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IRDAI Issues Guidelines on Standard Personal Accident Insurance Product

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IRDAI issues guidelines for standard personal accident coverOn February 25, 2021 The Insurance Regulatory and Development Authority of India (IRDAI) issued guidelines on Standard Personal Accident Insurance Product named ‘Saral Suraksha Bima’, succeeded by name of insurance company under the provisions of Section 34 (1) (a) of Insurance Act, 1938.

IRDAI has directed all the general and Health Insurers to offer this product from April 1, 2021. The product can be offered as a group product.

i.The policy tenure of the standard product will be for a period of one year.

ii.Insurers can use the name of the product for the group policy by adding the word “group”.

Purpose: To offer a standard product with common coverage and policy wordings.

Guidelines on Standard Personal Accident Insurance Product

Minimum & Maximum Sum Insured

Under the product, the minimum sum insured will be  Rs.2.5 lakhs and maximum sum insured will be Rs.1 Crore.

Multiples– The sum insured offered will be in multiples of Rs 50,000

Limit exceed- Beyond the limit mentioned above, insurers can provide on their own and can use the name of the product, if all terms and conditions remain the same

Family– If the product is offered as a family cover, the chosen sum insured will be applicable to each family member separately.

Regulations

i.The product will comply with all the provisions of IRDAI (Health Insurance) Regulations, 2016, and all other applicable Regulations & Guidelines.

ii.The insurer may determine the price on the basis of the mentioned above regulation and guidelines.

Age Category

The minimum entry age will be 18 years, while maximum will be at least 70 for the insured members including principal insured.

Can Fix Maximum Age– Insures have an option to fix the maximum age at entry beyond 70 years, subject to underwriting policy.

Dependent will be covered– Dependent Child / children will also be covered from 3 months of age to 25 years subject to the definition of ‘Family’ and underwriting policy.

Covers

Base Covers: There are 3 base covers namely, Death, Permanent Total Disablement, Permanent Partial Disablement.

  • The basic mandatory covers will be uniform across the market.

Optional Covers: There are 3 optional covers namely, Temporary Total Disablement, Hospitalisation Expenses due to Accident and Education Grant.

Category of Cover

i.The base covers and optional covers temporary Total Disablement and Education Grant will be offered on a benefit basis.

ii.While, Hospitalisation Expenses due to Accident will be offered on indemnity basis.

Guidelines issued for Policy Covers:

  • According to the guidelines, under the base cover benefit equal to 100% of sum insured will be payable on death of the insured person, due to an injury sustained in an accident during the policy period.
  • Similarly, 100% sum insured will have to be paid if the insured person suffers Permanent Total Disablement, “solely and directly due to an accident during the policy period.”
  • The permanent total disablement clause will apply to a number of conditions, including loss of sight or injury that disabled the insured person from engaging in any employment or occupation.
  • Hospitalization expenses due to the accident will also be subject to claim which shall be indemnified up to the limit of 10 percent of base sum insured.
  • A one-time educational grant of 10 percent of the base sum insured shall be payable to all dependent children till the age of 25 of the insured following an admissible claim made of the insured person towards death or total permanent disability.

Claim

Intimation about an  event or occurrence that may lead to a claim under this policy  must be provided within 30 days of its happening.

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Recent Related News:

On December 28, 2020 The Insurance Regulatory and Development Authority of India(IRDAI) issued an exposure draft on guidelines for standard travel insurance policies that is to be offered from April 1, 2021 by every general insurer and stand-alone health insurer.

About Insurance Regulatory and Development Authority of India (IRDAI):
Chairman – Subhash Chandra(C.) Khuntia
Headquarters – Hyderabad, Telangana