Max Bupa Personal AccidentCare Insurance Plan- Eligibility & Features

Updated: 04-07-2022 04:36:25 AM

It is estimated that every four minutes one person in India dies due to road accident. This is one of the reasons why Insurances related to accidents are needed. It is essential to have a financial reserve for your family and loved ones in the case of Family Accident. Max Bupa Insurance provides Max Bupa Personal AccidentCare Insurance Plan for individuals who may have lost their lives to accident or are subject to a total or partial disability.

Types of Personal Max Bupa AccidentCare Insurance Plan

Max Bupa offers Personal Accident care Insurance Plan offers Personal Accident care insurance plan under Individual and Family options respectively.

Eligibility Criteria

Parameters	Details
Entry Age	Min: 18 years Max: 65 Years
Dependent Children	Min: 2 years Max: 21 years
Sum Insured	Rs 5 Lacs – 2 Cr.
Policy Tenure	1 year/2 years/3 years
Policy Renewal Period	Lifelong Renewal Possible

Features of Personal Accident Care Insurance Plan

Features	Particulars
Claim Type [In house or TPA]	Direct Claim Settlement is provided under this claim.
Pre-Hospitalization	For sum insured relating to 60 days
Network Hospitals Count	4000+
Post-Hospitalization	For sum insured relating to 90 days.
Room Eligibility	Covered under Accident Hospitalization limit
Worldwide Coverage	This policy is subject to Worldwide Coverage
Maternity Cover	Not provided under this
Hospitalization at Home	Not provided under this
Emergency Ambulance	Limited to Rs 2000/- claim

Points to consider before buying a plan

1. Network Hospitals

The network hospitals need to be considered before purchasing an insurance plan. The policyholder should refer to the official website for the list of network hospitals as well as non-network hospitals. This also helps in increasing awareness about which hospital provides cashless facility or reimbursement basis.

2. Lifetime Renewal

The insured should check whether their policy offers lifetime renewal or not. As health tends to deteriorate more in the later phases, it is advisable to opt for lifetime renewals.

3. Waiting Period

The waiting periods associated with the policy must be checked and verified, It is beneficial to buy the policy at younger stages so that there are statistically fewer chances of filing up claims. Also, the waiting period can be easily covered.

4. Medical Checkups

The insured should check whether their policy covers for medical checks ups in their clause. Some insurance companies even provide free medical check-ups under their clause. That’s why it’s important to go through all the brochure and prospectus to know about the terms and conditions with respect to medical check-ups.

5. Pre and Post Hospitalization

The pre and post hospitalization conditions need to be checked before purchasing an insurance plan. This is a retrospective condition and differs from individual to individual.

6. Claim procedure

Check the claim procedure before buying the policy. Ensure that the claim procedure is simple and hassle-free. That is why all the brochure, prospectus and policy clause to check about the claim procedures.

Filing claims with Max Bupa Personal AccidentCare

The Claim procedure under Personal AccidentCare Insurance plan is as follows

1. In case of accidental death

• Claim form which is duly filled and signed.
• KYC documents.
• The copy of the death certificate which is issued by the office of the Registrar of Births and Deaths.
• Copy of FIR/Panchnama.
• The copy of Medico-Legal Certificate which is attested with the concerned hospital
• All copies of the hospital records.
• Copy of post-mortem reports

2. In case of Accident Permanent Total Disability

• The claim form and KYC documents which have been duly signed and filled.
• Hospital Discharge Summary  in original
• The self-attested copies need to be submitted if the official documents are with the insurer.
• The original Final Hospital Bill.
• All medical consultations along with investigations which are subject to outside the hospital.
• Certificate of Disability
• Copy of FIR/Panchnama.
• Copy of Medico-Legal Certificate

3. In case of Accident Permanent Partial Disability

• The claim form and KYC documents which have been duly signed and filled.
• Hospital Discharge Summary  in original
• The self-attested copies need to be submitted if the official documents are with the insurer.
• The original Final Hospital Bill.
• All medical consultations along with investigations which are subject to outside the hospital.
• Certificate of Disability
• Copy of FIR/Panchnama.
• Copy of Medico-Legal Certificate.

4. In case of Accidental  Temporary Total Disability

• The claim form and KYC documents which have been duly signed and filled.
• Hospital Discharge Summary  in original
• Final Hospital bill
• Copy of FIR/Panchnama.
• Copy of Medico-Legal Certificate
• The attendance record of the employer or Certificate of employer stating the period of absence for an employee.
• Disability certificate with stamp and seal
• Medical certificate with stamp and seal.
• Fitness certificate with stamp and seal.

5. In case of Accident Hospitalization

• The claim form and KYC documents which have been duly signed and filled.
• Hospital Discharge Summary  in original
• Copy of FIR/Panchnama.
• Copy of Medico-Legal Certificate
• Final hospital bill with all the respective receipts and copies attested in case if the documents are with the insured.
• Original hospital bills which support the relevant prescriptions which may be done outside the hospital.
• Original hospital bills which support the relevant prescriptions which may have been purchased outside the hospital.

Exclusions

• Any suicide attempts under this policy will be excluded.
• All injuries which have been termed self-inflicted.
• Being involved in committing an assault.
• Any disability which may have arisen out of pre-existing diseases.
• Involvement in hazardous sports or activities such as skydiving, paragliding and mountain/rock climbing.
• All breach of laws with criminal intent.
• All war invasions are excluded under this policy.
• Martial law
• The act of Foreign enemies
• Consumption accidentally or non-accidently of intoxicating substances such as alcohol, drugs, narcotics, related medicine along with sedatives or poison.
• Death or disablement which may have been caused due to exposure to any radioactivity of such kind.
• Any or all services are done in military or police enforcement agency during the times of war.
• All offenses categorized under Criminal Offense are considered to be excluded under this policy.
• All costs or expenses which may have been excluded under Annexure 2 of the policy document.

How long does the claim procedure take place?

The claim procedure will take the time as per the terms and conditions in the policy clause along with the formalities associated with it.

Advantages of Personal AccidentCare Insurance Plan

• There exists a 100% of sum insured in the case of Deaths due to Accidents.
• There exists a 125% of sum insured in the case of Permanent Total Disability.
• There exists a 100% of sum insured in the case of Permanent Partial Disability.
• There is a clause of Children’s Education Benefit in case of Permanent total disability or accidental death. It provides a minimum of 5% of your sum insured.
• This insurance plan covers for funeral expenses for up to Rs 5000/-[for sum insured up to Rs 25 lacs] or Rs 50,000/- [for sum insured more than Rs 25 lacs].
• This insurance plan even offers for Temporary Total Disability as 1% of sum insured payable every week.
• This insurance plan even offers Accident Hospitalization which is payable up to 2% of Accident care sum insured.
• This policy supports worldwide coverage aspect under its clause.

FAQs

Q1. Is this policy subject to income tax benefits?

Yes, Personal AccidentCare Insurance Plan is subject to income tax benefits under section 80D of The Income Tax Act, 1961.

Q2. What is different if I opt for a 2-3 year policy tenure?

The policy tenure for Personal AccidentCare Insurance Plan is provided as 1, 2 and 3 years respectively if the policyholder opts for 2 and 3-year policy tenure they avail discounts with them.

Q3. Does the Personal AccidentCare Insurance Plan cover for any Body or Mental infirmity?

No, all kinds of infirmities associated with Body or Mental Infirmity are excluded specifically to Personal AccidentCare Insurance Plan.

Q4. Does the insurance plan approve of the policyholder’s change of profession under Personal AccidentCare Insurance plan?

No, any kind of change of professions which may adverse the risk enhancement, if not endorsed by the insurance company is subject to Exclusion under the respective policy.

Q5. Are committing acts of suicide or any other self-intentional injuries excluded under this policy?

Yes, committing the act of suicide or any injuries which may be categorized as self-intentional are excluded under this policy.