What is a Personal Accident Insurance? - A Detailed Guide

An accident can shatter you physically and emotionally and even burn a hole in your lifelong savings. Whether it is a fun outstation trip or the regular work-to-home commute, a turn for the worse can bring life to a standstill and impact you and your loved ones. According to a report by the Ministry of Road Transport and Highways, over 4 lakh road accidents were reported during 2021 across the country, causing injuries and fatalities. The worst affected age group was 18-45 years.

While accidents may be unavoidable, a Personal Accident cover can ensure you have support for any financial hardship that follows.

Here's a comprehensive guide with all the information about a Personal Accident cover.

What is Personal Accident Insurance?

A Personal Accident Insurance policy can ensure financial coverage if you suffer from permanent total, partial disability, or temporary disability that may arise from an accident. It is like a Health Insurance plan but solely focuses on personal injuries caused by an accident.

A Personal Accident Insurance policy aims to cover the difficulties you may face during hospitalisation, treatment, and the inability to work during your recovery period. An individual Personal Accident Insurance policy includes benefits for death, disabilities and even loss of income due to an accident.

Eligibility criteria to buy Personal Accident Insurance

You can buy Personal Accident Insurance coverage if you are between 18 and 70 years old. It is important to understand that a Personal Accident cover is ideal for you and your family, as accidents can occur anywhere and anytime. It is essential if you travel often for personal or professional reasons or work in an environment with potential risks. If you own a vehicle, it is mandatory for you to have a Personal Accident cover.

Common inclusions of Personal Accident coverage

Cover for hospitalisation costs:

In addition to covering hospitalisation costs, your Personal Accident Insurance policy may also cover any medical expenses incurred due to the accident.

Temporary disability coverage:

Some plans offer protection if you suffer a temporary disability.

Permanent disability coverage:

In case of total and permanent disability, you may receive the entire sum assured for your lost income or as specified by your policy terms.

Permanent partial disability:

If you have a permanent partial disability, your insurer will compensate you with a percentage of the sum assured.

Death coverage:

In the event of your death, the insurer will pay the amount to your family member, listed as the beneficiary or nominee, as per the policy.

Common exclusions of a Personal Accident Insurance

A Personal Accident Insurance Policy can have various exclusions, which you must understand. These may differ according to the plans provided by your insurance company. So, be sure to read the documents to be aware of the details of your plan.

Intentional injury:

Insurance companies usually do not cover accident-related injuries if they believe the accident was intentional or due to intentional negligence. In such a case, your insurer may reject your claim under the policy.

Injuries under the influence of drugs or alcohol:

If your insurer determines that your injuries are from an accident in which you were under the influence of drugs or alcohol, they may reject your claim.

Pre-existing illnesses or sicknesses:

If you suffer injuries due to a pre-existing medical condition or an existing illness, your insurer can reject your claim.

War or armed conflict:

If you suffer trauma from participating in a foreign armed or civil conflict, your insurer can decline your claim.

AIDS or HIV or other STDs:

Your insurer can also reject your claim if your accident or trauma results from diseases like AIDS or HIV.

Injury on government duty:

If you suffer an injury while on duty with the armed forces, your claim will not be eligible under your Personal Accident policy.

Injuries caused by adventure sports:

Your insurer can also reject your claim if your injury results from an accident related to participation in an adventure sport, like river rafting, bungee jumping, mountain climbing, etc.

Benefits of Personal Accident Insurance

Personal Accident Insurance can be a vital component of your insurance portfolio and protect you from unforeseen events. Personal Accident Insurance may be included as a part of your comprehensive health policy or as a standalone plan. Such a plan can provide crucial coverage to your insurance portfolio and shield you from any uncertainties and risks that you may face in the future.

The following are some reasons why you should consider a Personal Accident Insurance policy:

Financial safety:

In the event of an unexpected mishap, you can face the heavy financial burden of hospital expenses. A Personal Accident Insurance plan can offer a financial safety net for unforeseen expenses.

Loss of income:

An accident can cause complete or partial physical disability and affect your physical health and financial income. In such cases, the best Personal Accident Insurance policy in India will offer a payout to help you cover your loss of income. Such protection can help you overcome challenging times.

Security to your family:

In case of temporary disability, your Personal Accident policy will offer payouts, and in case of permanent disability, the plan can provide a lump sum payout, per your policy terms and conditions.

Shielding your child's future:

An accident that results in your untimely demise or a disability can affect your child's future. In such a case, your Personal Accident policy can cover your child's expenses as per the stipulated terms.

Worldwide coverage:

Many insurance companies offer Personal Accident plans that provide worldwide coverage. This way, you can relax when travelling abroad alone or with your family, as your travel policy or Personal Accident policy will offer coverage to you and your loved ones, depending on the policy's terms.

Lifelong renewability:

The advantage of a Personal Accident plan is that you can renew your policy throughout your lifetime as long as you renew your policy consistently.

Cumulative bonus:

Many plans offer a cumulative bonus for every claim-free year and increase your protection at no extra cost.

Factors that may affect your Personal Accident claim

Several conditions can affect your Personal Accident claim settlement. For instance, there can be cases where you suffer an injury caused by pregnancy or childbirth-related complications, or you may suffer injuries resulting from participation in violent public strikes or labour disturbances. If the insurance company determines your trauma is related to the above circumstances, they may reject your claim.

Also Read: How to Buy Personal Accident Insurance Policy Online?

Difference between Life Insurance and Personal Accident Insurance policy

No	Criteria	Life Insurance	Personal Accident Insurance
1	Coverage	Coverage for life	Coverage for personal accident
2	Events	Death from all/ any cause	Death from accidental injuries
3	Premium	Higher premiums due to wider coverage	Lower premiums
4	Disability Cover	May not include disability cover	Coverage for partial and total disability
5	Medical Coverage	Limited coverage for medical expenses	Better coverage for medical treatment expenses
6	Terms	Long-term	Short-term
7	Exclusions	Suicide, specific hazards, pre-existing conditions	Self-inflicted injuries, pre-existing conditions, non-accident-related issues
8	Process	May require medical tests & documentation	Requires no medical tests and hassle-free documentation

Types of Personal Accident Insurance policies

A Personal Accident policy can be of the following types:

Health Insurance policy with a rider for accidents:

You can purchase a Personal Accident policy with a standard Health Insurance policy. This rider offers a separate sum insured and death benefit for you or any other insured individual under the same policy. Additionally, you can consider a Personal Accident cover as an add-on to a Family-Floater Insurance plan to ensure better protection for family members.

Personal Accident cover with Motor insurance:

You must have at least one Personal Accident cover in India as an add-on with a Motor Insurance policy. Earlier, the Personal Accident cover was a part of the mandated Third-Party Liability Motor insurance. But you can now buy this cover separately as an add-on. Remember, the Personal Accident cover is in your name and not attached to your vehicle. So, if you have one Personal Accident cover for your existing vehicle, you need not purchase another one for a new vehicle.

An add-on to the existing health plan:

Insurance companies now offer multiple riders and add-on covers to accommodate diverse medical events. You can use these to customise your plan according to your needs.

Group accident coverage:

Today, many companies provide their employees with Health Insurance. It is advisable to check if your employer includes accident protection as part of this insurance coverage.

Also Read: What is the difference between First Party and Third Party Motor Insurance?

Documents for filing Personal Accident Insurance claim

Making a Personal Accident Insurance claim entails filing it on time and knowing what documents you must submit to your insurer. Different claims require a different set of documents.

Enlisted are some of the documents you will require:

• Duly filled-in claim form
• Disability certificate from a doctor
• Medical certificate
• Medicine bills
• Discharge summary, if hospitalised
• Investigation report from relevant authorities
• Doctor's report
• FIR copy
• Death certificate
• Post-mortem report

Like all insurance policies, a Personal Accident cover can provide the necessary protection for you and your family when you need it most. So, research and find the right policy that suits your needs and situation.

FAQs – Frequently Asked Questions