1. 3 sections Basic, Wider , Comprehensive and two add on covers
medical expenses , Hospital confinement allowance , details and
coverageofeachsectionisgivenbelow:-
 Whatarethebenefitsunderthispolicy?
• Death–100%ofSumInsured
• PermanentTotalDisability(PTD)–Highestcompensationof
125%ofSumInsured
• PermanentPartialDisability(PPD)-Asperthetablegivenbelow
• Temporary Total Disability (TTD) - 1% of the Sum Insured or
Rs5000/-perweek,whicheverislesser
• Transportation of mortal remains - lower of Rs.5,000/- and
2% of the sums assured shown under the schedule headings
Basic,WiderandComprehensive.
• Children's Education bonus in case of Death or Permanent
Total disability of proposer - onetime payment of Rs.5,000/-
each towards the cost of education of up to 2 of your
dependentchildrenwhowereundertheageof19onthedate
youmetwithAccidentalBodilyInjury.
• Hospital Confinement Allowance - If the claim is accepted
under Death, Permanent Total Disability (PTD) , Permanent
Partial Disability (PPD), Temporary Total Disability (TTD)
thenwe will pay you Rs 1000/- per 24 hours of hospitalization,
maximumupto30daysperpolicyperiod
• Medical Expenses due to accidental injury - If the claim is
accepted under Death, Permanent Total Disability (PTD) ,
Permanent Partial Disability (PPD), Temporary Total Disability
(TTD) then reimbursement of the cost of medical expenses
due to accidental injury up to 40% of valid claim amount or
actualmedicalbills,whicheverislesser
• Cumulative Bonus -If You renew Your Personal Accident
InsurancePolicywithUswithoutanybreakinthePolicyPeriod
and there has been no claim in the preceding year, then We
willincreasetheLimitofIndemnityby10%ofSumAssuredper
annumasCumulativeBonus,
The maximum cumulative increase in the Limit of Indemnity
willbelimitedto5yearsand50%ofSumAssured.
 PermanentPartialDisablementtable:
Incaseofpermanentpartialdisablement,wewillpaythepercentage,
ofthesumassuredasapplicablegiveninthetablebelow
 Whataretheimportantexclusionsunderthispolicy?
1. AccidentalBodilyInjurythatYoumeetwith:
a. Through suicide, attempted suicide or self inflicted injury
orillness.
b. Whileundertheinfluenceofliquorordrugs.
c. Arising or resulting from the insured person(s)
committinganybreachoflawwithcriminalintent.
d. Whilst engaging in aviation or ballooning, whilst
mounting into, dismounting from or travelling in any
balloon or aircraft other than as a passenger (fare paying
or otherwise) in any duly licensed standard type of
aircraftanywhereintheworld.
e. Whilst participating as the driver, co-driver or passenger
ofamotorvehicleduringmotorracingortrialruns.
f. As a result of any curative treatments or interventions
thatyoucarryoutorhavecarriedoutonyourbody.
g. Arising out of your participation in any naval, military or
air force operations whether in the form of military
exercises or war games or actual engagement with the
enemy,whetherforeignordomestic.
2. Your consequential losses of any kind or your actual or alleged
legalliability.
3. Venerealorsexuallytransmitteddiseases.
4. HIV (Human Immunodeficiency Virus) and/or any HIV related
illness including AIDS (Acquired Immune Deficiency
Syndrome) and/or mutant derivatives or variations thereof
howevercaused.
5. Pregnancy, resulting childbirth, miscarriage, abortion, or
complicationsarisingoutofanyofthese.
6. War (whether declared or not), civil war, invasion, act of
foreign enemies, rebellion, revolution, insurrection, mutiny,
militaryorusurpedpower,seizure,capture,arrest,restraintor
detainment,confiscationornationalisationorrequisitionofor
damage by or under the order of any government or public
localauthority.
7. Nuclearenergy,radiation.
 SpecialConditions:
FreeLookPeriod
• If you are not satisfied with policy coverage, terms and
conditions, You have the option of canceling the policy within
15 days of receipt of the first year policy documents, provided
therehasbeennoclaim.
• Freelookperiodisnotapplicableforrenewalpolicies.
Renewal&Cancellation
• Undernormalcircumstances,renewalwillnotberefusedexcept
onthegroundsofYourmoralhazard,misrepresentationorfraud
• For age 66years and above, renewal Sum insured would be
restricted to lower of Rs10lacs (under Basic and or Wider) or
expiring policy sum insured under Basic and / or Wider
sections.
• Howeverrenewalscanbeconsideredwithhighersuminsured
subjecttosubmissionofrequisitedocumentationtoascertain
commensurationofincome.
• In case of Our own renewal a grace period of 30 days is
permissible and the Policy will be considered as continuous
coverage. Any claim incurred as a result of Accidental injury
duringthebreakperiodwillnotbeadmissibleunderthepolicy.
• Forrenewalsreceivedaftercompletionof30daysgraceperiod,
a fresh application of health insurance should be submitted to
Us,itwouldbeprocessedasperanewbusinessproposal.
• After the completion of maximum renewal age of dependent
 BajajAllianz
BajajAllianzGeneralInsuranceCompanyLimitedisajointventure
between Bajaj Finserv Limited (recently demerged from Bajaj
Auto Limited) and Allianz SE. Both enjoy a reputation of expertise,
stability and strength. This joint venture company incorporates
global expertise with local experience. The comprehensive,
innovative solutions combine the technical expertise and
experience of more than 110 year old Allianz SE, and indepth
marketknowledgeandgoodwillofBajaj.Competitivepricingand
quick honest response have earned the company the customer's
trustandmarketleadershipinaveryshorttime.
 TheBajajAllianzAdvantage
 PersonalAccidentInsurancePolicy:
Life is uncertain. Your future doesn't have to be. The accidental
death or injury of a breadwinner can create serious financial
problems for the family. Our Personal Accident Insurance policy
ensurestotalsecurityandpeaceofmind.
 Whatistheentryageunderthispolicy?
EntryageforProposerandSpouseis18to65years.
DependentChildrencanbecoveredfrom5yearsto21years.
 Whatwillbetherenewalage?
Under normal circumstances, lifetime renewal benefit is available
underthepolicyexceptonthegroundsoffraud,misrepresentation
ormoralhazard.
 Whatisthepolicyperiod?
Thisisanannualpolicy
 WhocanbecoveredunderthePolicy?
Self,Spouseanddependentchildrencanbecoveredunderthispolicy.
 WhatiscoveredunderPersonalAccidentInsurancePolicy?
Personal Accident Insurance Policy coverage is broadly divided in
An arm at the shoulder joint
An arm above the elbow joint
An arm beneath the elbow joint
A hand at the wrist
A thumb
An index finger
Any other finger
A leg above mid-thigh
A leg up to mid-thigh
A leg up to beneath the knee
A leg up to mid-calf
A foot at the ankle
A large toe
Any other toe
An eye
Hearing of one ear
Hearing of both ears
Sense of smell
Sense of taste
70 %
65 %
60 %
55 %
20 %
10 %
5 %
70 %
60 %
50 %
45 %
40 %
5 %
2 %
50 %
30 %
75 %
10 %
5 %
UIN: IRDA/NL-HLT/BAGI/P-P/V.I/280/13-14 UIN: IRDA/NL-HLT/BAGI/P-P/V.I/280/13-14 UIN: IRDA/NL-HLT/BAGI/P-P/V.I/280/13-14 UIN: IRDA/NL-HLT/BAGI/P-P/V.I/280/13-14
Details
Capital SI not
to exceed
120 times of
average
Monthly
Income
Coverage
Rs 1000/-
per 24 hours of
hospitalization,
maximum up to 30
days per policy
period
NANA
Hospital
Confinement
Allowance
Death+PTD+
PPD+TTD
Comprehensive
Death+
PTD+PPD
Wider
Death
Eligiblity
Basic
Max. 24 times of
Monthly Incomeor
maximum of Rs 5 Lakhs
Reimbursement
up to 40% of valid
claim amount or
Rs. 5lac, whichever
is less
NANA
Medical
Expenses
Max. 60 times of
Monthly Income
Max. 100 times of
Monthly Income
subject to maximum
of Rs 25 Lakhs

2. Contact Details
Bajaj Allianz General Insurance Company Limited,
G.E. Plaza, Airport Road, Yerawada, Pune - 411 006.
Tel: (020) 6602 6666. Fax: (020) 6602 6667.
www.bajajallianz.com
Email: info@bajajallianz.co.in
For any queries please contact:
BSNL/MTNL
(Toll Free)
1800 22 5858
Other
(Chargeble)
<Prefix City Code> 3030 5858
Bharati Mobile & Landline
(Toll Free)
1800 102 5858
BJAZ-B-0172/20-Sep-17
Insurance is the subject matter of the solicitation
Personal Accident Insurance Policy/V002/w.e.f. 01st October 2013
Get yourself and your family covered
by Personal Accident Insurance Policy
today and sleep easy.
Disclaimer: The above information is only indicative in nature. For details of the
coverage & exclusions please contact our nearest office.
To know more visit our website, Website: www.bajajallianz.com or get in touch with
Email: wellness.HAT@bajajallianz.co.in ;24*7 helpline number: 1800-103-2529
(toll free) / 020-30305858
Network Hospital & Value Added service Provider list is provisional & subject to
change based on the review of the providers
Personal Accident
Insurance Policy
From Insecure to Secure
Bajaj Allianz
WithdrawalofPolicy
There is possibility of withdrawal of this product at any time in
future with appropriate approval from IRDA, as We reserve Our
right to do so with a intimation of 3 months to all the existing
insured members. In such an event of withdrawal of this product,
at the time of Your seeking renewal of this Policy, You can choose,
among Our available similar and closely similar Personal Accident
Insurance products. Upon Your so choosing Our new product, You
will be charged the Premium as per Our Underwriting Policy for
suchchosennewproduct,asapprovedbyIRDA.
 Whatarethepremiumratesforthispolicy?
The Premium differs in case of different risk levels determined by
youroccupation.
RiskLevel-I
Administrative / managing functions, accountants, doctors,
lawyers,architects,teachersandsimilaroccupations
RiskLevel-II
Manual labour, garage mechanic, machine operator, paid driver
(car / truck / heavy vehicles) cash carrying employee, builder,
contractor,veterinarydoctorandsimilaroccupations.
RiskLevel-III
Workers in underground mines, electric installations with high
tension supply, Jockey, circus performers, big game hunters,
mountaineers,professionalriverraftersandsimilaroccupations.
(Foroccupationsnotspecifiedabove,pleaseenquirewithus.)
 AnnualPremiumRate
PremiumsareexclusiveofGST
 HowdoIsubmitmyclaim?
• If you meet with an accident and injure any part of your body
that may result in a claim, you or someone claiming on your
behalf must inform us in writing immediately, and in any
eventwithin30days.
• Incaseofdeathduetoaccident,thesamemustbeinformedto
us inwriting immediately and send us a copy of the post
mortemreport(Ifconducted)within30days.
Premium rates given below (%) - Rs. per 1000 /-
Cover
Basic
Wider
Comprehensive
Medical
Expenses
Hospital
Confinement
Risk Class
II
0.6
1.25
2.0
25% of above
premium
Rs. 300 per
person
I
0.45
1.0
1.5
25% of above
premium
Rs. 300 per
person
III
0.9
1.75
Not available
25% of above
premium
Rs.300 per
person
children, the policy would be renewed for lifetime. However a
separate proposal form should be submitted to us at the time
of renewal with the insured member as proposer. Suitable
credit of continuity for all the previous policy years would be
extended in the new policy, provided the policy has been
maintainedwithoutabreak.
• Premium payable on renewal and on subsequent
continuation of cover are subject to change with prior
approvalfromIRDA.
• We may cancel this insurance by giving You at least 15 days
written notice, and if no claim has been made then We shall
refundapro-ratapremiumfortheunexpiredPolicyPeriod.
• You may cancel this insurance by giving Us at least 15 days
written notice, and if no claim has been made then We shall
refund premium on short term rates for the unexpired Policy
Periodaspertheratesdetailedbelow.
Graceperiod:
• In case of our own renewal a grace period of 30 days is
permissible and the Policy will be considered as continuous
coverage.
• Any claim incurred as a result of Accidental injury during the
breakperiodwillnotbeadmissibleunderthepolicy.
WhencanIenhancemysuminsured?
SumInsuredenhancementcanbedoneatrenewals.
Discountsavailableunderthepolicy
Family discount of 10% is available for covering 2 and more
membersunderthepolicy
PortabilityConditions
As per the Portability Guidelines issued by IRDA, If you are insured
under any other Personal Accident Insurance Policy of Non life
insurer you can transfer to Personal Accident Insurance Policy
with all your accrued benefits after due allowances for waiting
periods and enjoy all the available benefits of Personal Accident
InsurancePolicy
Revision/Modificationofthepolicy:
Thereisapossibilityofrevision/modificationofterms,conditions,
coverages and/or premiums of this product at any time in future,
with appropriate approval from IRDA. In such an event of
revision/modificationoftheproduct,intimationshallbesetoutto
all the existing insured members at least 3 months prior to the
dateofsuchrevision/modificationcomesintotheeffect
Period on Risk
Upto 1 month
Exceeding 1 month and upto 3 months
Exceeding 3 months and upto 6 months
Exceeding 6 months
% of Annual Premium Refunded
75%
50%
25%
Nil
UIN: IRDA/NL-HLT/BAGI/P-P/V.I/280/13-14 UIN: IRDA/NL-HLT/BAGI/P-P/V.I/280/13-14
CIN: U66010PN2000PLC015329
UIN: IRDA/NL-HLT/BAGI/P-P/V.I/280/13-14UIN: IRDA/NL-HLT/BAGI/P-P/V.I/280/13-14
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