Hyderabad
With sweeping modifications, the insurance regulator IRDAI has proposed to make Standard Personal Accident Product a mandatory one to be part of business of all the general and health insurers in the country
The standard product will have the basic mandatory covers as specified in the guidelines which has to be be uniform across the market.
The standard product is allowed to be offered as a group product also.
Death
The Standard Personal Accident Product product will have Death: Benefit equal to 100% of sum insured payable on death of the insured person, due to an injury sustained in an accident during the policy period, provided that the insured person’s death occurs within 12 months from the date of the accident.
Permanent Total Disablement:
Benefit equal to 100% of Sum Insured will be payable if an insured person suffers permanent total disablement of the nature specified below, solely and directly due to an accident during the policy period, provided that the Permanent Total Disablement occurs within 12 months from the date of the accident:
-Total and irrecoverable loss of both eyes or
-Physical separation or loss of use of both hands or feet or
-Physical separation or loss of one hand and one foot or
-loss of sight of one eye and Physical separation or loss of use of hand or foot
-If such Injury shall as a direct consequence thereof, permanently, and totally, disables the Insured Person from engaging in any employment or occupation of any description whatsoever.
Hospitalisation expenses arising due to accident shall be indemnified up to the limit of 10% of base sum insured.
The hospitalisation expenses shall cover the following:
– Room, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home.
-Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist Fees whether paid directly to the treating doctor / surgeon or to the hospital.
-Anaesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines and drugs, costs towards diagnostics, diagnostic imaging modalities, and such other similar expenses.
During the course of payment under this benefit, the insurance company shall have right to call for a certification from an independent medical practitioner with regard to the continuity of temporary total disability specified under this section. The decision of independent medical practitioner would be binding on both the parties, said IRDAI .