Group Personal Accident

1Covered

• Accidental Death: If the employee dies in an accident, the insurance company gives the full insured amount to the person’s family or nominee.
• Permanent Total Disability: If the employee becomes completely disabled (loss of two limbs) after an accident, the full insured amount is paid to the employee and if the employee loses 1 limb, then 50% of the sum insured will be paid.
• Permanent Partial Disability: If the employee loses part of their ability to work (like losing a finger or eyesight), they will get a part of the insured amount — between 2% to 60%, depending on the injury and policy.
• Temporary total Disablement (Weekly Compensation): If the employee is not able to work for some time due to the accident, the insurance company gives a fixed amount every week for that period. This can be continued upto maximum 104 weeks.
• Broken Bones: A fixed amount of money will be given for certain bones broken in the accident, as listed in the policy.
• Education Support: If an employee’s family member passes away due to an accident, the policy helps cover the cost of education for the children.
• Accidental Hospitalization: The insurance covers the costs of treatment if an employee is hospitalized due to an accident, including medical bills.
• Ambulance Charges: If an employee needs to be taken to the hospital by ambulance after an accident, the insurance covers the ambulance fees.
• Funeral Expenses: If the employee dies due to an accident, the insurance helps cover the funeral costs.

1For Death Claim

These are the documents needed if you are claiming for death due to a personal accident:

• Claim Form
• Permanent Total Disability: If the employee becomes completely disabled (loss of two limbs) after an accident, the full insured amount is paid to the employee and if the employee loses 1 limb, then 50% of the sum insured will be paid.
• Police Report or FIR (First Information Report)
• Death Certificate
• Post-mortem or Coroner’s Report
• Salary Slip
• If the payment is given to a family member, a notarized affidavit or legal certificate confirming who is the legal successor
• Letter from the company’s HR department

2For Disability Claim

These are the documents needed if you are claiming for disability due to a personal accident:

• Claim Form
• Medical reports like pathology, X-rays, etc.
• Police FIR (if the accident was reported to the police)
• Statement from the attending doctor
• For permanent disability, a disability certificate from a surgeon or government office
• For permanent total disability, a sick leave certificate from the employer

1Step 1

Inform the insurance company about the accident by calling or sending an email.

2Step 2

The insurance company will register your claim once they get your information.

3Step 3

After registering, the insurance company will send you a claim form and a list of documents you need to provide.

4Step 4

If any documents are missing, the company will contact you via SMS, email, call, or other means.

5Step 5

Once all documents are received, the company will process the claim based on the policy’s rules.

6Step 6

After receiving all the necessary documents and the completed claim form, the claim will be processed, and the payment will be sent to you.

7Step 7

If the claim is rejected, the company will send a rejection letter to you, your contact person, or your HR department.