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Cholamandalam Personal Accident
Overview Life is full of uncertainty and nobody knows when any uncalled situation may come up. Any predicament situation can become lifes worst outlandish feeling if somebody is not prepared for it. An accident can happen in a flash of a second but leaves a scar for a lifetime. It can wreak havoc both financially and emotionally. A loss of life or a partial loss of sight or physical disability is not an easy thing to cope with. We cannot predict whats going to happen next, but can always plan our future well by buying Personal accident plans. Cholamandalam Personal Accident Protection Plans bring complete peace of mind and affirms financial stability in such unfortunate cases and covers death, physical injuries and bodily burns. The coverage offered under the plan helps the insured to deal with the sudden financial burden and also rehabilitation by providing a strong cover and protection. The salient features of the Personal Accident Protection Plans are An ideal protection plan covering all unseemly events such as Death, injury or any other disabilities caused by accidents Worldwide Comprehensive security coverage plans for individual and family members in case of an unfortunate event or a sudden accident. Complete peace of mind with high sum insured ranging from Rs. 5 Lakhs to 1 Crore uder the plans. Simple and hassle free plan documentation. Online enrollment available for instant plan coverage and transparent terms and conditions for all the plans in cholamandalam Plans are available for individuals between age group of 18 to 69 years under various sum insured plans . The plans have unique benefit composition of Weekly compensation for Individuals or family members in case of loss of income caused by disability or death due to an accident. A grace period of 30 days for renewal of plans. The plans have extended cover to spouse and two dependent children. The plans offer Compensation in the case of fractures of bones due to an accident. Reimbursements In the event of permanent disability due to an accident for modifications of the home or vehicle. A Free -Look period of 15 days from the date of receipt of this plan to review the terms and conditions of the plan and to return the same if not acceptable. Coverage for Family transportation costs is also available under the plan. In case the plan holder or insurer is a student, reimbursement of tuition fee is provided in the event of an accidental injury. Daily allowance for hospitalization in the case of an accident. In the occurrence of death of plan holder, all costs up to post-cremation or burial is covered under the plan.
Plan coverage
Accidental Death coverage in the event of death of the insured due to an accident within the plan period, Sum Insured is paid to the nominee as mentioned in the plan. Permanent Total Disability coverage for protection against any accidental injury, causing the insured Permanent Total Disability for 12 consecutive months. The compensation for such cases shall be paid proportionally as per table below. Permanent Partial Disability is covered for the cases where any accidental injury has resulted in Permanent Partial Disability for 12 consecutive months to the insured. The compensation shall be paid proportionally as per table below. If the accident impairs a number of physical functions, the degree of disablement given in the Table of Benefits will be added together, but liability in any case shall not exceed 100% of the Accidental Death Sum Insured. In the event of an accident to the Aircraft in which the Insured Person is traveling as a fare paying passenger and the body of the Insured Person cannot be located within 365 days from the date of such accident, then a compensation of 100% of the Sum Insured for Death Cover towards loss of life. In the event of Permanent Total Disablement or Permanent Partial Disablement, Insured Person will have to get examined himself/herself by the empanelled doctors and the cost shall be paid thereof. Compensation for any other disability arising out of accident to the insured individual/member and not specified above will be decided as assessed by the attending doctor of the Insured and validated on the advice of the Companys panel of medical practitioner Exclusion under the plan The Plan does not provide benefit for any death, disability, expense or loss incurred in result of any injury attributable directly or indirectly to the following: Intentionally self-inflicted injury, suicide or any attempt thereat while sane or insane Injury or Disease directly or indirectly caused by or contributed by ionizing radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from burning nuclear fuel. Injury or Disease directly or indirectly caused by or contributed by the radioactive, toxic, explosive or other dangerous properties of any explosive nuclear equipment or any part of that equipment; War, invasion, act of foreign enemy, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection, mutiny, military or usurped power, seizure, capture, arrests, restraints and detainment of all kings, princes, and people of whatsoever nation condition or quality, terrorism The Insured Persons participation in naval, military or air force operations whether in the form of military exercises or war games or actual engagement with the enemy with foreign or domestic; Loss sustained or contracted in consequence of the Insured being under the influence of alcohol or drugs unless administered on the advice of a physician and as mentioned in various plans. Any loss of which a contributing cause was the Insureds actual or attempted commission of, or willful participation in, an illegal act or any violation or attempted violation of the law or resistance to arrest; Any loss sustained whilst engaging in aviation or ballooning, whilst mounting into, dismounting from or travelling in any balloon or aircraft other than as a passenger (fare paying otherwise) in any duly licensed standard type of aircraft anywhere in the world; Any opportunistic infection and/or malignant neoplasm, if at the time of the accident or sickness the Insured had an Acquired Immune Deficiency Syndrome (AIDS) or having an antibody positive blood test to HIV (Human Immune-deficiency Virus). Opportunistic infection shall include but will not be limited to pneumosystis carinii pneumonia, organism of Kaposis Sarcoma, central nervous system lymphoma, and/other malignancies now known or which become known as causes of death in the presence of Acquired Immune Deficiency Syndrome; Any loss sustained while the Insured is participating in contests of speed using a motorized vehicle or bicycle and/or hunting and/or skiing and/or skydiving and/or gliding and/or mounteering and/or winter sports; Any loss resulting directly or indirectly from or, contributed or aggravated or prolonged by childbirth or from pregnancy. Loss caused directly or indirectly, wholly or partly by: a. bacterial infections (except pyogenic infections which shall occur through an accidental cut or wound) or any other kind of disease; Medical or surgical treatment except as may be necessary solely as a result of Injury; Claims Procedure In any of the event as covered under the scope of plan benefits, an immediate notice of occurrence or commencement of loss shall be done. Apart from this duly filled Claim Form with written evidence of loss must be furnished within thirty (30) days after the date of such loss. Upon acceptance of the offer of claim settlement by the Insured, the claim amount will be settled by the Company within 7 days from the date of acceptance of the offer by the Insured. In case of delay in the payment, the Company shall be liable to pay interest at the rates stipulated by IRDA from time to time.
Other Important Terms and Conditions
Cholamandalam MS General Insurance Company Limited reserves the right to revise any of the terms, conditions and exceptions of the various plans including the premium payable on renewal in accordance with the guidelines/rules framed by the Insurance Regulatory and Development Authority (IRDA) and after obtaining prior approval from the Authority. Any change in plans shall be notified at least three months before the revision are to take effect. Cholamandalam MS General Insurance Company Limited may also withdraw the insurance as offered hereunder after following the due process as laid down by the IRDA and after obtaining prior approval of the IRDA For withdrawn plans, insured shall be offered to cover under such revised/new terms, conditions, exceptions and premium.
Benefits
The plan benefit includes Weekly Compensation for loss of income due to a disability caused by accident. An insured in eligible for fixed compensation for Broken Bonesin the event of fractures or accidental bone damage under the plan. The plan benefit includes any modification of Residences / Vehicle In case of permanent total disability, the expenses incurred are reimbursed for modifying residential accommodation or own vehicle. Expenses towards transportation of the family member to the location of the insured in case of accidental death / permanent total disability under the plan Compensation towards the tuition fees if the insured under the plan is a student and is not able to attend school / college due to an accidental injury. The plan offers a daily cash allowance for hospitalization due to an accident. Expenses towards Repatriation of Mortal Remainsfrom the accident site to hospital, residence or cremation ground .Additionally the cost of cremation Ceremony to perform religious ceremonies up to the time of or post-cremation is covered under the scope of plan. The plan benefit include fixed Ambulance chargespaid for Ambulance hiring charges following an accident. The basic Sum Insured for Accidental Death, Permanent total disability and Permanent Partial Disability will be increased by 5% on every renewal up to maximum plan period of 3 years provided there is no claim under the plan
Claims Documentation
Death Claim Duly completed Claim form by the nominee Copy of FIR / Police Report, wherever necessary Copy of Post Mortem Report/Coroners report (If postmortem is conducted) Copy or Panchanama / Inquest report Death Certificate Original Plan Certificate for deletion of name of the Insured person from the list. Permanent Total / Partial Disablement Claims: Duly completed claim Form Report of the attending Doctor confirming disability Admit / Discharge card Investigation reports such as X-rays, Lab test etc FIR/ Police report, wherever necessary Weekly Benefit Claim Duly completed claim Form Report of the attending Doctor confirming disability Admit / Discharge card Investigation reports such as X-rays, Lab test etc Police report wherever necessary Fitness certificate Residential Accommodation or Vehicle Modification Benefit All documents for Permanent total disability along with bills and receipts for expenses incurred for modification of vehicle accommodation. Broken Bones Documents as per the Weekly Benefit except confirmation of the doctor regarding disablement. Proof of identity and residence of the beneficiary for claims exceeding Rs 1 Lakh All the documents should be sent to or such other address as may be notified to the Insured: Cholamandalam MS General Insurance Company Limited Chola MS HELP – Health Claims Department No. 163, Hari Nivas Towers, 2nd Floor, Thambu Chetty Street Parrys Corner, Chennai – 600001
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