Special Insurance Privileges - Terms & Conditions

Policy : Personal Accident & Air Accident Cover for Salary Account Holders of IndusInd Bank Ltd.

Risk Covered: Policy to Cover any employee working with any of the following (including but not limited to):

State Govt / Central Govt / Public Sector Undertaking and their Unions / Associations / Federations /Co-operative societies/ Agencies, Establishments of any State that are directly/ indirectly administered by local Government, State Govt, Central Government or Govt of India and who are holding Salary Account with IndusInd Bank.

Policy Terms

• Above Coverage's are subject to Salary Credit received within 90 Days prior from the date of Accident / Death in IndusInd Bank's Salary account
• All above covers offered under said policy is for both On Duty & Off Duty for all salary segments
• PA cover is payable where customer dies after account opening and before Salary credit, subject to that the salary of that month is credited in the IndusInd Bank’s salary account
• Education Grant for Dependent Child (Max Age Upto 23 yrs) - Max 2 Dependent Children
• Dependent Girl Child Benefit (Age 18 - 25 yrs) - Maximum 1 dependent Girl Child
• All other terms and conditions as per standard National Group Personal Accident Insurance Policy Claim document submission TAT is 180  Days from the date of accident / death/ loss
• Claim intimation submission TAT is 90 Days from the date of accident / death/ loss
• WAR is excluded from the scope of the policy
• Employee can be permanent/ temporary/ on contractual basis
• Addition of new accounts during the policy period -  Prorate premium basis the balance number days left till the policy expiry period to be charged
• Death / Total Permanent Disability / Permanent Partial Disability emanating from  occupational hazard is covered under the policy, subject to the accident not happening due  to negligence and no violation of professional SOP of insured member

 

1. PERSONAL ACCIDENT INSURANCE POLICY FOR COVERING SALARY ACCOUNT HOLDERS

Definitions:

The following words or terms shall have the meaning ascribed to them wherever they appear in this Policy, and references to the singular or to the masculine shall include references to the plural or to the female wherever the context so permits:

 “Age” is defined as number of full completed years.

“Policy” means the proposal, the Schedule, the Policy documents and any endorsement attaching to or forming part thereof either on the effective date or during the Policy Period.

“Claim” means a Claim under a Coverage part in respect of an Insured event that has taken place or is likely to take place.

“Schedule” means the schedule, and any annexure to it, attached to and forming part of this Policy.

“Accident” or “Accidental” means a sudden, unintended and fortuitous external and visible event.

 “Air Accident” Sustain any bodily injury resulting solely directly from Air accident caused by external, violent and visible means, the sum hereinafter set forth in respect of any of the Insured persons specified in the Schedule.

“Bodily Injury” means physical bodily harm or injury, but does not include any mental sickness, disease or illness.

“Physician” means a qualified medical practitioner holding a valid and subsisting license, granted by the appropriate Licensing authority, and acting within the scope of his license.

“Insured” means the person, or a person within a category, named in the Schedule.

“Named Insured” means the person or organization named in the Schedule.

“Policy Period” means the date between the commencement date specified in the Schedule and, in respect of any Insured.

“Permanent Total Disability” means Doctor certified total, continuous and permanent:
- Loss of the sight of both eyes.
- Physical separation of or the loss of ability to use both hands and/ or both feet
-Physical separation of or the loss of ability to use one hand and one foot
- Loss of sight of one eye and the physical separation of or the loss of ability to use either one hand or one foot.

“Last Query” means query raised by Surveyor/ Insurer on receipt of each and every claim related document shared by insured.

 

2. CHILDREN EDUCATION GRANT: (Max Age Upto 23 yrs) - Max 2 Dependent Children

Per Account Sum Insured: As per Annexure/Schedule

2.1 Coverage:
In the event of death of the Insured person due to an accident as defined, the Policy shall pay as education grant for maximum 2 dependent children as below:

• If the Insured Person has one or more dependent children upto to the age of 23 years , an amount equal to INR 5,00,000/- per child will be payable on upfront basis.
• This amount shall be paid provided the Personal Accident claim has been admitted.
• Maximum Sum Insured under this add-on is INR 10,00,000/-

 

3. DEPENDENT GIRL CHILD BENEFIT (Age 18 - 25 yrs) - Maximum 1 Dependent Girl Child

Per Account Sum Insured: As per Annexure/Schedule

3.1 Cover:
In the event of death of the Insured person due to an accident as defined, the Policy shall pay as Dependent Girl Child Benefit for the dependent Girl Child as below:

• If the Insured Person has one dependent girl children between 18 -25 years , an amount equal to maximum of INR 5,00,000/-  for dependent girl child will be payable on upfront basis.
• This amount shall be paid provided the Personal Accident Claim has been admitted.
• Maximum Sum Insured is INR 5,00,000/- Lakhs (max one Dependent Girl Child)
• Total Sum Insured : INR 5,00,000 /-

Please Note: Maximum payout under Education Grant for Dependent Child + Dependent Girl Child Benefit will be INR 10 Lakhs. Beneficiary will not be able to claim > INR 10 lakhs under both the above addons collectively.

 

4.0 PERSONAL ACCIDENT COVER

Coverage is only for those Salary Account Holder which have this Coverage (Specified in Annexure/Schedule)

4.1 Sum Insured:
Whereas the Named Insured has made a proposal to National Insurance Company  Ltd. (hereinafter referred to as the “Insurer”) which is hereby agreed to be the basis of this Policy and has paid the premium specified in the Schedule, the Insurer agrees, subject to the following terms, exclusion, definition, limitations and conditions, to make payment as is provided herein.

4.2 INCLUSIONS:

4.2.1 Insured Event

4.2.1.1 In the event of any Accidental Bodily Injury sustained by the Insured during the Policy   Period, the Insurer will make payment under such Coverage Parts as are specified in the Schedule as being operative.
4.2.1.2 The Insurer’s liability to make payment shall be limited to the Sum Assured for each Coverage Part.

4.3 Coverage Parts

4.3.1 Coverage Part A: Death
Coverage is only for those Salary Account holders which have this add on (specified in annexure/schedule)
The Insurer will pay the Sum Assured in the event of Accidental Bodily Injury causing the Insured’s death within 12 months of the Accident, where after the Policy shall expire.

4.3.2 Coverage Part B-Permanent Total Disability:

Coverage is only for those Salary  Account holders which have this add on (specified in annexure/schedule)

• The insurer will pay 100% of the sum assured if card holder meets with Accidental Bodily Injury during the Policy Period that causes Permanent Total Disability within 12 months of the accident.
• Sight of both eyes, or of the actual loss by “physical separation” of two entire hands or two entire feet, or of one entire hand and one entire foot, or of such loss of sight of one eye and such loss of sight of one eye and such loss of one entire hand or one entire foot, the Capital Sum Insure stated in the Schedule herein applicable to such Insured person.
• Use of two hands or two feet, or of one hand and one foot, or of such loss of sight of one eye and such loss of use of one hand or one-foot, the Capital Sum Insured stated in the Schedule hereto, applicable to such Insured person.
• Sight of one eye, or of the actual loss by physical separation of one entire hand or of one entire foot, fifty percent (50%) of the Capital Sum Insured stated in the Schedule hereto, applicable to such Insured person.
• Total and irrecoverable loss of use of a hand or a foot without physical separation, fifty percent (50%) of the Capital Sum Insured stated in the Schedule hereto, applicable to such Insured person.
• If the Insured was suffering from any permanent disability prior to the date upon which Accidental Bodily Injury was sustained, then the Insurer’s liability to make payment hereunder shall be reduced by the extent of the same, as advised by the Insurer’s medical advisors.

4.3.3 Coverage Part C: Permanent Partial Disablement

Coverage is only for those Salary  Account holders which have this add on (specified in annexure/schedule)

4.3.4 Coverage Part D: Air Accident Cover:
Coverage is only for those account holders for which salary  is credited as per condition no 1 (S I  specified in annexure/schedule)

4.4 Exclusion under Personal Accident Insurance:

• The Cover becomes operational only after the conditions laid out in the policy schedule are fulfilled.
• No indemnity is available hereunder and no payment will be made by the Insurer for any Claim directly or indirectly caused by, based on, arising out of or howsoever attributable to any of the following:
  • Whilst under the influence of intoxicating liquor or drugs;
  • Any deliberate or intentional, unlawful or criminal act, error, or omission of the Insured.
  • From war (whether declared or not), invasion, act of foreign enemies, rebellion, revolution, insurrection, mutiny, military or usurped power, seizure, capture, arrest, restraint or detainment, confiscation or nationalization
  • Any consequential losses of any kind, and/or any actual or alleged legal liability of the Insured.
  • Whilst engaging in ballooning, whilst mounting into, dismounting from or travelling in any balloon.
  • Any loss suffered by the Insured on account of his participation as the driver, co-driver or passenger of a motor vehicle during motor racing.
  • Payment of Compensation in respect of death of, or bodily injury or any disease or illness to the Insured person.
    (a)directly or indirectly caused by or contributed to by or arising from ionizing radiations or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel. For the purpose of this exception, combustion shall include any self-sustaining process of nuclear fission.
    (b) directly or indirectly caused by or contributed to by or arising from nuclear weapons  
    material.
  • Curative treatments or interventions that the Insured performs or has had performed on his body.
  • Venereal or sexually transmitted disease.
  • HIV (Human Immunodeficiency Virus) and/or any HIV related illness including AIDS (Acquired Immune Deficiency Syndrome) and/or mutant derivatives or variations thereof however caused.
  • Pregnancy, resulting childbirth, miscarriage, abortion, or complication arising out of any of the foregoing.
  • Rest all Exclusions as per National Insurance Group Personal Accident Policy

4.5 Conditions:

• PA cover for Salary Segment is active only if, there is at least one Salary Credit in their Indusind Bank’s salary account in past 90 days.
• Claim intimation within 90 days from date of accident / death / loss
• Claim document submission within 180 days from date of accident/ death/loss
• Claim documents for Children Education benefit / Dependent Girl Child Benefit to be submitted along with main claim documents and can be submitted within 60 days post settlement of respective claim
• Coverage is only for Salary Account Holders (as mentioned above)

4.6 On Duty Coverage wordings (On Duty & Off Duty Both Are Covered)

4.6.1 On duty Cover: 
Coverage is only for those account holders which have this Coverage (Specified in Annexure/Schedule)

4.6.2 Definition of On Duty:
The said personnel is said to be on duty, If He /She is on an assigned task, occupation, place of service to serve the functions assigned to him in his/her regular work shift including overtime (if any).

Sum Insured:  As per annexure/schedule
This feature shall be available only for Accidents after policy start date.
The cover shall be for any rescue operations as described above and in Indian Territory only.

Limit of Cover: As per schedule/annexure

4.7 Other Conditions:

• In case of multiple accounts related to a single customer, ONLY ONE account will be taken into consideration.
• Salary segments are covered, subject to at least one salary is credited in their Indusind bank account in past 90 days
• Benefit of Personal Accident cover will be available to the claimant only if the accounts are opened/ converted under the salary package. The Identity Card shall have to be submitted along with Claim documents.