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HDFC Ergo Personal Accident Insurance
Overview A joint venture between Indias leading Housing Finance Institution, HDFC Ltd and ERGO International AG, the primary insurance entity of Munich Re Group. HDFC Ergo General Insurance Company provides multiple insurance plans like Travel Insurance Plans, Health Insurance Plans, Motor Insurance Plans, Personal Accident Plans, Home Insurance Plans for Individuals and Property, Marine and Liability Insurance plans for the corporate sector too which are tailor made and customer friendly and completely transparent. Now, we will have an overview of HDFC Personal Accident Insurance plans. Personal Accident Plans plugs an important role in the insurance portfolio of an individual. Firstly, it provides a tremendous financial support to the policy holder if he/she is disabled after an accident resulting to permanent total disability, temporary total disability and even an unfortunate death. Secondly, the enormity or the degree of injuries doesnt matter; minor injuries are also usually cover dune the plan. HDFC Ergo Personal Accident insurance plans have all encompassing plans which acts as a cushion to cover the risks associated with an accident. HDFC Ergo has several health insurance plans as well as personal accident plans which forms a comprehensive insurance plans covering all types of risks . Why HDFC Ergo personal Accident Plans? Basic benefits are: Its not only a self insurance plan but a family coverage plan as well. One of the most unique proposition of this plan is parents are also covered Worldwide coverage. High coverage of Rs 2.5 lakhs to as high as Rs 15 lakhs. All accidental risks are covered like Permanent Disability, dismemberment, Accidental Death or even Broken Bones, Burns, etc are Online purchase and renewal. Personal Accident Plan Coverage scope: Accidental Death within 12 months from the date of the accident, then 100% of the sum assured is paid. Permanent Total Disability:This plan will covers 100% of basic sum insured if the person insured sustains bodily injury which is caused due to Accident solely and directly resulting in permanent disablement within 12 months from the date of accident. In Hospital Medical expenses for Accident cases only: If the insured person sustains bodily injury and needs to be hospitalized for 24 hours or more as a patient, then the company will reimburse the Usual and Reasonable In Hospital Medical Expenses which is incurred within 12 months from the date of loss to the Total Sum Insured. Usual and Reasonable In Hospital Medical Expenses under this plan would mean charges of semi-private hospital room and board, use of operation theaters, emergency room, ambulance, physician fees, charges for laboratory tests, ambulance services, prescribed medicine or drugs, therapeutics, artificial limbs, anesthetics, transfusions, x rays, artificial limbs or eyes and prosthetic appliances. Charges for registered nurse are also included under this. Emergency Medical expenses for Accident cases only: If the insured person sustains bodily injury the company will reimburse the Usual and Reasonable In Hospital Medical Expenses which is incurred within 12 months from the date of loss to the Total Sum Insured. Usual and Reasonable In Hospital Medical Expenses under this plan would mean charges of semi-private hospital room and board, use of operation theaters, emergency room, ambulance, physician fees, charges for laboratory tests, ambulance services, prescribed medicine or drugs, therapeutics, artificial limbs, anesthetics, transfusions, x rays, artificial limbs or eyes and prosthetic appliances. Charges for registered nurse are also included under this. Emergency Medical Expenses: If the insured person sustains bodily injury or sudden unanticipated sickness, the company will reimburse the Usual and Reasonable In Hospital Medical Expenses ( as stated in two pints above) which is incurred within 12 months from the date of loss to the Total Sum Insured. Hospital Cash: If the insured person sustains bodily injury which directly or indirectly of all other causes resulting to admission of the insured person as an inpatient within in one calendar month from the date of loss, then the company will pay the Daily Benefit to the insured. Hospital Cash and Home Convalescence for Accident cases only: If the insured person sustains bodily injury which directly or indirectly of all other causes resulting to admission of the insured person as an inpatient within in one calendar month from the date of loss, then the company will pay the Daily Benefit to the insured. Further to this, if the physician suggests that recovery can be done at his/her home, then a Daily Home Allowance Benefit is also being provided by the company. Hospital Cash for Accident and Sickness: If the insured person sustains bodily injury which directly or indirectly of all other causes resulting to admission of the insured person as an inpatient within in one calendar month from the date of loss, then the company will pay the Daily Benefit to the insured. Hospital Cash and Home Convalescence for Accident and Sickness: If the insured person sustains bodily injury which directly or indirectly of all other causes resulting to admission of the insured person as an inpatient within in one calendar month from the date of loss, then the company will pay the Daily Benefit to the insured. Further to this, if the physician suggests that recovery can be done at his/her home, then a Daily Home Allowance Benefit is also being provided by the company. Broken Bones: If the insured person sustains bodily injury which directly or indirectly of all other causes resulting to broken bone, then the company will pay as per the laid down schedule of benefits. Burns: If the insured person sustains bodily injury while travelling on a common carrier which directly or indirectly of all other causes resulting in second or third degree burns, then the company will pay the insured the compensation as stated in the schedule of benefits to the total sum insured. Last Rites Cost in case of accident and sickness: If the insured person sustains bodily injury or sickness which directly or indirectly of all other causes resulting in death within one calendar month of the date of loss, then the company will pay the Insured Persons Beneficiary or the legal representative to perform the last rites of the Insured Person. In Hospital Surgery Benefit: If during the tenure of the insurance plan, the insured person is hospitalized as a result of bodily injury or Sickness and is charged for any surgical procedure, then the company will pay an amount equal to the costs of the surgical procedure or the amount as stated in the Benefits Table as a percentage of the Total Sum Insured whichever is lesser. Temporary Total Disablement: If the insured person sustains bodily injury which directly and independently of all other cases resulting in Temporary Total Disablement, then the company will pay as stated in the schedule of benefits to the total sum insured. Hostage Release Fees: If the insured person is kidnapped during the tenure f the plan, then the company will pay the fees incurred for a company appointed professional negotiation organization to secure the release of the insured person upto the total sum insured. Assault: If the insured person sustains bodily injury that results in death or permanent disablement as a result of or arising out of assault, then the company will pay the Insured Persons Beneficiary or the legal representative the increased percentage of the accidental death or permanent disablement total sum insured as stated in the Benefits Table. Mobility Extension: If the insured person sustains bodily injury which directly and independently of all other cases resulting in Permanent Total Disablement, then the company will pay 95% of the costs of the equipments and the installations. Ambulance Costs: If during the tenure of the insurance plan, the insured person sustains any bodily injury which is life threatening then the company will pay the actual ambulance costs up to the total sum insured. Spouse or Dependent Child Consolation Benefit: The spouse and dependent child are also covered under this plan. Common Accident: If the insured person sustains bodily injury that results in death of the insured person as well as his spouse within 12 months after the date of loss, then the total sum insured payable under the plan for each of the insured person and spouse shall be either the Accidental Death Total Sum Insured applicable to the insured person and Accidental Death Total Sum Insured applicable to the spouse, whichever is greater. Other benefits or coverages under the plan are as under: Insured persons counseling benefit. Family Counseling Benefit. Evacuation Benefit. Medical Insurance Premium benefit. Dependent Child Education Benefit. Comatose Benefit for accidents only. Home Tuition Benefit Rehabilitation Benefit Reconstructive Surgery Benefit. Parental Care Benefit. Dependent Child Wedding Benefit. Various Plans HDFC Ergo Personal Accident Plan is a plan that allows extending coverage for all the family members including parents which make the policy or plan stand out. One can choose the following options under the same plan: Self Plan. Self and family Plan ( Two dependent children and spouse) Self and Dependents Parents upto 70 years Add On. Self and family Plan together with Dependents Parents Add On. Eligibility of the plan Individuals between 18 years to 65 years of age can apply for the Personal Accident Plan. Sum Insured under the plan The Sum Insured under this plan ranges from Rs 2.5 lakhs to Rs 15 lakhs. Claim Within 30 days of the occurrence of the incident, the insurance company should be intimated. Written Notice of Claim must be given to the company immediately in case of death or within 30 days after the date of loss in all other cases. One can call at the toll free no of company. Claims Service Representative will provide guidance and assistance for the documents. After all the documents are submitted, the total process will be completed within 7 working days. Documents needed for Accidental Injury Claims Claim form as per Form A. FIR Medical papers, x ray reports. For Permanent Disability – Disability Certificate from the Surgeon or Municipal Hospital. For Temporary Total Disability -Sick leave from the employer. Attending Physicians statement as per Form D. Documents needed for Accidental Injury Claims Claim form as per Form A. FIR Medical papers, x ray reports. Doctors prescription and line of treatment advised. Bills, receipts and cash memos. Attending Physicians statement as per Form D. Exclusions under the plan For Bodily injury or Sickness from Civil or Foreign Wars. For Bodily injury or Sickness aggravated by the insured person knowingly. For Bodily injury or Sickness due to intentional and deliberate exposure to danger Under the influence of drugs, narcotics or alcohol at the time of the accident If the insured person is injured due participating in any sport as a professional player. If the insured person is injured due to riding in a two wheeler of more than 150 cc. If there is any competition which involves utilization of motorized land , water or vehicle and the insured person participates in the same and is injured. For bodily injury while the insured person is travelling by air other than as a fare paying passenger. For bodily injury which occur due to participating in any criminal act. AIDS/ HIV. For bodily injury which occur due to participation in any violent labour disturbances riot or civil commotion or public disorder. Any pathological Fracture. Treatments of nervous or mental problems. Pre existing diseases. Hazardous Sports. Bodily injury caused as a result of terrorism. If the insured person is injured or fall sick due to venereal or venereal related disease.
HDFC Ergo Personal Accident Insurance- FAQs
1. How to pay premium? What are the modes of payment available? HDFC ERGO General Insurance offers three modes for payment of premium You can sign a debit mandate at time of signing the policy, thus your premium will be deducted automatically from the bank account By cash or cheque collection and By direct online payment 2. How can I check policy status for HDFC Ergo personal accident insurance? The right way to check the status of the policy is from the corporate website. Login into your website with user ID and password, and right-click on the policy number and get the details of the status of it. 3. What is the policy renewal process for HDFC Ergo personal accident insurance? If you have filled an auto debit mandate, the policy will be renewed automatically. Alternatively, renew the policy online by logging into e-Portal with valid login details. Pay via debit/credit card or Net banking and print you e-Payment receipt. 4. What is the companys process to settle claim for HDFC Ergo personal accident insurance? The company does not usually take more than 3 days for minor theft or accidents. They claim that they will settle all the cases within 7 days. You will have to submit the documents of proof and the claims form to the officer. Upon satisfactory evaluation, the claims amount will be deposited via NEFT in the policyholders bank account. 5. What is the policy cancellation process for HDFC Ergo personal accident insurance? Cancellation of the policy is possible any time. You will have to go to the site and order for cancellation. You can also put up a mail, After a short documentation process, the policy will be cancelled and you will receive an intimation message.
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