Personal Accident Health Insurance Policy

Personal accident health insurance is a plan designed to protect you and your family from financial impact during emergencies. Investing in a personal accident insurance cover is beneficial as it helps you cover cost against accidental death, disabilities, and hospitalization expenses that one might incur due to an accident.

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This insurance provides comprehensive coverage for a wide range of situations, covering everything from minor injuries to life-altering disabilities. It acts as a safety net that offers both immediate support and long-term financial stability during difficult times. Read on to know more about the coverage offered in personal accident insurance policy, eligibility criteria, documents required, and other related details. 

What is Covered under Personal Accident Health Insurance?

The following things are covered under personal accident insurance 

  1. Accidental death cover - For the family members who are financially and emotionally dependent, an accident can be devastating. The nominee named in the policy document receives the whole sum promised in the event of fatal injuries.
  1. Permanent partial disability cover - If physical harm results in a permanent partial disability, the insured receives a portion (up to 100%) of the benefit.
  1. Temporary total disability - If the insured suffers from temporary total disability and becomes bedridden, the insurer will pay a weekly allowance to make up for the income that was lost. If there is a loss of income, the insured may also use this claim amount to pay the EMIs.
  1. Permanent/Total disability cover - For the family members who are financially and emotionally dependent, an accident can be devastating. The nominee named in the policy document receives the whole sum promised in the event of fatal injuries.

What is Not Covered under Personal Accident Health Insurance?

These are the following things are not covered under personal accident insurance -

  1. Natural death
  1. Pregnancy and childbirth
  2. Pre-existing disability or injury
  3. Self-injuries
  4. Suicide
  5. Influence of intoxicants
  1. Committing a crime, participating in war-related actions, or having a mental illness.
  2. Taking part in sport, adventure, military, or air force activities.

Top Personal Accident Health Insurance Plans in India

These plans are offered from private & public health insurers and highly competitive features & cover is offered for the same -

Insurance Plan

Entry Ages

Sum Assured Amount

Aditya Birla Active Secure 

  1. Minimum - 5 years  
  1. Maximum - 65 years 
  1. Minimum – Rs. 1 lakh 
  1. Maximum – Rs. 20 crores 

Cholamandalam Accident Protection Plan  

  1. Minimum – 91 days 
  1. Maximum - 70 years 
  1. Minimum (for family) - Rs. 2.5 lakh 
  1. Maximum (for family) - Rs. 10 lakhs 
  1. Minimum (for individuals) - Rs. 5 lakhs 
  1. Maximum (for individuals) - Rs. 10 lakhs  

Care Secure Personal Accident Insurance

  1. Minimum - 91 days 
  2. Maximum - 70 years 
  1. Minimum - 15 lakhs 
  2. Maximum - 25 crores 

Bajaj Allianz Premium Personal Guard Plan

  1. Minimum - 5 years 
  2. Maximum - 65 years 
  1. Minimum - 10 lakhs 
  2. Maximum - 25 lakhs 

ICICI Lombard Personal Protect

  1. Minimum - 18 years 
  2. Maximum - 80 years 
  1. Minimum - 3 lakhs 
  2. Maximum - 25 lakhs 

HDFC ERGO Personal Accident Insurance

  1. Minimum - NA 
  2. Maximum - 65 years 
  1. Minimum - 2.5 lakhs 
  2. Maximum - 15 lakhs 

Star Health Accident Care Individual Insurance

  1. Minimum - 5 months 
  2. Maximum - 70 years 
  1. Minimum - 5 lakhs 
  1. Maximum - 15 lakhs 

United India Personal Accident Insurance

  1. Minimum - 5 years 
  2. Maximum - 70 years 
  1. Minimum - 25000 
  2. Maximum - 10 lakhs 

Reliance Personal Accident 360shield Plan 

  1. Minimum – 30 days 
  1. Maximum – 80 years 
  1. Minimum - 5 lakhs  
  1. Maximum – 25 crore 

National Insurance Individual Personal Accident Policy

  1. Minimum - 5 years 
  2. Maximum - 70 years 

NA

New India Personal Accident Policy

  1. Minimum - 5 years 
  2. Maximum - 70 years 

Maximum - 72 months of income from gainful employment 

Advantages of Personal Accident Health Insurance

The advantages of personal accident insurance are mentioned below -

  1. Substantial protection at a lesser cost
  1. There is no demand for medical examinations or records
  2. Security of family
  3. Global coverage
  4. The quick and reliable claim procedure
  5. Plans for both individuals and families are offered
  1. Education benefits for children
  2. Plans that can be customised are offered

Eligibility Criteria for Personal Accident Health Insurance

One should constantly think about purchasing a Personal Accident policy because accidents can have extremely negative impacts on a person and their loved ones.

  1. One must be 18 years old to purchase a health insurance policy, and they can purchase the PA add-on with a base plan. So, it is feasible to purchase a Personal Accident policy at the age of 18 and keep the insurance policy in effect by renewing it.
  1. Most insurance providers set a maximum entry age of 65 years for purchasing a regular health insurance plan. Individuals older than this must opt for a senior citizen plan, often with a personal accident (PA) add-on. Premiums for new policies may increase slightly with age, making it advisable to secure coverage as early in life as possible. 

Documents Required for Personal Accident Health Insurance

The following documents are required for personal accident insurance - 

  1. Proof of ID: Aadhaar card, PAN card, Passport, etc.
  2. Proof of address: Aadhaar card, PAN card, Ration card, etc.
  3. Multiple copies of passport sized photographs.
  4. Personal accident insurance application form
  5. Records of your medical history

Note: The documents listed above are in general, and you maybe requested to submit additional documents based on the insurer’s internal policies. 

How to File a Personal Accident Health Insurance Claim?

You must notify the insurance company within the allotted time range in order to begin the claim process. There's a chance that you'll get a claim reference number. When notifying a claim, the supplier must get the information listed below -

  1. Name and contact information for the injured insured party
  2. Your contact details and policy number
  1. Accident's date and time
  2. Accident location
  3. A brief description of the event's circumstances and its precise location

Government-Backed Accident Insurance Schemes

The Government of India offers two active plans that can be availed by any citizen of India. These plans are low cost insurance options that are aimed at cultivating the habit of availing insurance options among the common people of the nation. The plan details are mentioned in the following table -

Insurer and Insurance Plan

Entry Age

Sum Assured Amounts

Accidental Death Benefit

Permanent Total Disability

Pradhan Mantri Suraksha Bima Yojana

  1. Minimum - 18 years 
  2. Maximum - 70 years 
  1. Minimum and Maximum - 2 lakhs
  1. Rs. 2 lakhs for accidental death or total permanent disability 
  1. Rs.1 lakh for partial permanent disability 

Yes, equal to Sum Assured

Yes, equal to Accidental Death Benefit

Pradhan Mantri Jan Dhan Yojana (PMJDY) 

  1. Minimum - 18 years  
  1. Maximum - 59 years 

Maximum: Rs. 2 lakh

Up to Rs. 2 lakh

Up to Rs. 2 lakh

Different Types of Personal Accident Insurance Policies

The various types of personal accident insurance are mentioned below - 

  1. Individual Accident Insurance - An individual is protected by this kind of policy in the event of any accidental harm. It covers unintentional death, amputations, blindness, and other long-term impairments brought on by accidents.
  1. Group Accident Insurance - Employers purchase group accident insurance to protect their staff. Some insurers also offered a premium discount based on the size of the group. For small businesses, it is a terrific incentive and value-added benefit because it is affordable. However, compared to an individual plan, this is a fairly simple plan and may provide little benefits.

What are the Benefits of a Personal Accident Health Insurance Policy?

When choosing a personal accident insurance plan, it’s important to consider certain key factors related to the benefits offered. These factors serve as the foundational criteria for comparing plans from different insurers.

  • Plan Basis: You can choose between an individual plan or a family floater plan. An individual plan is more suitable for single individuals, while a family floater is usually more economical and practical for households with four or more members, especially when one person is the primary income earner. 
  • Age Limits - Entry ages are key to having a good insurance plan because contingencies relating to life and health can come at any time. Most plans do not have a cover ceasing age though there might be maximum entry ages. The more extensive the range of entry ages, the better a plan is.
  • Sum Assured - Most accident insurance plans come with a cap of sum assured of up to INR 1 crore or more and have a minimum sum assured too, ranging from INR 2 lakhs and more. Based on the profession one is in, a higher sum assured is always preferable.
  • Accidental Death Benefit - This is the value of the Sum assured and additional bonuses. The more the bonuses, the better the plan.
  • Disability Factors - Plans can cover permanent or temporary disability that is total or partial. Having the maximum number of options available always helps.
  • Medical Expenses and Ambulance Charges - In cases of accidents, immediate healthcare is always required and that too, at the nearest possible location. Ambulance charges might be required when push comes to shove. Covering both of these aspects is a sign of a good insurance plan.
  • Bonuses - Some plans might offer bonuses for dependent kids in the case of an accident. That is especially helpful if the treatment period is stretched long or the policyholder passes away.

GST rate of 18% applicable for all financial services effective 1 July 2017.

Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

Factors to Consider when Purchasing a Personal Accident Health Insurance Policy

Investing in a personal accident health insurance policy is an important decision and you should consider various factors before making the choice: 

  1. Type of Coverage: It is important to check what is covered in your personal accident health insurance policy at the time of purchase. This type of policy is not just an investment but a safety net during emergencies. Do check whether the policy offers coverage for accidental death, permanent total disability, permanent partial disability, and temporary total disability. 
  1. Sum Insured: It is important to have an adequate sum insured that can financially support your family during an unexpected accident or income loss.  
  1. Amount of Premium: Before you invest in a personal accident insurance policy, do check the premium amount you will be charged and ensure that it fits your budget.  
  1. Claim Settlement Ratio: This is an important factor to consider as it reflects the number of claims settled by the company. Choose a reputed insurer with a high claim settlement ratio when buying an insurance policy. 
  1. Wide Hospital Network: Opt for an insurer with a wide network of hospitals so that you can easily get cashless treatment during emergencies. 

FAQs on Personal Accident Health Insurance Policy

  • What is the purpose of Personal Accident Insurance?

    Personal Accident Insurance is designed to protect your financial well-being by offering lump-sum compensation in the unfortunate event of a fatal accident or a disabling injury. This compensation acts as a financial buffer for you and your loved ones and also covers expenses linked to accidental hospitalization. Please note that the compensation amount is determined by the sum insured.

  • What conditions are considered for Permanent Total Disability?

    Permanent Total Disability includes the complete loss of both eyes, both hands, and both feet or the loss of one hand and one foot.

  • As a homemaker who spends most of the time at home, is Personal Accident Insurance necessary?

    Yes, accidents can happen to anyone regardless of their activities. Personal Accident Insurance is essential as it ensures you are financially prepared to cover expenses in case of a crisis, whether accidents involve vehicles, natural disasters, or other unforeseen events.

  • I frequently travel abroad for business and leisure. Does Personal Accident Insurance cover accidents outside India?

    Yes, accident policies provide global coverage. Even accidents that occur outside India will be covered under the policy.

  • What does the coverage for Accidental Hospitalization entail?

    Accidental Hospitalization coverage provides reimbursement for medical expenses related to hospital stays. Additionally, the policy may offer a Daily Cash Cover, providing a daily cash allowance during the period of hospitalization.

  • Can you explain the benefits of having worldwide coverage in Personal Accident Insurance?

    Worldwide coverage in Personal Accident Insurance ensures that you are protected against accidents no matter where they occur. Whether you're travelling for business or leisure, the policy offers a safety net, providing compensation even for accidents that happen outside your home country.

  • What sets Personal Accident Insurance apart from other types of insurance, such as life and health insurance?

    Personal Accident Insurance serves as specialized coverage that focuses on accidental events leading to disability or death. Unlike life insurance which primarily provides a death benefit and health insurance that covers medical expenses, Personal Accident Insurance is tailored to protect against the financial impact of accidents and related disabilities, making it a valuable addition to your overall insurance portfolio.

  • Does Personal Accident Insurance cover death for those responsible for supporting their families?

    Yes, if you are the breadwinner of your family, Personal Accident Insurance covers death. By specifying the nominee's name in the policy document, the insured sum will be provided to them by the insurance company.

  • How can I purchase Personal Accident Insurance?

    Personal Accident Insurance is easily accessible online. It stands as a crucial financial solution to protect your finances from the expenses associated with accidents. It's important not to overlook the significance of obtaining this essential coverage.

  • Why should I consider Personal Accident Insurance if I already have life and health insurance?

    While life insurance and health insurance provide specific coverage, Personal Accident Insurance serves to protect against the financial risks associated with accidental permanent total disability or accidental death of a wage-earning family member. This coverage is crucial as it fortifies your financial portfolio and secures your dependents' future in unforeseen circumstances.

  • If the policyholder already has life insurance, is it still required to purchase personal accident coverage?

    According to the terms of the plan, a life insurance policy offers a death benefit and maturity benefit. It does not cover the cost of medical care for accident-related injuries. Therefore, even if life insurance is in effect, it is crucial to purchase a personal accident policy.

  • Should a low-risk individual choose a personal accident policy?

    Yes, the risk is unprecedented since accidents are entirely unpredictable. Therefore, every person should purchase personal accident coverage, regardless of their age, gender, or occupation.

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