What is covered

Accident insurance covers bodily injuries resulting directly from an accident caused by external, violent, and visible means, which end in death or permanent
or temporary disablement.

• Accidental death

• Permanent total disability

• Permanent partial disability

• Weekly Benefit (Loss of Pay/Income)

Add-on covers/riders

• Accidental Medical Expenses (Inpatient) Reimbursement

• Accidental Medical Expenses (Outpatient) Reimbursement

• Child Education Allowance

• Repatriation of mortal remains

• Repatriation of mortal remains

• Mobility Modification allowance

• Emergency family travel expenses.

• Broken bones

• Ambulance charges

What is not covered?

• Pre-existing conditions

• Suicide or self-injury

• Participation in sports or adventurous activities

• Illegal/Criminal Act.

• Natural death

• Non-allopathic treatments

• An injury caused by the influence of drugs/alcohol

• Pregnancy/childbirth

• Occupational diseases

• An injury caused by radioactivity

• Military Service or operations

• War/nuclear unrest

Who can buy the GPA Policy?

• This policy can be offered as an employee benefit by employers.

• The bank can offer coverage to its account holders, shareholders, etc.

• Members of cooperative societies can be covered by these policies

• NGOs or other social welfare organizations/associations can also have this policy

Group Personal Accident Insurance Vs Employee Compensation (Act) Policy

• The coverage provided by both policies is similar in case of death or disability. The GPA cover does not have limitations on work-related accidents, and you can choose higher sums assured, but you will not be covered for unlimited liability as with WC.

• GPA is a Benefit policy, whereas WC is a Legal Liability Policy.

• Workman’s Compensation policy can be enhanced by a Group Personal Accident Insurance policy so that employees receive extra benefits over and above that provided by WC. The GPA policy is a benefit policy and cannot replace a workers’ compensation policy.

• GPA provides coverage for accidents occurring 24 hours a day worldwide, whereas the Workmen’s Compensation Policy covers only accidents occurring while on duty.

• The GPA Policy also allows you to choose the benefit limit per employee or member based on your needs. A Workmen’s Compensation Policy defines only the maximum and minimum compensation in accordance with the WC Act.

• GPA policies can be issued on an unnamed or named basis, while Workmen’s Compensation policies can only be issued on an unnamed basis.

Claim Procedure and Documentation

• In the event of an accident, the insurance company must be notified

• A claim is filed, and the insurance company provides a checklist of required documents.

In the case of disability claims

• Claim form

• Proof of identity

• Employer’s incident report (cause of the accident).

• Leave certificate from the employer

• Certificate of salary or other income documentation.

• Doctor’s certificate of treatment.

• Related Medical Papers, Reports, and Final bills.

• Police FIR/ MLC (if done)

• A disability certificate signed by an attending doctor or civil surgeon

• The treating doctor or civil surgeon must provide a fitness certificate.

Additional Requirement (in case of death)

• Death certificate

• Post-mortem report

• Notarized affidavit or succession certificate (payment to the nominee)