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What is the Claims Process in a Group Personal Accident Insurance Policy?

Sep 26, 2023

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Group Personal Accident Insurance Policy

What is the Claims Process in a Group Personal Accident Insurance Policy?
Contents

A Group Personal Accident Insurance Policy is an important part of the employee benefits package provided by the employers to their employees. A Group Personal Accident Insurance Policy is also known as a GPA Insurance Policy. A GPA Insurance Policy provides compensation in case the employee suffers from accidental death or permanent disability (total or partial) or temporary total disability on account of an accident.

This article will explain the Claim Process under a Group Personal Accident Insurance Policy in detail.

How to file a death claim under a Group Personal Accident Insurance Policy?

The employer informs the insurance broker of the death of the employee who in turn informs the Group Personal Accident Insurance Provider.

The Insured needs to submit the following documents to the Group Personal Accident Insurance Company:

  1. Completely filled Group Personal Accident Claim Form with Company Stamp and Covering Letter from the Employer
  2. Attested Copy of the FIR issued by the Police Station
  3. Attested Copy of the Death Certificate
  4. Attested Copy of the Post-Mortem Reports
  5. Attested Copy of Spot Panchnama (In case of spot Accidental Death)
  6. Attested Inquest Panchnama (in case of spot Accidental Death where dead body shifted to hospital without informing to police – In case of panchayat)
  7. Attested Railway Police Panchnama and attested Railway station master report (In case of railway Accident)
  8. Certificate from State electricity board, Electricity Board’s Panchnama (Optional) in case of Electrocution
  9. The Forensic Science Laboratory (FSL) Report (If recommended in Post-Mortem Report) in case of Snake Bite/Poisonous Animal Bite

How to make a Permanent Total Disability and Permanent Partial Disability claim under a Group Personal Accident Insurance Policy?

The employer informs the insurance broker of the Permanent Total Disability or Permanent Partial Disability of the employee who in turn informs the Group Personal Accident Insurance Company.

The Insured needs to submit the following documents need to be provided to the GPA Insurance Company:

  1. Completely filled Group Personal Accident Claim Form with Company Stamp and Covering Letter from the Employer
  2. Attested Copy of the FIR (if reported to the Police Authority)
  3. Disability Certificate (Authorised by medical officer/civil surgeon of civil hospital / govt. hospital of the district / units concerned, stating percentage of disablement)
  4. Any Reports/X-Rays which are essential to confirm the type and percentage of disability
  5. Letter from the employer stating the description of the accident
  6. Photographs of the Injury reflecting Disability
  7. Original medical bills with prescriptions/treatment papers. (If medical benefits are covered)

How to file a Temporary Total Disability claim under a Group Personal Accident Insurance Policy?

The employer informs the Group Personal Accident Insurance Company of the Temporary Total Disability of the employee.

The Insured needs to submit the following documents need to the GPA Insurance Company:

  1. Completely filled Group Personal Accident Claim Form with Company Stamp and Covering Letter from the Employer
  2. Medical Certificate (Medical Practitioner’s certificate confirming injury and advising rest/ unfit to work for specified number of days)
  3. Fitness certificate from treating Doctor
  4. Attested Copy of the FIR (if reported to the Police Authority)
  5. Leave Certificate from the Employer
  6. Original Medical Bills with Prescriptions, Discharge Card, X-ray report in case of fracture or as the case may be. (Original medical bills required if medical expense is covered)

What are the additional Documents required in order to make the GPA Insurance Claims Payment?

The additional documents that need to be submitted in order to process the GPA Insurance Policy Claims are as follows:

  1. If Claim Payment needs to be done on the name of the employee
    1. No Objection Certificate from the Employer
    2. Bank Account Details of the employee to process the Group Personal Accident Insurance Policy Claim Amount
    3. KYC Documents (Photo ID Proof, Address Proof)
  2. If Claim Payment needs to be done on the name of the nominee
    1. Payee Name of the Nominee
    2. No Objection Certificate from the Employer to process the GPA Insurance Claim Amount in the bank account of the Nominee
    3. Bank Account Details of the Nominee to process the GPA Insurance Claim Amount
    4. KYC Documents (Photo ID Proof, Address Proof)
    5. Legal Heir Certificate/Consent Letter from all Nominees/Legal Heirs in case of more than 1 Nominee/Legal Heir

Conclusion

This article explained in Detail the Claims Process of a Group Personal Accident Insurance Policy. Many employers purchase a Group Personal Accident Insurance Policy in combination with a Group Medical Insurance Policy to provide a comprehensive benefits package to their employees. You can read our detailed blogpost on the difference between the GMC and GPA Policy. Qian is an experienced Insurance Broker for Group Personal Accident Insurance Policy in India having served a diverse set of clients across India over the years. If you wish to purchase a Group Personal Accident Insurance Policy, you can email us at 📧 support@qian.co.in or call us on 📞 022-35134695.

  1. Group Personal Accident Insurance Policy For Employees
  2. Secure Employees against Accidental Death or Disabilities
  3. What is a Group Personal Accident Insurance Policy?
  4. What does a Group Personal Accident Insurance Policy cover?
  5. Accidental Death:
  6. Permanent Total Disability:
  7. Permanent Partial Disability:
  8. Temporary Total Disability:
  9. What are the additional Covers available in a Group Personal Accident Insurance Policy?
  10. Repatriation of Mortal Remains:
  11. Ambulance Charges
  12. Loss of Job Cover:
  13. Daily Cash Allowance:
  14. Accidental Hospitalisation Expenses:
  15. Treatment Outside India:
  16. Children’s Education Expenses:
  17. Prosthesis And Artificial Limbs:
  18. What are the Best Group Personal Accident Insurance Policies in India?
  19. What is the Sum Insured for a GPA Insurance Policy?
  20. How to Cancel a Group Personal Accident Insurance Policy?
  21. What are the major exclusions under a Group Personal Accident (GPA) policy?
  22. How to make a Claim under a Group Personal Accident Insurance Policy?
  23. Compare and Buy Group Personal Accident Insurance Policy with Qian!
  24. FAQS
  25. Testimonials

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