In India, there are 5 lakh accidental deaths or disabilities every year, and the ones who suffer the most are the ones who are working and are young. Young people mostly die because of accidents and not natural deaths.

Not having accidental coverage will cost quite a hefty treatment fee, investing in an accidental death rider with a base plan is a way of securing yourself and your family from such unexpected events.  

Definition of Accidental Insurance


Accidents should be sudden and unpredictable.

The damage should be caused only by the impact that the accident has caused, only then will it be covered.

For instance, you fall from a building, the cause of falling from the building is important to determine if you can be insured or not.

If someone pushed you, then you cant be covered, but if you fell by accident, your insurer will protect you.

PS- To define the accident and its cause is to your insurance provider very imperative for your claim settlement.

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Damages can be caused by:

  1. A third-party
  2. You

PS- if it is caused by you, an insurer’s become a little hesitant about giving the claim and there are high chances of them conducting further investigations. And if you are self inflicting yourself in danger, your claim is most likely to get denied.

For example:-

  1. You deliberately went to a violent riot or you deliberately put yourself in      danger, your claim will get rejected.
  2. If you cross the road not from the zebra crossing and a car hits you      accidentally, your claim is likely to get denied.
  3. Riding a bike without a helmet and driving a car with a seat belt, claiming your money can be difficult.

Claim settlements of accidental insurance are a little tricky, you need to prove to the insurer that the accident is not caused by you but is caused by a third party.

The accident should have a proximate cause

For Example - After an accident took place, the policyholder lands up with lung disease because of the impact and within 30 dies due to lung damage

Will he get the claim?

In this situation, if the proximate cause of the damage in the lungs is because of the damage in his lungs and not the accident, his accidental claim will be rejected.

Damage is of 2 types

  1. Death
  2. Disability

Accidental insurance is sold by?

1. Life insurance providers sell accidental insurance policy but not as an independent product but as riders. That means your base plan, endowment plan, or ULIP plan can come with a rider of accidental insurance.

For example, with a 10 lakhs bhima, your accidental insurance will also be 10 lakh.

If your Term insurance is 1 crore with accidental insurance, your family will receive 2 crores.

If for a 1 core normal death policy you pay 20,000 premium, with only 4k extra you can add an accidental insurance rider too. So you pay 24k total for a normal death cover plus accidental insurance.

2. Health insurance companies sell as a separate product,

3. General insurance companies also sell them as a separate product.

To save money, you can also purchase accidents insurance by investing in a group accidental policy with your colleagues

This policy works on the concept of indemnity

They indemnify your value rather than giving you a fixed benefit, and after a certain age, accidental insurance isn't valid.

For instance,

If the death is caused by the accident, and if you weren't working then, this will come under an indemnity, and the claim won't give you 1 core, they will judge the value you had and accordingly decide the claim amount. If you weren't working then the claim amount can be near 30 lakhs

This is done only to indemnify the risks and nothing else. They evaluate your claim considering your income at the time of the accident.

Meaning of Disability Insurance


You can purchase this with some extra premium with the accidental insurance. It’s mostly sold with Accidental insurance

You can either take one of them or both together.

How do you define permanent disability

It means a total and permanent disability, where the earning capacity depends on his disability. For example, both the legs are disabled or hands are disabled, he becomes blind, vital organs are damaged - all these will be considered as permanent disabilities.

If this ain't the case, further investigation will be conducted.

Example- A surgeon had taken an accidental disability's hands and now his hands are being cut off, so he can't function properly Although insurers may argue that, he can operate as a doctor with his brains, but only because he mentioned he is a surgeon and surgeons can’t work without hands, his claim will be accepted.

What do you get if he is proved to be permanently disabled?

For insurance, you have a 40 lakhs insurance. Till 5 years, 20% of the sum assured i.e. 8 lakh per year will be given to you by your insurer.  

The percentage will depend on your contract

Temporary disability

If the policyholder has been prescribed to stay in bed for a year due to the accident, the insurer provides 20% of the Sum assured as a monthly payout. With the above example, 20% of the sum assured i.e. a total of 8 lakhs will be paid in one year.

Who should take accidental insurance?

Every young person who does a job, businessman, self-employed.

PS - In accidental insurance, the underwriting exists only of the risk and not of the finance, for example, a soldier would not be able to invest in accidental insurance as his job is putting him at risk all the time.      

FAQ Related to Accidental Insurance


1. Is murder an accident?

No, it is not, a normal term insurance policy will cover this but not an accidental insurance policy.  

2. If my loss is less than my coverage value, how much will I receive?

When we indemnify, we indemnify losses, if you have a 10 lakh policy for your car, and if the damage value is 3 lakhs, you will receive only 3 lakhs as insurers only cover your losses.

3. Death due to earthquakes or fires or floods will be covered?

Yes, since these are unforeseen events, accidental insurance will cover it, although if you risk your life to save someone from a fire, this will not be covered. And if there were floods somewhere you weren't supposed to be, then it will not be covered. The direct relationship to the proximity of the cause will be looked at.

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