Group Personal Accident Insurance Policy – Coverage, Benefits and Exclusions

Employees are a critical part of the success story of any organisation. They are the company’s most important assets, and a happy and motivated workforce is the key to ensuring the success of a Company.

It is the duty of an employer to take care of employees and stand by them during their tough times as they stood by yours.

Imagine one of your employees or his/her family meets with a tragic road accident. Apart from the bodily injury or disability that he may suffer, he might lose income on account of missing work. However, hospital bills keep mounting during this tough period. Also, the regular expenses such as children’s school expenses, food expenses etc would continue. It can be extremely tough to manage expenses during such a tough period. Your help at this critical juncture could prove crucial for the employee.

A GPA Insurance Policy for employees can prove to be of invaluable help for the employee during this tough time.

A Group Personal Accident Insurance Policy covers the following:

1. Accidental Death means any injury caused due to an accident which immediately or eventually results in the loss of life within 365 days from the date of accident which caused the injury. If an employee dies due to an accident, a Group Personal Accident Policy will pay 100% of the Sum Insured to a family member. The employer can opt for 24*7 cover which means that the Group Accident Policy will pay the compensation even if the accidental death happens after office hours.
2. Permanent Total Disability means any injury caused due to an accident that results in a disability which has continued for a period of 12 consecutive months and is total, continuous and permanent at the end of this period. The Insured Person suffering from Permanent Total Disablement is unable to engage in each and every occupation or employment for compensation for which he is reasonably qualified by education, training or experience for the rest of his life. If an employee suffers from an accident that results in Permanent Total Disablement such as loss of two limbs or loss of sight in both eyes, the GPA Insurance Policy Coverage will pay 100% of the Sum Insured to the employee.
3. Permanent Partial Disability means any injury caused due to an accident that results in a disability which has continued for a period of 12 consecutive months and is partial, continuous and permanent at the end of this period. The Insured Person suffers from a permanent loss of physical function or loss of use of Body Part due to Permanent Partial Disablement. If an employee suffers from an accident which results in Permanent Partial Disablement like loss of one hand or a foot or loss of sight in one eye, then the Group Personal Accident Policy would pay a pre-specified percentage (usually 50%) of the Sum Insured as per Group Personal Accident Insurance Policy Terms and Conditions. For Loss of Limbs other than complete hands or legs, the GPA Insurance Policy for employees has a specified compensation schedule as per which the insured employee is reimbursed.
4. Temporary Total Disability means a disability which continuously and wholly prevents the Insured from performing each and every duty pertaining to the Insured’s occupation. In case of a Temporary Disablement like a Fracture or Spinal Cord Damage, bed rest becomes necessary and in such a case an employee suffers from Loss of Wages. A GPA Insurance Policy would compensate the employee by paying a Weekly Benefit to the Client in such a case. Usually, the Weekly Benefit is fixed at 1% of the Sum Insured per week which would be payable for not more than 100 weeks. However, the Weekly Benefit can be enhanced in negotiation with the Group Personal Accident Insurance Company.

The Compensation from the Group Accidental Insurance Policy will help the family members of the employee to accomplish their goals and commitments even though they suffer from Loss of Income from the Death or Disability of the employee.

You can opt for various Add-On Covers by paying Additional Premiums as part of a GPA Insurance Policy. Some of the Add-On Covers are as follows:

• Repatriation of Mortal Remains: 

  A GPA Insurance Policy will compensate for the expenses incurred for the Transportation of Mortal Remains of the Insured Person from the Place of Death to the Place of Residence.

• Ambulance Charges:

  The Ambulance Charges Cover in a GPA Policy reimburses for the Ambulance Charges incurred to transport the Insured Person to the Hospital in an Ambulance in case of an Emergency.

• Loss of Job Cover:

  If the Insured Person loses a job on account of an Accidental Disability that renders the Insured Person unfit for the job, this Loss of Job Cover in a Group Accidental Insurance Policy would provide the Insured Person with a Pre-Specified Sum Insured. This would help the Insured replace the Income which he has lost on account of his Job Loss.

• Daily Cash Allowance:

  The Daily Cash Allowance Add-On Cover in a Group Accident Policy pays the Insured Person a pre-specified daily cash amount for each completed day of hospitalisation if the Insured Person has been hospitalised on account of an Accident.

• Accidental Hospitalisation Expenses:

  The Accidental Hospitalisation Extension in a Group Personal Accident Policy for Employees provides reimbursement to the Insured Person for the hospitalisation expenses incurred on account of an Accident.

• Treatment Outside India:

  This Extension in a Group Personal Accident Insurance Coverage reimburses the Insured Person for the Cost of Medical Treatment in a Country outside India in case of an Accidental Injury and if Overseas Treatment has been recommended by a Medical Practitioner.

• Children’s Education Expenses:

  This Group Personal Accident Policy will provide a pre-specified Sum Insured under the Children's Education Expenses Cover if the Insured suffers from an Accidental Death or Permanent Total Disablement. It enables the Insured’s Children to complete their education even though the Insured’s family will suffer from Loss of Income due to Death or Disability.

• Prosthesis & Artificial Limbs:

  The Group Personal Accident Insurance Coverage can also reimburse the Cost borne by the Insured for the purchase of Prosthetic and Artificial Limbs in case of Permanent Total Disablement due to an Accident if the employer opts for the add-on cover of Prosthetic and Artificial Limbs.

• Broken Bones:

• The Group Accidental Insurance Policy pays a lumpsum amount to the Insured under the Broken Bones Add-On Cover if the Insured Person breaks his/her bones due to an accident.

• Funeral Expenses

• A GPA Insurance Policy also provides reimbursement for expenses incurred on the funeral of the Insured Person.

A Group Accidental Insurance Policy offers the following benefits:

1. Coverage against Accidental Death: Employees covered under a Group Accidental Insurance Policy receive coverage against accidental death. The nominees receive the Sum Insured in case of the accidental death of the employee. Thus, it provides financial security for the employee’s family.
2. Coverage against Disablement: Employees covered under a Group Accidental Insurance Policy receive coverage in case they suffer from Permanent or Partial Disablement because of an accident. This helps the family financially as the employee is very likely to lose his earning capacity because of disablement.
3. Cover for Children’s Education Expenses: A Big benefit of a Group Personal Accident (GPA) Policy is that it offers support for Children’s Education Expenses in case the employee suffers from death or disablement on account of an accident. This allows the employee’s children to complete their education.
4. Tax Benefits of a Group Personal Accident Insurance Policy: An important benefit of a Group Personal Accident Policy is that employers can claim tax deductions on Group Personal Accident Insurance Premiums. The Premiums paid towards the Group Personal Accident

Following are the top Group Personal Accident Insurance Policies in India:

1. HDFC Ergo Group Personal Accident Insurance Policy
2. SBI General Group Personal Accident Insurance Policy
3. New India Assurance Group Personal Accident Insurance Policy
4. Bajaj Allianz Group Personal Accident Insurance Policy
5. ICICI Lombard Group Personal Accident Insurance Policy
6. Oriental Insurance Group Personal Accident Insurance Policy