accident care nandagopal-9994910202

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITEDPERSONAL & CARING

S.V.NANDAGOPAL SENIOR SALES MANAGER STAR HEALTH & ALLIED INSURANCE CO.LTD

THANKS FOR OPPORTUNITY TO SERVE

WE ARE ONE OF THE LEADING INSURANCE & INVESTMENT

CONSULTANT IN COIMBATORE SINCE 2000MOBILE

99949 10202, 94431 86864,83000 20102Email [email protected],[email protected]

www.licnanda.blogspot.com

mailto:[email protected],[email protected]


Accident Care


Accident Means Not only Road/Rail or Air Travel accidents but also includes

• Accidental Fall• Electric Shock• Snake Bite• Drowning in Water

Covers

Accidental DeathDisablement

Age LimitsAvailable for Persons aged between 18 years and 70 years.

Children from 3 years can be covered under family package when at least any one of the parents are covered.


Table of Benefits

Table I Death Cover Only

Table II Death+

Permanent Total Disablement (PTD)+

Permanent Partial Disablement (PPD)

Table III Death+

Permanent Total Disablement (PTD)+

Permanent Partial Disablement (PPD)+

Temporary Total Disablement (TTD)


Table I : Accidental Death

Covers Death of the Insured Person

Death occurring within 12 Months from the date of Accident

Compensation payable is 100% of Capital Sum Insured

Table II : Accidental Death + PTD + PPD

Death Cover - As per Table I

Disablement cover

The disablement should occur within 12 Calendar months from the date of the Accident

The disablement is confirmed and claimed for, prior to the expiry of a period of 60 days since occurrence of the disablement


Table II : Percentage of Compensation PayableBenefits Benefits Percentage of Sum Insured

1. Death2. Permanent Total Disablement Total and irrevocable loss of a. Sight of both eyesb. Physical separation of two

entire handsc. Physical separation of two

entire foot d. One entire hand and one entire

foote. Sight of one eye and loss of one

handf. Sight of one eye and loss of one

entire foot

100%150%

150%150%

150%

150%

150%

100%


Table II : Percentage of Compensation Payable (contd.)Benefits Benefits Percentage of Sum Insured

g. Use of two handsh. Use of two footi. Use of one hand and one footj. Sight of one eye and use of one

handk. Sight of one eye and use of one

footl. Sight of one eyem. Physical separation of one

entire handn. Physical separation of one

entire footo. Use of one hand without

physical separationp. Use of one foot without physical

separation

100%100%100%100%

100%

50%50%

50%

50%

50%


Table II : Percentage of Compensation Payable (contd.)BENEFITS Percentage of Sum Insured

Loss of toes – allGreat - both phalanges Great - one phalanxOther than Great, if more than One toe lost – for each toeLoss of hearing - both earsLoss of hearing - one earLoss of four fingers and thumbs of One handLoss of four fingersLoss of thumb - both phalanges - One phalanx Loss of index finger - three phalanges - Two phalanges - One Phalanx

2052

17530403525101084


Table II : Percentage of Compensation Payable (contd.)BENEFITS Percentage of Sum

Insured Loss of middle finger - Three phalanges - Two phalanges - One phalanx Loss of ring finger - Three phalanges - Two phalange - One phalanx Loss of little finger - three phalanges - Two phalanges - One phalanxLoss of metacarpals - first or second (Additional)Third, fourth or Fifth (Additional)Any other permanent partial disablement

64254243232Percentage as assessed by the panel Doctor of the Company


Table III - Accidental Death+PTD+PPD+TTD

Death Cover - As per Table I

Death+PTD+PPD Cover- As per Table II

TTD Cover

• Weekly compensation @ 1% of the Sum Insured not exceeding Rs. 5000 per week

Capital Sum Insured - Maximum LimitTABLE I - 150Times of monthly income

TABLE II - 120 Times of monthly income

TABLE III - 50 Times of monthly income max. of 5 Laks

(Table III cover can be given only with the approval of Corporate Office)


Risk Groups

Risk Group I Persons engaged primarily in administrative functions

Risk Group II Persons engaged in manual work other than what is specifically provided under Group III

Risk Group III Persons working in explosives industry, mine and / or magazine workers, high tension supply, horse racing including jockeys, athletes and occupations of similar hazard.


Premium Rating

COVERAGE / RISK GROUP

GROUP 1 GROUP 2 GROUP 3

Table I 0.45 0.60 0.80

Table II 0.80 1.30 1.75

Table III 1.25 1.75 2.00

Note: Rate provided is “Per Mille” i.e., Per Thousand


Additional BenefitsEducational Grant – Rs.5000 per Child below 18 years maximum Rs.10000Transportation of Mortal Remains – Rs.3000 if Accident outside the place of ResidenceTravel Expenses for Relative – Actual Travel Expenses, maximum of Rs.1000 (Relative means spouse, children, parents, siblings or in-laws)

Group DiscountGroup Discount Applicable to Accident Care (Group) Policies

Group Size Discount on Premium

2 – 100 5%

101 – 1000 10%

1001 – 5000 12.5%

5001 – 10000 15%

Above 10000 20%


Medical Expenses Extension ADDITIONAL PREMIUM - 10%

COVERAGE 25% of valid claim under P.A. or the Actual Medical Expenses incurred because

of Accident, which ever is less subject to a maximum of 10% of Capital Sum Insured.

Restricted CoverOn-duty cover : @75% of Applicable Premium

Off-duty Cover : @50% of Applicable Premium

Cumulative BonusApplicable for Death and PTD cover only.

5 % increase in Capital Sum Insured for every claim free year.

Maximum 50 %.

In the event of a Claim

Two Steps back i.e. 10%


Documents required for granting Cumulative Bonus (a) Renewal Notice with Cumulative Bonus details• Cumulative Bonus as shown in the Renewal Notice is given

(b) No Renewal Notice or Renewal Notice without Cumulative Bonus details• Cumulative Bonus as shown in the Previous Policy is given• If a declaration stating No Claim under the expiring policy is obtained from

the insured, eligible Cumulative Bonus will be given Note: To obtain the above mentioned benefits there should be a continuous renewal without break.


Major Exclusions

Any Claim,In Respect of Pre Existing Conditions.If the Insured acts against the advice of the Physician.Whilst under the influence of intoxicating liquor or drugs.Arising out of mental diseases, suicide or attempted suicide, self inflicted injuries or sexually transmitted conditions, anxiety, etc.Due to participation in hazardous sport / activities.By persons who are physically and mentally challenged unless specifically agreed and endorsed in the policy.

Note: For a detailed list kindly refer the policy conditions.


Claims ProcedureDocument to be submitted in case of Death Claims

Completed Claim formDeath certificate, PanchanamaFIR, wherever applicable Postmortem report In the absence of assignment, Legal Heir ship Certificate/Succession Certificate / Will duly probatedOriginal Policy, if issued for Individual Coroner’s Report/Police Inquest Report

Document to be submitted in case of Disablement ClaimsOriginal Policy Disability Certificate from the attending Doctor confirming the %age of

disability. Photo of the person indicating the disability. Completed claim form FIR, Wherever applicable Employer’s Certificate for the period of absence from duty (for TTD Claims)

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITEDPERSONAL & CARINGFHO-rev2014/cpu/ver1.4/16 Oct 2014 18

• ALSO WE PROVIDE • LIFE INSURANCE• HEALTH INSURANCE• CHILD FUTURE PLANS• TAX SAVING & PLANNING• PAN CARD & PASSPORT • MOTOR VEHICLE INSURANCE• IMPORT & EXPORT INSURANCE• INDIVIDUAL,FAMILY,GROUP &

CORPORATE INSURANCE NEEDS

accident care nandagopal-9994910202

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