Thursday, August 6, 2009

Personal Accident Insurance Policy

The Policy Covers : If at any time during the currency of the policy the insured person shall sustain any bodily injury solely & directly from accident caused by external violent and visible means then Company shall pat to insured or his legal personal representative as the case may be sum or sums as per terms / condition of the policy.

S. No.

Benefits

Rs.

1

Death only (100% C.S.I.)

1,00,000/-

2

Loss of two limbs two eyes or one limb and one eye (100% C.S.I.)

1,00,000/-

3

Loss of one limbs or one eye (50% C.S.I.)

50,000/-

4

Permanent Total disablement from injuries other than those named above (PTD) (100% C.S.I.)

1,00,000/-

5

Permanent Partial disablement (PPD) as per percentage of CSI as shown on page 101


6

Temporary total disablement (TTD) at 1% of CSI upto 100 weeks (Max. weekly benefits per week not exceeding Rs. 3,000 however limited to Capital Sum Insured.

1,000/-


ADDISTIONAL BENEFITES FREE OF COST AVAILABLE UNDER ALL TABLES :


Expenses incurred for carriage of dead body of Insured Person (death due to accident only) to place of residence subject to a maximum of 2% of the CSI or Rs. 2500/- Whichever is less.


EDUCATIONS GRANT :


In the event of death or permanent total disablement of the insured du e to accident as defined in the policy, the policy shall also pay following amount as education grant for dependent children.


One dependent child (Below 25 years)

10% of C.S.I. subject to maximum of Rs. 5,000/-
(Maximum all policies on one life).

More than one dependent child (Below 25 years)

10% of C.S.I subject to Rs. 10,000/-(Maximum all policies on one like)

This Benefits is beased on C.S.I. and not on cumulative bonus. This is a one payment.


RISK GROUP

PREMIUM RATES (PER MILLE)


I

II

III

Table D Benefits as per (a) above

0.45

0.60

0.90

Table C Benefits as per (1) to (4) above

0.70

0.90

1.30

Table B Benefits as per (1) to (5) above

1.00

1.25

1.75

Table A Benefits as per (1) to (6) above

1.50

2.00

3.00


Note :


(1) Limit of Age is 5-702 years.
(2) The aforesaid limits would apply cumulatively in the event of there being more than one policy on the life of the insured person.
(3) The Proposer may choose any one or more the above tables.
(4) The Cover is worldwide.
(5) Cumulative Bonus : The Sum payable under item 1 to 4 is increased by 5% each year on renewal of Policy upto a limit of 50 percent. Earned cumulative bonus will not be lost if the Policy is renewed within 30 days of its expiry.

Family Package Cove :


Family Package Cover can be granted on the following pattern :


(i)Earning Member (Person (Insured)and Spouse if earning

C.S.I. for each as per norms given.

(ii) Spouse : (if not earning member)

50% of the Capital Sum Insured of the earning member or Rs. 1 Lakh whichever is lower.

(iii) Children (between the age of 5 years and 25 years)

25% of the Capital Sum Insured of either earning member or Rs. 50,000/- whichever is lower per child


Note :


1. For Children the maximum cover shall be limited to Death and Permanent Disablement (total and partial)i.e. upto Table B benfits only.
2. A discount of 10% may be granted on the gross premium under the Family Package Cover.
3.Where Sum Insured petaining spouse works out to less than the Sum Insured allowable, if such spouse was not earning the Later Sum Insured may be allowed.

EXTENSTION COVER :


The policy can be extended to include reimbursement medical expenses to the extent of 40% of the valid claim amount or 10% of Capital Sum Insured whichever is less subject to payment of additional premium at the rate of 20% of basic premium.


RISK GROUP I :


Accountants, Doctors, Lawyers, Architects, Consulting Engineers, Teachers, Bankers, Person engaged in administrative functions and persons primarily engaged in occupation of similar hazard.


RISK GROUP II :


Builders, Contractors and Engineers engaged in superintending functions only, Veterinary Doctors, paid drivers of motor cars and light motor vehicles and person engaged in occupation of similar hazard and not engaged in manual labour.


All persons engaged in manual labour (except those falling under group iii) cash carrying employees, Garage and Motor Machanics, Machines operators, Drivers of trucks or lorries and other heavy vehicles, Professional Athletes and Sportsmen, woodworking Machinists and persons engaged in occupations / activities of similar hazards.


RISK GROUP III :


Persons working in underground mines, Explosives Magazines, Workers involved in electrical Installation with high tension supply Jockeys, Circus Personnel, Persons engaged in activites like racing on wheels or horse back, big game, hunting, mountaineering, winter sports, skiing, ice hockey, ballooning, polo and persons, engaged in occupations/activities of similar hazard.


Note : Occupations not included in the above will be decided by insurer depending upon the merits of each case.


EXCLUSION


The policy does not cover death, injury or disablement resulting from :



(a) Service on duty with any Armed Force.
(b) Intentional self injury, suicide or attempted suicide, insanity, venerals disease or the influence of intoxicating drink or drugs.
(c) Medical or Surgical treatment (except where such treatment is rendered necessary within the scope the Policy.)
(d) Aviation other than as a passenger (fare-paying or otherwise) in any duly licenced standard type of aircraft any where in the world.
(e) Nuclear radiation of nuclear weapons materials.
(f) Nuclear radiation of nuclear weapons materials.
(g) Any consequence of War, Invasion, Act of Foreign Enemy, Hostilites (whether war be declared or not) Civil war, Rebelion, Revolution, Insurrection, Mutiny Military or Usurped Power, Sezure, Capture, Arrests, Restraint and Detainments of all Kings, Princes and People of whatsoever nation condition or quality.
(h) Child birth, Pregnancy or other Princes and People of whatsoever nation condition or quality.
(i) Child birth, Pregnancy or other Physical causes peculiar to the female sex.
(j) Whilst committing any breach of low with criminal intent.


PERMANENT PARTIAL DISABLEMENT

(1)Parts Lost

Compensation In Percentage of C.S.I.

1. Loss of toes all
2. greate both phalanges
3. great one phalanx
4. Other than great, if more than one toe-lost, each


(2)Loss of hearning both ears


(3)Loss of hearing one ear


(4)Loss of four fingers and thumb of one hand


(5)Loss of four fingers


(6)Loss of thumb-both phalanges one phalanx phalanx


(7)Loss of index finger three phalanges or two phalanges or one phalanx


(8)Loss of index finger three phalanges or two phalanges or one phalanx


(9)Loss of ring finger three phalanges or two phalanges or one phalanx


(10)Loss of little finger three phalanges or two phalanges or on phalanx


(11)Loss of metacarples first or second (additional) or third, fourth or fifth additional)


Any other Permanent partial disablement

% as assessed by the panel Doctor of the Company.



Note :


1) The cover is worldwide.
2) The capital sum insured shall be fixed at the commencement of the policy No change in the C.S.I. is permissible during the currency of policy.
3) Occupation not included in the above will be decided by insurer depending upon the merit of each case in consultation with RO/HO Technical dept.
4) Sum insured of Table A should not exceed insured’s 2 years income and total sum insured comprising all the table should not exceed 6 years income :
5) Retired Person of GIC & its subsidiaries) can be covered up to his/her death. The sum insured to be given on 50% basis of last policy or Rs. 5 lacs which ever is less for table B only. i.e. Weekly Compensation benefit (table A should not be given.
6) The aforesaid limits would apply cumulatively in the event of there being more than one policy on the life of the insured by any one or more of the subsidiaries of the G.I.C.
7) Table A can be taken upto Rs. 5 Lacs with prior R.O. approval.

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