Accidental Disability, Modification & Re-training Expenses Cover

Accident Permanent Partial Disablement (PPD)

If the policyholder suffers from an injury due to an accident covered under the policy and directly results in undergoing a surgical procedure covered under the policy and suffers permanent partial disablement of the nature specified below, the cash coverage will be payable. The illness or accident must occur within the policy year. The cash cover is payable as per the policy schedule within 365 days from the date of the injury if caused due to an accident.

The cover will be payable if: 

1. The permanent partial disablement is proved. A disability certificate issued by a civil surgeon or the equivalent appointed by the District, State, or Government Board needs to be submitted. 
2. For disablement other than physical separation of limb/s, digit/s, the permanent partial disablement continues for at least 180 days from its commencement. If at the expiry of the 180 days there is no reasonable medical hope of improvement, such disability is considered permanent at the end of this period. 
3. If the policyholder passes away before the claim is admitted, no amount will be payable under this cover. However, coverage under Accidental Death shall become payable instead of this cover if opted. 
4. If the policyholder suffers a loss that is not of the nature of permanent partial disablement specified above, then a disability certificate issued by a civil surgeon or the equivalent appointed by the District, State, or Government Board will determine the degree of disablement and the amount payable, if any.

Accidental Permanent Total Disablement (PTD)

If the policyholder suffers from an injury due to an accident covered under the policy and directly results in undergoing a surgical procedure covered under the policy and suffers permanent total disablement of the nature specified below, the cash cover will be payable. The illness or accident must occur within the policy year. The cash coverage is payable as per the policy schedule within 365 days from the date of the injury if caused due to an accident. For this policy, a limb means a hand at or above the wrist or a foot above the ankle, and physical separation of one hand or foot means separation at or above the wrist or at or above the ankle, respectively.

The cover will be payable if: 

1. The permanent partial disablement is proved. A disability certificate issued by a civil surgeon or the equivalent appointed by the District, State, or Government Board needs to be submitted. 
2. For disablement other than physical separation of limb/s, digit/s, the permanent partial disablement continues for at least 180 days from its commencement. If at the expiry of the 180 days there is no reasonable medical hope of improvement, such disability is considered permanent at the end of this period. 
3. If the policyholder passes away before the claim is admitted, no amount will be payable under this cover. However, coverage under Accidental Death shall become payable instead of this cover if opted. 
4. If the policyholder suffers a loss that is not of the nature of permanent partial disablement specified above, then a disability certificate issued by a civil surgeon or the equivalent appointed by the District, State, or Government Board will determine the degree of disablement and the amount payable, if any.

Accidental Modification Allowance

If the policyholder suffers an injury during the policy year due to an accident caused by an event covered under the policy directly results in the permanent total disablement or permanent partial disablement of the policyholder within 365 days. If the policyholder is disabled to the extent that necessarily requires them to modify their vehicle or make modifications in their house to adjust to the disablement, the sum insured will be paid as specified in the policy schedule.

Accident Retraining Expenses

If the policyholder undergoes an accident due to an event covered under the policy and as a direct result incurs an injury resulting in permanent total disablement, permanent partial disablement or mental disability, however, is capable of taking up an alternate occupation that requires training, any expenses incurred will be paid. The payout is up to the limit as specified in the policy schedule or certificate of insurance. The payout manages reasonable costs incurred to retrain the policyholder for an alternative occupation either in the line of work of the policyholder or elsewhere.

Note: For definitions of permanent total disablement, permanent partial disablement, temporary total disablement, or coma, please refer to the product brochure before concluding a sale.