Home / Insurance / News /  Irdai notifies guidelines for standard personal accident insurance

The Insurance Regulatory and Development Authority of India (IRDAI) has directed all general and health insurance companies to mandatorily offer a standard personal accident insurance policy by 1 April, 2021.

The policy will be named Saral Suraksha Bima, succeeded by name of the insurance company. It will be offered with a tenure of one year.

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To make available a standard personal accident product with common coverage and policy wordings across the industry, an exposure draft on "Guidelines on Standard Personal Accident product" along with standard terms and conditions were issued by Irdai in December 2020.

The minimum entry age to buy such a policy shall be 18 years and the maximum age at entry at least 70 for insured members, including the principal insured. Insurers are permitted to fix the maximum age at entry beyond 70 years, subject to underwriting policy. Dependent child will be covered from the age of three months to 25 years subject to the definition of ‘family’ and underwriting policy, said the final guidelines.

The standard PA product shall be offered on an individual basis. When offered as a family cover, the chosen sum insured will apply to each family member separately. The minimum sum insured shall be 2.5 lakh and the maximum sum insured shall be 1 crore. Sum insured offered shall be in multiples of 50,000. Beyond the range specified above, insurers can offer on their own and can use the same name for the product if all terms and conditions remain the same.

Policy coverage

Along with the base covers of Standard PA product, the policy will come with three optional covers. Temporary total disablement benefit and education grant covers will be offered on a benefit-basis. However, the third optional cover -- hospitalisation expenses due to accident -- will be offered on an indemnity basis. This means that the insured will get the claim settled equally to the actual amount of loss sustained, subject to the maximum sum insured.

The intimation about an event or occurrence that may give rise to a claim under this policy must be given within 30 days of its happening.

Major policy exclusions

Any claim for death or disablement (whether of a permanent nature or a temporary nature), hospitalization of the insured person directly or indirectly due to war (whether declared or not) and warlike 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 will not be covered, the final guidelines said.

Accident arising from intentional self-injury unless in self-defence or to save life, suicide or attempted suicide will not be covered either. An accident arising from ionizing radiation or contamination by radioactivity from any nuclear fuel or any nuclear waste from the combustion of nuclear fuel or any nuclear waste from combustion of nuclear fuel are excluded from the policy.

There can be many other exclusions under the policy. Therefore, one must read the policy document carefully before zeroing in on the policy.

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