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Personal Accident Insurance Policy-Benefits and Exclusions You Must Know!

Published On Apr 12, 2019 5:30 AM By Sakshi Aggarwal

General health insurance certainly helps the policyholder in taking care of him and his family members but does not offer financial assistance in case the insured gets partially or fully disabled (either temporarily or permanently). Here, personal accident insurance comes to the rescue!

Personal Accident Insurance covers the insured in case of death or disability that takes place due to an accident. 

Right personal accident insurance acts as a blessing in disguise as it offers the policyholder all that he could wish for in the event of an accident.

All the general insurance companies (Private or PSU) or top insurance brokers like offer this policy. Generally, the personal accident insurance covered by insurers in PSU is cheaper than the ones offered by private companies. But, private companies undoubtedly come with quite a lot of benefits. The information on the same is available on the official websites of health insurance companies

Personal Accident Insurance policies not only cover losses of all types like temporary disablement, income loss, and hospitalization but also cover all kinds of accidents. These can be falling down the stairs, breaking a limb(s) while playing sports or a road accident.   

Personal Accident Insurance-What all it covers?

1. Accidental death 

If you go through accidental death, the insurer will pay the sum insured to your family. The nominee in such cases gets the entire sum assured as per the cover of the policy. 

2. Permanent partial disability

A permanent partial disability is an injury that leads to loss of speech, eyesight, feet or hands due to an accident. The policyholder here gets some part of the sum assured for a specific period of time or as a one-time lump sum payment. 

3. Permanent total disability 

Permanent total disability is when a loss occurs due to an injury that does not allow the individual to continue with normal responsibilities. It is considered a permanent total disability when the insured individual is disabled for a continuous time frame for over 12 months without any hope of recovery. Typically, the policy gets terminated if the policyholder gets totally disabled following an accident. The policy pays the sum assured.  

4.Temporary total disability 

If a bodily injury occurs to the insured individual during the policy year where it stops him/her from any kind of occupation, it is considered as a temporary total disability. The injury must not exceed a period of 104 weeks since the date of injury to the time you are fit enough to resume to the chores, as the Medical Professional certifies the same.  

The insurer generally provides a daily or weekly benefit in similar cases. The amount of compensation depends on the nature of impairment following the accident. You get the freedom to customize coverage options. For instance, ICICI Lombard lets you opt for a sum insured from starting range of Rs. 3-5 lac. It may rise as high up to Rs. 20-25 lac.    

Exclusions in personal accident insurance

The premium for personal accident insurance is the same for people of different age groups as the risk factor is similar for all of them. Whereas in health insurance plans the premium differs depending on the age, lifestyle habits etc. However, the main factor to be considered while deciding premium is an individual’s income.

For instance, Tata AIG offers accident policy for the salaried individuals where the sum insured is only 10 times the annual income and for self-employed, it is 20 times of it. 

However, there are some high-risking jobs like that of a pilot or air hostess where, due to high risks, there are certain exclusions or may even not cover them. Extreme sports such as paragliding or bungee jumping fall under these exclusions. 

Also Read

Personal Accident Cover - What Is so Special About It?

Exploring Group Personal Accident Insurance & More About It


Irrespective of which type of accident insurance you are purchasing, you must read the terms and conditions before finalizing the deal. For example, a fractured leg is a temporary disability. Here, you will get cover against this only if your policy covers temporary disability. 

Also, never hesitate to ask questions from your insurer as clearing even slightest doubts could get you nothing but the best health insurance. You can contact and all we ask for is a few minutes, a few health-related disclosures and your good health to get you the best plan. You may write to us at or simply visit the official website to leave your personal details. Our experts will get back to you in no time to assist you. 

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