Ram Awadh Singh provides an overview of miscellaneous insurance and personal accident insurance. Personal accident insurance covers death and disablement resulting from accidental bodily injury. It analyzes key terms like accident, bodily injury, and disablement. It also outlines exclusions, additional benefits, renewal processes, rating classifications, group personal accident policies, and different types of personal accident covers available in India.

1. RAM AWADH SINGH
Insurance Surveyor and Loss Assessor
BSc., MBA, AIII,DME,PDTQM& ISO 9000,FIIISLA
MISCELLANEOUS INSURANCE AND
CLAIMS

2. Miscellaneous Insurance
Personal Accident Insurance
Covers death and disablement
Basic principles
• UT MOST GOOD FAITH:
• Yes, as in other class of insurance
• INDEMNITY:
• Contracts are not strictly subject to the principles of
indemnity.
• Can be termed as “benefit policies”. Rather than policies of
Indemnity.
• CONTRIBUTION:
• No strict contract of indemnity, the principle of indemnity
does not apply.

3. • SUBROGATION:
• Subrogation does not apply to contracts which are
not strict indemnity.
• BASIC COVERAGE:
• Basically covers death and disablement resulting
solely and directly from bodily injuries sustained in
an accident, caused by external violent and visible
means.

4. • Analysis of terms:
• Bodily injury : Injury caused by accident.
• Solely and directly: By an accident.
• Accident : Un expected not intended or
designed.
• External, violent : Internal injury caused death
and Visible means : or disablement

5. • DISABLEMENT:
• Permanent total disablement : loss of both sight.
• Permanent partial disablement : Two entire hands,
two entire feet's, one entire hands and one entire feet's.
• Temporary total disablements : Loss of one eye
sight and such loss of one entire hand/ foot.

6. ADDITIONAL BENEFITS AT NO EXTRA PREMIUM
• Carriage of dead body to place of residence
reimbursed subject to certain limit.
• Education fund to dependent children
onetime payment in addition to capital sum
insured- is applicable in PA Individual policy
not on cumulative bonus.
• Cumulative Bonus : 5% in respect of each
completed year.

7. EXCLUSION IN PERSONAL ACCIDENT
• Intentional self injury, suicide or attempted
suicide.
• Influence of intoxicating liquor or drugs.
• Engaging in aviation or ballooning,
dismounting from or travelling in any balloon
or aircraft other than as a passenger.
• Directly or indirectly caused by venereal
disease or insanity

8. • Committing any breach of law with criminal
intent.
• Service with armed forces.
• Resulting directly and indirectly from child
birth or pregnancy.
• War, kindred perils and nuclear risks.

9. Renewal, cancellation, assignment and
rating
• Renewal by mutual consent every year before
the date of expiry.
• By notice in writing policy can be terminated
and the company shall a pro rata part of
premium.
• Assignment not permissible under the act,
These policies can be assigned under the
transfer of property act.
• Rating as per the occupation of the insured.

10. Classification of risk
• 1-Accountants, Doctors, lawyers , Architects,
consulting engineers, teachers , bankers,
Persons engaged in administration functions,
person primarily engaged in occupations of
similar hazards.
• 2-Builders, contractors and engineers engaged
in superintending functions only, veterinary
doctors, paid drivers of motor cars/ LMV and
persons engaged in similar hazards.

11. • 3- Persons working in underground mines,
explosive magazines Involved in electrical
installation with high-tension supply, jockeys,
circus personal, persons engaged in activities
like racing on wheels or horseback, big game
hunting , , mountaineering, winter sports ,
skiing, ice hockey, Ballooning, hang gliding,
river rafting, polo and activities of similar
hazards. Risk groups are also known as
normal, medium, high respectively.

12. GPA POLICIES
• Employers appreciated- welfare benefits for their
employees.
• Also available associations, clubs etc– administratively
convenient to arrange a group policy to cover their
members.
• Group discount- In respect named group, employee’s
relationship and dependent of employee’s, state
central governments segments, members of registered
cooperative societies/clubs, holders of credit cards of
banks/diners/master/visa, deposit certificates issued
by banks /NBFC’S, share holders of banks/ public ltd
companies.

13. • No group discount to anticipated group size.
• On duty cover---reduced premium equivalent
to 75% appropriate premium is charged.
• Cover applies to accident to employee’s
arising out of employment only.
• Off duty covers—cover is required only for the
restricted hours when the employee is not at
work and or not in official duty the reduced
premium 50% of the appropriate premium.

14. Claim form, proximate cause
• Notice of the occurrence be given immediately and to
be followed by full details.
• Insured shall furnish satisfactory proof of all matters
upon which claim is based.
• Pre existing disease before the accident and accident
causes which in no way contributed by disease is
proximately caused by accident.
• If either accident or disease could have produced the
result then claim for accident can not be admitted
unless there is proof of accident. The disease promotes
the accident but the injuries are due to the accident.

15. Types of personal accident covers
• Flight insurance coupons, junta personal accident
insurance, Group junta personal accident, Student
safety insurance, Traffic accident policy/Rastha apathy
cover, Domestic travelers policy, Suhana safar,Policy
covering education expenses/amartya siksha yojna.
• Rajeshwari mahila kalyan yojna permanent total
disablement Rs 25000 in the event of death,
Permanent disablement Rs 25000.00, Loss of limb Rs
12500.00, Temporary disablement Rs 500 per month
subject to maximum Rs 1500, Expenses incurred legal
divorce proceedings Rs 2000.00, Loss damage due to
fire and flood riot terrorism up to a limit of Rs 2000.0

16. • Bhagya shree child welfare policy whose
parents age does not exceed 60 years—
applicable to girl child up to age of 18 years.
• Intended to provide insurance cover to one
child a family who loses either father or
mother due to accidental death.
• Age 0-5----Rs 1200 pa to parent or guardian
6-11—Rs 1200 pa, 12-17 –Rs 2400pa,
• Age 18 to the insured's girl child.

17. THANKS