Group Personal Accident Insurance and Its Exclusions

Just like you cannot predict any unfortunate incident, you cannot predict the outcome it brings with it. You can only try to minimise the financial expense you may have to bear if any such unforeseen situation arises. One of the most sought-after solutions to help your employees overcome financial difficulties is opting for group accident insurance. The term insurance itself denotes you will be reimbursed for the expenses you incur due to an injury or accident. Insurance will truly be your buddy during testing times, even if you face any disability.

Organisations are moving one step ahead to provide the desired financial security to their workforce. Only when you take care of your employees in the true sense will you be able to claim that you are running your organisation rightly and safely. Personal accident insurance will be that X-factor that will help you attract and retain the best available talent in the industry. Furthermore, employees value companies who go above and beyond to look into the interest of their people. The accident insurance helps the employees to cover the loss of income during difficult periods apart from providing financial protection. It offers extensive coverage to the insured members, including protection from fire, collision, rail, road, air accidents and explosions.

Disability insurance provides coverage if an employee becomes disabled, making the plan a lucrative option to consider. The employees are generally awarded monthly income depending on the type of disability and terms. Such policies are ideal because they promote a healthy work environment and come with a positive message – to continue living despite unfortunate circumstances. An important point to note here is that you can choose personal accident insurance as an additional rider along with group life insurance. However, you may not be able to enjoy the benefits that a standalone personal accident policy may offer. Riders are not as comprehensive as standalone policies.

What Are The Eligibility Criteria For The Accident Insurance Plan?

Employees or field workers who perform duties that may put them at risk should have an accident insurance policy in place. In fact, forward-thinking employers take the initiative to protect all their employees under the plan as soon as they join the organisation. Some of the plans have an option to include family members of the employee as well. The plan is an agreement between the organisation and the insurance company. The employees do not have any power to influence any decision at the time of policy finalisation. The minimum age required to be under a group is 18 years. The maximum age at which the insurance can cover a worker is 65 years.

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General Exclusions Under The Group Accident Insurance

Under the group accident insurance, there are several inclusions and exclusions. The employees must go through the policy document to be aware. When employees understand the clauses, it eventually proves beneficial for them as they can utilise the policy to its best possible extent. The following are some of the general exclusions not covered by the group accident insurance policy.

  • Injury or death as a result of the influence of intoxicating drugs or liquor
  • Injury or death resulting due to indulgence in any hazardous activity or adventure sports
  • All pre-existing diseases or disability conditions which may lead to a severe illness are not included under the policy
  • No compensation will be paid in case of any injury or damage resulting from attempting suicide
  • Treatment cost of infertility or abortion, miscarriage or complications during childbirth
  • Damages caused due to war, any intentional conduct of criminal act or revolution, seizure
  • Non-allopathic treatment costs are excluded
  • Illness due to mental disorder

The above exclusions may be included under the policy depending on the flexibility provided after paying an additional premium. You can assess the needs and requirements of your workforce and opt for a plan which fits into their basic needs.

Some Of The Major Inclusions Forming Part Of The Policy Are As Follows:

  • Accidental disability causing physical impairment leading to inability to perform duties
  • The policy covers accidental death, which ensures a lump sum payment of the principal amount to the dependent members of the family
  • Loss of toes, fingers, sight, limbs or occurrence of permanent paralysis due to an accident
  • Injuries sustained by the employees due to terrorist activity are treated under the policy

How Is The Policy Helpful Despite The Exclusions?

The group accident policy not only considers the present unfortunate situation but also helps the family of an injured/deceased employee move to the brighter side of life by providing compensation. It gives them a huge respite in terms of money when they become eligible to receive compensation.  Additionally, it enables employees to enjoy various benefits at zero cost to their salary.

Holding policy awareness sessions can help you gain the trust of your employees. You can even avail a wider coverage for your staff as there is a possibility to utilise bulk policy discount. Since the policies are annually renewed, the requirements and inclusions can be modified from time to time. It is advisable to consider all leavers and joiners while renewing the policy. You can also opt for a combination of group health insurance and group personal accident insurance at a reasonable premium cost. Combining the two policies will help ensure all the possible coverage is provided to the people. There are benefits such as 24×7 chat support, which employees can utilise for claims-related queries. The accident coverage is as high as INR 25 lakhs which is substantial to cover major accidents to an extent. Family members will benefit up to INR 10,000 per dependent child when the sole breadwinner loses their life. Overall, the coverage is quite wholesome and ensures a smooth flow. You can successfully create a positive work environment for your staff with the help of the policy!