Accident Benefit

Accident benefit is an item appearing under the title ‘Conditions and privileges’ of a life insurance policy. If the proposer has opted not to seek accident benefit this will be excluded by showing it under the heading ‘Conditions and privileges not applicable’.

The accident benefit is available only if the policy is kept in-force by payment of all premiums and the accident should occur during premium paying period or before the policy anniversary on which the age nearer birthday of the life assured is 70, whichever is earlier. As a result of accident either death or permanent disability of the life assured shall occur.

(a) Benefits payable on disability of the assured:

(i)                  To pay in monthly installments spread over ten years an additional sum equal to the sum assured under the policy; if the policy becomes a claim before the expiry of the said period of ten years the disability benefit installments which have not fallen due will be paid along with the claim

(ii)                 To waive the payment of future premiums.

The maximum aggregate of sum assured under all policies on the same life to which benefits (i) and (ii) above apply shall not exceed Rupees 50, 00, 000 (including assurance from all insurers and group insurance cover). These figures vary from insurer to insurer.

The waiver of premiums will extinguish all options under the policy as also benefits covered under para (b) of this clause except as to such assurances , if any, as exceeds the maximum aggregate limit of Rupees 50, 00, 000 and which have been kept in force by continued payment of premium.

Benefits payable on death of the life assured:

To pay an additional sum equal to the sum assured under this policy.

Death or bodily injury or disability shall be caused solely and directly from an accident caused by external, violent   and visible means and such injury shall within 180 days of its occurrence solely, directly and independently of all other causes result in the death or permanent disability of the life assured.

Exclusions:

The insurer shall not be liable to pay the additional sum referred in (a) and (b) above if the death or disability of the life assured shall:

(i)                  be caused by intentional self injury, attempted suicide, insanity or immorality or whilst the life assured is under the influence of intoxicating liquor, drug or narcotic; or

(ii)                take place as a result of accident while the life assured is engaged in aviation or aeronautics in any capacity other than that of a fare paying, part paying or non paying passenger in any aircraft which is authorized by the relevant regulations to carry such passengers and flying between established aerodromes, the life assured having at that time no duties on board the aircraft or requiring descant there from; or

(iii)                be caused by injuries resulting from riots, civil commotion, rebellion, war (whether war be declared or not) invasion, hunting, mountaineering, steeple chasing or racing of any kind; or

(iv)              Result from the life assured committing any breach of law; or

(v)                Arise from the employment of the life assured in the armed forces or military service of any country at war (whether war be declared or not) or from being engaged in police duty in any military, naval or police organization.

The disability referred above must be disability which is the result of an accident   and must be total and permanent and such that there is neither then nor at any time thereafter any work, occupation or profession that the life assured can ever sufficiently do or follow to earn or obtain any wages, compensation or profit. Accidental injuries, which independently of all other causes and within 180 days from the happening of such accident, result in the irrecoverable loss of the entire sight    of both eyes or in the amputation of booth hands at or above the wrists, or in the amputation of both feet at or above ankles, or in the amputation of one hand at or above the wrist and one foot at or above the ankle, shall also be deemed to constitute such disability.

Immediately on the happening of the disability the same shall be reported to the insurer. Evidence of disability and accident to the satisfaction of the insurer must be provided.

In the event of it being discovered at any time that the claim under this clause was admitted wrongly all the benefits received must be returned to the insurer along with premium that was waived, with interest, in one lump sum. Otherwise the benefits available under the policy shall stand reduced as if the policy has been discontinued as on the date from which premiums have been waived or from payment of first installment of additional sum assured, whichever is earlier and installments of additional sum assured paid shall be treated as debt on the policy    and shall be deducted with interest from proceeds of the policy.

Key words:

Conditions and privileges of policy

Accident benefit

Permanent disability benefit

Waiver of premiums