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Universal Sompo General Insurance Pvt Ltd - Individual Personal Accident Policy


Individual Personal Accident Policy

The Policy provides for defined benefits based on the nature of injury sustained, by the insured person in an accident during the Policy period.

Coverage

The Policy provides for three different options as under:-

  • Basic Cover - covers against Death only
  • Wider Cover - covers against Death, Permanent Total Disablement & Permanent Partial Disablement
  • Comprehensive Cover - covers against Death, Permanent Total Disablement Permanent Partial Disablement & Temporary Total Disablement

Compensation Benefit

The compensation benefits will depend upon the nature of injury and the Capital Sum Insured under the Policy.

For accidents resulting in Death or Permanent Total disablement, we will provide compensation equivalent to the full Capital Sum Insured.

For Permanent Partial Disablement the compensation will depend on the nature of injury and corresponding percentage of Capital Sum Insured as detailed in the 'Table of Benefit' under the Policy document or as per the medical advices of our appointed Medical Practitioner.

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In respect of Temporary Total Disablement, we will provide compensation at 1% of Capital Sum Insured or Rs 5000/- whichever is less per week for a maximum period of 104 weeks.

Additional benefits under the Policy

In addition to the Compensation benefit stated above, we also undertake to provide compensation in respect of the following:

Transportation Cost for carriage of dead body to Home including funeral charges. 1% of Capital Sum Insured or 2,500/- (Two thousand five hundred) whichever is lower.
Cost of Clothing damaged in the Accident as described above and liability for disablement is admitted by Us. Actual expenses subject to maximum of Rs 1000/-
Ambulance charges for transportation of Insured person to Hospital following Accident Actual expenses subject to maximum of Rs 1000/-
Education Fund In the event of death, permanent total disablement i.e. 1 & 2 of Table of Benefit of Insured Person, We will approve compensation towards Education Fund up to 2 dependent children. -5% (Five percent) of C.S.I Subject to a maximum of Rs. 15000/-
Loss of Employment In the event of accident leading to loss of employment as a consequence of Permanent Total Disability as per the table of benefits. 2% of CSI subject to a maximum of Rs 25000/-
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Optional Extension available under the Comprehensive Cover Policy

The Policy can be extended to cover the following by payment of additional Premium

Medical Expenses Extension: Cover the medical expenses reasonably and necessarily incurred by you towards medical expenses as a result an accident resulting in thebodyily injury, death or disablement. There are 4 options for extent of medical expenses cover, which you can choose from.

Hospital Confinement Allowance: Daily allowance of Rs 500/- per day to a maximum of 30 days if you or any of the insured person(s) is hospitalized as a result of an accident resulting in the bodily injury, death or disablement.

Exclusions

  • Self-injury, suicide, venereal disease or insanity
  • Influence of intoxicating liquor or drugs
  • Death due to pregnancy or childbirth
  • Breach of law with criminal intent
  • War and nuclear group of perils
  • On duty with armed forces
  • Injury/death while participating in adventurous sports
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Documents required for settlement of claims

  • Claim form
  • Doctor's report, bills in case of temporary/permanent disablement
  • Police report/post mortem report in case of accidental death
  • Leave certificate from employer in case of temporary disablement
  • Any other relevant document if any

Note: The above are only the salient features of the Policy, for complete terms and conditions please refer to Policy Wordings.

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