10 things to know about standard personal accident insurance

NEW DELHI: The standard personal accident insurance or Saral Suraksha Beema offers three mandatory base covers and three optional covers which can be chosen by the policyholder based on the requirement. The policy is offered for a tenure of one year.

The Insurance Regulatory and Development Authority of India (Irdai) has directed all health insurers to mandatorily offer a standard personal accident insurance policy by 1 April. In this piece, we take a look at ten important features of the policy.

1. The minimum entry age is 18 years and the maximum age at entry is 70 years. Dependent children are covered from age 3 months to 25 years. The policy can be availed by a family on an individual basis which means that the chosen sum insured will apply to each family member separately.

2. You will get the minimum sum insured of Rs2.5 lakh and a maximum of Rs1 crore. You can choose any sum insured within these limits in the multiples of 50,000.

3. The policy has three mandatory base covers. These are death, permanent total disablement and permanent partial disablement. The policy also has three optional covers which can be chosen by the policyholder based on the requirement. These covers are temporary total disablement, hospitalization expenses due to accident and education grant

4. 100% sum insured benefit is payable on the death of the insured person, due to an injury sustained in an accident during the policy period, provided that the insured person’s death occurs within a year from the date of the accident.

5. The benefit applicable to permanent partial disablement cover ranges from 1% to 50% of the sum insured payable to the insured. Loss of one entire hand, one entire foot, the sight of one eye or both ears’ accounts for 50% sum insured payable. While the loss of four fingers and thumb of one hand or only four fingers’ accounts for 40% and 35% sum insured payable respectively.

6. In the case of optional cover- education grant, if the insured person meets death or permanent total disability due to accident, a one-time educational grant of 10% of the base sum insured, per child, is payable to all dependent children of the insured if the dependent children are pursuing an educational course as a full-time student in an educational institution or the age of the child is not more than 25 completed years.

7. In the case of optional cover – hospitalisation expenses due to accident, the hospitalisation expenses arising due to the accident shall be payable under this cover, up to the limit of 10% of the base sum insured. Expenses related to hospitalisation, including the cost of prosthetic and other devices or equipment if implanted internally during a surgical procedure are covered under this optional cover. Further, expenses related to dental treatment, plastic surgery and all day-care treatments necessitated due to injury are covered under this policy.

8. In the case of optional cover – temporary total disablement, the cover compensates the insured person at the rate of 0.2% of the base sum insured per week if the insured person is completely incapacitated from engaging in any employment or occupation, due to accident. The minimum period of the disablement shall be four weeks, for the benefit to be payable under this cover. After completion of a minimum of four weeks, the policyholder is entitled to the benefit from the date of temporary disablement.

9. Cumulative bonus (CB), which means any increase or addition in the sum insured granted by the insurer without an associated increase in premium, is applicable only in respect of base cover. Sum insured (excluding CB) will get increased by 5% of sum insured in respect of each claim-free policy year subject to a maximum of 50% of the sum insured, provided the policy is renewed without a break. If a claim is made in any particular year, the cumulative bonus accrued will be reduced at the same rate at which it has accrued.

10. You can pay a premium on a yearly, half-yearly, quarterly and monthly basis. However, you must know that for yearly payment of mode, a fixed period of 30 days is allowed as a grace period and for all other modes of payment, a fixed period of 15 days is allowed as a grace period.

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