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The extent of the coverage of the group personal accident cover is dependent upon the terms of the plan. Generally, these are the covers that are provided by most of the group personal accident insurance cover:
Compensation is paid to the family member of the employee in case there is an injury resulting in the loss of life of the worker.
If the employee meets any accident that resulted in a permanent disability that continued for 12 months, then the compensation up to sum assured is paid to the employee.
In case there is any injury to the employee due to which he became partially disabled, then 2% to 60% of the sum assured depending on the terms of the policy is paid by the insurer to the employee. But, the disability should be continued for more than 12 months.
The employee is entitled to a weekly benefit if he is full disabled, but for a temporary period to compensate the loss of salary due to not working.
If in the case of injury, your employee is needed to be taken to the hospital by ambulance, then the insurer reimburses the ambulance charges.
The policy also reimburses all the expenses relating to transportation of mortal remains of the employee to his home or ground.
If any of the bones are damaged or break due to an accident or injury of any of your workers, the policy pays a lump sum amount to the employee.
The plan reimburses all the medical expenses and hospitalization charges related to the injury.
The insurance company reimburses the educational costs of the children, in the case of unfortunate death or permanent disability of the employee.
The permanent disability can bring changes to the lifestyle of the employee like a modification to the car or in his home to make them handicap The policy also reimburses some part of these expenses.
Following documents are needed to avail group personal accident insurance:
Cashless claims for the medical treatment can be filed directly by the network hospital with the TPA (Third Party Administrator) of the group health insurer or the insurer.
However, the documents to be submitted for other types of claims under Group Personal Accident Insurance will be as follows:
Note : Policy details given are indicative, not exhaustive. Please contact your nearest Arunaya office for further details.