Personal Accident
  • Safety form unforeseen events
  • Benefits of personal accident insurance
  • Inclusions & Exclusions
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Personal Accident Insurance

Personal accident insurance is a policy that provides financial coverage to the policyholder against uncertainties like death, temporary disability and permanent disability resulting from an accident. The policy gives the compensation amount to the family member of the policyholder in case of the death of the policyholder. The policyholder will also get this compensation amount in case of partial or permanent disability.

For instance, Mr. Rehman is driving home from his office. Suddenly, a bus rammed into his car. Onlookers rushed Mr. Rehman to hospital. There, the doctors informed him that his foot has been fractured and it needs complete bed rest till it heals completely. Mr. Rehman is completely tension-free as he has a good personal accident plan and he does not have to pay any treatment cost to the hospital as the insurance company will reimburse the medical cost.

Types of Personal Accident Insurance Policy:

Policyholders should be financially prepared to deal with unpredictable accidents. In case of an unpredictable accident, the Personal Accident Insurance Policy becomes very useful. There are several types of personal accident policies available in the market. Such as:

  • A health insurance policy with coverage for accidents: A Personal Accident Policy can be purchased with a comprehensive health insurance policy. It provides a separate sum insured and death benefit for the policyholder. If this add-on is purchased for a Family-Floater insurance plan , the policyholder and insured family members will get Personal Accident cover.
  • Group Accident Insurance Policy: A group accident insurance policy is a type of policy in which an employer of an organization provides financial security to the dependents of the employee in the event of an accident. An employee can also avail Personal Accident coverage in case of bodily injury, permanent or temporary disability.

What Is the Need For a Personal Accident Insurance Plan?

As we know, an accident can happen at any time. It can happen at your workplace, while traveling, etc. So, the personal accident insurance plan becomes essential for every individual. Having a Personal Accident Insurance policy ensures financial security to you and your dependents in the event of unforeseen accidents. It covers ambulance and medical service costs, hospitalization due to any type of accident, burns, cuts, fractured bones, loss of limbs, or loss of vision, etc.

Benefits Most Insurers Provide Under a Personal Accident Health Insurance Policy

You can get the following benefits under the Personal Accident Insurance policy:

  • Accidental Benefits: If the insured person died due to an accident then the nominee will get the predetermined benefit amount.
  • Permanent partial disability in an accident: If the insured person becomes partially disabled i.e. He/she loses an eye, an ear, a finger, etc. due to an accident then the insured person will get the promised amount from the insurance company.
  • Permanent total disability in an accident: In case of an insured person losing both ear, eyes, etc. in an accident then he/she will get the benefit amount from the insurance company.

Additional Benefits of Personal Accident Health Insurance

While most health insurance companies give the above-mentioned benefits as part of a personal accident plan, insurers may also provide the following additional benefits:

  • Funeral Expense: If the insured person dies in an accident then the insurance company will reimburse the funeral expense to the insured family.
  • Temporary Total Disability: A certain benefit amount is to be paid to the insured person if he/she suffers a total disability for a temporary time.
  • Child Education Benefit: If the insured person passes away or is disabled permanently, then the fixed amount will be paid regularly to the insured family for his/her child’s education.
  • Accident Hospitalization: If the insured is hospitalized due to an accident then the insurance company will cover all the hospitalization expenses of the insured person.

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How much does a Personal Accident Insurance cost?

Personal Accident premiums are calculated based on a variety of criteria, including:

  • Age
  • Nature of your occupation
  • Income
  • The number of additional members (like parents, spouses, or children)
  • Geographical location
  • Sum insured amount

Documents Required to Buy Personal Accident Insurance

Insurance providers may require a specified set of documentation when purchasing a health insurance plan. To purchase a Personal Accident Health Insurance policy, you need the following documents:

  • ID proof
  • Address proof
  • Details of known pre-existing diseases
  • Photographs
  • Medical records
  • Application form

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General Categorization of Risk Levels for Different Types of Occupations

We have categorized some occupations into three types based on the risk level in general:

CategoryRisk LevelCoverage
SET 1Low RiskManagers
Office workers
SET 2Medium RiskManual laborers
Machine operators
Drivers of heavy vehicles
Cash carrying employees
Builders and contractors
Veterinary doctors
SET 3High RiskMineworkers
Circus performers
Dangerous sport persons like river rafting, etc.
Mountaineers, etc.

What is Covered in Personal Accident Insurance?

Situations that are covered by the health insurance policy are referred to as inclusions. If a policyholder files a claim for any of these events, the insurance company is responsible for paying the claim according to the terms and conditions of the policy.

  • Treatment Cost
  • Cosmetic Surgery
  • Dental Treatment
  • Funeral Expense
  • Accidental Death
  • Accidental Dismemberment
  • Child Education Support

What is Not Covered in Personal Accident Insurance?

A personal accident plan comes with some exclusions. Exclusion can vary from insurer to insurer. A general list of exclusions is given below:

  • Suicide
  • Natural Death
  • Self Injury
  • Injuries from War
  • Injuries occured due to consumption of alcohol or drugs

Always read the policy terms and conditions attentively if you decide to buy personal accident insurance for your protection. This will help you understand the inclusions and exclusions properly.

How to Claim Personal Accident Insurance?

To intimate the claim, the following details are to be provided to the Company:

  • Policy Number
  • Name and contact detail of the policyholder
  • Location of the accident
  • Brief description about the incident
  • Name and address of the attending Medical Practitioner and Hospital
  • Date of accident

In case of a death or disability claim, following are the documents required to be submitted:

  • Death claim (in case of death)
  • Disability certificate (in case of disability)
  • Post-mortem report (in case of death)
  • FIR report
  • Medical certificate
  • Original bills
  • Original duly completed and signed caim form

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sandeep singh


January 12, 2023

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December 9, 2022

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Naval Goel

Reviewed By : Naval Goel

Naval Goel is the CEO & founder of Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of Insurance Web Aggregator.