Group Personal Accident Insurance – Inclusions, Exclusions and Documents Required
Mr Sharma is an owner of a company. He’s looking to insure his employees against unexpected medical expenses that may arise due to an injury or death resulting from an unfortunate event at the workplace.
In this context, he might want to consider a group accident insurance plan from reputed insurance companies. Irrespective of his company’s size, he can purchase a customisable group personal accident insurance policy to meet the requirements of employees.
To know more about group insurance plans, read the following sections –
Why Do You Need Group Personal Accident Insurance?
- Comprehensive Coverage
Group insurance policies offer comprehensive coverage against all accident-related expenses. - Pays Compensation
In the case of a policy member’s demise, the insurance provides financial assistance to the nominees in the form of compensation. - Funds education
If a policyholder suffers from permanent disability due to an accident, this policy covers the education costs of an employee’s child. - Weekly benefits
There might be an accident that results in the complete disability of an employee. In such a scenario, the insurance company offers weekly compensation for a certain period. - Medical reimbursement
Group insurance policies reimburse the hospitalisation and other medical expenses incurred due to an accident or injury. - Ambulance charges
In case insured employees avail of ambulance services, a group insurance policy covers the associated costs.
Features of Group Insurance Policy
- Employees of clubs, institutions, corporate firms and associations can obtain group personal accident insurance for overall financial protection against hefty charges in case of accidents.
- This type of insurance policy extends benefits to its policy members for a tenure of 1 year.
- Some insurance companies offer discounts on the group insurance premiums based on the size of the group.
- In case of an employee’s permanent disablement or death, this policy funds his or her child’s education.
- Individuals can renew the policy to continue receiving benefits.
Inclusions under Group Accident Insurance
- Basic Cover: Accidental bodily injury resulting in death.
- Wider Cover: Includes death and permanent total or partial disability resulting from accidents.
- Comprehensive Cover: Covers death, permanent total or partial disability, and temporary total disability.
- Repatriation of Mortal Remains and Funeral Expenses: The policy covers transportation costs of an insured person’s mortal remains to a hospital, cremation ground or residence and also includes funeral expenses.
Group Personal Accident Insurance Exclusions
- Natural death
- Expenses resulting from committing or attempting suicide or from self-inflicted injuries
- Death or injury from drug abuse and alcoholism
- Injuries from adventurous sports or other hazardous activities
- Consequential loss
- Injuries resulting from breach of law with criminal intent
- Expenses arising from injuries in wars, invasions etc.
- Pregnancy-related expenses
- Treatment costs of individuals in the naval, air force or military operations
- Curative treatments or interventions
- Venereal or Sexually Transmitted Diseases (STDs)
- HIV/AIDS
However, individuals looking for comprehensive group personal accident insurance might want to consider insurance companies like Navi. Their group insurance policies provide additional financial protection in case of accidental death or other injuries. Further, their app-based processes allow members to intimate claims without any hassle. To avail the plans and benefits, just download the Navi app from the google play store.
How to Make a Claim against a Group Insurance Policy?
- Firstly, policy members need to intimate the insurance provider about the accident via call or mail.
- During claim intimation, the insurer might ask for the following details:
- Policy number
- Name
- Employee code
- Nature of event
- Name of the insured person for whom the claim has been filed
- Address and name of the hospital from where he or she is receiving treatment
- Event date
- After successful registration of the claim, the insurance company sends a claim form along with a checklist of necessary documents.
- Individuals need to submit the said documents and the duly filled claim form for processing. In case of any discrepancy, the insurance company will notify the members via mail or call.
- After complete verification of the documents and thorough scrutiny, the claim is processed. Further, the companies prepare a cheque at this stage to settle the claim amount against the individual’s group insurance policy.
Documents Required to Claim Group Personal Accident Cover
- Duly signed claim form
- Copy of FIR if an accident has been reported to the police
- Death certificate copy
- Copy of post mortem report
- Hospital record copy
- Identity proof of nominee in case the deceased has not filed a nomination
- Original passenger ticket or boarding pass in case of death in public transport
- Disability certificate
- Leave or absence certificate from the employer
- Study certificate from the school of a dependent child
- Original bills, prescriptions etc.
- Salary slips for the last 3 months
- Photo identity proof such as Voter ID, Aadhaar etc.
- Cancelled cheque
Also Read
Why Do You Need Group Insurance if You Have Health and Life Insurance Cover?
- In the case of individual health or life insurance plans, policy members need to bear the premium amounts themselves, which increases their financial liability. However, in the case of group insurance plans, employers pay the premium amount, which allows the insured individuals to enjoy an extensive range of benefits.
- Group personal accident insurance provides coverage benefits as long as the person is associated with an institution irrespective of his age or medical history.
- Considering the legacy of an employer, group insurance policies come with an easy and hassle-free claim process. An employee simply needs to present his health card and intimate the claim.
Final Word
Needless to say, group insurance policies cover various expenses arising from accidents and injuries at a workplace. Therefore, individuals with a well-rounded group personal accident insurance plan can protect their savings and meet their financial goals effectively due to the comprehensive coverage benefits. Now that you know everything about this plan, obtaining such insurance would not be a daunting task.
FAQs
Ans: There are no tax benefits in relation to group accident insurance policies. However, you can opt for individual health or life insurance plan to obtain tax benefits under Section 80D of the Income Tax Act, 1961.
Ans: There are various factors that determine the premium of a group insurance policy. They are as follows:
Employees’ exposure to risk in the workplace
Employment category
Number of employees in the organisation
Ans: There are various additional benefits that you can enjoy by opting for a group insurance policy. Some of them are listed below:
Education allowance
Family transportation
Allowance modification
Repatriation of mortal remains
Ans: Yes, group insurance policies cover the cost of treating injuries that you may pick up while travelling abroad. That said, note that you will only receive coverage in case you visit a foreign country for business trips that are organised by the employer who pays the premium.
Ans: The insurer will offer coverage benefits to individuals with permanent disabilities such as:
Loss of eyesight
Loss of hands and feet
Paralysis leading to permanent disability
Loss of one hand and one foot
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Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.
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