An injury or a disability caused by an accident can leave the person physically and financially distressed. An accidental death, on the other hand, could leave the person’s family helpless. Reliance General’s Personal Accident Plan has been created to financially aid the injured individual and his/her family during such critical times. It is a simple and beneficial plan that provides benefits for accidental death and accidental disabilities. The documentation process is hassle-free, and round the clock insurance protection is provided by the company.
Eligibility for Personal Accident Plan
The insurer mentions who can be covered in the policy.
- A policyholder can cover himself/herself, his/her spouse and his/her dependent children.
- The minimum age at entry for the policyholder and his/her spouse is 18 years.
- Dependent children between 5 years and 25 years can be covered under the policy.
Features of Personal Accident Plan
The policy has certain special features that make it one of the best personal accident plans.
- This insurance policy provides worldwide personal accident insurance coverage.
- If no claim has been made in a policy year, the sum insured is increased by 5% to provide extra coverage as a bonus for maintaining a claim-free year.
- Medical expenses incurred after an accident can be reimbursed under this plan. Either 40% of the benefit paid or 20% of the sum insured, whichever is lower, is paid to the policyholder. This benefit can be availed by paying a 20% extra premium.
- A grace period of 30 days, starting from the premium due date, is given to the policyholder to pay the premium amount due to continue or renew a policy.
- A 15-day free-look period is provided to the policyholder, during which time he/she can go through the policy and return it if he/she is unhappy with the policy. On such return of the policy, the premium paid will be refunded after making necessary deductions.
- The sum insured amount for the spouse, in case he/she has a source of income, is equal to the policyholder’s sum insured. However, if he/she does not have a source of income, the sum insured for that person is 50% of the policyholder’s sum insured or Rs.1 lakh, whichever is lower. For dependent children, the sum insured is either 25% or Rs.50,000, whichever is lower.
- Reliance has a three-class risk classification. Risk Class I comprises of people who are involved in managerial, administrative or other such jobs. Risk Class II comprises of people who are involved in risky jobs such as machine operating, garage and motor mechanics, paid motor vehicle drivers, etc. Risk Class III includes people who are involved in dangerous activities such as installing high-tension electrical supply, working in underground mines, and so on.
- The risk class to which the individual belongs to will be one of the factors that determine the premium payable towards the policy.
Benefits of Personal Accident Plan
The policy offers a host of benefits that the policyholder can utilise throughout the term of the policy.
||Upon accidental death of the insured individual, 100% of the sum insured will be provided to the nominee.
|Permanent Total Disability benefit
- In case of permanent total disability caused by an accident, 100% of the sum insured will be provided.
- In case of loss of two eyes, or two limbs or one eye and one limb, 100% of the sum insured will be provided.
- In case of loss of one limb or one eye, 50% of the sum insured will be provided.
|Permanent Partial Disability benefit
||In case of permanent partial disability caused by an accident, a certain percentage of the sum insured, as mentioned in the policy, will be provided.
||In case of accidental death, the transportation expenses incurred on transporting the mortal remains to the individual’s residence are reimbursed, up to a maximum of Rs.2,500.
|Education fund benefit
||If the parent policyholder expires due to an accident, an education fund is provided for two children.
Exclusions of Personal Accident Plan
The insurer specifies certain conditions for which coverage will not be offered.
- Disability or death caused by pregnancy or childbirth is excluded from the policy.
- More than one benefit (Permanent Total Disability benefit, Permanent Partial Disability benefit or Death Benefit) cannot be paid during the same period of time.
- After admission of a claim that provides 50% or 100% of the sum insured, no further payment will be made in the same period of time.
- No claim exceeding the sum insured will be accepted after the benefit has already been paid out.
- Weekly compensation will not be paid until the amount is ascertained.
- Death or disability caused under the influence of drugs/alcohol, whilst engaging in aviation while mounting, dismounting, or travelling in an aircraft or balloon apart from a standard licensed passenger aircraft; from AIDS, insanity or venereal diseases, or from being involved in activities that break the law is not included in the policy.
- Death caused by suicide or disability caused by an attempt to commit suicide.
- Death or disability caused by war-like situations, rebellion, revolution, etc. is not included in the policy.
- Death or disability caused by ionizing radiation or nuclear weapons is an exclusion of the policy.
If an individual wishes to raise a claim for a certain injury, he/she should notify the insurance company about the accident or injury at the earliest. The notification can be a call or a written notice. In case of death, or loss of sight, or loss of a limb, a written notification is required. Here is the list of documents that need to be submitted at the time of claim intimation:
Name of the policyholder
Name of the insured person
Nature of the accident
Date of the accident
Name and address of the hospital and the attending doctor
In addition to the above-mentioned documents, any other document as requested by the insurer needs to be submitted.
The policyholder, the insured individual, or the nominee is required to submit the following documents when he/she raises a claim:
- Death/Disability certificate, as the case may be
- Post-mortem report if available (for death claim)
- Original claim form - duly filled and signed
- Referral letter by a medical practitioner advising hospitalisation
- Prescription and diagnostic test reports conducted by a medical practitioner
- Bills and receipts from the hospital or medical practitioner
- Discharge card from the hospital
- First Information Report or Final Police Report
Any other document that is requested by the insurer apart from the above-mentioned documents will need to be submitted. The insurer will then process and verify the claim. The insured individual may be medically examined by an agent of the insurance company. After verification, the claim amount, as mentioned in the policy, will be provided to the insurer by NEFT.