Saral Suraksha Bima, Royal Sundaram General Insurance Co. Limited

Accident comes unannounced. It will put a spoke in your routine life. The dent which an accident brings to one’s emotion and finance is very serious. Some accidents may create vacuum in the family due to bread winner’s death while some may end up in physical disability.

Though few accidents may have a lighter impact, it may still compel one to be away from routines such as attending office for quite a long time. Hospital Expenses adds to one’s financial burden apart from mental agony. A prudent solution for meeting all the uncertainties is signing up for a Personal Accident Insurance.

Saral Suraksha Bima, Royal Sundaram General Insurance Co. Limited brings a unique solution to all worries related to an accident.

It is a package designed to take care of you and your family in the unfortunate event of an accident resulting in death or disability. The various benefits include Accidental Death Benefit, Accidental Disability Benefit apart from other special features.

 

Base covers:

 

Death:

Benefit equal to 100% of Sum Insured shall be payable on death of the insured person, due to an Injury sustained in an Accident during the Policy Period, provided that the Insured Person’s death occurs within 12 months from the date of the Accident.

 

Permanent Total Disablement:

Benefit equal to 100% of Sum Insured shall be payable if an insured Person suffers Permanent Total Disablement of the nature specified below, solely and directly due to an Accident during the Policy Period, provided that the Permanent Total Disablement occurs within 12 months from the date of the Accident:

• Total and irrecoverable loss of sight of both eyes or
• Physical separation or loss of use of both hands or feet or
• Physical separation or loss of use of one hand and one foot or
• loss of sight of one eye and Physical separation or loss of use of hand or foot
• If such Injury shall as a direct consequence thereof, permanently, and totally, disables the Insured Person from engaging in any employment or occupation of any description whatsoever.

Permanent Partial Disablement:

Sum Insured specified below shall be payable if the Insured Person suffers Permanent Partial Disablement of the nature specified below solely and directly due to an Accident during the Policy Period provided that the Permanent Partial Disablement shall occur within 12 months of the date of the Accident.

 

Policy Features

 

Age Eligibility:

Minimum entry age shall be 18 years and maximum age at entry shall be 70 years for the insured members including principal insured. Dependent Child / children shall be covered from the age of 3 months to 25 years subject to the definition of ‘Family’ and underwriting policy.

 

Type of Policy:

Individual basis only, when offered as a family cover, the chosen sum insured shall apply to each family member separately.

 

Family:

Family consists of the proposer and any one or more of the family members as mentioned below: (i) legally wedded spouse. (ii) Parents and Parents-in-law. (iii)   Dependent Children (i.e. natural or legally adopted) between the age 3 months to 25 years. If the child above 18 years of age is financially independent, he or she shall be ineligible for coverage in the subsequent renewals.

 

SI eligibility in a family plan:

Proposer has to be mandatorily covered under the Family cover.

In case of Family cover, following shall be the sum insured limits for Family Members:

Self has to be earning and mandatorily have to be covered 

• Self/Proposer-100%

• Spouse – 50% of the sum insured of proposer

• Parents/Parents-in-Law - 25% of the sum insured of proposer for each

• Child/Children - 20% of the sum insured of proposer for each

If a higher sum insured is sought for any of the family members then they will have to opt for a separate policy, issuance of which shall be subject to the acceptance and income criteria guidelines.

 

Tenure:

Customer can buy the policy for a tenure of one year only. 

 

Sum Insured Options:

Minimum sum insured shall be Rs.2.5lakhs to a maximum sum insured of Rs.5crores.

For Sum Insured from Rs. 2.5 lakhs to Rs. 1 crore (in multiples of Rs. 50,000/-.)             

However, for Sum insured greater than Rs.1crore, Sum Insured shall be in multiples of Rs. 50 lakhs.

Approval for choice of SI, will be based on the below eligibility criteria.

• Up to 50 lakhs – 5 times annual income

• 50.5 lakhs to 1 crore – 8 times annual income

• 1.5 crores to 5 crores – 10 times annual income

 

Premium:

The Premium charged on the Policy will depend on the Sum Insured and Occupation.

The premium will vary for the below 4 risk categories.

 

RISK CLASS I

skilled white-collar class with no exposure to occupational hazard

Accountants, Doctors, Lawyers, Architects, Consulting Engineers, Teachers, Bankers, Persons engaged in administrative functions etc.

RISK CLASS II

skilled white-collar class with minimal exposure to occupational hazard

Builders, Contractors and Engineers engaged in superintending functions only etc.

RISK CLASS III

skilled/semi-skilled class with moderate exposure to occupational hazard

Delivery boys, Diploma engineers working on shop floor etc.

RISK CLASS IV

unskilled class having high exposure to occupational hazard.

 Loaders, Mining workers etc.

 

 Modes of Premium Payment

 Premium payment can be made Yearly, Half-yearly, Quarterly and Monthly. ECS (Auto Debit facility) is also allowed in respect of the above-mentioned modes.

Premium Example

 

Risk Group I
Coverage	Base SI	Base Rate/Per mille	Base Premium	GST 18%	Final premium
Base Cover (Death, PTD, PPD)	5000000	0.42	2100	378	2478
Temporary Total Disablement	1000000	0.14	140	25	165
Educational Grant	500000	0.04	21	4	25
Hospitalisation Expenses	500000	0.02	116	21	136
				Total	2804

Exclusions (applicable to all sections of the policy)
The Company shall not be liable to make any payments under this policy in respect of:

• Any claim for death or disablement (whether of a permanent nature or of a temporary nature), hospitalisation of the insured person, directly or indirectly due to War (whether declared or not) and war like occurrence or invasion, acts of foreign enemies, hostilities, civil war, rebellion, revolutions, insurrections, mutiny, military or usurped power, seizure, capture, arrest, restraints and detainment of all kinds.


• Any claim for death, disablement (whether of a permanent nature or of a temporary nature), hospitalization of Insured Person


• from intentional self-injury unless in self-defense or to save life, suicide or attempted suicide;
• whilst under the influence of intoxicating liquor or drugs or other intoxicants except where the insured is not directly responsible for the injury / accident though under influence of intoxication.
• whilst engaging in aviation or ballooning, or whilst mounting into, or dismounting from or travelling in any balloon or aircraft other than as a passenger (fare-paying or otherwise) in any Scheduled Airlines in the world. [Standard type of aircraft means any aircraft duly licensed to carry passengers (for hire or otherwise) by appropriate authority irrespective of whether such an aircraft is privately owned or chartered or operated by a regular airline or whether such an aircraft has a single engine or multiengine;
• arising or resulting from the Insured Person committing any breach of law with criminal intent.;


• Any claim for death, disablement (whether of a permanent nature or of a temporary nature), hospitalization of Insured Person due to participation as a professional in hazardous or adventure sports, including but not limited to, para-jumping, rock climbing, mountaineering, rafting, motor racing, horse racing or scuba diving, hand gliding, sky diving, deep-sea diving.


• Any claim resulting or arising from or any consequential loss directly or indirectly caused by or contributed to or arising from:
  1. Ionizing radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel or from any nuclear waste from combustion (including any self-sustaining process of nuclear fission) of nuclear fuel.
  2. Nuclear weapons material
  3. The radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof.
  4. Nuclear, chemical and biological terrorism
• Any loss arising out of the Insured Person's actual or attempted commission of or willful participation in an illegal act or any violation or attempted violation of the law.

 

 

Claim Procedure

 

Notification of claim:

• Intimation about an event or occurrence that may give rise to a claim under this policy must be given within 30 days of it happening.
• Claims for insurance benefits must be submitted to the Company not later than one (1) month after the completion of the treatment or after transportation of the mortal remains/ burial in the event of Death.
•  If any treatment for which a claim may be made is to be taken and that treatment requires Hospitalisation in an Emergency, the company shall be informed within 24 hours of the admission of the insured person in Hospital.

 

Documents to be submitted:

Basic documents required for All claims

• Duly completed claim form
• Photo Identity Proof of the insured person
• Copy of FIR/ Panchnama /Police Inquest Report (wherever these reports are required as per the circumstance of the Accident) duly attested by the concerned Police Station
• Copy of Medico Legal Certificate (wherever it is required as per the circumstance   of the Accident) duly attested by the concerned Hospital
• Any other relevant document required by the Company for assessment of the claim

Documents required in case of Death covered under Base cover

• Death certificate;

• Post Mortem Report (if conducted);

• Identity proof of Nominee or Original Succession Certificate/Original Legal Heir Certificate or any other proof to the satisfaction of the Company for the purpose of a valid discharge in case nomination is not filed by deceased.

• Copy of FIR/ Panchnama /Police Inquest Report (wherever these reports are required as per the circumstance of the Accident) duly attested by the concerned Police Station

• Accident report

• Chemical analysis report of viscera / blood sample

• Admission / Discharge / Death summary issued by hospital authority viii. English translation of vernacular documents

 

Documents required in case of Permanent Total Disablement (PTD) / Permanent Partial Disablement (PPD), covered under Base cover

• Original treating Medical Practitioner’s certificate describing the disablement

• Original Discharge summary from the Hospital

• Disability certificate issued by treating Medical Practitioner

• Any other medical, investigation reports, inpatient or consultation treatment papers, as applicable. 

• Copy of FIR/MLC/Accident register

 

Documents required in case of Temporary Total Disablement (TTD), covered under Optional cover

• Original treating Medical Practitioner’s certificate confirming the disability

• Original Discharge summary from the Hospital

• Any other medical, investigation reports, inpatient or consultation treatment papers, as applicable

• Leave/Absence Certificate from Employer (If Employed)

• Medical Practitioner’s certificate confirming the Injury and advising rest/ unfit to work for specified number of days

• Fitness Certificate issued by the treating doctor.

• Copy of FIR/MLC/Accident register

  

Documents required for coverage under Hospitalisation Expenses due to Accident:

• Discharge Summary from The Hospital

• Medical & Investigation reports

• Prescriptions, and consultation papers of the treatment

• Any other medical, investigation reports, as applicable

 

Documents required for coverage under Education Grant:

• Proof to establish relationship – Passport/Education certificate establishing proof of relationship of child with parents/Birth Certificate.

• Photo Identity Proof of Child

• Age proof of Child

• Bonafide Certificate issued by the educational institution confirming that he/she is a full-time student of the institution

Cancellation

The Insured may cancel this Policy by giving 15days’ written notice, and in such an event, the Company shall refund premium on short term rates for the unexpired Policy Period as per the rates detailed below.

Period on Risk	Rate of Premium to be refunded
Up to 1 month	75% of premium
Up to 3 months	50% of premium
Up to 6 months	25% of premium
> than 6 months	Nil Premium

 

Notwithstanding anything contained herein or otherwise, no refunds of premium shall be made in respect of Cancellation where, any claim has been admitted or has been lodged or any benefit has been availed by the Insured person under the Policy.

Free Look Period:

The Free Look Period will be applicable on the new policy and not on renewals 

1. The insured will be allowed a period of fifteen days from date of receipt of the policy to review the terms and conditions of the Policy, and to return the same if not acceptable.

2. If the insured has not made any claim during the Free Look Period, the insured shall be entitled to

(a) a refund of the premium paid less any expenses incurred by the company on medical examination of the insured person and the stamp duty charges or;

(b) where the risk has already commenced and the option of return of the Policy is exercised by the insured, a deduction towards the proportionate risk premium for period of cover or;

(c) where only a part of the insurance coverage has commenced, such proportionate premium commensurate with the insurance coverage during such period.

 

FAQ’s

What is Personal Accident Insurance?

An insurance policy which, in return for regular premiums, pays a specific sum in the event of death, loss of sight or limbs or other permanent disablement due to an accident. The promised sum insured will be paid in full in the event of the occurrence of the peril, for each of the listed benefits above.

How is accident defined?

Accident means a sudden, unforeseen and involuntary event caused by external, visible and violent means.

Why do I need an accident policy?

Accidents don’t come scheduled. They happen anytime and anywhere. The personal accident policy covers several eventualities, including train and road accidents, plane crashes, and even a slip in the bathroom. In the event of happening the policy compensates to meet the expenses incurred during this period subject to maximum of sum insured.

What is the basis of determining the sum insured?

Occupation nature, income level and age are the main factors which play a vital role in determining the sum insured. The sum insured offered is generally the certain times of the annual income.

I have a health policy. Do I still need an accident policy?

Yes definitely, A personal accident insurance policy is an insurance contract that covers risk arising from accidents be it at home, or outside. An accident insurance policy compensates you with a lumpsum amount at the time of need to provide financial support during crisis arisen due to death/disablement of the insured.

My spouse is a housewife. Can she be covered under personal accident policy?

Accidents can happen anywhere and at home too, hence she is eligible for cover of 50% of sum insured opted by the proposer.

Do I need to buy individual policy for each of my family member or will one policy cover my entire family?

Family cover is available to Individuals under Saral Suraksha Bima, Royal Sundaram General Insurance Co. Limited whereby the proposer, spouse, dependent children, parents and parents – in - laws can be covered under a single policy. They will all have separate SI, which will be a specific % of the proposer’s SI, as shown below.

• Self/Proposer-100%

• Spouse – 50% of the sum insured of proposer

• Parents/Parents-in-Law - 25% of the sum insured of proposer for each

• Child/Children - 20% of the sum insured of proposer for each

Is there any cumulative bonus available in this policy policy?

Sum insured will increase by 5% every year and not exceed beyond 50% at the time of renewal for every claim free year.

 

Can I insure a child age below 18 years in the policy, what is the SI limit?

Yes, Children are eligible for cover of 20% of Sum Insured opted by the proposer, provided they are dependent and aged between 3 months to 25 years.

 

Who determines the percentage of compensation in case of partial loss?

The amount of compensation for a partial loss depends on the extent of loss and it is clearly specified under the policy terms and conditions.

 

Is there any income tax benefit for premium paid under Personal Accident insurance?

There is NO income tax benefit available against premium paid for Personal Accident insurance.

 

Is there any specific type of accidents which are excluded from purview of cover?

 

The following type of accidents are generally not covered

 

• From intentional self-injury, suicide or attempted suicide

• Whilst under the influence of intoxicating liquor or drugs

• Whilst engaging in sporting activities (aviation or ballooning for example)

• Directly or indirectly caused by venereal disease or insanity

• Childbirth or pregnancy related

• War, invasion, act of foreign enemy, hostilities, civil war and many more

Disclaimer

Insurance is the subject matter of solicitation. Saral Suraksha Bima, Royal Sundaram General Insurance Co. Limited is a Personal Accident insurance product underwritten and issued by Royal Sundaram General Insurance Co. Limited. Claims will be settled by Royal Sundaram General Insurance Co. Limited as per the terms and conditions of the policy. This brochure is not a contract of Insurance. Please refer policy document for exact terms and conditions and specific details applicable to this Insurance. Your participation in this insurance product is purely on a voluntary basis. We advise you to take your own professional advice before you participate. The Saral Suraksha Bima, Royal Sundaram General Insurance Co. Limited (UIN- RSAPAIP21632V012021) is a Personal Accident insurance product of Royal Sundaram approved by IRDAI.

Section 41 of the Insurance Act, 1938 - Prohibition of rebates

1. No person shall allow or offer to allow either directly or indirectly as an inducement to any person to take out or renew or continue an insurance in respect of any kind of risk relating to lives or property in India any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy nor shall any person taking out or renewing or continuing the policy accept any rebate except such rebate as may be allowed in accordance with the published prospectus or tables of the Insurer.

2. If any person fails to comply with sub-regulation (1) above, he shall be liable to payment of a fine which may extend to ten lakh rupees.

ABOUT ROYAL SUNDARAM:

Royal Sundaram General Insurance Co. Limited is the first private non-life Insurance Company licensed to operate in India. Started in the year 2000, Royal Sundaram offers a range of innovative general Insurance products which includes Health, Personal Accident, Home and Travel Insurance for individual customers. The company's Accident and Health claims process received ISO 9001-2008 certification for its effective customer service delivery. For commercial clients, Royal Sundaram offers a wide range of specialised insurance covers in Fire, Marine, Engineering, Liability and Business Interruption risks.

The company also offers specially designed products to the Small and Medium Enterprises and rural customers. Royal Sundaram currently has over five million customers, 1700 employees and has its presence in over 180 cities across India.

Please visit www.royalsundaram.in for more details.

 

Call 1860 258 0000, 1860 425 0000 for details on how to buy this product.

 

Saral Suraksha Bima, Royal Sundaram General Insurance Co. Limited – UIN - RSAPAIP21632V012021