Group personal accident insurance

Know about group personal accident insurance, its benefits, and coverages. Check the buy and claim process.
Check Health Insurance Plans
3 mins
08-August-2023

A group personal accident insurance is a type of comprehensive insurance plan that provides accident coverage for a large number of people, collectively referred to as a group. Group accident insurance protects policyholders and their families financially against loss of income due to accidental disablement or death. Organisations or companies purchase group personal accident insurance for their group of employees or members.

Here are the details about group personal accident insurance, and how it benefits you.

What is group personal accident insurance?

Group personal accident insurance, also known as a group accident guard policy, offers coverage to individuals who belong to a group. A Group Personal Accident Policy enhances this coverage by offering comprehensive protection for groups, such as employees, at affordable premiums. This type of insurance is an invaluable employee benefit, ensuring that individuals are financially supported during unforeseen accidents. For organisations, a Group Personal Accident Policy represents a strategic and caring investment in their workforce’s safety and well-being, fostering a secure and supportive work environment.

The policy offers lump sum compensation in the event of accidental death or permanent disability, and may also provide benefits for temporary disablement, medical expenses, and transportation costs. Group Personal Accident Insurance offers comprehensive coverage at affordable premiums, making it a valuable employee benefit or group insurance option for organisations.

Why is group personal accident insurance necessary?

Personal accidents can occur at any time and can have a significant impact on your financial stability. Group accident guard policy is necessary because it provides added protection to you and your loved ones in case of an unexpected event. Accidents, whether minor or major, can result in severe financial loss and can significantly impact your standard of living. Having personal accident insurance can help you have peace of mind and stay prepared for any eventuality.

Benefits of group personal accident insurance

Group personal accident insurance comes with several benefits, including:

  • Comprehensive coverage: Group Personal Accident Insurance provides extensive coverage for accidental death, bodily injury, or disability sustained by members of a group.
  • Financial protection: It offers substantial financial security to insured individuals and their families through lump sum compensation in case of accidental death or permanent disability.
  • Cost-effective: Group policies generally have lower premiums compared to individual plans, making them affordable for organisations and groups.
  • Employee retention: Offering Group Personal Accident Insurance as an employee benefit can enhance retention rates by demonstrating care for employees' well-being.
  • Simplified administration: Group policies are easy to manage, with streamlined enrollment processes and centralised administration, reducing administrative burden.
  • Customisable options: Group policies often offer customisable options to meet the specific needs and budget constraints of different organizations or groups.
  • Additional benefits: Some Group Personal Accident Insurance plans may include additional benefits such as coverage for medical expenses, temporary disablement, or transportation costs.

Types of group personal insurance plans with features and benefits

Bajaj Finserv offers group personal insurance plans for its customers. Given below are the features and benefits of this plan:

Name of the plan

Features and benefits

Exclusions

Aditya Birla Group Activ Health

  • Sum insured of up to Rs. 5 lakh.
  • Pre-hospitalisation cover of up to 30 days.
  • Post-hospitalisation benefits of up to 60 days.
  • 527 day care procedure.
  • Domiciliary hospitalisation covered.
  • Road ambulance expenses up to Rs. 1,000 covered, per accident.

  • No pre-existing medical illness is covered up to waiting period of 2 years.
  • Illnesses detected before 30 days from the purchase of policy.

What does group personal accident insurance cover?

Group personal accident insurance policies cover a wide range of incidents that can occur due to an accident. It covers the following expenses:

  • Accidental death: Group personal accident insurance provides coverage in the event of the insured person's death resulting directly from an accident, offering financial compensation to their beneficiaries or nominated individuals.
  • Permanent Total Disablement: This coverage offers financial compensation if the insured person becomes permanently and wholly disabled due to an accident, resulting in the loss of their ability to perform any occupation or work.
  • Permanent Partial Disablement: In case of permanent partial disablement caused by an accident, this coverage provides financial compensation based on the extent of the disability, as determined by the policy terms and conditions.
  • Temporary Total Disablement: Group personal accident insurance offers coverage for temporary total disablement, providing financial support to the insured person if they are unable to work temporarily due to injuries sustained in an accident.
  • Medical expenses: The policy covers medical expenses incurred by the insured person for the treatment of injuries sustained in an accident, including expenses for consultations, diagnostic tests, medications, and other necessary medical procedures.
  • Hospitalisation expenses: Group personal accident insurance reimburses the insured person for hospitalisation expenses incurred due to injuries sustained in an accident, including room charges, nursing care, surgical fees, and other hospital-related expenses.
  • Ambulance charges: This coverage reimburses the insured person for the expenses incurred for ambulance services required to transport them to the hospital or medical facility following an accident, ensuring timely access to medical care.

Permanent partial total disability coverage under group personal accident insurance

Group personal accident insurance typically provides coverage for Permanent Partial Disability (PPD) and Permanent Total Disability (PTD). PPD compensates the insured for the loss of a body part or function, such as the loss of a limb or sight, with benefits based on the severity of the disability.

PTD provides coverage when the insured becomes permanently unable to perform any occupation due to injury or illness. These coverages offer financial protection by providing lump sum payments or ongoing benefits to help mitigate the financial impact of disabilities resulting from accidents.

What group personal accident insurance does not cover?

There are certain incidents that a group personal accident insurance policy may not cover, such as:

  • Injuries or deaths that occur when under the influence of drugs or alcohol.
  • Injuries due to sports or activities not included in the policy.
  • Pre-existing medical conditions.
  • Injuries due to acts of war or terrorism.

Key features of group accidental insurance policy

Discussed below are the key features of a group accident health insurance plan:

Feature

Details

Coverage group

Employee accidental insurance can be extended to clubs, corporates, associations, institutions, and firms.

Educational benefit

Certain plans include an educational fund for dependent children in case of the insured's permanent disablement or death.

Policy tenure

The typical tenure of these policies is one year from the policy start date.

Discounts and offers

Many insurance providers offer group size-based discounts.

Renewal process

Renewing a group accidental insurance policy follows the same steps as any other ordinary policy.

Customisable options

Policies can often be customised to include various add-ons such as coverage for medical expenses, funeral costs, and repatriation of mortal remains.

Claim process

The claim process usually involves submitting necessary documentation, including proof of the accident, medical reports, and identification, to the insurer.

Eligibility criteria

Generally, all employees or members of the group are eligible, but some policies may have specific age limits or health requirements.

Additional coverages

Additional coverages such as accidental medical expenses, emergency evacuation, and daily hospital cash benefits can be included in the policy based on the group's needs.


Read more:
 Best health insurance plans for senior citizens 2024

Pro Tip

Avail hospitalisation and treatment benefits with health insurance plans starting at just Rs. 15*/day.

How to apply for group personal accident insurance?

Employers or organisations can easily apply for group personal accident insurance online.

  • Visit the preferred insurance provider’s website.
  • Look for group health insurance policies and select a group personal accident insurance based on your requirements.
  • Fill out the application form with some personal details like name, mobile number, and address.
  • Select add-on covers or any modifications required in the policy.
  • Review the shared information and policy details.
  • Make the payment through any of your preferred online payment modes.

You will receive the policy document on your registered email address immediately.

You can also visit the insurance company’s website if you wish to buy a group personal accident insurance offline.

Besides this, you can also compare and buy various health insurance policies on Bajaj Finance Insurance Mall.

Read more: Check Health Insurance Premium Calculator

A step-by-step guide to applying for health insurance policies on Bajaj Finance

Here is a step-by-step process of applying group personal accident policy:

Step 1: Click here to open the online application form.
Step 2: Fill in the application form with your basic details or the person that you want to insure. Provide name, gender, mobile number, date of birth, and residential PIN code.
Step 3: Now click on ‘Get Quote’ to proceed.
Step 4: Enter the One Time Password (OTP) received on your registered mobile number for verification.
Step 5: Choose your preferred group health insurance policy from the list of health insurance policies and click on ‘Buy Now’.
Step 6: Your personal details will appear pre-filled based on our records. All you need to do is check if the details are correct and click on ‘Next’.
Step 7: Enter your address and nominee details.
Step 8: Answer a few questions about your health and lifestyle by clicking the relevant checkboxes. Click on the ‘Next’ button to proceed.
Step 9: Verify if the previously filled details are correct and click on the ‘Proceed’ button to visit the payment page.
Step 10: Make the payment through net banking, UPI, debit, or credit card to buy the policy.

Documents required for group personal accident policy

Given below is a list of documents required to apply for group personal accident policy:

  • Employee/member information: Details of all individuals to be covered under the policy, including names, ages, and occupations.

  • Proof of identity: Copies of government-issued IDs such as Aadhaar card, passport, or driver's license for each insured member.

  • Proof of employment/membership: Documents confirming the affiliation of individuals with the group, such as employee ID cards or membership certificates.

  • Group details: Information about the organisation or association availing the policy, including registration documents and tax identification numbers.

  • Declaration of pre-existing conditions: Some insurers may require disclosure of pre-existing medical conditions of the insured individuals.

  • Premium payment: Evidence of premium payment, which may include bank statements or payment receipts.

  • Claim forms: Pre-filled claim forms provided by the insurer for ease of claim processing in case of an accident.

  • Additional documentation: Depending on the insurer's requirements, additional documents such as medical certificates or accident reports may be requested.

Documents required for personal accident insurance claim process

When submitting a claim for group personal accident insurance, there are a few documents that you need to provide, such as:

  • Policy document
  • Medical certificate or disability certificate
  • Hospital discharge summary
  • Police FIR (in case of accidental death)

How to claim for group personal accident insurance?

There are two ways to claim for group personal accident insurance - the cashless claim process and the reimbursement claim process.

Cashless claim process:

If you go to a network hospital, you can benefit from a cashless claim process, where you will not have to pay anything out of pocket. To do this under your group personal accident insurance, you will need to follow these steps:

  • Inform the insurance company of your visit and provide your policy number.
  • Show your policy document at the hospital reception desk.
  • The hospital will provide the necessary treatment and send the bills directly to the insurance company.
  • The insurance company will settle the bill according to the terms and conditions of the policy.

Reimbursement claim process:

If you visit any other hospital than those listed in the network hospitals, you can opt for the reimbursement claim process. Follow the below process to make a claim:

  • Inform the insurance company of your visit and provide your policy number.
  • Submit all bills and receipts to the insurance company along with a claim form.
  • The insurance company will assess the claim and reimburse you according to the terms and conditions of the policy.

Group personal accident insurance assures that the insured has a financial backup in case of an accident and does not worry about the treatment costs. Choose a group personal accident insurance that meets all your requirements for your employees or members.

Frequently asked questions

Do I get tax benefits on group personal accident insurance?

Yes, you get tax exemption for premiums paid towards a group personal accident insurance policy. You get tax benefits under Section 80C of the Income Tax Act. The employers largely get the tax benefit. If a portion of the premium gets deducted from the employee’s salary, then the employee also gets the tax benefit.

Is there any pre-medical check-up for group personal accident insurance?

No, for a group personal accident insurance policy, pre-medical check-ups are not mandatory. However, if an employee has a pre-existing medical condition, the insurer may require a medical examination to determine the premium or whether to provide coverage.

Does the group personal accident insurance cover the insured employee’s family?

Typically, a group personal accident insurance policy only covers the registered employees of the organisation. However, some insurers may offer an option to add coverage for family members of the insured employee. It may come at an additional premium under a group accident guard policy.

What is group accident guard policy?

Group Accidental Insurance (GAG) offers extensive protection for a group of people, safeguarding them in the event of any unexpected occurrence or accident. It serves as a proactive solution, equipping them beforehand to minimise potential losses resulting from accidents.

Can I avail tax benefits of group personal accident insurance?

No, you cannot avail tax benefits with a group personal accident insurance policy. This is because the premium for the insurance policy is paid by the employer and not by any individual.

What is the difference between group life and group personal accident insurance?

Group life insurance provides coverage for death due to any cause, while group personal accident insurance offers coverage specifically for accidental death or bodily injury. Additionally, group personal accident insurance may cover temporary disabilities and medical expenses resulting from accidents.

What are the benefits offered under a group personal accident cover?

Under a group personal accident cover, beneficiaries typically receive benefits such as financial compensation for accidental death, permanent disability, or temporary disability due to accidents. Additionally, medical expenses arising from accidents may be covered, along with access to services like cashless hospitalisation and reimbursement of treatment costs.

Can I claim tax benefits for paying the premiums towards group personal accident cover?

Yes, premiums paid towards a Group Personal Accident cover may be eligible for tax benefits under Section 80D of the Income Tax Act, subject to certain conditions. However, the tax benefits would depend on the specific terms and provisions of the policy and the prevailing tax regulations at the time of filing your taxes.

Does group personal accident insurance provide coverage for a natural death?

Group Personal Accident Insurance typically does not provide coverage for natural death. It mainly covers accidental death, permanent or temporary disability resulting from accidents, and related medical expenses. Natural death is generally excluded from the policy coverage.

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