The insurance regulator has come out with a standard personal accident cover, which the general and standalone health insurers have to mandatorily offer from April 1 this year. The product, named Saral Suraksha Bima, will have a maximum sum assured of Rs 1 crore and minimum Rs 2.5 lakh.
“Beyond the range specified, insurers can offer (sum assured) on their own and can use the same name for the product if all terms and conditions remain the same,” the Insurance Regulatory and Development Authority of India (Irdai) said in its final draft.
The product will have a basic cover under which the entire sum assured will be paid by the insurance company on the death of the insured person due to an injury sustained in an accident, provided the death occurs within 12 months from the date of the accident.
In the case of permanent total disablement, a similar benefit will be paid by the insurance firm. For partial disablement, depending on the severity, a benefit equal to the sum assured of up to 50 per cent will be paid. The regulator has said the policyholder will get the benefit under the base cover even after the end of policy period, but within 12 months from the date of the accident.
There will also be an optional cover, under which if the insured person sustains an injury in an accident that renders them incapable from engaging in any employment, then they will be eligible for a compensation at the rate of 0.2 per cent of the base sum insured per week, till the time they are able to return to work.
Moreover, hospitalisaiton expenses will be indemnified up to the limit of 10 per cent of base sum insured. Also, a one-time educational grant of 10 per cent of the base sum insured will be payable to all dependent children of the insured, provided they are pursuing an educational course and are not above the age of 25.
The regulator said the sum insured will increase by 5 per cent each year for each claim-free policy year, provided the policy is renewed without a break.
This increase in coverage has been capped at 50 per cent of the basic sum insured.
If a claim is made in any particular year, the cumulative bonus accrued may be reduced at the same rate at which it has accrued, the regulator said.