ACCIDENT INSURANCE
Chapter 1
Introduction To Insurance:
? ? ? ? ? ? Introduction Meaning of insurance. Definition of insurance. Features of insurance Important Elements of insurance. Advantages and Disadvantages of Insurance. ? Types of Insurance.
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1.1 INTRODUCTION
Insurance is the equitable transfer of the risk of a loss, from one entity to another in exchange for payment. It is a form of risk management primarily used to hedge against the risk of a contingent, uncertain loss. An insurer, or insurance carrier, is a company selling the insurance; the insured, or policyholder, is the person or entity buying the insurance policy. The amount to be charged for a certain amount of insurance coverage is called the premium. Risk management, the practice of appraising and controlling risk, has evolved as a discrete field of study and practice. The transaction involves the insured assuming a guaranteed and known relatively small loss in the form of payment to the insurer in exchange for the insurer's promise to compensate (indemnify) the insured in the case of a financial (personal) loss. The insured receives a contract, called the insurance policy, which details the conditions and circumstances under which the insured will be financially compensated
1.2 MEANING
“Insurance in broad terms may be described as a method of sharing financial losses of few from a common fund that are equally exposed to the same loss.”
1.3 Definition of Insurance
“A contract (policy) in which an individual or entity receives financial protection or reimbursement against losses from an insurance company. The company pools clients' risks to make payments more affordable for the insured”.
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1.4 FEATURES OF INSURANCE
? Insurance (excluding life insurance which tends to pay after certain period of time) is not an investment rather it is a hedge against the future probable losses. ? It gives you the comfort that in the event of any loss from unforeseen events will be compensated by the insurance companies. ? One has to pay premiums regularly to the companies providing insurance in order to enjoy the benefits of insurance. ? It can be of many types like life insurance, fire, marine, health insurance and so on and one can take any of the above polices depending on the risk with which an individual is exposed to. ? Insurance policies can be modified and offered to people depending on their risk profile and the need of the insurer. ? There is a limit to the amount by which an insurance company will compensate for the loss incurred by the insurer. The amount is mentioned in the insurance policy and the more the amount of insurance cover the more will be the premium which one has to pay to the company. ? A person can take more than one policy, in other words there are no restrictions on the number of policies which one can take.
1.5 IMPORTANT ELEMENTS INVOLVED IN THE CONCEPT OF INSURANCE
? SUBJECT MATTER OF INSURANCE….. Subject matter is property, human life, machinery, goods etc.,
? THE PERIL (RISK)…..
Peril is fire, storm, burglary, earth quake, injury,
Explosion etc. ? THE FINANCIAL LOSS….. Contract is signed. Financial loss is normally defined before the
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1.6 ADVANTAGES OF INSURANCE
? Removal of uncertainties :Insurance company takes the risks of large but uncertain losses in exchange for small premium. So it gives a sense of security, which is real gift to the business man. If all uncertainty could be removed from business, income would be sure. Insurance removed many uncertainties and to that extent is profitable.
? Promotion of saving :Saving is a device of preparing for the bad consequences of the future. Insurance policy is often very suitable way of providing for the future. This type of policy is found particularly in life assurance. It promotes savings by making it compulsory which have a beneficial effect both for the individual and nation.
? Reduction of the chances of loss :Insurance companies spend large sums of money with a view to finding out the reasons of fire accidents, theft and robbery and suggest some measures to prevent them. They also support several medical programmers in order to make the public safety minded. Without such losses preventive activities of insurance companies, the chances of loss would have been greater than they are at present days.
? Solution of social problems :Insurance serves as a useful device for solving complex social problems e.g. compensation is available to victims of Industrial injuries and road accident while the financial difficulties arising from old age, disability or death are minimized. It thus enables many families and business units to continue intact even after a loss.
? Productive utilization of fund :Insurer accumulates large resources from the various insurance funds. Such resources are generally invested in the country, either in the public or private sector. This facilitates considerably in over all development of the economy.
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? Removing fear :Insurance helps to remove various types of fear from the mind of the people. The insured is secured in the knowledge that the protection of the insurance fund is behind him if some sad event happens. It thus creates confidence and eliminates a worry which is difficult to evaluate, but the benefit is very real. ? Dividends enable growth:-
Customary policies enable prospect to share in the monetary increase without taking
the risk of investment. The investment revenue is shared out among the policyholders through yearly announcement of bonus and/or dividends. ? Risk guard:Because life is filled with uncertainties, life insurance guarantees that your dear ones continue to have monetary back up in case of any unexpected incident that may lead to your detriment or demise. ? Tax benefits: Insurance plans offer tax-benefits that are appealing for both at the entry and exit period under the majority of the plan.
1.7 Disadvantages of Insurance
? Inconsistent premiums:Most policies contain mandatory premiums that increase in due course. For an insured on a budget, who desires to buy coverage adequate to profit his relations upon his decease, this policy can be quite costly. The unstable inflation guarantees a steep climb. ? Deduction of funds:-
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While policies include conditions in which shares from cash accounts can be used to disburse premiums, such a request practically always results in deducting funds from the cash value / investment account.
? Insufficient funds:There is a lack of assurance that ample finance will be accessible to cover unpaid premiums when the policyholder holds inadequate funds.
? Expiration of term insurance:This kind of insurance in not permanent; it is either for a fixed number of years or until a certain age. On completion of the term or when the insured reaches a certain age the policy expires compelling them to qualify for another insurance program, which may require higher premium depending on the age and other factors.
? Language of premium:It is usually difficult to resolve precisely how costly commissions truly are. The cost is commonly concealed within the fine print of the terms and conditions, and it is normally explained in language that is complex for someone who is unfamiliar to insurance policies
1.8 TYPES OF INSURANCE
In general, there are 2 major types of insurance - general insurance and life insurance. However, some other types of insurance are available as well. In India life insurance is the most availed form along with health and accident based plans.
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Insurance Policies – Categorization
? Personal Insurance
Personal insurance is essentially a plan availed by an individual to take care of various requirements like health and coverage against death or injury by accident. There are several policies nowadays where there is an option to cover the family members in an individual policy.
TYPES OF PERSONAL INSURANCE:
? Medical Insurance. ? Accidental Insurance. ? Property Insurance. ? Vehicle Insurance. 7
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? Rural Insurance
Rural insurance is meant to cater to the requirements of rurally bases businesses or individuals. These policies provide a wide range of coverage starting from life and health to protection against natural disasters that can have a negative effect on business.
? Industrial Insurance
The industrial insurance policies are availed by various companies to get protection for important projects, construction, contracts, and equipment from situations like fire, theft and any form of damage or loss.
? Life Insurance
Life insurance is taken primarily to secure oneself and/or one's family when the ability to earn is less or provide for the dependents when the insured is either deceased or unable to earn a livelihood.
? Whole Life Insurance
Whole life insurance policies are taken for the entire duration of an insured's life. In these policies premium has to be paid on a yearly basis as long as the policy lasts.
? Endowment Plans
The endowment plans are supposed to provide a lump sum once the policyholder dies or when the policy matures. Certain endowment policies also provide payment in case of critical illnesses.
? ULIPs
The ULIPs or Unit Linked Insurance Plans are one where the financial worth of a policy is dependent on the present net asset value of the core investment assets related to it. These policies are both flexible and protective, which is a unique feature. The premiums of these policies are used to buy investment asset units selected by the policy owners.
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Chapter 2
LITERATURE REVIEW
Health Insurance coverage-without any option By: R.Kantsharma | Sep 11, 2006 01:50 PM Health Insurance is a concept which is widely accepted by Indian public, who dare not to meet high medical expenses. Sometimes employers cover them under Group Insurance Policies but rests of the people who are in business or in profession are required to take care of their health expenses. A health insurance policy is a
contract between an insurer and an individual or a group, in which the insurer agrees to provide specified health insurance at an agreed-upon price the premium. Depending on the policy, the premium may be payable either in a lump sum or in installments. Health insurance has become a necessity in today?s world considering the rise in the cost of medical care and treatment and the huge population of the country. The escalating cost of medical treatment today is beyond the reach of the common man. Even if an individual is healthy and has never had any major problem, it is not possible to predict what may happen in the future. There is a growing public awareness for better health care and desire to have better health care from private medical providers. In case of a medical emergency, cost of hospital room, doctor?s fees, medicines and related health services all add up to a huge sum. In such times, health insurance provides the much needed financial relief. In anticipation of unexpected events that create the need for medical goods and services, the health insurance does not cover certain ailments. It is very important to know what your policy covers and what you have to pay yourself. Health Insurance policies generally cover boarding, nursing and diagnostic expenses, which include room rent charged at the hospital or nursing home, fees of the surgeon, anesthetist, doctor, etc. Some policies even offer fixed cash amount for each day you stay at any hospital for treatment. Expenses on hospitalization, incurred in the first 30 days after taking a policy are also not entitled, except in case of an injury from accident. Treatment of certain diseases is not covered during the first year of your policy. The list of diseases may vary from one health policy to another.
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Chapter 3
3. FIELD STUDY
“Better Safe than Sorry”
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3.1 Introduction of Accident Insurance. 3.2 Meaning of Accident Insurance. 3.3. Definition of Accident Insurance. 3.4 Features of Accident Insurance. 3.5 Benefits of Accident Insurance. 3.6 Types of Accident Insurance. 3.7. Accident Insurance Policies 3.8 Accidental Insurance Policy Premiums 3.9 Age Limit For Taking This Policy 3.10 Coverage Details of Accidental Insurance Policies. 3.11 Selection Of The Sum Insured 3.12 Top Accidental Insurance Companies 3.13 Claim Settlements Procedure 3.14 Documents Required For Settlement Of Claim. 3.15 Different Modes Of Payment
3.1 INTRODUCTION
Accidental insurance is one of the most ignored insurance categories in India. As we all know majority people buy insurance either for tax planning or investment purpose but unfortunately both these benefits are not available in Accidental Policy. But does that mean you should not buy accidental Insurance. Insurance is the foundation of any financial life – a person who is having dependents must first completely insure himself & then only should start thinking about investments. We should know that term plan is not for us but for our family and medical insurance is for us. So one should buy term plan when he is having
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dependents but medical insurance is must for everyone. If we talk about accidental insurance it is equally important for us & family. When I bought my first vehicle; my mom advised drive safe these days accidents are increasing – hope you would have received similar advice from your parents or given to your kids. Impact from accident can be as small as a scratch to as big as death – impact can be temporary or sometime even permanent. Accidental insurance policy covers this risk but first check the definition of accident. “Accident or Accidental means a sudden, unforeseen and unexpected event caused by external, violent and visible means (but does not include any illness or disease) which results in physical bodily injury (but does not include mental, nervous or emotional disorders, depression or anxiety)". Accidental Insurance also excludes suicides, self injury, armed force operations, war etc. In case of death term plan will help family to cope up with financial hardship but what about an accident where one looses body parts & that impacts his earning abilities. In such situation Accidental Insurance can be very helpful.
3.2 Meaning
Accident or Accidental means a sudden, unforeseen and unexpected event caused by external, violent and visible means (but does not include any illness or disease) which results in physical bodily injury (but does not include mental, nervous or emotional disorders, depression or anxiety). Accidental Insurance also excludes suicides, self injury, armed force operations, war etc. In case of death term plan will help family to cope up with financial hardship but what about an accident where one looses body parts & that impacts his earning abilities. In such situation Accidental Insurance can be very helpful.
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“Insurance coverage against loss by accidental bodily injury. These insurance policies pay out a sum of money when an accident occurs. The amount paid out depends on the injury, and policy documents will detail amounts paid for different injuries or death”.
3.4 FEATURES OF ACCIDENTAL INSURANCE
Yearly Contract: Similar to term plan & medical insurance – accidental insurance is also yearly contract that you can renew every year. Maximum Insurance: It depends on your income – some insurance companies give 60-100 times of your monthly income others give 8 to 10 times of your yearly income. For Non Earning Members: Few insurance companies provide accidental insurance to dependents but have limitation in sum assured. 25% to 50% of the proposers sum insured with maximum limits in rupee terms
3.5 BENEFITS OF ACCIDENTAL INSURANCE
? Now days there are several term plans that offer financial benefits in case of the death of the insured and the health plans always come in handy if the insured is hospitalized due to some reason.
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? These plans also offer accident related benefits. However, experts feel that the benefits available on these plans are not as good as independent accident insurance plans. They opine that since most of the insured are salaried persons traveling between locations to earn their livelihood or for other necessary purposes the chances of them facing an accident are greater than before. According to them, the present situation necessitates that people place more importance on these policies than the life and health insurance policies. They also point out that these policies are pretty inexpensive as well.
? Nowadays, on an average, accidental insurance cover of INR 10 lakh can be availed by paying a premium of 800-1500 rupees a year. The premium normally varies depending on the benefits being provided in the plan as well as the company that is providing the same.
The accidental insurance policies also cover the non earning members or dependents of the insured. However, the payment provided for them is part of the insured sum.
? With Personal Protect Insurance, you avail the following
benefits:
• Cover against Accidental Death or Permanent Total Disablement (PTD) on account of an Accident. • Optional Cover against Accidental Hospitalization Expenses and Accidental Hospital Daily Allowance. • Covers different types of accidents like road, rail accidents, accidents due to natural calamities and arising out of terrorism/ terrorist acts.
• No health check up required.
• Easy Claim Process with minimal documentation. • Digitally signed policy available 24X7 online.
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3.6 TYPES OF ACCIDENTAL INSURANCE
The accidental insurance policies can be broadly categorized into the following:
Individual Accidental Insurance
These policies can be availed by anyone and often benefit the children and partners of the insured as well. These policies have some restrictions when it comes to covering a certain kind of activities like various types of adventure sports and cover for both death and various forms of disability owing to an accident.
Group Accidental Insurance
The group accidental insurance policies are normally availed by employers to cover the accident related expenditure of their employees. A variant of these policies is the team accidental insurance policies that are used to cover sports teams.
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3.7 ACCIDENT INSURANCE POLICIES:Accidents can occur any time since life is uncertain. In order to reduce the burden of an accident most of the insurance companies in India have come up with numerous accident insurance policies. Accident insurance provides assistance to the insured when he or she meets with an accident and suffers certain injuries. Accident insurance policies do not only help the insured to clear his /her hospital and medical bills but they also provide money to the family members in the event of death of the insured.
Below is a list of some of the important Accident Insurance Policies in India. Accident Shield: Accident Shield by Royal Sundaram is currently one of the
most popular online accident policies today. The policy is a worldwide plan that covers the individual from unforeseen events that lead to total disability, death and partial disability. The policy only covers the person insured.
Key Features of the Policy
? Any person between the ages of 18 years to 70 years can opt for this policy ? No medical examinations are required to avail this policy ? The policy offers three types of plans Silver, Gold and Platinum. ? The policy offers grants for education for two children up to Rs 10,000 per policy. ? The policy offers hassle free claims. ? Individual Personal Accident Plan: The Individual Personal Accident plan by Apollo Munich is another important accident insurance plan. Known for its umpteen benefits this plan does not only cover the individual but his or her family too. The policy assures compensation due to an unforeseen event that result in bodily injuries or death.
? ?
The policy covers people between the age group of 5 - 70 years. The plan is for tenure is for a period of one year
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? ?
In case of death a lump sum amount is paid to the nominee of the insured. In case of Temporary Total Disablement the insured is entitled to a weekly allowance.
Personal Accident Insurance policy: ICICI Lombard's Personal
Accident Insurance policy is also a popular accident policy. The accident policy provides coverage against Death, Accidental and Permanent Total Disablement. This is a worldwide policy and provides immediate assistance to the insured in any part of the world.
Key Features of the
Policy
? ? ? ?
The minimum entry age to avail benefits of this policy is 18 years and the maximum age is 70 years. The policy does not compensate claims arising from ailments. The policy provides a customized coverage which allows you to select between Rs 10,000 Lakh, Rs 20,000 The nominee of the policy is compensated with the entire amount in the event of death of the insured within the policy tenure.
Accidental Insurance Policy
The accidental insurance policies provide a wide range of benefits such as coverage against death by accident or total and permanent and total disablement occurring due to such a situation. These plans provide optional coverage facilities in case of expenses incurred due to accidental hospitalization. They also provide the insured daily expenses in such cases.
Yet another benefit of these programs is that they provide customized coverage whereby the insured can opt for an amount as per his or her convenience or requirement.
3.8 ACCIDENTAL INSURANCE POLICY PREMIUMS
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The premiums of these policies do not depend on the age of the insurer. The main factors in these policies are the type of job being done by the insurer and the overall working conditions. Following
are some professions that are
considered less risky:
Doctors. Bankers. Engineers. Accountants.
Laborers are normally regarded as medium risk propositions. Some professions that are regarded as very risky may be mentioned below:
Underground workers in mines. Mountaineers, bungee jumpers, and rock climbers. Jockeys and people working in circuses. Top Accidental Insurance Policies.
3.9 AGE LIMIT FOR TAKING THIS POLICY
Any adult residing in India can take the policy covering him / her and dependent family members between the ages of 5 and 70yrs.
3.10 COVERAGE DETAILS OF ACCIDENTAL INSURANCE POLICIES
? ? IIT TC CO OV VE ER RE ED D
In case the insured passes away due to an accident (death), an accidental insurance policy will pay the total sum assured to the nominee. There are a few insurers that
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provide special facilities such as education bonus for children. However, there is a specified number in these cases. In case the insured is permanently disabled for life owing to an accident he or she receives the total sum assured. There are a few companies that make additional payment in such case that include the following situations:
? Loss of both hands and feet. ? Loss of a limb and an eye. ? Loss of a hand or feet. ? Loss of sight in both eyes or hearing in both the ears and the ability to speak.
If the insured suffers permanent partial disablement then only a certain amount of the sum insured is paid to him or her and the payment is normally done on a monthly or weekly basis. The following situations are covered: ? Loss of thumb or index finger. ? Loss of sight in one eye. ? Loss of hearing in one ear. ? Loss of one hand. In case the insured has been completely disabled for a certain period of time in the future and is not able to earn the companies pay a certain percentage of the sum insured. These situations are referred to as temporary permanent disablement and carry a cap as in a certain upper limit for payment. Following are certain situations that are considered in these cases: ? Fractured limbs. ? Bed rest for an ensuing period of 3 months. ? Additional Benefits of Accidental Insurance Policies.
?N NO OT TC CO OV VE ER RE ED D
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The accidental insurance policies do not provide coverage in case of death or disability due to any of the following situations:
The Company shall not be liable under this policy for:
Compensation / Claim under both Cover 1 and Cover 2 as mentioned above. Claims arising from sickness/illness.
Death, injury or disablement of Insured Person as a result of
Intentional self injury, attempted suicide, or suicide. Pre-existing physical or mental condition. In a drugged or intoxicated state Crew and pilots of aircraft, member of armed forces, or artists who take part in dangerous activities. Breaking law with a criminal purpose. 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 kinds. Nuclear weapon induced treatment. Childbirth or pregnancy or in consequence thereof.
3.11 SELECTION OF THE SUM INSURED
It is very difficult to put a value to a human life. Hence the principle of indemnity cannot be applied in this policy. However it becomes necessary to apply some yardstick for fixing the sum insured so that human lives are not overvalued for ulterior motives. Hence the capital sum insured is restricted to 72months income from gainful employment. This means that income from property, shares etc. will not be taken into account. For non working spouse, the sum insured is restricted to 50% of the sum insured of earning spouse subject to a maximum of Rs. 1,00,000/- and for dependent children to 25% of the sum insured of earning parents subject to a maximum of Rs.
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50,000/-. In case of Gramin Personal Accident, Student Safety, Raj Rajeshwari, Bhagyashree policies the sum insured is fixed. In Individual Personal Accident policy, facility of cumulative bonus is given whereby the capital sum insured is increased by 5% every year on claim free renewals subject to a maximum of 50%. This cumulative bonus is available only under tables A, B & C.
3.12 THE TOP ACCIDENTAL INSURANCE COMPANIES PROVIDING ACCIDENT POLICIES
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I IC CI IC CI IL LO OM MB BA AR RD DG GE EN NE ER RA AL LI IN NS SU UR RA AN NC CE E Personal Protect
Coverage for permanent total disablement or death owing to an accident. Customized coverage and choice of sum insured ranging from INR 3 lakh to 25 lakh. Optional coverage facilities for daily allowance and overall expenses of hospitalization due to accident.
A AP PO OL LL LO OM MU UN NI IC CH HH HE EA AL LT TH HI IN NS SU UR RA AN NC CE E Individual Personal Accident Plan
Lump sum payment in case of death from an accident. Weekly allowance for temporary total disablement. 50% of sum insured in case of permanent total disablement. Compensation of medical expenses in case of hospitalization due to accident. Educational bonus for a maximum of 2 children. Lump sum payment in case of bone fracture from accident. Repayment of hospital transfer expenses for an immediate family member in case of permanent total disablement or accidental death.
S ST TA AR RH HE EA AL LT TH HI IN NS SU UR RA AN NC CE E Accident Care
Coverage for accidental death or permanent or partial disability due to an accident. Travel costs of 1 relative covered. Weekly benefits for temporary total disability.
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Cumulative bonus. Educational grant for 2 children. Medical expenses covered upon payment of extra premium.
R RE EL LI IA AN NC CE EG GE EN NE ER RA AL LI IN NS SU UR RA AN NC CE E Reliance Individual Personal Accident Insurance Policy
Quick provision of policy in case of online applications. Convenient and simple claims procedures. Less paper work and substantial coverage. Compensation provided to family in case of disablement or death of policyholder. Choice of features.
H HD DF FC CE ER RG GO O Personal Accident Insurance
The maximum age for entry is 65 years. Sum insured range - INR 2.5 lakh to INR 15 lakh. Coverage for family as well. Worldwide coverage. The plan also covers the following situations resulting from an accident: Burns. Ambulance expenses. Broken bones. Daily cash payments for hospitalization in case of sickness and accidents. Death or permanent disability due to accident. Oriental Insurance. Personal Accident Insurance. Covers rail, air, and road accidents. Covers snake bite, dog bite, or frost bite.
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Covers injuries owing to fall or collision. Covers burn injury, poisoning, and drowning.
3.13 CLAIM SETTLEMENTS PROCEDURE
In the event of an accident giving rise to a claim the following steps should be taken:In case of death claim:1. Assignee under the policy should immediately notify the policy issuing office. 2. Submit the claim form along with death certificate, post mortem report, police report and original policy.
In case of injury claim:1. Notify the policy issuing office immediately. 2. Submit Police report if any. 3. Submit claim form along with medical certificate certifying the disablement. 4. In case medical expenses extension has been taken, then the prescription along with bills are to be submitted.
Here are some important points, which would help you in the claims procedure.
1. The loss or damage should be reported to the insurer immediately. 2. On receipt of claim intimation, the insurer will forward a claim form. 3. Submit the completed claim form along with an estimate of the loss to the insurer. It is preferable to submit an itemized estimate with separate values. 4. The insurer will arrange for inspection of the damaged items to assess the loss. In case of major losses, a specialist-licensed surveyor is deputed. 5. The insured has to provide the required documents to substantiate the extent of loss.
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6. In case the cause of loss is not established, it is for the insured to prove that the loss or damage has occurred due to an insured peril. 7. On agreement of claim amount between the insured and the insurer, the claim is settled.
3.14 DOCUMENTS NEEDED TO MAKE A CLAIM
The documents required for processing a claim are as follows: For Accidental Death
• Claim Form.
• Attested Copy of FIR. • Attested copy of PM (Post-mortem) report. • Attested/Original Death certificate. • Indemnity cum declaration bond. • No objection certificate.
For Permanent Total Disablement (PTD) Due To Accident
• Claim form.
• Attested copy of FIR - (Not mandatory). • Doctor certificate of disability. • Photograph of the injured with reflecting disablement, Medical bills with prescriptions/ treatment
For Accidental Hospitalization Reimbursement Expenses
• Policy copy.
• Claim form duly filled & signed by claimant. • F.I.R and Panchnama wherever applicable (original or certified copies). • Medical & Investigation report. • Prescriptions.
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• Medical and Investigation Bills. • Discharge Card.
3.15 DIFFERENT MODES OF PAYMENT
There are 5 payment options to pay premium online:
Credit Card – Make secure premium payment with your VISA, Master and AMEX card. Avail EMI. Net banking - Transfer premium amounts online through ICICI Bank and 9 other select Banks. Bill Pay – Use your ICICI Bank Internet Banking account to pay your Motor Insurance premium. Debit Card – Just enter your Citibank Debit Card details to pay your insurance premium directly. Cash Card - Use your Done Card to make payment online.
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? It was found that accidental insurance is equally important for us as well as for family. ? In case of death term plan will help family to cope up with financial hardship but what about an accident where one looses body parts & that impacts his earning abilities. In such situation Accidental Insurance can be very helpful. ? As we know most of the insured are salaried persons traveling between locations to earn their livelihood or for other necessary purposes the chances of them facing an accident are greater than before, so the present situation necessitates that people place more importance on these policies than the life and health insurance policies . ? Accidents can occur any time since life is uncertain. In order to reduce the burden of an accident most of the insurance companies in India have come up with numerous accident insurance policies. Accident insurance policies do not only help the insured to clear his /her hospital and medical bills but they also provide money to the family members in the event of death of the insured and There are a few insurers that provide special facilities such as education bonus for children. ? Insurance company provide two type of policy that is
Individual Accidental Insurance policies can be availed by anyone and often benefit the children and partners of the insured as well. The group accidental insurance policies are normally availed by employers to cover the accident related expenditure of their employees.
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I can say that an accident policy not only provide benefit to insured but their family members also. The insurance policy offers the various insurance policies covering the risk of various stages of life of any person in case of accident (term and conditions apply). Covering the risk is become so important and necessary for any person. In the present scenario the life is becoming so risky due to the innovation of the various latest technology and modern way of livings. Insurance products available for life and non-life are many. In non-life, apart from personal covers such as accident covers and health insurance, there are products covering liabilities under a particular law and or common law. An insurance contract promises to make good to the insured a certain sum in consideration for a payment in the form of premium from the insured. Human life cannot be valued; hence the sum assured is by way of a „benefit? in the case of accident insurance. If we see the percentage of persons having accident insurance policies then 60% person having the accident insurance policy and 40% person don?t have. If we see the satisfactory level of insurance policy then 56% insurance policy holder is satisfied followed by 44%of unsatisfied insurance policy holder. The conclusion of this project report is accident insurance is the necessary and considerable factor for any person for covering the risk of life and for future security.
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Chapter 6
? CASE STUDY ON NEW INDIA ASSURANCE CO LTD ? INTRODUCTION OF THE NEW INDIA ASSURANCE CO LTD. ? HISTORY OF THE COMPANY. ? BOARD OF DIRECTORS OF COMPANY. ? FINANCIAL RATING. ? PRESENT POSITION. ? REWARDS. ? PRODUCT PROVIDED BY THE COMPANY.
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6.1 CASE study
New India Assurance Co Ltd v/s Hardip Singh & Others – II (2003) CPJ 103 (NC).
An insurance company independently challenge the award under a professional indemnity policy During a gall bladder surgery, Mohinder Kaur developed ventricular tachycardia, followed by ventricular fibrillation. She suffered cardiac dysrhythmia and went into coma due to medical negligence, becoming bedridden at the age of 45. A case was filed against the surgeon, the an aesthetist and the hospital. The insurance company was a party to the proceedings. The District Forum awarded a compensation of Rs 2 lakh, payable by the insurance company on behalf of the doctors under the professional indemnity policy. This was challenged in appeal before the State Commission, which upheld the Forum?s order. The doctors did not continue further litigation, but the insurance company filed a revision petition before the National Commission. Observing that it was incumbent on the insurance company to indemnify doctors under the professional indemnity policy by paying the amount awarded by the consumer for a, the commission stated the challenging of the order by the insurance company without rhyme or reason is neither proper nor desirable. The commission expressed deep anguish that such petitions were being filed. It observed that such cases are not meant to be fodder for the legal department and the insurance company cannot go on a spree in filing such petitions. The commission stated it was restraining itself this time, but warned that if such petitions are filed in future, heavy cost would be imposed. The agony of a consumer must end at some stage. It is the duty of the insurance company to see that frivolous cases were not filed so as to clog the wheels of justice, which result in wastage of time. While dismissing the revision petition, the commission directed the order be sent to the chairman-cum-managing directors of all insurance companies. [New India Assurance Co Ltd v/s Hardip Singh & Others – II (2003) CPJ 103 (NC)]
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6.2 INTRODUCTION OF THE NEW INDIA ASSURANCE CO LTD
New India is a leading global insurance group, with offices and branches throughout India and various countries abroad. The company services the Indian subcontinent with a network of 1068 offices, comprising 28 Regional offices, 393Divisional offices and 648 branches. With approximately 21000 employees, New India has the largest number of specialist and technically qualified personnel at all levels of management, who are empowered to underwrite and settle claims of high magnitude. New India has been rated "A-" (Excellent) by A.M.Best Co., making it the only Indian insurance company to have been rated by an international rating agency. Rating based on following factors:
? ? ?
Superior Capital Position Strong Operating Performance Only Company to develop significant International operations, long record of successful trading outside India.
6.3 HISTORY
Established by Sir Dorab Tata in 1919, New India is the first wholly Indian owned insurance company in India. With a wide range of policies New India has become one of the largest non-life insurance companies, not only in India, but also in the Afro-Asian region.
6.3 BOARD OF DIRECTORS
Shri G. Srinivasan
Chairman cum Managing Director
Mr. Arvind Kumar
IAS,Government Nominee Director.
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6.5 FINANCIAL RATING
For the sixth consecutive year, the Company has been rated as "A-" (Excellent) by M/s. A.M. Best Europe Ltd. The rating reflects Company's excellent risk adjusted capitalization, prospective improvement in underwriting performance and its leading business profile in the direct insurance market in India. A partially off-setting factor is the Company's reliance on investment income which counter balances underwriting losses. A.M. Best believes the Company's risk adjusted capitalization is excellent and anticipates that it will remain sufficient to absorb the likely growth in the net premium. The Company is likely to maintain its leading business position as the largest direct insurer in India, despite increased competition from private players.
Rated As "A - (Excellent)"" By A.M. Best The New India Assurance Co. Ltd
6.6 PRESENT POSITION
Gross Premium (in India) of Rs. 8542.86 crores in the year 2011-2012, as against Rs. 7097.14 crores in the year 2010-2011. Assets Rs. 42162.74 crores as on 31st March 2012. Network of Offices-28 Regional Offices, 5 Large Corporate Offices, 400 Divisional Offices, 588 Branches, 26 Direct Agent Branches and 149 Micro Offices. Rank No. 1 in the Indian market. Largest Non-Life insurer in Afro-Asia excluding Japan. First Indian non-life company to reach Rs. 10073.88 crores Gross Premium. Global Japan, Re-insurance facilities. Over-seas presence in countries like U.K, Middle East, Fiji and Australia.
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6.7 PRODUCTS:
Personal Insurance
? Pravasi Bharatiya Bima Yojana Policy ? Mediclaim 2007 policy ? Family Floater Mediclaim Policy ? Janata Mediclaim Policy ? Senior Citizen Mediclaim Policy
? PERSONAL ACCIDENT POLICY
? Overseas Mediclaim Policy ? Householders Policy ? Motor Policy ? Money Insurance ? Rasta Apatti Kavach (Road Safety Insurance) ? Suhana Safar Policy ? TV/VCR/VCP Insurance ? Mobile/Cellular Phone Insurance ? Other Personal Insurance ? Group Mediclaim Policy
Commercial Insurance
Industrial Insurance
Liability Insurance
Social Insurance
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NIA-Indian Assurance Even In Japan
30th September, Source: Financial Express
Japan is the 2nd largest non-life insurance market in the world, after the USA. There are 32 Japanese companies and 21 foreign companies operating in Japan. The market share of 21 foreign companies is just over 4.5%. There is only one company that has kept the flag of the Indian and Asian insurance industry high for more than 5 decades in the highly competitive market- The New India Assurance Co. Ltd. One of the major business operations of the company in Japan is to assist the Indian office in procuring business emanating from Japanese companies that undertake projects in India. New India Japan is approached by not only Japanese companies but also by Japanese insurance companies whose clients are in the process of acquiring interest in India, for guidance. Its gross premium income in 2002-03 was Yen 3.8 billion (Rs.153 crore), which was 15 percent higher than the previous year. The company made a profit around Yen 40 million (Rs.1.64 crore) during the year, all this despite a nearly zero growth and zero interest economy and continuing recession in Japan. New India writes all classes of traditional non-life insurance business and more than 95% of its business is derived from Japanese clients through its agents network.
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Q.1) DO YOU PROVIDE ACCIDENT INSURANCE? Ans) Yes, our company provides all types of general insurance including accident insurance. Q.2) TO WHAT EXTENT YOUR COMPANY PROVIDES THIS POLICY? Ans) As per the liability of the insurer. Q.3) WHAT IS THE MATURITY OF THE ACCIDENT INSURANCE? Ans) For all policy maturity period is 1 year after that you have to renew your policy. Q.4) WHAT DO YOU COVER IN ACCIDENT INSURANCE? Ans) Uncertain events. Q.5) HOW MUCH PEOPLE OR POPULATION APPLY FOR ACCIDENT INSURANCE? Ans) Approximately 60% . Q.6) WHAT ARE THE TYPES OF ACCIDENT INSURANCE? Ans) Personal Accident Policy. Q.7) WHAT IS THE PREMIUM RATE FOR ACCIDENT INSURANCE?
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Premium is depends on the types of accident insurance and risk involve it. Q.8) PROGRAMS RELATED TO THIS INSURANCE? Ans) we provide internal training. Q.9) WHAT IS THE CLAIM SETTLEMENT PROCESS? Ans)
? Intimate insurance company inmates. ? Fill up claim forms. ? Estimate losses. ? Submit the book of account. ? Repairs bill calculated. ? Co-operate with surveyors. ? Submit required documents in time. ? Inform to policy authority if required.
Q.10) HOW YOU MANAGE THE RISK? Ans) ? Assigning or evaluate the proposal. ? Check the risk prone areas. e.g- in case of flood insurance lower areas effected more.
Q.11) IT IS NECESSARY TO TAKE THIS POLICY? Ans) yes, if you want to reduce risk or expenses of uncertain event then yes it is necessary to take.
Q.12) ARE THERE ANY INTERMEDIARY FOR TAKING UP OF ACCIDENT INSURANCE. Ans) No.
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BOOKS:
1.General Insurance Year Book - A Ready Referncer of Non Life Insurance Industry in India Author : Dr. Rakesh Agarwal (Ed.) 2. Principles of Insurance Law Author : M.N.Srinivasan, revised by Dr. Avtar Singh
WEBLIOGRAPHY:http://articles.economictimes.indiatimes.com/2011-06-13/news/29653453_http://www.monash.edu.au/miri/research/reports/muarc255.pdfhttp://business.mapsofindia.com/insurance/policies/
http://www.newindia.co.in/#maincontenthttp://business.mapsofindia.com/insurance/pol icies/accident-insurance-policy.html
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doc_309477718.docx
Chapter 1
Introduction To Insurance:
? ? ? ? ? ? Introduction Meaning of insurance. Definition of insurance. Features of insurance Important Elements of insurance. Advantages and Disadvantages of Insurance. ? Types of Insurance.
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1.1 INTRODUCTION
Insurance is the equitable transfer of the risk of a loss, from one entity to another in exchange for payment. It is a form of risk management primarily used to hedge against the risk of a contingent, uncertain loss. An insurer, or insurance carrier, is a company selling the insurance; the insured, or policyholder, is the person or entity buying the insurance policy. The amount to be charged for a certain amount of insurance coverage is called the premium. Risk management, the practice of appraising and controlling risk, has evolved as a discrete field of study and practice. The transaction involves the insured assuming a guaranteed and known relatively small loss in the form of payment to the insurer in exchange for the insurer's promise to compensate (indemnify) the insured in the case of a financial (personal) loss. The insured receives a contract, called the insurance policy, which details the conditions and circumstances under which the insured will be financially compensated
1.2 MEANING
“Insurance in broad terms may be described as a method of sharing financial losses of few from a common fund that are equally exposed to the same loss.”
1.3 Definition of Insurance
“A contract (policy) in which an individual or entity receives financial protection or reimbursement against losses from an insurance company. The company pools clients' risks to make payments more affordable for the insured”.
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1.4 FEATURES OF INSURANCE
? Insurance (excluding life insurance which tends to pay after certain period of time) is not an investment rather it is a hedge against the future probable losses. ? It gives you the comfort that in the event of any loss from unforeseen events will be compensated by the insurance companies. ? One has to pay premiums regularly to the companies providing insurance in order to enjoy the benefits of insurance. ? It can be of many types like life insurance, fire, marine, health insurance and so on and one can take any of the above polices depending on the risk with which an individual is exposed to. ? Insurance policies can be modified and offered to people depending on their risk profile and the need of the insurer. ? There is a limit to the amount by which an insurance company will compensate for the loss incurred by the insurer. The amount is mentioned in the insurance policy and the more the amount of insurance cover the more will be the premium which one has to pay to the company. ? A person can take more than one policy, in other words there are no restrictions on the number of policies which one can take.
1.5 IMPORTANT ELEMENTS INVOLVED IN THE CONCEPT OF INSURANCE
? SUBJECT MATTER OF INSURANCE….. Subject matter is property, human life, machinery, goods etc.,
? THE PERIL (RISK)…..
Peril is fire, storm, burglary, earth quake, injury,
Explosion etc. ? THE FINANCIAL LOSS….. Contract is signed. Financial loss is normally defined before the
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1.6 ADVANTAGES OF INSURANCE
? Removal of uncertainties :Insurance company takes the risks of large but uncertain losses in exchange for small premium. So it gives a sense of security, which is real gift to the business man. If all uncertainty could be removed from business, income would be sure. Insurance removed many uncertainties and to that extent is profitable.
? Promotion of saving :Saving is a device of preparing for the bad consequences of the future. Insurance policy is often very suitable way of providing for the future. This type of policy is found particularly in life assurance. It promotes savings by making it compulsory which have a beneficial effect both for the individual and nation.
? Reduction of the chances of loss :Insurance companies spend large sums of money with a view to finding out the reasons of fire accidents, theft and robbery and suggest some measures to prevent them. They also support several medical programmers in order to make the public safety minded. Without such losses preventive activities of insurance companies, the chances of loss would have been greater than they are at present days.
? Solution of social problems :Insurance serves as a useful device for solving complex social problems e.g. compensation is available to victims of Industrial injuries and road accident while the financial difficulties arising from old age, disability or death are minimized. It thus enables many families and business units to continue intact even after a loss.
? Productive utilization of fund :Insurer accumulates large resources from the various insurance funds. Such resources are generally invested in the country, either in the public or private sector. This facilitates considerably in over all development of the economy.
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? Removing fear :Insurance helps to remove various types of fear from the mind of the people. The insured is secured in the knowledge that the protection of the insurance fund is behind him if some sad event happens. It thus creates confidence and eliminates a worry which is difficult to evaluate, but the benefit is very real. ? Dividends enable growth:-
Customary policies enable prospect to share in the monetary increase without taking
the risk of investment. The investment revenue is shared out among the policyholders through yearly announcement of bonus and/or dividends. ? Risk guard:Because life is filled with uncertainties, life insurance guarantees that your dear ones continue to have monetary back up in case of any unexpected incident that may lead to your detriment or demise. ? Tax benefits: Insurance plans offer tax-benefits that are appealing for both at the entry and exit period under the majority of the plan.
1.7 Disadvantages of Insurance
? Inconsistent premiums:Most policies contain mandatory premiums that increase in due course. For an insured on a budget, who desires to buy coverage adequate to profit his relations upon his decease, this policy can be quite costly. The unstable inflation guarantees a steep climb. ? Deduction of funds:-
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While policies include conditions in which shares from cash accounts can be used to disburse premiums, such a request practically always results in deducting funds from the cash value / investment account.
? Insufficient funds:There is a lack of assurance that ample finance will be accessible to cover unpaid premiums when the policyholder holds inadequate funds.
? Expiration of term insurance:This kind of insurance in not permanent; it is either for a fixed number of years or until a certain age. On completion of the term or when the insured reaches a certain age the policy expires compelling them to qualify for another insurance program, which may require higher premium depending on the age and other factors.
? Language of premium:It is usually difficult to resolve precisely how costly commissions truly are. The cost is commonly concealed within the fine print of the terms and conditions, and it is normally explained in language that is complex for someone who is unfamiliar to insurance policies
1.8 TYPES OF INSURANCE
In general, there are 2 major types of insurance - general insurance and life insurance. However, some other types of insurance are available as well. In India life insurance is the most availed form along with health and accident based plans.
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Insurance Policies – Categorization
? Personal Insurance
Personal insurance is essentially a plan availed by an individual to take care of various requirements like health and coverage against death or injury by accident. There are several policies nowadays where there is an option to cover the family members in an individual policy.
TYPES OF PERSONAL INSURANCE:
? Medical Insurance. ? Accidental Insurance. ? Property Insurance. ? Vehicle Insurance. 7
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? Rural Insurance
Rural insurance is meant to cater to the requirements of rurally bases businesses or individuals. These policies provide a wide range of coverage starting from life and health to protection against natural disasters that can have a negative effect on business.
? Industrial Insurance
The industrial insurance policies are availed by various companies to get protection for important projects, construction, contracts, and equipment from situations like fire, theft and any form of damage or loss.
? Life Insurance
Life insurance is taken primarily to secure oneself and/or one's family when the ability to earn is less or provide for the dependents when the insured is either deceased or unable to earn a livelihood.
? Whole Life Insurance
Whole life insurance policies are taken for the entire duration of an insured's life. In these policies premium has to be paid on a yearly basis as long as the policy lasts.
? Endowment Plans
The endowment plans are supposed to provide a lump sum once the policyholder dies or when the policy matures. Certain endowment policies also provide payment in case of critical illnesses.
? ULIPs
The ULIPs or Unit Linked Insurance Plans are one where the financial worth of a policy is dependent on the present net asset value of the core investment assets related to it. These policies are both flexible and protective, which is a unique feature. The premiums of these policies are used to buy investment asset units selected by the policy owners.
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Chapter 2
LITERATURE REVIEW
Health Insurance coverage-without any option By: R.Kantsharma | Sep 11, 2006 01:50 PM Health Insurance is a concept which is widely accepted by Indian public, who dare not to meet high medical expenses. Sometimes employers cover them under Group Insurance Policies but rests of the people who are in business or in profession are required to take care of their health expenses. A health insurance policy is a
contract between an insurer and an individual or a group, in which the insurer agrees to provide specified health insurance at an agreed-upon price the premium. Depending on the policy, the premium may be payable either in a lump sum or in installments. Health insurance has become a necessity in today?s world considering the rise in the cost of medical care and treatment and the huge population of the country. The escalating cost of medical treatment today is beyond the reach of the common man. Even if an individual is healthy and has never had any major problem, it is not possible to predict what may happen in the future. There is a growing public awareness for better health care and desire to have better health care from private medical providers. In case of a medical emergency, cost of hospital room, doctor?s fees, medicines and related health services all add up to a huge sum. In such times, health insurance provides the much needed financial relief. In anticipation of unexpected events that create the need for medical goods and services, the health insurance does not cover certain ailments. It is very important to know what your policy covers and what you have to pay yourself. Health Insurance policies generally cover boarding, nursing and diagnostic expenses, which include room rent charged at the hospital or nursing home, fees of the surgeon, anesthetist, doctor, etc. Some policies even offer fixed cash amount for each day you stay at any hospital for treatment. Expenses on hospitalization, incurred in the first 30 days after taking a policy are also not entitled, except in case of an injury from accident. Treatment of certain diseases is not covered during the first year of your policy. The list of diseases may vary from one health policy to another.
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Chapter 3
3. FIELD STUDY
“Better Safe than Sorry”
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3.1 Introduction of Accident Insurance. 3.2 Meaning of Accident Insurance. 3.3. Definition of Accident Insurance. 3.4 Features of Accident Insurance. 3.5 Benefits of Accident Insurance. 3.6 Types of Accident Insurance. 3.7. Accident Insurance Policies 3.8 Accidental Insurance Policy Premiums 3.9 Age Limit For Taking This Policy 3.10 Coverage Details of Accidental Insurance Policies. 3.11 Selection Of The Sum Insured 3.12 Top Accidental Insurance Companies 3.13 Claim Settlements Procedure 3.14 Documents Required For Settlement Of Claim. 3.15 Different Modes Of Payment
3.1 INTRODUCTION
Accidental insurance is one of the most ignored insurance categories in India. As we all know majority people buy insurance either for tax planning or investment purpose but unfortunately both these benefits are not available in Accidental Policy. But does that mean you should not buy accidental Insurance. Insurance is the foundation of any financial life – a person who is having dependents must first completely insure himself & then only should start thinking about investments. We should know that term plan is not for us but for our family and medical insurance is for us. So one should buy term plan when he is having
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dependents but medical insurance is must for everyone. If we talk about accidental insurance it is equally important for us & family. When I bought my first vehicle; my mom advised drive safe these days accidents are increasing – hope you would have received similar advice from your parents or given to your kids. Impact from accident can be as small as a scratch to as big as death – impact can be temporary or sometime even permanent. Accidental insurance policy covers this risk but first check the definition of accident. “Accident or Accidental means a sudden, unforeseen and unexpected event caused by external, violent and visible means (but does not include any illness or disease) which results in physical bodily injury (but does not include mental, nervous or emotional disorders, depression or anxiety)". Accidental Insurance also excludes suicides, self injury, armed force operations, war etc. In case of death term plan will help family to cope up with financial hardship but what about an accident where one looses body parts & that impacts his earning abilities. In such situation Accidental Insurance can be very helpful.
3.2 Meaning
Accident or Accidental means a sudden, unforeseen and unexpected event caused by external, violent and visible means (but does not include any illness or disease) which results in physical bodily injury (but does not include mental, nervous or emotional disorders, depression or anxiety). Accidental Insurance also excludes suicides, self injury, armed force operations, war etc. In case of death term plan will help family to cope up with financial hardship but what about an accident where one looses body parts & that impacts his earning abilities. In such situation Accidental Insurance can be very helpful.
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“Insurance coverage against loss by accidental bodily injury. These insurance policies pay out a sum of money when an accident occurs. The amount paid out depends on the injury, and policy documents will detail amounts paid for different injuries or death”.
3.4 FEATURES OF ACCIDENTAL INSURANCE
Yearly Contract: Similar to term plan & medical insurance – accidental insurance is also yearly contract that you can renew every year. Maximum Insurance: It depends on your income – some insurance companies give 60-100 times of your monthly income others give 8 to 10 times of your yearly income. For Non Earning Members: Few insurance companies provide accidental insurance to dependents but have limitation in sum assured. 25% to 50% of the proposers sum insured with maximum limits in rupee terms
3.5 BENEFITS OF ACCIDENTAL INSURANCE
? Now days there are several term plans that offer financial benefits in case of the death of the insured and the health plans always come in handy if the insured is hospitalized due to some reason.
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? These plans also offer accident related benefits. However, experts feel that the benefits available on these plans are not as good as independent accident insurance plans. They opine that since most of the insured are salaried persons traveling between locations to earn their livelihood or for other necessary purposes the chances of them facing an accident are greater than before. According to them, the present situation necessitates that people place more importance on these policies than the life and health insurance policies. They also point out that these policies are pretty inexpensive as well.
? Nowadays, on an average, accidental insurance cover of INR 10 lakh can be availed by paying a premium of 800-1500 rupees a year. The premium normally varies depending on the benefits being provided in the plan as well as the company that is providing the same.
The accidental insurance policies also cover the non earning members or dependents of the insured. However, the payment provided for them is part of the insured sum.
? With Personal Protect Insurance, you avail the following
benefits:
• Cover against Accidental Death or Permanent Total Disablement (PTD) on account of an Accident. • Optional Cover against Accidental Hospitalization Expenses and Accidental Hospital Daily Allowance. • Covers different types of accidents like road, rail accidents, accidents due to natural calamities and arising out of terrorism/ terrorist acts.
• No health check up required.
• Easy Claim Process with minimal documentation. • Digitally signed policy available 24X7 online.
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3.6 TYPES OF ACCIDENTAL INSURANCE
The accidental insurance policies can be broadly categorized into the following:
Individual Accidental Insurance
These policies can be availed by anyone and often benefit the children and partners of the insured as well. These policies have some restrictions when it comes to covering a certain kind of activities like various types of adventure sports and cover for both death and various forms of disability owing to an accident.
Group Accidental Insurance
The group accidental insurance policies are normally availed by employers to cover the accident related expenditure of their employees. A variant of these policies is the team accidental insurance policies that are used to cover sports teams.
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3.7 ACCIDENT INSURANCE POLICIES:Accidents can occur any time since life is uncertain. In order to reduce the burden of an accident most of the insurance companies in India have come up with numerous accident insurance policies. Accident insurance provides assistance to the insured when he or she meets with an accident and suffers certain injuries. Accident insurance policies do not only help the insured to clear his /her hospital and medical bills but they also provide money to the family members in the event of death of the insured.
Below is a list of some of the important Accident Insurance Policies in India. Accident Shield: Accident Shield by Royal Sundaram is currently one of the
most popular online accident policies today. The policy is a worldwide plan that covers the individual from unforeseen events that lead to total disability, death and partial disability. The policy only covers the person insured.
Key Features of the Policy
? Any person between the ages of 18 years to 70 years can opt for this policy ? No medical examinations are required to avail this policy ? The policy offers three types of plans Silver, Gold and Platinum. ? The policy offers grants for education for two children up to Rs 10,000 per policy. ? The policy offers hassle free claims. ? Individual Personal Accident Plan: The Individual Personal Accident plan by Apollo Munich is another important accident insurance plan. Known for its umpteen benefits this plan does not only cover the individual but his or her family too. The policy assures compensation due to an unforeseen event that result in bodily injuries or death.
? ?
The policy covers people between the age group of 5 - 70 years. The plan is for tenure is for a period of one year
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? ?
In case of death a lump sum amount is paid to the nominee of the insured. In case of Temporary Total Disablement the insured is entitled to a weekly allowance.
Personal Accident Insurance policy: ICICI Lombard's Personal
Accident Insurance policy is also a popular accident policy. The accident policy provides coverage against Death, Accidental and Permanent Total Disablement. This is a worldwide policy and provides immediate assistance to the insured in any part of the world.
Key Features of the
Policy
? ? ? ?
The minimum entry age to avail benefits of this policy is 18 years and the maximum age is 70 years. The policy does not compensate claims arising from ailments. The policy provides a customized coverage which allows you to select between Rs 10,000 Lakh, Rs 20,000 The nominee of the policy is compensated with the entire amount in the event of death of the insured within the policy tenure.
Accidental Insurance Policy
The accidental insurance policies provide a wide range of benefits such as coverage against death by accident or total and permanent and total disablement occurring due to such a situation. These plans provide optional coverage facilities in case of expenses incurred due to accidental hospitalization. They also provide the insured daily expenses in such cases.
Yet another benefit of these programs is that they provide customized coverage whereby the insured can opt for an amount as per his or her convenience or requirement.
3.8 ACCIDENTAL INSURANCE POLICY PREMIUMS
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The premiums of these policies do not depend on the age of the insurer. The main factors in these policies are the type of job being done by the insurer and the overall working conditions. Following
are some professions that are
considered less risky:
Doctors. Bankers. Engineers. Accountants.
Laborers are normally regarded as medium risk propositions. Some professions that are regarded as very risky may be mentioned below:
Underground workers in mines. Mountaineers, bungee jumpers, and rock climbers. Jockeys and people working in circuses. Top Accidental Insurance Policies.
3.9 AGE LIMIT FOR TAKING THIS POLICY
Any adult residing in India can take the policy covering him / her and dependent family members between the ages of 5 and 70yrs.
3.10 COVERAGE DETAILS OF ACCIDENTAL INSURANCE POLICIES
? ? IIT TC CO OV VE ER RE ED D
In case the insured passes away due to an accident (death), an accidental insurance policy will pay the total sum assured to the nominee. There are a few insurers that
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provide special facilities such as education bonus for children. However, there is a specified number in these cases. In case the insured is permanently disabled for life owing to an accident he or she receives the total sum assured. There are a few companies that make additional payment in such case that include the following situations:
? Loss of both hands and feet. ? Loss of a limb and an eye. ? Loss of a hand or feet. ? Loss of sight in both eyes or hearing in both the ears and the ability to speak.
If the insured suffers permanent partial disablement then only a certain amount of the sum insured is paid to him or her and the payment is normally done on a monthly or weekly basis. The following situations are covered: ? Loss of thumb or index finger. ? Loss of sight in one eye. ? Loss of hearing in one ear. ? Loss of one hand. In case the insured has been completely disabled for a certain period of time in the future and is not able to earn the companies pay a certain percentage of the sum insured. These situations are referred to as temporary permanent disablement and carry a cap as in a certain upper limit for payment. Following are certain situations that are considered in these cases: ? Fractured limbs. ? Bed rest for an ensuing period of 3 months. ? Additional Benefits of Accidental Insurance Policies.
?N NO OT TC CO OV VE ER RE ED D
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The accidental insurance policies do not provide coverage in case of death or disability due to any of the following situations:
The Company shall not be liable under this policy for:
Compensation / Claim under both Cover 1 and Cover 2 as mentioned above. Claims arising from sickness/illness.
Death, injury or disablement of Insured Person as a result of
Intentional self injury, attempted suicide, or suicide. Pre-existing physical or mental condition. In a drugged or intoxicated state Crew and pilots of aircraft, member of armed forces, or artists who take part in dangerous activities. Breaking law with a criminal purpose. 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 kinds. Nuclear weapon induced treatment. Childbirth or pregnancy or in consequence thereof.
3.11 SELECTION OF THE SUM INSURED
It is very difficult to put a value to a human life. Hence the principle of indemnity cannot be applied in this policy. However it becomes necessary to apply some yardstick for fixing the sum insured so that human lives are not overvalued for ulterior motives. Hence the capital sum insured is restricted to 72months income from gainful employment. This means that income from property, shares etc. will not be taken into account. For non working spouse, the sum insured is restricted to 50% of the sum insured of earning spouse subject to a maximum of Rs. 1,00,000/- and for dependent children to 25% of the sum insured of earning parents subject to a maximum of Rs.
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50,000/-. In case of Gramin Personal Accident, Student Safety, Raj Rajeshwari, Bhagyashree policies the sum insured is fixed. In Individual Personal Accident policy, facility of cumulative bonus is given whereby the capital sum insured is increased by 5% every year on claim free renewals subject to a maximum of 50%. This cumulative bonus is available only under tables A, B & C.
3.12 THE TOP ACCIDENTAL INSURANCE COMPANIES PROVIDING ACCIDENT POLICIES
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I IC CI IC CI IL LO OM MB BA AR RD DG GE EN NE ER RA AL LI IN NS SU UR RA AN NC CE E Personal Protect
Coverage for permanent total disablement or death owing to an accident. Customized coverage and choice of sum insured ranging from INR 3 lakh to 25 lakh. Optional coverage facilities for daily allowance and overall expenses of hospitalization due to accident.
A AP PO OL LL LO OM MU UN NI IC CH HH HE EA AL LT TH HI IN NS SU UR RA AN NC CE E Individual Personal Accident Plan
Lump sum payment in case of death from an accident. Weekly allowance for temporary total disablement. 50% of sum insured in case of permanent total disablement. Compensation of medical expenses in case of hospitalization due to accident. Educational bonus for a maximum of 2 children. Lump sum payment in case of bone fracture from accident. Repayment of hospital transfer expenses for an immediate family member in case of permanent total disablement or accidental death.
S ST TA AR RH HE EA AL LT TH HI IN NS SU UR RA AN NC CE E Accident Care
Coverage for accidental death or permanent or partial disability due to an accident. Travel costs of 1 relative covered. Weekly benefits for temporary total disability.
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Cumulative bonus. Educational grant for 2 children. Medical expenses covered upon payment of extra premium.
R RE EL LI IA AN NC CE EG GE EN NE ER RA AL LI IN NS SU UR RA AN NC CE E Reliance Individual Personal Accident Insurance Policy
Quick provision of policy in case of online applications. Convenient and simple claims procedures. Less paper work and substantial coverage. Compensation provided to family in case of disablement or death of policyholder. Choice of features.
H HD DF FC CE ER RG GO O Personal Accident Insurance
The maximum age for entry is 65 years. Sum insured range - INR 2.5 lakh to INR 15 lakh. Coverage for family as well. Worldwide coverage. The plan also covers the following situations resulting from an accident: Burns. Ambulance expenses. Broken bones. Daily cash payments for hospitalization in case of sickness and accidents. Death or permanent disability due to accident. Oriental Insurance. Personal Accident Insurance. Covers rail, air, and road accidents. Covers snake bite, dog bite, or frost bite.
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Covers injuries owing to fall or collision. Covers burn injury, poisoning, and drowning.
3.13 CLAIM SETTLEMENTS PROCEDURE
In the event of an accident giving rise to a claim the following steps should be taken:In case of death claim:1. Assignee under the policy should immediately notify the policy issuing office. 2. Submit the claim form along with death certificate, post mortem report, police report and original policy.
In case of injury claim:1. Notify the policy issuing office immediately. 2. Submit Police report if any. 3. Submit claim form along with medical certificate certifying the disablement. 4. In case medical expenses extension has been taken, then the prescription along with bills are to be submitted.
Here are some important points, which would help you in the claims procedure.
1. The loss or damage should be reported to the insurer immediately. 2. On receipt of claim intimation, the insurer will forward a claim form. 3. Submit the completed claim form along with an estimate of the loss to the insurer. It is preferable to submit an itemized estimate with separate values. 4. The insurer will arrange for inspection of the damaged items to assess the loss. In case of major losses, a specialist-licensed surveyor is deputed. 5. The insured has to provide the required documents to substantiate the extent of loss.
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6. In case the cause of loss is not established, it is for the insured to prove that the loss or damage has occurred due to an insured peril. 7. On agreement of claim amount between the insured and the insurer, the claim is settled.
3.14 DOCUMENTS NEEDED TO MAKE A CLAIM
The documents required for processing a claim are as follows: For Accidental Death
• Claim Form.
• Attested Copy of FIR. • Attested copy of PM (Post-mortem) report. • Attested/Original Death certificate. • Indemnity cum declaration bond. • No objection certificate.
For Permanent Total Disablement (PTD) Due To Accident
• Claim form.
• Attested copy of FIR - (Not mandatory). • Doctor certificate of disability. • Photograph of the injured with reflecting disablement, Medical bills with prescriptions/ treatment
For Accidental Hospitalization Reimbursement Expenses
• Policy copy.
• Claim form duly filled & signed by claimant. • F.I.R and Panchnama wherever applicable (original or certified copies). • Medical & Investigation report. • Prescriptions.
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• Medical and Investigation Bills. • Discharge Card.
3.15 DIFFERENT MODES OF PAYMENT
There are 5 payment options to pay premium online:
Credit Card – Make secure premium payment with your VISA, Master and AMEX card. Avail EMI. Net banking - Transfer premium amounts online through ICICI Bank and 9 other select Banks. Bill Pay – Use your ICICI Bank Internet Banking account to pay your Motor Insurance premium. Debit Card – Just enter your Citibank Debit Card details to pay your insurance premium directly. Cash Card - Use your Done Card to make payment online.
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? It was found that accidental insurance is equally important for us as well as for family. ? In case of death term plan will help family to cope up with financial hardship but what about an accident where one looses body parts & that impacts his earning abilities. In such situation Accidental Insurance can be very helpful. ? As we know most of the insured are salaried persons traveling between locations to earn their livelihood or for other necessary purposes the chances of them facing an accident are greater than before, so the present situation necessitates that people place more importance on these policies than the life and health insurance policies . ? Accidents can occur any time since life is uncertain. In order to reduce the burden of an accident most of the insurance companies in India have come up with numerous accident insurance policies. Accident insurance policies do not only help the insured to clear his /her hospital and medical bills but they also provide money to the family members in the event of death of the insured and There are a few insurers that provide special facilities such as education bonus for children. ? Insurance company provide two type of policy that is
Individual Accidental Insurance policies can be availed by anyone and often benefit the children and partners of the insured as well. The group accidental insurance policies are normally availed by employers to cover the accident related expenditure of their employees.
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I can say that an accident policy not only provide benefit to insured but their family members also. The insurance policy offers the various insurance policies covering the risk of various stages of life of any person in case of accident (term and conditions apply). Covering the risk is become so important and necessary for any person. In the present scenario the life is becoming so risky due to the innovation of the various latest technology and modern way of livings. Insurance products available for life and non-life are many. In non-life, apart from personal covers such as accident covers and health insurance, there are products covering liabilities under a particular law and or common law. An insurance contract promises to make good to the insured a certain sum in consideration for a payment in the form of premium from the insured. Human life cannot be valued; hence the sum assured is by way of a „benefit? in the case of accident insurance. If we see the percentage of persons having accident insurance policies then 60% person having the accident insurance policy and 40% person don?t have. If we see the satisfactory level of insurance policy then 56% insurance policy holder is satisfied followed by 44%of unsatisfied insurance policy holder. The conclusion of this project report is accident insurance is the necessary and considerable factor for any person for covering the risk of life and for future security.
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Chapter 6
? CASE STUDY ON NEW INDIA ASSURANCE CO LTD ? INTRODUCTION OF THE NEW INDIA ASSURANCE CO LTD. ? HISTORY OF THE COMPANY. ? BOARD OF DIRECTORS OF COMPANY. ? FINANCIAL RATING. ? PRESENT POSITION. ? REWARDS. ? PRODUCT PROVIDED BY THE COMPANY.
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6.1 CASE study
New India Assurance Co Ltd v/s Hardip Singh & Others – II (2003) CPJ 103 (NC).
An insurance company independently challenge the award under a professional indemnity policy During a gall bladder surgery, Mohinder Kaur developed ventricular tachycardia, followed by ventricular fibrillation. She suffered cardiac dysrhythmia and went into coma due to medical negligence, becoming bedridden at the age of 45. A case was filed against the surgeon, the an aesthetist and the hospital. The insurance company was a party to the proceedings. The District Forum awarded a compensation of Rs 2 lakh, payable by the insurance company on behalf of the doctors under the professional indemnity policy. This was challenged in appeal before the State Commission, which upheld the Forum?s order. The doctors did not continue further litigation, but the insurance company filed a revision petition before the National Commission. Observing that it was incumbent on the insurance company to indemnify doctors under the professional indemnity policy by paying the amount awarded by the consumer for a, the commission stated the challenging of the order by the insurance company without rhyme or reason is neither proper nor desirable. The commission expressed deep anguish that such petitions were being filed. It observed that such cases are not meant to be fodder for the legal department and the insurance company cannot go on a spree in filing such petitions. The commission stated it was restraining itself this time, but warned that if such petitions are filed in future, heavy cost would be imposed. The agony of a consumer must end at some stage. It is the duty of the insurance company to see that frivolous cases were not filed so as to clog the wheels of justice, which result in wastage of time. While dismissing the revision petition, the commission directed the order be sent to the chairman-cum-managing directors of all insurance companies. [New India Assurance Co Ltd v/s Hardip Singh & Others – II (2003) CPJ 103 (NC)]
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6.2 INTRODUCTION OF THE NEW INDIA ASSURANCE CO LTD
New India is a leading global insurance group, with offices and branches throughout India and various countries abroad. The company services the Indian subcontinent with a network of 1068 offices, comprising 28 Regional offices, 393Divisional offices and 648 branches. With approximately 21000 employees, New India has the largest number of specialist and technically qualified personnel at all levels of management, who are empowered to underwrite and settle claims of high magnitude. New India has been rated "A-" (Excellent) by A.M.Best Co., making it the only Indian insurance company to have been rated by an international rating agency. Rating based on following factors:
? ? ?
Superior Capital Position Strong Operating Performance Only Company to develop significant International operations, long record of successful trading outside India.
6.3 HISTORY
Established by Sir Dorab Tata in 1919, New India is the first wholly Indian owned insurance company in India. With a wide range of policies New India has become one of the largest non-life insurance companies, not only in India, but also in the Afro-Asian region.
6.3 BOARD OF DIRECTORS
Shri G. Srinivasan
Chairman cum Managing Director
Mr. Arvind Kumar
IAS,Government Nominee Director.
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6.5 FINANCIAL RATING
For the sixth consecutive year, the Company has been rated as "A-" (Excellent) by M/s. A.M. Best Europe Ltd. The rating reflects Company's excellent risk adjusted capitalization, prospective improvement in underwriting performance and its leading business profile in the direct insurance market in India. A partially off-setting factor is the Company's reliance on investment income which counter balances underwriting losses. A.M. Best believes the Company's risk adjusted capitalization is excellent and anticipates that it will remain sufficient to absorb the likely growth in the net premium. The Company is likely to maintain its leading business position as the largest direct insurer in India, despite increased competition from private players.
Rated As "A - (Excellent)"" By A.M. Best The New India Assurance Co. Ltd
6.6 PRESENT POSITION
Gross Premium (in India) of Rs. 8542.86 crores in the year 2011-2012, as against Rs. 7097.14 crores in the year 2010-2011. Assets Rs. 42162.74 crores as on 31st March 2012. Network of Offices-28 Regional Offices, 5 Large Corporate Offices, 400 Divisional Offices, 588 Branches, 26 Direct Agent Branches and 149 Micro Offices. Rank No. 1 in the Indian market. Largest Non-Life insurer in Afro-Asia excluding Japan. First Indian non-life company to reach Rs. 10073.88 crores Gross Premium. Global Japan, Re-insurance facilities. Over-seas presence in countries like U.K, Middle East, Fiji and Australia.
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6.7 PRODUCTS:
Personal Insurance
? Pravasi Bharatiya Bima Yojana Policy ? Mediclaim 2007 policy ? Family Floater Mediclaim Policy ? Janata Mediclaim Policy ? Senior Citizen Mediclaim Policy
? PERSONAL ACCIDENT POLICY
? Overseas Mediclaim Policy ? Householders Policy ? Motor Policy ? Money Insurance ? Rasta Apatti Kavach (Road Safety Insurance) ? Suhana Safar Policy ? TV/VCR/VCP Insurance ? Mobile/Cellular Phone Insurance ? Other Personal Insurance ? Group Mediclaim Policy
Commercial Insurance
Industrial Insurance
Liability Insurance
Social Insurance
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NIA-Indian Assurance Even In Japan
30th September, Source: Financial Express
Japan is the 2nd largest non-life insurance market in the world, after the USA. There are 32 Japanese companies and 21 foreign companies operating in Japan. The market share of 21 foreign companies is just over 4.5%. There is only one company that has kept the flag of the Indian and Asian insurance industry high for more than 5 decades in the highly competitive market- The New India Assurance Co. Ltd. One of the major business operations of the company in Japan is to assist the Indian office in procuring business emanating from Japanese companies that undertake projects in India. New India Japan is approached by not only Japanese companies but also by Japanese insurance companies whose clients are in the process of acquiring interest in India, for guidance. Its gross premium income in 2002-03 was Yen 3.8 billion (Rs.153 crore), which was 15 percent higher than the previous year. The company made a profit around Yen 40 million (Rs.1.64 crore) during the year, all this despite a nearly zero growth and zero interest economy and continuing recession in Japan. New India writes all classes of traditional non-life insurance business and more than 95% of its business is derived from Japanese clients through its agents network.
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Q.1) DO YOU PROVIDE ACCIDENT INSURANCE? Ans) Yes, our company provides all types of general insurance including accident insurance. Q.2) TO WHAT EXTENT YOUR COMPANY PROVIDES THIS POLICY? Ans) As per the liability of the insurer. Q.3) WHAT IS THE MATURITY OF THE ACCIDENT INSURANCE? Ans) For all policy maturity period is 1 year after that you have to renew your policy. Q.4) WHAT DO YOU COVER IN ACCIDENT INSURANCE? Ans) Uncertain events. Q.5) HOW MUCH PEOPLE OR POPULATION APPLY FOR ACCIDENT INSURANCE? Ans) Approximately 60% . Q.6) WHAT ARE THE TYPES OF ACCIDENT INSURANCE? Ans) Personal Accident Policy. Q.7) WHAT IS THE PREMIUM RATE FOR ACCIDENT INSURANCE?
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Premium is depends on the types of accident insurance and risk involve it. Q.8) PROGRAMS RELATED TO THIS INSURANCE? Ans) we provide internal training. Q.9) WHAT IS THE CLAIM SETTLEMENT PROCESS? Ans)
? Intimate insurance company inmates. ? Fill up claim forms. ? Estimate losses. ? Submit the book of account. ? Repairs bill calculated. ? Co-operate with surveyors. ? Submit required documents in time. ? Inform to policy authority if required.
Q.10) HOW YOU MANAGE THE RISK? Ans) ? Assigning or evaluate the proposal. ? Check the risk prone areas. e.g- in case of flood insurance lower areas effected more.
Q.11) IT IS NECESSARY TO TAKE THIS POLICY? Ans) yes, if you want to reduce risk or expenses of uncertain event then yes it is necessary to take.
Q.12) ARE THERE ANY INTERMEDIARY FOR TAKING UP OF ACCIDENT INSURANCE. Ans) No.
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BOOKS:
1.General Insurance Year Book - A Ready Referncer of Non Life Insurance Industry in India Author : Dr. Rakesh Agarwal (Ed.) 2. Principles of Insurance Law Author : M.N.Srinivasan, revised by Dr. Avtar Singh
WEBLIOGRAPHY:http://articles.economictimes.indiatimes.com/2011-06-13/news/29653453_http://www.monash.edu.au/miri/research/reports/muarc255.pdfhttp://business.mapsofindia.com/insurance/policies/
http://www.newindia.co.in/#maincontenthttp://business.mapsofindia.com/insurance/pol icies/accident-insurance-policy.html
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