Life is full of unexpected twists and turns, and accidents can happen when you least expect them. These unforeseen events can be expensive as well as pose physical difficulties. Without financial security, accidents can drain an individual’s savings in the blink of an eye. That’s where personal accident cover insurance comes to the rescue. It is a crucial safety net, providing peace of mind and financial help.
This article will discuss personal accident insurance plans, including their benefits, inclusion and exclusions, and the step-by-step process by which any individual can get a claim under personal accident cover insurance.
What is a Personal Accidental Insurance Plan?
Personal accident insurance means insurance that offers protection in case of accidental death or disability. In such situations, the insurance provider pays the insured individual or their family payment up to the predetermined coverage level.
If the policyholder is partially disabled, the insurance payout is adjusted according to the severity of the disability. Similarly, If the policyholder passes away due to an accident, the nominee will receive full compensation from the insurance company.
What are the Benefits of a Personal Health Accidental Insurance Plan?
When choosing any healthcare insurance plan, knowing how many benefits it can offer is important. Here are the benefits of a personal accidental insurance plan:
1. Worldwide coverage
Insurance policies may not offer compensation if an incident occurs outside of India. However, an individual personal accident insurance policy provides guaranteed benefits regardless of where the accident occurs. It has no geographical restrictions and proves valuable in emergencies.
2. Easy claim process
An easy claims process is important for policy buyers, especially during emergencies when swift action is necessary. With this insurance, individuals can easily submit a claim online or offline. The company will then verify the claim, and they will promptly pay it out if it checks out.
3. No medical test
One major advantage of this policy is that individuals do not need to undergo medical tests.
What are the Inclusions and Exclusions Under the Personal Accidental Health Insurance Plan?
The inclusions and exclusions of the individual personal accident insurance policy are:
| Inclusions | Exclusions |
| Death by accident | Natural death and pre-existing disability or injury |
| Accidental dismemberment | Self-injury cases like suicide |
| Medical expenses/ hospitalisation charges | Non-allopathic treatments |
| Burns, broken bones and Ambulance | Intoxicants influence |
| Permanent Total/Partial Disability | Criminal act and involved in fighting activities, suffering from mental illness |
What is the Process of Getting a Claim Under a Personal Accidental Health Insurance Plan?
To make a personal accident insurance claim promptly, follow these steps:
Step 1: Inform the Insurer
If an individual is involved in an accident or is hospitalised within 24 hours, the first step is to inform the insurer. It can be done by contacting customer care or using the insurance company’s website.
Step 2: Provide Policy Documents
Once the insured individual has informed the insurer, the insurer will request policy-related documents. These documents include the policy card, purchase receipts, and premium receipts, all of which contain vital information about the policy and its status.
Step 3: Provide a Duly Filled Claim Form
The company will give the policy claim form. If not, then anybody can request it directly from the company. Fill the form with the necessary and accurate information, and it should bear the signature of the policyholder or their nominee. Once completed, submit the form to the insurer or TPA.
Step 4: Submit Other Required Documents if Required
Upon submitting the form and policy documents, the insurer will request additional verification documents, including ID and address proof. Copies of these documents should be provided to the company.
Step 5: Scrutiny by Insurer
Upon receiving all the documents and policy-related information, the insurance company will thoroughly examine the claim’s authenticity and the accident. This scrutiny aims to ensure that the treatment being claimed is necessary, not excessive, and directly linked to an accident or an event covered by the policy’s terms and conditions.
Step 6: Claim Settlement
Following the inquiry and verification process, they may approve if the company is content with the claim’s authenticity. In case of rejection, the company may request additional documents for further validation. If satisfaction is achieved, they can accept the claim.
Conclusion
A personal accidental insurance plan is a crucial safeguard against the unexpected challenges that accidents can bring. It offers financial protection in the form of compensation for accidental death or disability with many advantages. This insurance provides worldwide coverage, ensuring security no matter where an accident occurs.
For comprehensive health and accident coverage, consider Niva Bupa best health insurance plans. Niva Bupa provides great insurance coverage for better health and well-being so individuals can live peacefully.
