Health Insurance 153 views February 9, 2021

Accidents can happen to people at any time, and you will need to pay for the medical expenses arising from the same. However, with Oriental Insurance Personal Accident-Individual Plan, you can avoid paying for the same. With this policy from Oriental Insurance, individuals can enjoy compensation for injuries caused directly or indirectly from an accident resulting in death or permanent or temporary disablement.

Want to know more about Oriental Insurance Personal Accident-Individual Plan? On this page, we will discuss its coverage, benefits, free look period, exclusions, etc. Keep reading to know more!

What is Covered under Oriental Insurance Personal Accident-Individual Plan?

One of the important aspects of any insurance plan is to know what this policy covers when you decide to choose the same. The Oriental Insurance Personal Accident-Individual Plan offers different benefits according to different situations arising from an accident during the policy term. We are showing these situations below that you can check!

  1. If any bodily injury happens within 12 months of policy commencement; and that is the sole and direct cause to the death of the life insured, the company will provide the capital sum assured to the nominee or beneficiary.
  2. If any bodily injury happens within 12 months of policy commencement; and that injury is the total and irrevocable cause of sight of both eyes or the loss by physical separation of two hands, or two entire feet or one entire hand or one foot, or of loss of sight of one eye and loss of one entire hand or one entire foot, the company will provide a sum insured to the nominee.
  3. If an injury is the direct and sole cause of the total and irrevocable cause of the sight of one eye or actual loss of one hand or one entire foot, the company will provide 50% of the capital sum assured to the nominee. If an insured person loses one hand or one foot without physical separation, the individual will also get 50% of the sum assured.
  4. If a bodily injury causes permanent disablement to the insured person engaging in any employment or occupation, he/she will get 100% of the capital sum insured as a lump sum amount.
  5. If any injury happens to the insured person within 12 months from the policy inception, the sum assured will be according to the different situations shown below. Have a look!
LossesPercentage of the Capital Sum Insured
Loss of toes – all20%
Both Great phalanges5%
One Great phalanx2%
Other than great, if there’s a loss of more than one toe1%
Loss of hearing from both ears50%
Loss of hearing from one ear15%
Loss of four fingers and thumb of one hand40%
Loss of four fingers35%
Loss of thumb both phalanges25%
Loss of thumb-One Phalanx10%
Loss of index finger- three phalanges10%
Loss of index finger - two phalanges8%
Loss of index finger- one phalanx4%
Loss of middle finger- three phalanges6%
Loss of middle finger - two phalanges4%
Loss of middle finger- one phalanx2%
Loss of ring finger- three phalanges5%
Loss of ring finger - two phalanges4%
Loss of ring finger- one phalanx2%
Loss of little finger- three phalanges4%
Loss of little finger - two phalanges3%
Loss of little finger- one phalanx2%
Loss of metacarpals - first or second ( additional)3%
Loss of metacarpals--third, fourth or fifth(additional)2%
Any other permanent - Partial disablementAs assessed by the Doctor

Oriental Insurance Personal Accident-Individual Plan Benefits

We are showing the benefits of the Oriental Insurance Personal Accident-Individual Plan that you should know before choosing the same. Have a look!

Weekly Benefits

One of the best features of the Oriental Insurance Personal Accident-Individual Plan is the weekly benefits that individuals will get if any of the injuries cause temporary total disablement that stops them from engaging in any employment or occupation. However, this benefit will be 1% of the capital sum insured up to INR 20,000 per week for a maximum of 100 weeks.

Transportation Expenses Coverage

If an insured person dies during the policy term due to an accident outside his or her residence, the company will provide coverage for the expenses incurred on the transportation of the insured person’s dead body to the place of residence. This benefit will be up to 2% of the capital sum insured or INR 2,500, whichever is lower. This coverage will also include the funeral expenses of the insured person.

Education Compensation Benefits to Dependent Children

This policy from Oriental Insurance also provides compensation towards the education of the dependent children if the insured person dies or faces permanent total disablement due to an accident. We are showing the benefits below. Have a look!

  1. If the insured person has only dependent children who are below 23 years of age, the compensation benefit will be an amount equal to 10% of the capital sum insured, up to INR 5,000
  2. If the insured person has more than one dependent child below the age of 23 years, this benefit will be equal to 10% of the sum insured, up to INR 10,000.

Compensation for the Loss of Employment

In case an individual faces a loss of his or her employment due to total disablement, the policy will provide 1% of the capital sum insured or INR 1,500, whichever is lower.

Medical Expenses Coverage

Oriental Insurance Personal Accident-Individual Plan also provides the option of additional protection if you are willing to pay an extra premium amount. With this additional coverage, the accident part can be extended to include medical expenses up to 25% or 50% of the valid claim with an additional premium at the rate of 10% or 25% of the basic premium respectively.

Free Look Period

You can return the policy within a free look period of 15 days from its inception if you are unsatisfied with its terms and conditions.

What is not covered under the Oriental Insurance Personal Accident-Individual Plan?

There are a few situations where you will not get a claim under this policy. We are showing them below. Do check!

  1. Compensation under the same period of disablement
  2. Death, injury or disablement from suicide, liquor or drugs, law or criminal intent, etc.
  3. Death or injury from war, invasion, an act of foreign enemy, capture, seizure, civil war, etc
  4. Death directly or indirectly from nuclear weapon material
  5. Death or disablement during childbirth or from pregnancy

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