Personal Accident Insurance

Presented by:-
Savita Sharma
BBA(B&I)
Introduction
 A policy that will pay out an income or a lump sum in the event of
disability, dismemberment or death, caused by an accident.
 Personal Accident Insurance is not Life Assurance.
 Insurance against bodily injury or death because of accident.
 The minimum entry age is 18 years and the maximum entry age is 70 years
(age as on last birthday).
 The applicant can buy the policy for his spouse aged between 18-70 years .
History
 Just like today, in early times if a man couldn't work because of an
accident, his family would suffer.
 In 1694, Hugh the Elder Chamberlain proposed a policy to cover a family
income in the event of an accident, and, late in the 1800s, it became a
reality.
 Even though they called it accident insurance, it resembles today's
disability income, providing payments to the injured person.
 In 1850, the Franklin Health Assurance Company of Massachusetts offered
the first policy that covered injury from a train or steamboat accident.
Terminology
1. 'BODILY INJURY' means identifiable physical injury
which

(a) is caused by an Accident, and

(b) solely and independently of any other cause, except sickness or disease
directly resulting from, or medical or surgical treatment rendered necessary
by such injury, occasions the death or disablement of the Insured person
within twelve months from the date of the Accident.
Cont…
2. 'ACCIDENT' means a sudden, unexpected, unusual, specific event
which occurs at an identifiable time and place during the Period of
Insurance.
Accident shall also include
(a) exposure resulting from a mishap to a conveyance in which the Insured
Person is travelling;
Cont…
(b) disappearance. If the Insured Person is not found within twelve months of
disappearing, and sufficient evidence is produced satisfactory to the
Underwriters that leads them inevitably to the conclusion that the Insured
Person has sustained Bodily Injury and that such injury has caused the
Insured Person’s death, the Underwriters shall forthwith pay any death
benefit, where applicable, under this Insurance, provided that the person or
persons to whom such sum is paid shall sign an undertaking to refund such
sum to the Underwriters if the Insured Person is subsequently found to be
living.
Cont…

3. 'TEMPORARY TOTAL DISABLEMENT' means disablement which

entirely prevents the Insured Person from attending to their business or

occupation.

4 'TEMPORARY PARTIAL DISABLEMENT' means disablement

which prevents the Insured Person from attending to a substantial part of

their business or occupation.

Cont…
5 'PERMANENT TOTAL DISABLEMENT' means disablement which
entirely prevents the Insured Person from attending to any business or
occupation for which they are reasonably suited by training, education or
experience and which lasts twelve months and at the end of that period is
beyond hope of improvement.
6. 'LOSS OF A LIMB' means permanent loss by physical separation of a
hand at or above the wrist or of a foot at or above the ankle and includes
permanent total and irrecoverable loss of use of hand, arm or leg.
Covers
 All personal accident insurance policies differ.
 Normally a life insurance company will cover you for any bodily injury
sustained solely and directly by an accident.
 The injuries need to be external and visible and independent of any other
cause.
 This means that you are generally covered for general accidents that may
cause you to suffer an injury which prevents you from working.
 This injury needs to have occurred within the last 60 days from the time
that you ceased work.
Types of Personal Accident Insurance Policies

Under personal accident insurance, the policyholder, if injured, receives

cash benefits every month, just like income, for as long as s/he is unable

to work due to the accidental injuries. This income is non-taxable and

does not exceed the policyholder’s after-tax earnings minus the state

benefits s/he can claim. In case of death of the policyholder due to an

accident, the family receives a specific lump-sum amount.

  There are eight common types of personal accident insurance policies :

Types
 Group: This policy is used by companies to cover employees for

expenses related to accidents.

 Self-employed: Since self employed individuals are not eligible for

employee benefits, they are worse off when injured in an accident.

 Team: Through a team accident insurance policy, organizers can

seek cover for all the members of a sports team.

 
Cont…
 Professional: This policy is specifically for self employed
professionals, such as a sportsperson, actor, lawyer or doctor, who
have special requirements.
 Over 50: This policy targets people over 50 years of age, as
accidents can cause more grievous injuries to them.
 Travel accidents: This policy offers benefits in case the
policyholder meets with an accident while traveling.
Cont…
 Children: The purpose of this policy is to provide financial help to parents
if they are unable to work or if they incur expenses as a result of an
accident.
 Individual: This policy can be taken by any individual. The benefits
usually enclose partners and children. Since several activities are excluded
from this policy, it is not as useful for people who love adventurous sports,
like mountaineering and rock climbing.
Exclusions
This Insurance does not cover death or disablement in any way caused or
contributed to by
 war, whether war be declared or not, hostilities or any act of war or civil war;
 radioactive contamination;
 the Insured Person engaging in or taking part in armed forces service or
operations;
 the Insured Person engaging in flying of any kind other than as a passenger;
 the Insured Person’s suicide or attempted suicide or intentional self-injury or
the Insured Person being in a state of insanity;
Cont…
 Acquired Immune Deficiency Syndrome (AIDS), AIDS Related Complex (ARC) or
Human Immune- deficiency Virus (HIV) howsoever these have been acquired or may
be named;
 the Insured Person’s deliberate exposure to exceptional danger (except in an attempt
to save human life);
 the Insured Person’s own criminal act;
 the Insured Person being under the influence of alcohol or drugs.
 Dental injuries are sometimes excluded in policies.
 All illnesses are excluded.

 
Benefits
 A great benefit of personal accident insurance is that the premiums are
fully tax deductible.
 Personal accident insurance will cover one for up to 75% of one’s income
and one have the choice of either two or five years benefit periods or until
one reach the age of 65.
 This is a good policy to have as one are secure in the knowledge that in the
event of an accident that should keep one off work for a long period of
time, one have a policy that will cover you.