A group personal accident insurance policy is an insurance product that provides accident coverage to a large group of people, particularly the employees of an organisation. In case of accidental disablement or death of the insured, the insurance provider offers financial compensation that helps cover associated medical bills and income loss. Hence, investing in this insurance policy ensures quality healthcare and financial security for the employees. Let’s talk about group personal accident insurance in detail. We will also tell you how to file a claim under this insurance product.
What is a group personal accident insurance policy?
A group personal accident insurance policy offers financial protection to employees, workers, or members of an organisation against personal accidents. If an accident leads to hospitalisation, disablement, or death of the policyholder, the insurance company offers financial protection to the insured and their loved ones. Thus, employers and organisations choose to cover their employees or members under this insurance policy to ease their financial stress during such unforeseen events.
Coverage of group personal accident insurance
A group personal accident insurance policy offers coverage to employees or members of an organisation against the following expenses —
- Personal accident expenses: If a covered member meets with an accident, the insurer will cover his/her hospital bills and associated expenses.
- Permanent partial disability: If an accident leads to permanent partial disability of the insured, the insurer may offer up to 50% of the sum insured or as mentioned in policy terms and conditions.
- Permanent total disability: In the event of total disability of the insured, the insurer offers the total sum insured to the covered employee or member.
- Temporary total disability: If an accident leads to temporary total disability of the insured, the insurer will give him/her a certain percentage of the sum insured, as per policy terms and conditions.
- Ambulance bills: If the insured meets with an accident and is taken to the hospital in an ambulance, the insurance company will reimburse the ambulance bills.
- Physiotherapy bills: If the insured is advised physiotherapy by the treating doctor after the accident, the insurance provider will cover the bills.
- Education expenses: If an accident leads to permanent disability or death of the insured, the policy may cover the education expenses of the policyholder’s children.
- Funeral expenses: If the insured employee or member dies in an accident, the policy will cover the person’s funeral expenses.
- OPD expenses: If the insured avails of OPD treatment after an accident, the insurer will cover the bills.
How to file a claim under group personal accident insurance?
The following are the steps to file a claim under a group personal accident insurance policy —
- Inform the insurer about the accident right away.
- Collect the required documents and submit them to the insurer. These include the original policy documents, a duly filled claim form, the autopsy report, the police report, a death certificate or any other supporting document to the insurance provider. The documents required for the claim process depend on the event that has occurred or the claim type.
- Some common documents required for the claim process include the following:
- Proposal form
- Declaration form
- Details of the employee
- Medical reports of the employee
Documents to submit for accidental hospitalisation
If the insured meets with an accident, they must submit the following documents to the insurance provider:
- Claim form, duly filled and signed
- Doctor’s prescriptions
- Original diagnostic test reports
- Original hospital bills, such as surgery charges, nursing charges, pharmacy bills, etc.
- Copy of the employee’s photo ID card
- A cancelled cheque in the name of the employee
Documents required for filing an accidental death claim
If the insured dies in an accident, the insurer will require the following documents for claim settlement:
- Claim form, duly filled and signed
- Police panchanama or FIR copy
- Copy of the post-mortem/autopsy report
- Copy of the death certificate
- Copy of police investigation report
- Copies of the required documents of the nominee/claimant
Documents required for filing an accidental disability claim
The documents required for filing an accidental disability claim under group personal accident insurance are:
- Duly filled claim form
- Police FIR copy
- Hospital bills and medical reports, such as X-rays, pathology reports, surgery bills, pharmacy bills, etc.
- Certificate of disability from a recognised healthcare practitioner
- Statement of the attending physician
- Certificate of leave or sick leave letter from the employer or organisation
Conclusion:
To sum up, a group personal accident insurance policy shields employees or members of an organisation against accidents and other unforeseen events. If you are covered under this insurance product, take some time to check policy inclusions, exclusions, the claim filing process, and other terms and conditions to avoid any hassles later. Incorrect or wrong information on the claim form and missing documents can result in the rejection of your group personal accident insurance claim.