Personal Accidental Insurance Cover

More insights into the Insurance on Personal Accident and Injury

Capital sum assured

This is generally the limit for which the insurance cover is taken. In other words it is the maximum sum of amount the insurer will pay for a claim under this policy during the policy period.

Accident It may be defined as a sudden, unforeseen and arguably unexpected event, and happens by chance and not by choice and this may be due to force acting from external, which is violent and visible in nature. External It is defined as a force acting from the exterior and generally outward in nature and excludes the internal factors acting on the body by way of diseases, natural means of illness etc.

Violent Force

It is defined as the degree of force acting on the body resulting in injury.

Visible

It is the sequelae or the result of the impact which resulted in injury. The injury shall be visible or clinically proven for the claim to be processed and paid. The personal accidental policy covers the risks involved in plane crash, train collision, loss due to bites from snake, accidental fall from stairs (not intentional!), hit and run etc. but loss resulting from diseases, suicides are a strict no-no under this policy.

Accidental bodily injury

It is a self explanatory term and denotes the injury caused to the body of the person (covered under personal accident) by means of accident.

Benefits

It is the quantum of amount that will be compensated to the insured person on the happening of injury.

Total permanent disablement

This term denotes any kind of disability that prevents the insured under question from being employed in any kind of occupation during the lifetime of the individual for which he is eligible and this is determined based on the educational qualification and experience. In such total disablement, one hundred percent of the claim will be paid as compensation.

Partial permanent disablement

It is defined as the force, generally external force that makes the affected person unfit for carrying out some of the routine official duties for the remaining period of his/her life. As the name suggests, the partial disablement robs part of the earning potential of the insured person. The results from the partial disablement may be horrible and the insured suffers from loss of body parts (may be hand or leg or some kind of mutilation etc.).Among the parts of the body, say with in the fingers of a hand, loss of thumb is given greater importance than other fingers (because it acts as the anchor for the entire hand) and the loss calculated accordingly.

Temporary total disablement

As the name suggests, it is the total disability that is suffered by an insured under the personal accidental policy and this disablement prevents the affected from carrying out his/her routine official duties for a temporary period. Beyond the temporary period, the insured recoups and regains the original health and returns to the original occupation.

A classic example is fracture involving hand or leg which immobilizes the affected person for a period of one to two months during which period the claim will be calculated and may be paid in installments to compensate the economic loss suffered by the insured.