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Bharti AXA Smart Individual Personal Accident Insurance Plan

  • Bharati AXA General Insurance Company Limited is a joint collaboration between a leading Indian business group Bharati Enterprises and AXA, a global leader in insurance sector, financial protection and wealth management. The company marked its presence from 2008 and it is the first general insurance company to receive dual certification of ISO 9001:2008  and ISO 27001:2005 within the first year of its operations in India and thereafter the certification was renewed for another 2 years. The vision of the company is “to be the most preferred general insurance company for customers, employees, shareholders, business partners and the society. Bharati AXA’s comprehensive and inventive insurance plans are such that it meets the requirements of an individual as well as the organizations. Various products ranging from the basic insurance plans like health insurance plans, travel insurance plans, home insurance plans to business/ corporate solutions/ plans, SME solutions/ plans, motor insurance plans, two wheeler plans and a lot more. Here we will discuss about the Home Insurance Plans for this company.

    Personal Accident Plans plugs an important role in the insurance portfolio of an individual. Firstly, it provides a tremendous financial support to the policy holder if he/she is disabled after an accident resulting to permanent total disability, temporary total disability and even an unfortunate death. Secondly, the enormity or the degree of injuries doesn’t matter, minor injuries are also usually cover dune the plan. Bharati AXA Personal Accident insurance Plans named as Smart Individual  Plan have all encompassing plans which acts as a cushion to cover the risks associated with an accident.

    Now we will see the coverages under the Smart Individual Plan.

    The following are the coverages under the Smart Individual Plan.

    • Accidental Death Plan which includes transportation of mortal remains, funeral expenses and education grant for children.
    • Permanent Total Disablement Plan.
    • Permanent partial Disablement Plan.
    • Temporary Total Disablement Plan.
    • Hospital Daily cash Allowance Plan.
    • Accidental medical expenses Plan.
    • Double Indemnity death or Permanent Total Disablement while travelling as a passenger in public transport.
    • Legal Expenses.

Coverages - Bharti AXA Smart Individual Personal Accident Insurance Plan

The company will pay the insured person, his/her nominees or legal representatives if the insured person sustains bodily injury resulting solely and directly due to accident caused by external , violent and visible means.

    • If the injury takes place within 12 calender months and the sole and direct reason is death of the insured /insured persons, the capital sum insured mentioned in the schedule.
    • If the injury takes place within 12 calender months and the sole and direct cause of the total and irrecoverable loss of the following:
      • Both eye sights or of the actual loss of physical separation of two entire hands or entire two feet , or of one entire hand and one entire foot or loss of one eye sight or one entire hand or one entire foot  as mentioned in the schedule.
    • Use of two hands or two feet or of one hand and one foot , or loss of one eye sight or loss of use of one hand  and one foot  as mentioned in the schedule.
    • If the injury takes place within 12 calender months and the sole and direct cause of the total and irrecoverable loss of the following:
      • Loss of one eye sight or of the actual loss of physical separation of one entire hand or of one or of one entire foot  50% of Capital Sum Insured as mentioned in the schedule.
    • Use of a hand or a foot without physical separation , 50% of the capital sum insured as mentioned in the schedule.
    • If the injury takes place resulting in immediately  permanently , totally and absolutely  and therefore disable the  Insured person from engaging in any employment or occupation then a lump sum amount is given as stated in the schedule.
    • If the injury takes place within 12 calender months of its occurrence be the sole and direct cause of the total and/ or partial and irrecoverable loss of use of the actual loss by physical separation of the following then the percentage of the Capital Sum Insured.
    • If such injury is the sole and direct cause of temporary total disablement, then as long as the insured person is disabled from engaging in any employment or occupation,  a sum at the rate of 1% of the capital sum insured as mentioned in the schedule. However the same will not exceed Rs 10000/- per week under all plans.
    • In case of death of the insured person due to bodily injury resulting solely and directly from due to accident caused by external , violent and visible means, the company will pay a lump sum allowance of 1% of the capital sum insured for transferring the insured person’s dead body to the residence.
    • Funeral expenses: The company will provide a payment for a fixed amount as mentioned in the schedule for funeral expenses of the insured person.
    • The company will also provide an Educational Grant   of Rs 10000/- is also given if the insured has one dependent child upto age of 23 years and is pursuing studies. And if the insured has more than one dependent child upto age of 23 years and is pursuing studies, then the amount will be Rs 20000/-
    • Legal expenses: The legal costs and expenses are also reimbursed which is incurred by the insured person or his/her legal representatives for claims for compensation of death or disablement. However, the same should be incurred with the consent of the company.

    Value Added Benefits under the plan: The following are the value added benefits under the plan:

    • Hospital Daily cash Allowance: This benefit compensates towards daily payment for the number of days the insured person is hospitalized after treatment of bodily injury caused by accidental, external , violent and visible means.
    • Accident Medical Expenses: Under this plan, reimbursement of actual medical expenses is reimbursed.
    • Double indemnity for Death or Permanent Total Liability: An unique plan with 200% of the sum insured is covered in case of death or permanent total disablement.

Various Plans under Smart Individual Personal Accident Plan

  • Very well designed and tailor made 7 Smart Individual Personal Accident Plans  ( IPA)  are available . These are:

    • Smart IPA Basic.
    • Smart IPA Regular.
    • Smart IPA Standard without medical expenses cover).
    • Smart IPA Standard (with medical expenses cover).
    • Smart IPA Silver (applicable if the minimum monthly income is Rs 20000 and for Occupation Groups I & II).
    • Smart IPA Gold (applicable if the minimum monthly income is Rs 40000 and for Occupation Groups I & I ).
    • Smart IPA Superior.

    Now we will see an overview of the benefits that are available under each plan:

    Smart IPA Basic Plan

    • Accidental Death Benefit is Rs 200000/-.
    • Permanent Total Disability is Rs 300000/-.
    • Permanent Partial Disablement is the % of indemnity as mentioned in the policy.
    • Double Indemnity for Death or Permanent Total Disability – No coverage for this under this plan.
    • Temporary Total Disablement- No coverage for this under this plan.
    • Hospital Daily Cash: No coverage for this under this plan.
    • Transportation of Mortal Remains: 1% of the Sum Insured.
    • Funeral expenses- No coverage.
    • Accidental Medical Expenses- No coverage.
    • Education Grant:  This benefit provides education grant of Rs 10000/- per child upto 2 dependent children upto 23 years of age.
    • Legal Expenses- No cover for this.

    Smart IPA Regular Plan

    • Accidental Death Benefit is Rs 200000/-.
    • Permanent Total Disability is Rs 300000/-.
    • Permanent Partial Disablement is the % of indemnity as mentioned in the policy.
    • Double Indemnity for Death or Permanent Total Disability – No coverage for this under this plan.
    • Temporary Total Disablement- No coverage for this under this plan.
    • Hospital Daily Cash: No coverage for this under this plan.
    • Transportation of Mortal Remains: 1% of the Sum Insured.
    • Funeral expenses- No coverage.
    • Accidental Medical Expenses- 20% of Section I Sum Insured.
    • Education Grant:  This benefit provides education grant of Rs 10000/- per child upto 2 dependent children upto 23 years of age.
    • Legal Expenses- No cover for this.

    Smart IPA Standard Plan (without medical expenses cover)

    • Accidental Death Benefit is Rs 500000/-.
    • Permanent Total Disability is Rs 750000/-.
    • Permanent Partial Disablement is the % of indemnity as mentioned in the policy.
    • Double Indemnity for Death or Permanent Total Disability – No coverage for this under this plan.
    • Temporary Total Disablement- 1% of the Sum Insured per week subject to maximum of Rs 5000 payable for 104 weeks.
    • Hospital Daily Cash: Rs 200 for every day of hospitalization after first 2 days, for a maximum of 50 days.
    • Transportation of Mortal Remains: 1% of the Sum Insured.
    • Funeral expenses- No coverage.
    • Accidental Medical Expenses- No coverage.
    • Education Grant:  This benefit provides education grant of Rs 10000/- per child upto 2 dependent children upto 23 years of age.
    • Legal Expenses- Rs 5000.

    Smart IPA Standard Plan (with medical expenses cover)

    • Accidental Death Benefit is Rs 500000/-.
    • Permanent Total Disability is Rs 750000/-.
    • Permanent Partial Disablement is the % of indemnity as mentioned in the policy.
    • Double Indemnity for Death or Permanent Total Disability – No coverage for this under this plan.
    • Temporary Total Disablement- 1% of the Sum Insured per week subject to maximum of Rs 5000 payable for 104 weeks.
    • Hospital Daily Cash: Rs 200 for every day of hospitalization after first 2 days, for a maximum of 50 days.
    • Transportation of Mortal Remains: 1% of the Sum Insured.
    • Funeral expenses- Rs 2000.
    • Accidental Medical Expenses- 20% of Sum Insured.
    • Education Grant:  This benefit provides education grant of Rs 10000/- per child upto 2 dependent children upto 23 years of age.
    • Legal Expenses- Rs 5000.

    Smart IPA Silver Plan

    • Accidental Death Benefit is Rs 1000000/-.
    • Permanent Total Disability( PTD) is Rs 1500000/-.
    • Permanent Partial Disablement is the % of indemnity as mentioned in the policy.
    • Double Indemnity for Death or Permanent Total Disability – For Death Rs 2000000/- and for PTD its Rs 3000000/-.
    • Temporary Total Disablement- 1% of the Sum Insured per week subject to maximum of Rs 10000/- payable for 104 weeks.
    • Hospital Daily Cash: Rs 500 for every day of hospitalization after first 2 days, for a maximum of 50 days.
    • Transportation of Mortal Remains: 1% of the Sum Insured.
    • Funeral expenses- Rs 3500.
    • Accidental Medical Expenses- 20% of Sum Insured.
    • Education Grant:  This benefit provides education grant of Rs 10000/- per child upto 2 dependent children upto 23 years of age.
    • Legal Expenses- Rs 5000.

    Smart IPA Gold Plan

    • Accidental Death Benefit is Rs 2000000/-.
    • Permanent Total Disability( PTD) is Rs 3000000/-.
    • Permanent Partial Disablement is the % of indemnity as mentioned in the policy.
    • Double Indemnity for Death or Permanent Total Disability – For Death Rs 4000000/- and for PTD its Rs 6000000/-.
    • Temporary Total Disablement- 1% of the Sum Insured per week subject to maximum of Rs 10000/- payable for 104 weeks.
    • Hospital Daily Cash: Rs 1000 for every day of hospitalization after first 2 days, for a maximum of 50 days.
    • Transportation of Mortal Remains: 1% of the Sum Insured.
    • Funeral expenses- Rs 5000.
    • Accidental Medical Expenses- 20% of Sum Insured.
    • Education Grant:  This benefit provides education grant of Rs 10000/- per child upto 2 dependent children upto 23 years of age.
    • Legal Expenses- Rs 5000.

    Eligibility of the plan

    Individuals between 18 years to 70 years of age can apply for the SmartIndividual  Personal Accident Plan . Its also a lifelong renewable plan.

    Exclusions under the plan

    The following are the exclusions under the plans under which the company will not pay any benefit to the Insured Person:

    • For Bodily injury or Sickness aggravated by the insured person knowingly.
    • For Bodily injury or Sickness due to intentional and deliberate exposure to danger, self inflicted injury, suicide or attempted suicide or non adherence to the medical advise.
    • If the insured person is injured or fall sick due to consumption of alcohol or drugs or narcotics unless professionally advised by the Doctor.
    • Payment of compensation in respect of death, disablement, injury, illness disease hospitalization of the insured person due to or arising out of , directly or indirectly due to
    • Ionizing radiation or contamination by radioactivity from any nuclear fuel or nuclear waste.
    • Nuclear weapon materials.
    • Working in underground mines or explosive magazines, or involving electrical installation with high tension supply, or as jockies or circus personnel, or engaged in activities like racing on wheels, horseback, big game hunting.
    • If there is any competition which involves utilization of motorized land , water or vehicle and the insured person participates in the same and is injured.
    • For bodily injury while the insured person is travelling by air other than as a fare paying passenger.
    •  For bodily injury which occur due to participating in any criminal act or or any breach of law with that of criminal intention.
    • AIDS/ HIV.
    • For bodily injury which occur due to participation in any violent labour disturbances riot or civil commotion or public disorder.
    • Payment of compensation in respect of death, disablement, injury, illness disease hospitalization of the insured person due to or arising out of , directly or indirectly due to war irrespective of declared or not, invasion, hostilities, civil war, martial law, act of foreign enemy, rebellion, revolution, insurrection, military or usurper power, riot or civil commotion, seizure, capture , arrests, restraints and detainments.
    • Treatments of nervous or mental problems.
    • Pre existing diseases.
    • Hazardous Sports.
    • If the insured person is injured or fall sick due to venereal or venereal related disease.
    • Payment of compensation in respect of death, disablement, injury, illness disease hospitalization of the insured person due to or arising out of , directly or indirectly due to prolonged childbirth or pregnancy.

    Claims

    • One can call at the 24x7 toll free number to register a claim at the earliest.  The following details are to be furnished:
      • Name of the Insured person
      • Nature of loss.
      • Date, time and location of loss.
      • Policy Number.
      • Contact Details.
      • One can also email at claims[at]bharti-axagi[dot]co[dot]in
      • The basic documents under the plan  are as follows:
        • Claim form.
        • Death/ Disability Certificate.
        • Admission or Discharge Summary.
    • On receipt of the documents and investigation reports, the company will inform the policy holder on the claim status within 10 days.

    Documents needed for Personal Accident Death Claims

    • Claim form.
    • Policy Copy.
    • Attested/Original FIR
    • Attested/Original Post Mortem Report
    • Death Certificate from Municipal Authorities.

    Documents needed for Personal Accident Disability Claims

    • Claim form.
    • Policy Copy.
    • Attested FIR copy.          
    • Disability Certificate from Doctor.
    • Hospital Medical Records.
    • Original bills, receipts, cash memos with related treatment papers.

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