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Paralysis caused Disability claim in PA Insurance and Snake Bite claim

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24 Jun, 2021 by  Dipak Gandhi

Sir,


Is the disability - temporary or permanent, total or partial - caused due to paralysis admissible claim in Personal Accidental Insurance ?


I remember to have read it somewhere, so would like to get it verified from experts.


Also, is the death or hospitalization caused due to SNAKE BITE admissible claim in Personal Accidental Insurance ? In interiors or in small towns, it is only the government hospitals that treat snake bite victims. But most of the times, the staff of the hospital DO NOT REGISTER it as a MEDICAL LEGAL CASE on the case papers of the patient. This makes the case clear of the police involvement. Can this affect the claim settlement in Personal Accidental Insurance.


Will you please guide.


Thanking you


Regards


Dipak R Gandhi

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24 Jun, 2021

Hey Dipak,


PA policy pays for Death or Disability caused by Accident.

I cannot say with confidence if snake bite is considered as accident. It doesn't matter if hospitals makes it medico legal or not. If insurer considers snake bite as accident, then a claim is admissible if it leads to death. Let me get more clarity on this and I'll post a follow-up reply on this.


Now, coming to disability, it is in the bucket of permanent or temporary and full or partial. The coverage varies from policy to policy, so it is important that you go through the T&Cs carefully. Accident must be the source for the disability. Everything else as a reason is excluded from a PA claim.


Anuj

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24 Jun, 2021
Dipak R Gandhi
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25 Jun, 2021

Hi Dipak & Anuj,


Accident is defined as an injury due to external, violent & visible means. Snake bite fits within the definition of accident. It is covered as a valid cause/peril for honoring PA claims in most policies that I know of. However, you should carefully read the policy wordings of the product that you are considering. The policy wordings are quite detailed and they list all causes which will be treated as valid by the underwriters.


For processing PA claims, the Insurer will demand an FIR copy, postmortem report (if dead) and death certificate. If the person dies due to snake bite, I am sure the post mortem will establish the cause of death beyond doubt. But if the person survives and disability claim is triggered because of total or partial disability, how the hospital registers the case may have a bearing on the Insurer's decision.


Let Anuj also find out & confirm it. Thanks


Asad Akbar


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25 Jun, 2021
Dipak Gandhi
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