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26 Jul, 2022 | Personal Accident Insurance

Group Personal Accident Insurance - Know What All It Covers!

Aakansha Jain
By Aakansha Jain
Research & Content Ninja at Beshak
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Employees are the greatest assets of any company. This is why besides providing group health insurance coverage, a lot of employers also offer group personal accident insurance coverage to their employees. This insurance policy offers financial protection to the employees against accidental risks. 

Accidents can happen to anyone, anywhere. You neither see them coming, nor can you completely stop them from happening.  They can happen to the healthiest and most cautious and have a huge financial impact on the near and dear ones. Group personal accident cover offered by employers will protect both the employees and their families against a variety of financial risks arising out of accidents.

In this article, let's take a look at how a group personal accident insurance policy works, what it covers, and what it does not.

What Is Group Personal Accident Insurance?

Group personal accident insurance is a type of insurance that employers offer to their employees to protect them against the medical expenses incurred because of an injury, disability or death resulting from an accident.

How Does A Group Personal Accident Policy Work?

A group personal accident insurance policy will pay a fixed sum of money under various circumstances like death or disability caused due to an accident. 

An accidental disability can impact your ability to earn and live a regular life. In fact, speaking purely in monetary terms, it can impact your family even more than your death. 

This is because your family will have to incur some major expenses like making drastic structural changes around the house like building a ramp or putting up safety rails, etc. or, you might need physical therapy, rehabilitation care, other treatments, etc. So, not only will there be a loss of income but also a rise in expenses. 

The benefits of group insurance are that it covers various types of disabilities and death due to accidents and helps you and your family deal with the expenses that come with them - at least in the short run. 

How much will the policy pay? Let’s find out. 

  • Accidental Death: In case your death happens due to an accident, the insurance company will pay the entire policy sum assured to your nominee. So, suppose Aman is covered under a group personal accident policy for employees worth INR 50 Lakhs. A few years later, he passes away in an accident. So, his family will receive the entire INR 50 Lakhs.
  • Partial Disability: If an accident results in partial disability, the insurance company will offer a specific percentage of the sum insured depending on which part is lost & its impact on your employability. This percentage could range anywhere between 20% to 70%.  So, say you’re covered under your employer’s personal accident cover of INR 75 Lakhs. You meet with an accident and lose sight in one eye. In such a case, you’ll get, say, 30% of 75 Lakhs, i.e., INR 22.5 Lakhs.
  • Total Disability/Loss of Vital Limbs: If you meet with an accident where you lose a vital limb such as your arm, leg, etc. the group accidental insurance policy will pay 100% sum insured. So, if you are covered under your company’s group personal accident policy of INR 1 Crore and you lose a limb, the insurance company will pay you and your family a sum of INR 1 Crore. 

What Does It Cover?

Here’s a quick rundown of some common things that most group personal accident insurance policies will cover: 

  • Accidental death: If you pass away because of an accident, the group personal accident policy will pay the entire sum assured as a death benefit to your nominee.
  • Medical expenses: The expenses incurred while availing treatment for an accidental injury will also be covered by a group personal accident insurance plan. You can claim these expenses on a reimbursement basis, i.e., pay for the expenses from your pocket first and then later, apply for a claim with the insurance company. 
  • Permanent total disability: These include injuries that are irrecoverable and cannot be reversed even after treatments and long-term therapy. If you meet with an accident that results in such injuries, you can claim under this policy. 
  • Permanent partial disability: You can also claim under this policy if you meet with an accident that leads to permanent partial disability, i.e., a disability with no possibility of recovery even with treatments. Examples include losing the ability to hear in one ear, losing a limb, or a finger, losing sight in one eye, etc. 
  • Temporary Total Disability: If the accident causes temporary total disability & leaves you unemployable, the group personal accident insurance cover pays a weekly compensation (usually 1% of SA) upto 52 weeks. This is a major relief as it can keep running your household expenses while you are out of work. 
  • Other: A group personal accident insurance policy will cover injuries attributable to external, violent, and visible means. So, broken bones due to an accidental fall or burns resulting from an accidental fire, etc. are covered under a group personal accident insurance plan too. 

What Is Not Covered?

Here’s a list of injuries, and conditions that are not covered under most group personal accident insurance policies -  

  • Attempted suicide or accident resulting from suicide
  • Self-inflicted injury, insanity, mental and nervous disorders
  • Influence of drugs, alcohol, and other intoxicants
  • Breach of law with criminal intent. 
  • War or nuclear radiations
  • Venereal diseases, AIDS
  • Pregnancy

Got a question you’d like to get clarified? 

You can post it on the Beshak Insurance Forum - and get answers from vetted experts, for free!

Key takeaways
  1. If an accident leads to death or loss of vital limbs, the insurer will pay 100% of the sum insured, whereas if the accident results in partial disability, 50% of the sum insured will be provided.
  2. The policy will offer a cover in case of accidental death, permanent total, and permanent partial disability due to an accident.
  3. You can also claim for medical reimbursement for treatment of accidental injuries under a group personal accident insurance cover.
  4. Pregnancy, AIDS, self-inflicted injuries, mental and nervous disorders, etc. are not covered under a group personal accident insurance policy.
Aakansha Jain
Written by,
Aakansha Jain, Research & Content Ninja at Beshak

Aakansha is a Content Ideator and Writer at Beshak. With her easy-to-understand content, she makes insurance simple for everyone. She comes with a strong background in finance and commerce and wants to help families make positive insurance decisions that are good for a lifetime.

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