Accident Care Individual Insurance Policy
Accident comes uninvited and they can unsettle your life and those of your loved ones. A little planning in this regard goes a long way for financial protection.
Presenting Accident Care Individual Insurance from Star Health and Allied Insurance Co Ltd.- a policy that offers protection to you and your loved ones in case you meet with an accident because whatever happens, life must go on.
- Entry age between 18 years and 70 years.
- Dependent Children can be covered from 5 months.
- Family means Insured Person, Spouse, Dependent Children between 5 months and 25 years of age.
- Sum Insured shall be on the basis of the monthly income from gainful employment as prescribed by the Company.
|Table A||Accidental Death||100% of Sum Insured + Bonus (if any)|
|Table B||a. Accidental Death||100% of Sum Insured + Bonus (if any)|
|b. Permanent Total
|150% of Sum Insured + Bonus (if any)|
|c. Permanent Partial
|Specified percentage depending on the disability|
|Table C||b. Permanent Total
|150% of Sum Insured + Bonus (if any)|
|c. Permanent Partial Disablement||Specified percentage depending on the disability|
|d. Temporary Total Disablement||The benefit under this table is payable during the period of Temporary Total Disablement of the person covered due to an accident and resulting in hospitalization. The compensation payable is at the rate of 1% of the sum insured, subject to a maximum of Rs.15,000/- , per completed week, upto 100 weeks.|
- If the Accident affects any physical or mental function, which was already impaired prior to the accident, a deduction as certified by a Government Doctor will be made in respect of this prior disablement.
- If the accident impairs a number of physical or mental functions, the degree of disablement given in the Table of Benefits will be added together, but liability in any case shall not exceed 100% of the Sum Insured (150% in case of Permanent Total Disablement)
- In case of Permanent Partial Disablement claim the Sum Insured under the policy will be reduced by the amount of admissible claim under the policy in respect of the Insured Person to whom such sum shall become payable.
- In the event of Permanent Disablement, the Insured Person will be under obligation:
- To have himself/herself examined by doctors appointed by the Company / and the Company will pay the costs involved thereof.
- To authorize doctors providing treatments or giving expert opinion and any other authority to supply the Company any information that may be required. If the obligations are not met with due to whatsoever reason, the Company may be relieved of its liability to pay. Provided however the insured shall be deemed to have discharged his duties/obligations if he authorizes / gives consent to the treating doctor/s or the experts who gave opinion. Any subsequent failure on the part of the treating doctor/experts who gave opinion / hospital will not be held up against the insured.
- Where a claim for 100% of the Capital Sum Insured (150% for Permanent Total Disablement) is admitted / admissible, the coverage under the policy ceases and the policy cannot be renewed for such relevant person.
- Where a claim for less than 100% of the Sum Insured is admitted / admissible, the coverage under the policy will continue until expiry for the balance sum insured and Company would exclude such disability on renewal in respect of such relevant person.
Additional Benefits (No Extra Premium):
- Educational grant to children (1 child: Rs.10,000/-, 2 or more children: Rs. 20,000/-)
- Ambulance Charges / Transportation expenses of mortal remains: Rs. 5,000/-
- Travel expenses of one relative : Upto 1% of Total sum insured or actuals subject to a maximum of Rs. 50,000/-
- Vehicle and/or Residence Modification: Upto 10% of sum of Table B and Table C sum insured subject to a maximum of Rs. 50,000/-.
- Purchase of Blood: Upto 5% of the sum insured under relevant table / tables opted subject to a maximum of Rs.10,000/-
- Transportation of Imported medicines: Upto 5% of Total sum insured subject to a maximum
of Rs. 20,000/-
Note : These benefits apply only when there is an admissible claim under the policy.
Optional Benefits (on payment of additional premium):
- Medical Expenses Extension: 25% of the valid claim or 10% of the sum insured or actuals whichever is less, subject to a overall limit of Rs.5,00,000/- per policy period. This amount is payable in addition to the sum insured.
- Coverage for winter sports: This extension can be granted for the period the Insured person proposes to participate in such sports.
- Hospital Cash: The Company will pay Cash Benefit of Rs 1000/- for each completed day of Hospitalization provided such hospitalization happens within 30 days from the date of accident. The maximum period for which the benefit is payable is 15 days per occurrence and 60 days per policy period. Where the policy term is more than one year, this benefit is applicable for each year. This benefit cannot be cumulated or carried forward to the next year. This amount is payable in addition to the sum insured.
For the purpose of this benefits the days of admission and discharge will not be taken into account. This amount is payable in addition to the sum insured.
- Home Convalescence: The Company will pay Rs 500/- for each completed day subject to a maximum of 15 days per occurrence and 60 days per policy period towards the cost of engaging one attendant at residence immediately after discharge from the hospital provided the same is recommended by the attending physician. Where the policy term is more than one year, this benefit is applicable for each year. This benefit cannot be cumulated or carried forward to the next year. This amount is payable in addition to the sum insured.