Group Personal Accident Insurance

A group personal accident insurance is a policy purchased for a group of people. This policy is mostly purchased by corporate people. It covers the hefty medical expenses incurred due to accidental injuries or even a death benefit in case the insured dies in an accident. This ensures that

the family of the insured receives a sum assured in case their bread earner dies due to an accident. The claims are settled on a priority basis and within a short period, the admissible expenses or death benefit is disbursed to the insured/nominee. It is one of the most popular insurance policies among corporations.

Important Update (Dated May 30, 2024) – Good news for Health Insurance policyholders! According to the Master Circular on Health Insurance Business 29052024 rolled out on May 29, 2024 by IRDAI, insurers are to decide on the request for cashless claims within 1 hour of receiving the request. Also, the final claim is to be granted within 3 hours after the policyholder’s discharge from the hospital. Insurers have been directed by IRDAI to establish necessary systems and procedures for this process by July 31, 2024.

The Master Circular on Health Insurance Business 29052024 circular is available here - https://irdai.gov.in/document-detail?documentId=4942918

As the name suggests, group personal accident insurance is a type of coverage for employees under their organisation’s group health insurance plan that covers accidental death or disability. The policy coverage is available to both the employer as well as the employees of the company.

Group personal accident insurance offers comprehensive protection to the employee against hefty medical expenses incurred due to disablement in an accident. The policy also covers the death of the insured due to the mishap.

Employees are an organisation’s greatest asset, and it is the fundamental responsibility of an employer to keep its employees protected. Hence, to fulfil this fundamental responsibility, employers secure their employees with group personal accident insurance to provide financial security to them and their dependents in case of any unforeseen accidents.

Moreover, offering group personal accident insurance acts as an incentive to the employees and shows them that they are valued in the organisation. Hence, employers need to provide group personal accident insurance to their employees.

Following are the key features and benefits of group personal accident insurance plans available in India: 

• It covers a group of people belonging to the same company or community that has taken the policy.

• This group or community is created by the employer/owner of the company.

• The policy acts as an incentive to the employees.

• It covers the medical and treatment expenses arising in case of accidental death or treatment of the insured.

• It provides compensation to the dependents in case the insured dies in an accident.

• It also offers compensation to the dependents in case of permanent total/partial disability of the insured in an accident.

Here are the steps to buy a group personal accident insurance policy online:

1. Visit the insurance provider’s official website and navigate to the ‘Group Personal Accident Insurance’ section.

2. Fill out the online application form with your details and submit it.

3. A representative from the insurance company will get in touch with you to discuss the various policies available and will initiate the application process.

4. Submit all the necessary documents and pay the insurance premium.

5. Your group personal accident insurance policy will be sent to your registered email ID shortly.

Typically, the coverage of personal group accident insurance depends on the type of plan offered by the employer. Most personal group accident insurance plans cover the following things -

• Accidental Death: The policy provides a lump sum benefit to the dependents of the insured if they die in an accident.

• Permanent Total Disability: If the accident causes permanent total disability to the insured that continues for over a year, the insurer shall offer compensation as per the sum insured.

• Permanent Partial Disability: If the accident causes permanent partial disability, then the insurer pays 2-60% of the total sum insured amount. However, the benefit is paid if the disablement continues for over a year.

• Weekly Benefits: The policy provides weekly benefits to the insured in case of full disablement. However, the said benefit is temporary and compensates for the loss of income incurred due to the accident.

• Ambulance Cost: The policy also covers ambulance charges.

• Mortal Remains Expenses: The policy reimburses the expenses incurred due to the transportation of the insured’s mortal remains to its dependents.

• Reimbursement of Medical Bills: The medical treatment and hospitalisation expenses are also covered under the plan.

• Education Benefits: In case the insured dies in the accident or faces permanent disability, the education costs of the children are covered under the policy.

• Lifestyle Changes: If the permanent partial/total disability leads to lifestyle changes in the insured’s life wherein they need a car for transportation or constant care, the policy covers the said expenses.

While group personal accident insurance policies cover employees during unforeseen risks, such policies do not cover certain aspects. Some of these exclusions are:

• Self-inflicted Injuries: Suicide or self-inflicted injuries are not covered under such policies.

• Illegal Activities: Injuries caused while indulging in any criminal or illegal acts are excluded.

• Intoxicants: Injuries caused while being under the influence of intoxicants like alcohol, drugs, etc.

• Maternity-related Complications: Injury or death caused due to childbirth or pregnancy.

• War-like Situations: Accidents caused due to nuclear weapons, armed forces, etc.

Here are the steps to file a claim for group personal accident insurance:

1. Inform your insurance provider about the accident. You can do this by contacting their customer care number or via email.

2. The insurance provider will then register the claim and ask you (the insured) to fill out the claim form and submit all the necessary documents.

3. The insurer will then process the claim as per the policy terms.

4. If the claim is rejected, the insurer will send a rejection letter to you (the insured) or the HR of your organisation

If you wish to file a death claim under a group personal accident insurance plan, you will need the following documents:

• Insurance claim form

• Copy of the Police FIR

• The post-mortem report of the insured

• Death Certificate

• A succession certificate or notarized affidavit certifying the legal inheritor status

• A letter from the organisation’s HR

If you wish to file a disablement claim under a group personal accident insurance plan, you will need the following documents:

• Insurance claim form

• Copy of the Police FIR

• Necessary medical reports

• Disability certificate from a reputed doctor or a government office (in case of permanent disability)

• A statement provided by the attending doctor

Group personal accident insurance plans are an excellent way for companies to show that they care for their employees and their families. Many health insurance plans in India have a provision to customise group coverage to fulfil the needs of the employees.

It may require the employees to pay additional premiums to enhance the coverage of their health insurance plan. However, the primary health coverage is free, and the organisation pays the premiums.

Overall, this only reiterates the importance of having a comprehensive health insurance plan that covers the medical needs of you and your family. In case your organisation does not offer this incentive, you can always choose to buy health insurance with a trusted provider.

The health insurance plans available on Bajaj Markets offer extensive coverage at affordable prices, bespoke health plans, reinstatement benefits, cashless insurance, hassle-free renewals, and so much more.