What is personal accident insurance and why is it important?


Accidents can have a devastating impact on individuals and their loved ones. They can result in death, serious injuries, and permanent disabilities, causing immense physical, mental, and emotional distress. To mitigate the financial burden that comes with such unfortunate events, insurance companies offer a specialized policy known as personal accident insurance.

In this comprehensive guide, we will explore the various aspects of personal accident insurance, including its coverage, benefits, eligibility criteria, and the best policies available in India. Whether you are the sole breadwinner of your family, involved in high-risk occupations, or frequently engage in highway driving, personal accident insurance is essential for everyone. It provides financial security and peace of mind in the face of unforeseen accidents.

What is Personal Accident Insurance?

Personal accident insurance is a type of policy designed to provide protection against death, permanent total or partial disability resulting from accidents. In the event of accidental death or permanent disability, the insurance company compensates the insured or their family up to the sum assured coverage. For partial disability, a portion of the sum assured is paid, depending on the severity of the disability.

Unlike health insurance, which covers immediate treatment post-accident, personal accident insurance focuses on alleviating the financial burden caused by accidents. It also covers minor injuries such as fractures and dislocations, as well as expenses like ambulance costs, hospital bills, and even a child’s education expenses.

How Does Personal Accident Insurance Work?

Personal accident insurance provides a broader scope of coverage compared to health insurance. It offers immediate cash payouts, relieving the insured of any financial strain resulting from an accident. Additionally, there is no waiting period, ensuring prompt compensation.

Who Should Opt for Personal Accident Insurance?

Accidents can happen to anyone, regardless of age, occupation, or health condition. Therefore, personal accident insurance is ideally essential for everyone. It is particularly important for:

  1. Sole Breadwinners: If you are responsible for supporting your family financially, a personal accident insurance policy can provide much-needed security in your absence.
  2. High-Risk Occupations: Individuals involved in dangerous professions such as builders, contractors, and engineers engaged in superintending functions should consider personal accident insurance.
  3. Highway Drivers: Those who frequently drive on highways are at a higher risk of accidents and should prioritize personal accident insurance.
  4. Cash Carrying Employees: Employees who handle cash and are exposed to a higher risk of theft or accidents should have personal accident insurance.

What Does Personal Accident Insurance Cover?

Personal accident insurance covers the following:

  1. Accidental Death: The policy provides coverage in the event of the policyholder’s accidental death.
  2. Disability: It offers coverage for permanent or partial disabilities resulting from accidents.
  3. Hospitalization Expenses: Personal accident insurance covers hospitalization expenses and other medical costs related to accidents.
  4. Child’s Education Expenses: In case of accidental death or permanent total disability, the policy provides compensation for a child’s education expenses below the age of 19.
  5. Specific Injuries: It covers burns, fractures, and other injuries resulting from accidents.
  6. Daily Cash Allowance: Some policies offer a fixed amount for each day spent in the hospital due to an accident.
  7. Transportation Costs: Certain insurance companies provide coverage for the transportation costs associated with the mortal remains of the policyholder.

Types of Personal Accident Insurance Policies

There are two main types of personal accident insurance policies:

  1. Individual Accident Insurance: This policy covers the main policyholder against financial losses resulting from accidents. It provides coverage for accidental death, permanent disabilities, and temporary disabilities arising from accidents.
  2. Group Accident Insurance: Under this policy, a group of individuals, such as employees, receive coverage for accident insurance. Employers often provide group accident insurance to their employees at a lower premium cost. However, the benefits of group insurance are usually limited compared to individual accident insurance policies.

Benefits of Buying Personal Accident Insurance

Personal accident insurance offers several significant benefits, including:

  1. Financial Security: In the event of accidental death, the policy provides financial security to your family by paying the sum insured to the nominee.
  2. Coverage for Permanent Disability: The policy offers financial support in case of permanent disabilities resulting from accidents.
  3. No Pre-Requisite Medical Tests: Unlike many other insurance policies, personal accident insurance does not require any pre-requisite medical tests before purchase.
  4. Hospitalization Expenses Coverage: All hospitalization expenses related to accidents are covered by personal accident insurance.
  5. Child’s Education Coverage: The policy compensates for a child’s education expenses below the age of 19 in the event of accidental death or permanent total disability.
  6. Customizable Coverage: Personal accident insurance allows you to choose from a variety of sum assured options to suit your needs.
  7. Daily Cash Allowance: You can receive a fixed amount for each day spent in the hospital due to an accident.
  8. Fast Claim Disbursement: Personal accident health insurance policies offer faster claim disbursals once the insurer is informed within the stipulated time frame.
  9. Transportation Coverage: Some insurance companies cover the cost of transporting the mortal remains of the policyholder.
  10. Affordable Option: Personal accident health insurance is an inexpensive option, with the cost depending on the coverage and state of the insured.

How is Personal Accident Insurance Premium Calculated?

Calculating the premium for personal accident insurance is a straightforward process. Most insurance companies provide online premium calculators on their websites. To calculate the premium, you need to fill in essential details such as:

  1. Sum Assured Coverage
  2. Age
  3. Profession
  4. Duration of the Policy

Once you enter these details, the premium calculator evaluates the information and provides the possible premium amount for the accident insurance policy.

Exclusions in Personal Accident Insurance

Like any insurance policy, personal accident insurance has certain exclusions. The following are typically excluded from coverage:

  1. Natural Death: It does not cover death resulting from natural causes.
  2. Pre-Existing or Birth Disabilities: Any disabilities that exist prior to purchasing the policy are not covered.
  3. Childbirth or Pregnancy: It does not cover complications arising from childbirth or pregnancy.
  4. Self-Imposed Injuries: Injuries resulting from intentional self-harm or suicide attempts are not covered.
  5. Injuries Related to War or Riots: Personal accident insurance excludes injuries caused by war, civil unrest, or riots.
  6. Mental Disorders: Accidents resulting from mental disorders are generally not covered.
  7. Injuries Related to Adventure Sports: Personal accident insurance may exclude coverage for injuries sustained during adventure sports activities.

It is essential to thoroughly review the policy terms and conditions to understand the specific exclusions of your personal accident insurance.

How to Make a Claim in Personal Accident Insurance

The claim settlement process for accident insurance is quick and hassle-free. The policyholder can choose between a cashless claim settlement or a reimbursement claim process, depending on the situation and policy terms.

Cashless Claim Settlement Process

  1. Notify the Insurance Company: Notify the insurance company within 48 hours of hospitalization in case of an emergency.
  2. Present Insurance Card: Show your insurance cashless card along with an ID proof at the hospital’s desk.
  3. Fill Claim Form: Fill out the claim form and submit it to the hospital.
  4. Claim Review: The insurer will review the form and submitted documents and clear the claim process immediately.

Reimbursement Claim Settlement Process

  1. Notify the Insurance Company: Notify the insurer within 48 hours of hospital admission.
  2. Collect and Submit Documents: Collect and submit the required documents after 15 days of discharge from the hospital.
  3. Claim Review: The insurer will review the documents and either approve or reject the claim.
  4. Reimbursement: If approved, the insurance company will send the reimbursement amount to your registered bank account and notify you via email.

List of Documents Required

In the event of the accidental death of the policyholder, the following documents need to be submitted:

  1. Death Certificate
  2. Original Policy Documents
  3. ID Proof
  4. Age Proof
  5. Discharge Summary
  6. Medical Certificate
  7. Police First Information Report (FIR), if needed
  8. Hospital Records or Certificate

Best Personal Accident Insurance Plans in India

Now that we have covered the various aspects of personal accident insurance, it is crucial to know the best policies available in India. The following insurance companies offer some of the top personal accident insurance plans:

  1. Niva Bupa Accident Insurance – AccidentCare
    • Benefits: 50% discount under No Claim Bonus, Fast claim settlement, Personal Accident Coverage
    • Number of Network Garages: 10000+

Forbes Advisor adheres to strict editorial integrity standards. The opinions expressed in this article are the author’s alone and have not been provided, approved, or otherwise endorsed by our partners. The content is accurate as of the date posted, though offers contained herein may no longer be available.

In conclusion, personal accident insurance provides vital financial protection in the event of accidents resulting in death or disability. It offers coverage for hospitalization expenses, child’s education expenses, and various other benefits. By understanding the coverage, exclusions, and claim process, individuals can make informed decisions about purchasing personal accident insurance and ensuring the security of their loved ones in times of uncertainty.

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Deepa Bapat
Deepa Bapathttps://www.storifynews.com/
Doctor of Psychology in Clinical Neuropsychology from Macquarie University, Australia; Bachelor of Psychology (Honours) -Macquarie University, Sydney; Cleared the NET exam for Psychology. Dr.Deepa Bapat has been attached to the Child Development Centre at Hinduja Hospital, Mumbai and was the Clinical Neuropsychologist at Fortis Hospital, Mulund, Mumbai. She has also been involved in teaching psychology at tertiary education centers in Mumbai and Pune. Deepa’s research interests lie in the development of culturally appropriate neuropsychological tests. She is particularly interested in dealing with disorders of memory in the elderly, early detection of these conditions and appropriate rehabilitation of the same. Recently she has join Storify News as an health related article published. Here is her profile for your reference: https://www.flame.edu.in/faculty/deepa-bapat

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