• Dial 16622 (24/7)
  • Group Personal Accident Benefit

    Group Personal Accident Benefits

    Supplementary Benefit (Disability)

    Group personal accident insurance plans cover multiple types of disabilities. The disabilities caused by accidents are classified under the following three sections for determining compensation:

    Accidental death benefit shall pay to the employer (organization) the sum insured in respect of the said insured member in addition to death benefit if an insured member dies directly from an accident caused through external and violent, within 7 days from the date of occurrence.

    Permanent and Total Disability coverage shall pay to the organization the sum insured in respect of said insured employee in case of permanent and total disability caused directly by an accident from bodily injury, which prevents the insured member from engaging in any business, occupation or work whatsoever for remuneration or profit and which disability has continued uninterruptedly for a period of at least six months and has been certified to be incurable by a physician approved by the company.

    In the interpretation of this definition the Company will, however, recognize as Total and Permanent Disability the entire and irrevocable loss of:

    1. both eyes
    2. both hands above the wrist,
    3. both feet above the ankle,
    4. one hand above the wrist and one foot above the ankle,
    5. one eye and one hand above the wrist,
    6. one eye and one foot above the ankle.
    7. If an insured Member becoming totally and permanently disabled die within 365 days from the date of such disablement the Company shall pay the sum insured in respect of the said insured employee.

    Permanent and Partial Disability coverage will be paid to the employer as per the benefit specified in the following schedule where applicable in respect of the said insured employee in case of a permanent partial disablement caused directly by an accident. However, one sum namely the larger sum will be paid for multiple injuries resulting from one accident:

    18
    Sl No.Description of injury% of loss earing capacity
    1Loss of both hands or amputation from higher parts100
    2Loss of 1 (one) hand and one leg100
    3Loss of sight of both eyes to such an extent as to render the claimant unable to perform any work for which eye-sight is essential100
    4Amputation of both legs or thighs, or amputation of one leg or thigh and loss of any leg100
    5Severe facial disfigurement100
    6Absolute deafness100
    7Amputation up to shoulder joint80
    8Amputation below shoulder with stump less than 20 centimeters from tip of acromion.70
    9Amputation from 20 centimeters from tip of acromion to less than 11 centimeters below tip of olecranon60
    10Loss of a hand or of the thumb and four fingers of one hand or amputation from 20 centimeters below tip of olecranon60
    11Loss of thumb30
    12Loss of thumb and its metacarpal bone30
    13Loss of 4 (four) fingers of 1 (one) hand50
    14Loss of 3 (three) fingers of 1 (one) hand30
    15Loss of 2 (two) fingers of 1 (one) hand20
    16Loss of terminal phalanx of thumb10
    17Amputation of both feet90
    18Amputation through both feet proximal to the metatarsophalangeal joint80
    19Loss of all toes of both feet through the metatarsophalangeal joint40
    20Loss of all toes of both feet from proximal to the proximal inter- phalangeal joint30
    21Loss of all toes of both feet from distal to the proximal inter- phalangeal joint20
    22Amputation from lower part of the hip90
    23Amputation from lower part of the hip with stump exceeding 12.5 centimeters measured from tip of great trochanter, but not beyond middle thigh80
    24 Amputation from lower part of the hip with stump not exceeding 12.5 centimeters measured from tip of great trochanter70
    25Amputation from middle thigh to 9 centimeters below knee60
    26Amputation below knee with stump exceeding 9 centimeters but not exceeding 12.5 centimeters50
    27Amputation below knee with stump exceeding 12.5 centimeters40
    28Amputation of 1 (one) foot resulting in end-bearing30
    29Amputation of one foot from proximal to the metatarso-phalangeal joint30
    30Loss of all toes of 1 (one) foot through the metatarso-phalangeal joint20

    Permanent disabilities that are not mentioned above shall be compensated in accordance with their severity as compared to those listed. Permanent, partial or total loss of the use of a limb shall be deemed to be same as permanent, partial or total loss of the said limb. No indemnity is payable for any pre-existing degree of disablement and if further injury occurs, only the difference between the condition prior to and after current injury shall be considered.