circumstances in which the Insured Person was placed, it was not possible for the Insured Person or any other person claiming on his/her behalf to give notice or file claim within the prescribed time limit.
- We may cancel this insurance by giving You at least 15 days written the notice, and if no claim has been made then we shall refund a pro-rata premium for the unexpired Policy Period. Under normal circumstances, Policy will not be canceled except for reasons of misrepresentation, fraud, non-disclosure of material facts or Your non-cooperation.
- You may cancel this insurance by giving us at least 15 days written the notice, and if no claim has been made then we shall refund premium on short term rates for the unexpired Policy Period as per the rates detailed below.
Period in Risk |
Premium Refund |
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Policy Period 1 Year |
Policy Period 2 Year |
Policy Period 3 Year |
|
Within 15 Days |
Pro-Rate Refund |
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Exceeding 15 days but less than 2 months |
75.00% |
80.00% |
85.00% |
Exceeding 2 months but less than 4 months |
60.00% |
75.00% |
80.00% |
Exceeding 4 months but less than 6 months |
45.00% |
65.00% |
75.00% |
Exceeding 6 months but less than 8 months |
30.00% |
60.00% |
70.00% |
Exceeding 8 months but less than 10 months |
15.00% |
50.00% |
65.00% |
Exceeding 10 months but less than 12 months |
0.00% |
45.00% |
60.00% |
Exceeding 12 months but less than 14 months |
|
35.00% |
55.00% |
Exceeding 14 months but less than 16 months |
|
30.00% |
50.00% |
Exceeding 16 months but less than 18 months |
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20.00% |
45.00% |
Exceeding 18 months but less than 20 months |
|
15.00% |
40.00% |
Exceeding 20 months but less than 22 months |
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5.00% |
35.00% |
Exceeding 22 months but less than 24 months |
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0.00% |
30.00% |
Exceeding 24 months but less than 26 months |
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|
25.00% |
Exceeding 26 months but less than 28 months |
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|
20.00% |
Exceeding 28 months but less than 30 months |
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|
15.00% |
Exceeding 30 months but less than 32 months |
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|
10.00% |
Exceeding 32 months but less than 34 months |
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|
5.00% |
Exceeding 34 months but less than 36 months |
|
|
0.00% |
However, if any claim has been made then no refund will be given for cancellation of policy.
- Claim Reimbursement
- Other Health Insurance Related Claims
- Links for Claim Settlement Forms
- List of Network Hospitals
- List of Exclusions
- Table With Fracture & Dislocation Details
Link to redirect customers to links category.
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Reimbursement Form
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Self Declaration of KYC Document Submission - For Individual Partner
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Non-Medical Expenses List of Exclusions
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Personal Accident Claim Form
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Cashless Claims Request Form
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Reimbursement Form
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Self Declaration of KYC Document Submission - For Individual Partner
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Personal Accident Claim Form
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Non-Medical Expenses List of Exclusions
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List of Network Hospitals
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This is the link to the list of remaining 'Exclusions'
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This is the link to the table containing Fracture & Dislocation details
Need further assistance? Reach out on the Toll-Free Number: 1800-209-5858 to connect with an insurance expert.
Manage all your queries here
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What is Fracture Cover?
This policy covers you in case of any kind of accidental bodily injury resulting in any kind of fracture (hand, leg, etc.) and provides you a lumpsum benefit depending upon the type of fracture and the body part fractured (with benefits ranging from 2% to 100% of sum insured i.e. Rs. 50000). The fracture treatment cover also provides for your income loss to the extent of Rs. 1000/week in case of permanent partial disablement.
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What are the benefits offered?
This insurance covers bone fractures (hand fracture, leg fracture etc.) resulting from a cycling or any other accident and provides Sum Insured of up to Rs. 50,000 depending upon nature of the fracture. This cover also provides for income loss of up to Rs. 1000 a week and lets you choose between two coverage variants.
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Does this fracture cover policy cover any other type of fracture which is not mentioned in the policy document?
No, all possible kind of fractures are included in the ‘list of fractures’ mentioned in the policy document and hence anything apart from the list will not be covered.
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What is ‘Loss of Income Due to Disability’ under Fracture cover?
If due to an accidental injury the insured is not able to perform his duties pertaining to his employment or occupation, then a weekly benefit of Rs. 1000 is paid to the insured, under this fracture treatment insurance.
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Is there any age limit involved if one wants to buy this insurance?
Yes, there is an entry age limit. The insured’s entry age should be between 18 years to 70 years.
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