HDFC Ergo Koti Suraksha: Personal Accident
Insurance
1264 No. of accidents/day (2022)
462 No. of deaths/day (2022)
Why Personal Accident Policy?
By โaccident,โ we mean any mishapโnot just motor accidents. A slip-and-fall, burns, animal attacks, accidents due
to natural causes, โฆ and motor accidents. An accident can cause:
unforeseen financial loss due to emergency medical care
temporary loss of income for several weeks or months
permanent loss of income due to disability or death
Itโs too late to raise funds to meet emergency medical expenses
after you meet with an accident.
A good Personal Accident insurance policy will protect you from all these instances of income loss.
โBut I have health insurance!โ
Even if you own a health insurance policy, you still need
a personal accident policy. Your
health insurance policy will not help you
unless you are admitted to a hospital for at least 24 hours.
Most accident related injuries are treated in less than 24 hours
in a hospitalโs casualty.
After you are discharged from the casualty, you may have to
follow the doctorโs orders regarding a complete bed rest for
several weeks. Your medical insurance will not compensate you
for your loss of income during this period of
Temporary Total Disability.
โBut I have a
compulsory
vehicle owner insurance!โ
If you own a vehicle, you may already have a compulsory personal
accident policy. But that policy is applicable only to accidents
that happen when you travel in your vehicle. Most
accidents happen at home, at the workplace, or in public
transport facilities. Besides, the compulsory personal accident
policies lack adequate income protection features. It kicks in
only after you have lost a limb, an eye, or after you have lost
your life!
Road accidents are not the only accidents! People slip and fall
at home. Workers sustain injuries at the workplace. And, then,
there are animal attacks.
HDFC Personal Accident Policy offers:
Income Benefits
Temporary Disability Allowance:
Rs 10,000 per week* for up to 2 years of full bed rest ordered by a
medical doctor.
Permanent Disability Payout : The sum assured (Rs 10 lakhs)
Emergency Medical Benefits
Emergency medical expenses incurred after an
accident: up to Rs. 1 Lakh
Hospital cash allowance: Rs 3000 per day for 30
days.
For treatment of broken bones: up to Rs. 1 Lakh
For treatment of burns: up to Rs. 50,000
Terminal Benefits
If patient goes into coma - 50% of sum assured (=Rs 5 lakh)
Death due to accident - sum assured (=Rs. 10 lakh) is paid to the nominee.
Disappearance due to accident/disaster - sum assured of Rs. 10 lakh is paid to the
nominee.
Last rites expenses Rs. 10k
Dependent Parents Allowance Rs 50,000
Children's education allowance Rs 1 lakh
*The above figures are applicable to the base policy with a sum
assured of Rs. 10 lakhs; higher sum assured of Rs 25 lakh, 50 lakh,
1 crore, etc. are available as shown in the table given below.
Details of Benefits
Sum Assured (Lakhs)
Benefits
10
25
50
100
Temporary Total Disability - weekly
10k
25k
50k
100k
Permanent Total Disability
10L
25L
50L
100L
Emergency Medical Expenses
1L
1L
1L
1L
Treatment of Fractures
1L
1L
1L
1L
Treatment of burns
50k
50k
50k
75k
Hospital Daily Expenses (30 Days)
3k
3k
3k
3k
Coma due to accident
5L
12.5L
25L
50L
Disappearance in accident
10L
25L
50L
100L
Accidental Death
10L
25L
50L
100L
Last Rites Expenses
10k
10k
10k
10k
Child Education Allowance
1L
2.5L
5L
10L
Allowance To Dependents
50k
50k
50k
100k
Annual Premium
3,612
6,531
11,395
21,172
Discounted Premium (2 Years)
6,680
12,080
21,080
39,168
Discounted Premium (3 Years)
9,747
17,629
30,763
57,162
Whatโs the cost of PA Insurance?
It costs just about Rs. 10 per dayโcheaper than a cup of tea!
For a sum assured of Rs. 10 lakhs, the annual premium is just Rs.
3612โwhether you are 18 years old or 65 years old.
If you purchase the policy for a period of two or three years, you
will get a discount on the annual premium. Two years: Rs. 6680;
three years: 9747. All figures are inclusive of GST.
Is HDFC Ergo Koti Suraksha available to families?
Yes, this product is available as a Family Floater policy. Details of premium
are given below.
Sum Assured Rs. 10 lakhs
2 Adults: Rs. 4888
2 Adults & 1 child: Rs. 6085
2 Adults & 2 children: Rs. 7282
Sum Assured Rs. 25 lakhs
2 Adults: Rs. 8421
2 Adults & 1 child: Rs. 9980
2 Adults & 2 children: Rs. 11,540
Sum Assured Rs. 50 lakhs
2 Adults: Rs. 14,920
2 Adults & 1 child: Rs. 17,192
2 Adults & 2 children: Rs. 19,464
Sum Assured Rs. 1 crore
2 Adults: Rs. 20,054
2 Adults & 1 child: Rs. 22,326
2 Adults & 2 children: Rs. 24,599
Is HDFC Ergo Koti Suraksha available to groups?
Yes, it is available for organisations with a minimum strength of
seven persons. Even if there is a high turnover of staff, it does
not matter. HDFC Ergo needs to maintain contact with just one key
person. Staff who leave and can be removed from the group. New staff
can be added.
Group Personal Accident Insurance will work out to be cheaper for
members of an organization. This is because the lower
Sum Assured is available, starting from 3 lakhs and moving on
to 5 lakhs, 7 lakhs, 10 lakhs, etc.
Emergency hospital expenses: Rs. 100,000
Treatment of fractures: Rs. 50,000
Allowance for treatment of burns
Covers permanent disability
Weekly allowance of Rs. 5000 for temporary disability (total bed
rest)
Hospital Cash allowance: Rs. 1000 per day as in-patient
Accident Death: Sum Assured (3L, 5L, 7L, 10L, 15L, 20L or 25L)
is offered
Eligibility Criteria
Any earning member of a family is eligible. For sum assured
above Rs. 50 lakh, proof of income is required.
Age limit: 18 years to 65 years
Uniformed personnel belonging to defense forces are not
eligible.
Politically exposed persons, adventure sportsmen, and media
personnel are not eligible.
Accidental Death Cover is normally available as a Rider or
Inbuilt Option. Accident is a sudden, unforeseen and involuntary
event caused by external, visible and violent means. Accidental
Death means death by or due to a bodily injury caused by an
Accident, independent of all other causes of death. Accidental
Death must be caused within 180 days of any bodily injury.
Accidental Disability Rider
An optional but necessary addon. Get additional income benefits
over and above your Sum Assured in the event of total permanent
disability due to an Accident. In the event of
Total Permanent Disability due to accident, you will be
paid a regular monthly income equal to 1% of Sum Assured for a
fixed period of 10 years. Disability as a result of injury
or accident and is thereby rendered totally incapable of being
engaged in any work or any occupation or employment for any
compensation, remuneration or profit and he/she is unlikely to
ever be able to do so. Alternatively, the
life assured suffers an injury/accident due to which
there is total and irrecoverable loss of: a. The use of two
limbs; or b. The sight of both eyes; or c.ย The use of
one limb and the sight of one eye; or d.ย Loss by severance
of two or more limbs at or above wrists or ankles; or e.
The total and irrecoverable loss of sight of one eye and loss by
severance of one limb at or above wrist or ankle.
Claim settlement ratio (CSR)
An insurance companyโs claim settlement ratio (CSR) refers to
the number of claims successfully resolved versus the number of
requests received in a given year. For example, if XYZ company
receives 100 claim requests in a year and successfully settles
90 of them, its CSR is 90%. CSR acts as an indicator of their
credibility.
Critical Illness
A list of illnesses are defined as critical illness. See product
brochure
online. Signs or Symtoms must have first commenced 90 days
following date of an insurance policy.
Critical Illness Riders
HDFC Life Critical Illness Plus Rider provides a lump
sum benefit on diagnosis of any one of the listed critical
illnesses. The Life and CI Rebalance Option waives all
future premiums after the detection of a critical illness.
Exclusions
The insurance contract specifies certain situations in which the
insurance company will not honor their promise. For example,
suicide is a common exclusion. If the insured person commits
suicide, the company will not pay the sum assured or death
benefits. Losses due to activities such as automibile racing,
diving, underground activities, etc., are also excluded from
coverage.
Free Look Period
The free look period is the period given to a
policyholder to assess and review the policy document. He/she
can terminate the policy during the free look period if they are
not satisfied with its inclusion and exclusion terms which were
explained at the time of purchase.
Grace Period
If you fail to pay your premium by date, your contract with the
insurance company will come to an end. To prevent such a
situation, you are given a grace period of 30 days from the due
date every year.
Insurance
Insurance is a contract you make with an insurance company. For
a certain amount you pay (that is, the premium), the insurance
company undertakes to compensate you (the insured) for a loss.
Also, see definition of Risk Transfer.
Life Assured
The person whose life is insured.
PPT
Policy Paying Term: The time period for paying annual
premiums
PT
Policy Term: The total life of the life insurance
contract
Premium
Premium is the cost of insurance. It is the amount you
pay the insurance company periodically (annually) to keep
yourself insured (and as seed for your investment).
Rider
Life insurance riders are contingent additional benefits over a
primary policy, which come into play in case of a specific
eventuality. They offer financial cover over and above basic sum
assured in a life insurance policy. Even with the occurrence of
the event, the life cover remains intact. This means that even
if you have drawn on a particular rider, you remain eligible for
the death benefit on the life insurance plan.
Risk Transfer
A good way to deal with risk is to transfer our risks to someone
who is willing and capable of handling or dealing with them.
This process of
transferring of risk from one person to another is called
insurance. Insurance, therefore, is a risk transfer mechanism.
SA
Basic Sum Assured is the amount of sum assured chosen
by the policyholder
Sum Assured on Death
is the absolute amount of benefit which is guaranteed to become
payable on death of the life assured in accordance with the
terms and conditions of the policy or an absolute amount of
benefit which is available to meet the health cover.
Sum Assured on Maturity
is the amount which is guaranteed to become payable on maturity
of the policy, in accordance with the terms and conditions of
the policy.