Personal Accident Insurance
A fixed benefit for death or disablement by accident. Not indemnity, so every policy pays.
Personal accident (PA) insurance pays a fixed sum if an accident kills or disables the insured. It does not measure a loss the way fire or motor cover does: a lost hand has no market price, so the policy pays an agreed percentage of the sum insured. That makes PA a benefit policy, outside indemnity, and a person can hold and claim under several PA policies at once.
Cover is for accidental bodily injury. A typical wording describes the accident as sudden, unforeseen and involuntary, caused by external, violent and visible means: a road crash, a fall from scaffolding at a Pune site, or a burn. Illness is not an accident and is excluded.
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The Benefits, as in IRDAI's Standard PA Product
Saral Suraksha Bima is the standard PA product every general and health insurer must sell online. Its structure is the template the market uses.
Death
What is paid
100% of the sum insured, if death occurs within 12 months of the accident
Cover type
Base
Permanent total disablement (PTD)
What is paid
100% of the sum insured: loss of sight of both eyes, of both hands or feet, of one hand and one foot, or total inability to work in any occupation
Cover type
Base
Permanent partial disablement (PPD)
What is paid
A percentage from a table: 50% for one entire hand, one foot or sight of one eye; 40% for four fingers and thumb of one hand; 25% for a whole thumb
Cover type
Base
Temporary total disablement (TTD)
What is paid
0.2% of the base sum insured per week while completely unable to work, after a minimum four weeks of disablement
Cover type
Optional
Accident hospitalisation
What is paid
Hospital expenses up to 10% of the base sum insured
Cover type
Optional
Education grant
What is paid
10% of the base sum insured per dependent child, on death or PTD
Cover type
Optional
| Benefit | What is paid | Cover type |
|---|---|---|
| Death | 100% of the sum insured, if death occurs within 12 months of the accident | Base |
| Permanent total disablement (PTD) | 100% of the sum insured: loss of sight of both eyes, of both hands or feet, of one hand and one foot, or total inability to work in any occupation | Base |
| Permanent partial disablement (PPD) | A percentage from a table: 50% for one entire hand, one foot or sight of one eye; 40% for four fingers and thumb of one hand; 25% for a whole thumb | Base |
| Temporary total disablement (TTD) | 0.2% of the base sum insured per week while completely unable to work, after a minimum four weeks of disablement | Optional |
| Accident hospitalisation | Hospital expenses up to 10% of the base sum insured | Optional |
| Education grant | 10% of the base sum insured per dependent child, on death or PTD | Optional |
Saral Suraksha Bima: Other Terms Worth Knowing
- check_circleSum insured from ₹2.5 lakh to ₹1 crore, in multiples of ₹50,000. Policy period one year.
- check_circleEntry age 18 years, with a maximum entry age of at least 70; dependent children covered from 3 months to 25 years.
- check_circleA cumulative bonus of 5% of the sum insured for each claim-free year, up to 50%.
- check_circleThe policy ends once 100% of the sum insured has been paid for an insured person.
Compulsory PA for Owner-Drivers and Group PA
A motor policy's third-party cover does not protect the owner-driver. To fill that gap, IRDAI requires compulsory personal accident (CPA) cover for the owner-driver under motor policies; its 2018 circulars on CPA, including one that raised the capital sum insured, remain in force under the 2024 master circular. Check the policy schedule for the CPA sum insured.
Group PA covers a defined group, such as an employer's staff, a bank's account holders or a contractor's workforce, under one master policy. The group's premium is rated on its occupation mix and claims experience, and individual members usually get a certificate of insurance.
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Mediclaim in One Paragraph
Mediclaim, the courseware's name for the older individual hospitalisation policy, is different in kind: it reimburses actual hospital bills for illness or injury, so it is an indemnity cover. The courseware describes it with waiting periods and an initial 30-day exclusion for illness. IC-11 places it with personal accident and specialty insurance, but expect only definitional questions on it.
How IC-11 Tests This
Expect "PA pays fixed compensation for death or disablement resulting from what" (accidental bodily injury), a PPD percentage, and PTD vs PPD. The trap is treating PA as indemnity and applying contribution between two PA policies. Both pay in full, because the benefit is fixed.
FAQs
What does personal accident insurance cover?expand_more
Death and permanent total disablement (100% of the sum insured), permanent partial disablement (a percentage from a table), and optionally weekly temporary disablement benefit, accident hospital costs and an education grant.
What is the difference between PTD and PPD?expand_more
Permanent total disablement is loss of both eyes, both limbs, a hand and a foot, or total inability to work, and pays 100%. Permanent partial disablement is a lesser permanent loss, such as one hand or one eye, paid as a percentage of the sum insured.
Is personal accident cover compulsory in motor insurance?expand_more
Yes, for the owner-driver. IRDAI requires compulsory personal accident cover for the owner-driver under motor policies, because third-party cover does not protect the owner.
Can I claim under two personal accident policies?expand_more
Yes. PA pays fixed benefits, not indemnity, so each policy pays its own benefit. IRDAI's 2024 master circular confirms that under benefit-based policies the policyholder can claim from all insurers.
Next steps
- Motor Policy Typesarrow_forward
- Miscellaneous Policiesarrow_forward
- Syllabusarrow_forward
- Principle of indemnity (IC-01)arrow_forward
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