1% of sum insured as weekly income for 2 years, coverage for coma, 6 key features you must have in accidental policy Taking care of household becomes difficult and many people often end up spending their savings built over many years or have to sell their assets or at worst have to resort to big debt. This is where an accidental policy helps you afford a costly treatment and taking care of household expenses as well
People who survive near-fatal accidents may end up with temporary disabilities that make it impossible for them to rejoin work for a considerably long period. This would mean a loss of income as the options would be to take unpaid leave or quit the job during the rehabilitation period. While they may eventually recover from the physical damage, it becomes difficult to recover from financial damage caused by the loss of income. There is a way for you to blunt the impact of such a situation — build a financial support system using disability coverage. Read on to know the details.How an accidental policy offers vital critical coverage
A comprehensive health insurance policy may work well to help you get treatment in case of an accident. But these plans usually have a limited sum insured, and the trauma caused by an accident may require costly treatment for a prolonged period. To cover this expense, many often spend their savings built over many years, sell their assets or take expensive loans.
This is where an accidental policy can help you, by making the costly treatment affordable.
It is better to have additional coverage to deal with accidents either as a rider with a life insurance policy or a health insurance policy, or through a separate accidental coverage policy. “It supplements health insurance by specifically covering accident-related costs, like hospitalisation and treatment. Accidental coverage provides extra security for unforeseen events, reducing the burden on one’s primary health insurance. It’s a prudent step to safeguard against accidents and their financial implications,” says Rakesh Goyal, Director of Probus Insurance Broker.
Another financial burden during such periods is managing household expenses in the absence of a regular income. This can be stressful. Most health insurance policies will fall short of providing any meaningful financial support to take care of household-related expenses if the treatment needs a prolonged recovery period at home.
This is where weekly payout feature of accidental policy can help you in case of temporary total disability.
However not all accidental coverage policies have the critical benefits needed for adequate financial protection in such a situation. Here are the 6 important features that you can look for in an accidental coverage policy:
Critical features you must have in your accidental coverage policy
Features
HDFC ERGO my: health Koti Suraksha Personal Accident
ICICI Lombard Family Shield
Niva Bupa Personal Accident Plan
Sum Insured
Rs 50 lakh
Rs 50 lakh
Rs 50 lakh
Permanent Total Disability
Max up to Rs 50 lakh
Max up to Rs 50 lakh
100% or 50% of sum insured (SI)
Permanent Partial Disability
Max up to Rs 50 lakh
Max up to Rs 50 lakh
As per policy
Temporary Total Disability
Rs 50,000 per week for maximum 104 weeks
Rs 20,000 per week
Optional, earning members: 2% of base sum insured per week; Max. Rs 1 lakh per week; For max. 100 weeks
Non-earning members: 1% of base sum insured per week; Max. Rs 25,000 per week; For max. 50 weeks
Comatose benefit
Rs 25 lakh
Optional
25% of base sum insured; Max. ₹ 10 lakh*
Disappearance benefit
Up to sum insured
Up to sum insured
NA
Loan Protector
Not available
Yes
Latest principal outstanding loan amount as per bank details. Maximum up to base sum insured
*Only in V3, V4, V5 and V6 variants of the plan
Benefit payout against permanent total disability
Cover for permanent total disability is an extremely important feature to have in an insurance policy. An accident can cause permanent total disability, and this can lead to long-lasting financial implications. Usual health insurance policies may only provide limited or no coverage for permanent disabilities due to accidents.
“An accidental coverage policy is specifically designed to cover disabilities and injuries arising due to accidents. It would provide higher sum insured and wider coverage for permanent total disabilities compared with a usual health plan,” says Goyal.
Most accidental coverage policies typically pay the entire or balance sum insured in case of permanent total disability. Make sure that your policy has this feature.
Permanent partial disability benefit
If you survive an accident but with a permanent partial damage like loss of limbs, vision, hearing capacity and so on your life will not be same. It is most likely to hamper your earning capacity to a great extent. Having an accidental health insurance policy which has good coverage for such permanent partial disability due to an accident, will help you deal with such loss to a great extent.
Regular income against temporary total disability
Having a provision for regular income during the rehabilitation period in an accidental policy is extremely critical. “Temporary total disability due to an accident can last for several months, sometimes even years. During this time, the individual is usually unable to work and generate income. An accidental coverage policy that provides a percentage of the insured’s monthly salary can help meet the person’s expenses during the recovery period. This is an important benefit as it ensures financial stability for the individual and their family while they are unable to work,” says Goyal.
Koti Suraksha Personal Accident Policy from HDFC Ergo pays 1% of sum insured as weekly payout in case of temporary total disability. For instance, if you take a policy with a sum insured of Rs 50 lakh, you would be eligible to get a weekly payout of Rs 50,000 for a maximum of 104 weeks. Select variants of Personal Accident Plan from Niva Bupa offer this feature as an optional benefit. For earning members, it pays 2% of base sum insured per week — which can be a maximum of Rs 1 lakh per week and for up to 100 weeks. For non-earning members, it pays 1% of base sum insured per week and the maximum payout in this case can be Rs 25,000 per week for 50 weeks. Family Shield Health Insurance policy from ICICI Lombard GI pays a fixed amount of Rs 20,000 per week for policies with sum insured between Rs 10 lakh and Rs 1 crore.
However, you need to be careful about your weekly payout expectation as there may be restrictions in the policy even if you have an eligible policy with a higher sum insured. “We shall not be liable to make any payment which is more than the insured person’s gross weekly income,” according to the terms and conditions of the Family Shield accidental group insurance policy.
Daily hospital cash during the treatment phase
Daily Hospital Cash is indeed a valuable feature in an accidental coverage policy. “It provides an extra amount of money that can be used to meet the additional expenses that a standard health insurance policy may not cover during hospitalisation. This feature can help with costs such as transportation, accommodation for family members, and other incidental expenses. It offers an additional layer of financial support during the hospital stay,” says Goyal. However, it’s essential to review the policy terms and conditions to understand the specific coverage and limits associated with the Daily Hospital Cash feature.
Loan protection benefit
Many people usually have many loans such as a home loan, auto loan or personal loan. A family struggling with accident-related financial stress can find it difficult to pay a big loan outstanding amount. This can result in the family being dispossessed of their assets such as house or car, in case the dues are not cleared. However, if your accidental coverage policy has a loan protection feature, it will help your family pay the loan amount.
The Family Shield group insurance policy from ICICI Lombard General Insurance has this feature. Under this policy, if an insured person suffers an injury due to an accident that occurs during the period of cover and solely and directly results in the death or the permanent total disablement of the insured person, then it will pay an amount equal to the principal outstanding amount as on the date of accident in respect of the insured person’s outstanding loan specified in the policy certificate. The loan protection coverage is optional in case of Personal Accidental Plan from Niva Bupa.
Coverage for comatose is very critical
It is not uncommon for accident victims to slip into a coma before regaining consciousness and surviving. Such people would need a life support system, and sometimes for long. It gives the victims a better chance to survive. But it is a high-cost system that only people with deep pockets can afford.
This is where comatose benefit helps people in case of accidental trauma.
Disappearance benefit becomes handy when other coverages fail
Sometimes, accidents can lead to the disappearance of the insured. An accidental health insurance policy with coverage for disappearance can be very useful in such a situation, especially if the insured is the earning member.
Koti Suraksha accidental policy from HDFC Ergo offers coverage for disappearance and comatose. However, the accidental death sum insured is the maximum liability of the insurer which is payable under all the covers, including accidental death, disappearance and comatose. Niva Bupa’s Personal Accidental Plan pays up to 25% of the sum insured under comatose benefit, but the maximum payout is limited to Rs 10 lakh.
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This story originally appeared on: India Times - Author:Faqs of Insurances
