Health Insurance 369 views August 5, 2021

Chola Accident Protection Plan provides financial protection to you and your family against accidental injuries and their consequences such as death, permanent total/partial disablement, etc. You can provide financial protection to self, spouse, dependent children under Chola Accident Protection Plan. Read this page and know more about the Chola Accident Protection Plan benefits.

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Chola Accident Protection Plan Coverage Explained

If you sustain any bodily injury and it is the direct cause of death or disability, the insurer shall pay the benefit as mentioned below:

Accidental Death: The insurer shall pay the sum insured, as stated in the policy schedule, provided the death occurs within twelve months from the date of injury and it is the sole and direct cause of death.

Permanent Total Disablement: In case of permanent total disability, the insurer will pay 100% of the sum insured for the following losses:

  1. Loss of sight of both eyes
  2. Loss of two entire hands or two entire feet
  3. Loss of one entire hand and one entire foot
  4. Loss of sight of one eye and loss of one entire foot or hand
  5. Loss of hearing of both ears and loss of speech
  6. Loss of hearing of both ears or loss of speech and loss of one limb or loss of sight of one eye

Permanent Partial Disablement: If the injury causes permanent partial disability, the insurer shall pay a percentage of the sum insured as shown below:

  1. Loss of toes (all) – 20%
  2. Loss of Great toe (both phalanges) – 5%
  3. Loss of Great toe (one phalanx) – 2%
  4. Loss of other than great toe (if more than one toe lost) for each – 2%
  5. Loss of hearing (both ears) – 60%
  6. Loss of hearing (one ear) – 30%
  7. Loss of speech – 60%
  8. Loss of four fingers and thumb of one hand – 40%
  9. Loss of four fingers – 35%
  10. Loss of thumb (both phalanges) – 25%
  11. Loss of thumb (one phalanx) – 10%
  12. Loss of index finger (three or two phalanges or one phalanx) – 10%
  13. Loss of middle finger (three or two phalanges or one phalanx) – 6%
  14. Loss or ring finger (three or two phalanges or one phalanx) – 5%
  15. Loss of little finger (three or two phalanges or one phalanx) – 4%
  16. Loss of metacarpals (first or second, third, fourth or fifth) – 3%
  17. Loss of Sense of smell – 10%
  18. Loss of Sense of taste – 5%
  19. Loss of Sight of one eye – 50%
  20. Loss of one hand – 50%
  21. Loss of one foot – 50%

Conditions Applicable to the Above-mentioned Benefits

  1. If the accident causes impairment of several physical functions, the degree of disablement given will be added together, but the claim shouldn’t exceed 100% of the Accidental Death Sum Insured.
  2. In case of an accident to the aircraft wherein you are traveling as a fare-paying passenger and your body cannot be located within 365 days from the date of such an accident, the insurer will pay 100% of the sum insured.
  3. If you file a claim under Permanent Total Disablement or Permanent Partial Disablement, you need to be examined by doctors appointed by the company. The insurer shall pay the costs involved in the medical examination.
  4. The policy will remain active unless 100% of the sum insured is exhausted under Accidental Death or Permanent Total Disablement Benefit.
  5. Compensation for any other disability arising out of an accident that is not specified above will be decided by the attending doctor of the insured and validated on the advice of the company’s panel of medical practitioners.

Repatriation of Mortal Remains: In addition to the Accidental Death Benefit, the insurer shall pay up to 3% of the accidental death sum insured or a lump sum of INR 6,000 (whichever is lower). It is payable for transporting the mortal remains of the insured from the place of death to the hospital/residence/cremation/burial ground.

Cost of Cremation Ceremony: The insurer shall pay the actual cost or a lump sum of INR 5,000 (whichever is lower) for the post-cremation ceremony.

Ambulance Charges: You’ll receive ambulance cover up to INR 1,000.

Accident Weekly Benefit: The company pays a weekly benefit of 1% of the Principal Sum Assured, up to INR.10,000, in case of continuous Temporary Total Disability. You can avail of this benefit if the disablement restricts you from engaging in any employment or occupation of any description. This benefit shall be payable to you for 100 weeks from the date of the accident/bodily injury.

Note: If you are totally disabled for a week, one-seventh of the Weekly Benefit shall be payable for each day you are totally disabled.

Broken Bones: In case of a fracture of bones, the insurer shall pay a percentage of the sum insured as mentioned below:

  1. Injury to Vertebral Body resulting in spinal cord damage – 100%
  2. Pelvis – 100%
  3. Skull (excluding nose and teeth) – 30%
  4. Chest (all ribs and breast bone) – 50%
  5. Shoulder (collarbone and shoulder blade) – 30%
  6. Arm – 25%
  7. Leg – 25%
  8. Vertebra – vertebral Arch (excluding coccyx) – 30%
  9. Wrist (Colles or similar fractures) – 10%
  10. Ankle (potts or similar fracture) – 10%
  11. Coccyx – 5%
  12. Hand and fingers – 3%
  13. Foot and Toes – 3%
  14. Nasal Bone – 3%

Modification of Residential Accommodation and Vehicle: The insurer will reimburse the reasonable charges to modify your residential accommodation or vehicle in case of Permanent Total Disability. You can avail of this benefit if these alterations are necessary as per the advice of your treating medical practitioner. The benefit under this section is payable if the claim is accepted under Permanent Total Disability.

Family Transportation Benefit: In case of a valid claim under Accidental Death and Permanent Total Disability, the insurer will refund the actual expenses incurred by the immediate family member for transportation to the hospital. This benefit is payable if you are more than 250 km away from your residence.

Fee for Private Tuition: If the insured is a school/college student and he/she isn’t able to attend the same due to an accidental injury, the company will pay compensation per day for private tuition. The benefit is payable if the same is advised by the medical practitioner. However, compensation for the first three days is not payable.

Chola Accident Protection Plan Optional Cover

You can add this optional cover to Chola Accident Protection Plan by paying an additional premium for it.

Accidental Hospital Daily Cash: If you are hospitalized due to an accidental injury, the company will pay a Daily Hospital Cash Allowance as mentioned in the policy schedule. You can avail of this benefit for each continuous and completed period of 24 hours of hospitalization (in India) for a limited period per person/family per policy period.

The benefit is subject to the hospitalization related to accidental injury if there is a valid claim admitted under Accidental Death, Permanent Total Disablement, Permanent Partial Disablement, Weekly Indemnity or Broken Bones.

Chola Accident Protection Plan Cumulative Bonus

The basic sum insured for Accidental Death, Permanent Total Disability and Permanent Partial Disability will  increase by 5% on renewals if there is no claim under the policy. In case of a claim, the cumulative bonus for the subsequent policy year shall become NIL.

Note: Cumulative Bonus is available to you for up to 3 years.

Free Look Period

You will have a free look period of 15 days from the date of receipt of the policy to review the terms and conditions and return the same if not acceptable. On cancellation, the insurer shall refund the paid premium after retaining charges towards medical tests, stamp duty charges and pro-rata premium from the risk start date till the date of cancellation.

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