Insurance Plans India 347 views January 28, 2022

Navi Saral Suraksha Bima is designed to cover all your expenses incurred during the policy term due to an accident. The coverage will include the death and disability of the insured. When you’re no longer alive due to an accident, the insurance company will pay your nominee an amount as specified in the policy schedule. It ensures the financial protection of your loved ones in case of your absence. To know more about the Navi Saral Suraksha Bima benefits, read this page further.

List of Unfortunate Events covered Under the Navi Saral Suraksha Bima Policy

Navi Saral Suraksha Bima covers the below-mentioned events during the policy term –

Death Claim & How the Insurer Disburses the Same

The nominee will get 100% of the sum insured, as specified in the policy schedule, upon death due to an injury sustained in an accident during the policy period. However, the payment would happen only if the death occurs within 12 months from the date of the accident. Your nominee will get the claim amount in case of your disappearance following an accident. If you’re found after the payment of an accidental death claim amount, you need to refund the same.

Permanent Total Disablement (PTD) Cover

You’ll get 100% of the sum insured. as specified in the policy schedule, should you suffer from the following PTD. The payment would happen only if the PTD happens solely and directly due to an accident during the policy period. Same as a death claim, the PTD should happen within 12 months from the date of the accident to get a claim.

  • Total and irrecoverable loss of sight of both eyes
  • Physical separation or loss of use of both hands or feet
  • Physical separation or loss of use of one hand and one foot
  • Loss of sight of one eye and physical separation or loss of use of hand or foot
  • Any injury which is a direct consequence of permanent and total disablement and restricts you to engage in any employment or occupation of any description whatsoever.

How Does the Permanent Partial Disablement (PPD) Cover Work?

The company will pay a percentage of the sum insured, as specified in the policy schedule, if you suffer from PPD due to an accident during the policy period. Like the previous two casualties, this also needs to happen within 12 months from the date of the accident for getting a claim. The maximum amount payable in case of multiple disablements shall be restricted to the sum insured.

Important Notes

  • The base sum insured and the cumulative bonus apply cumulatively for all the three covers as specified above
  • If the accident happens during the policy period, benefits of death, PTD, and PPD are payable, even if the claim arises in any combination and occurs after the completion of the policy period but within 12 months from the date of the accident.

Navi Saral Suraksha Bima Optional Covers

You can customize the Navi Saral Suraksha Bima by choosing any of the following covers –

How Does the Temporary Total Disablement (TTD) Cover Benefit You?

If you sustain an injury due to an accident during the policy period and it restricts you from engaging in any employment or occupation of any description, the company shall pay the specified benefit until you’re able to return to work, subject to meeting the following –

  •  The period of TTD shall exceed four consecutive weeks from the date of the accident. However, the benefit shall be reckoned from the date of the accident and is payable for the entire duration of disablement.
  • You won’t get the TTD amount for more than 100 weeks from the date of commencement of disablement and in no case shall exceed the sum insured.
  • The treating medical practitioner must certify TTD in writing within 30 days from the date of the accident.
  • You’ll get the compensation at quarterly intervals. If the period of TTD is < a quarter or three months, the compensation amount is payable at the end of the disablement period.
  • Before paying, the company can call for certification from an independent medical practitioner concerning the continuity of TTD
  • You need to notify the insurance company immediately on resuming your occupation/employment. And if the company finds that you have resumed the occupation/employment and received the compensation under this cover, the company will recover such benefit.

Notes: Under this cover, ‘week’ is a period of seven consecutive calendar days.

Hospitalization Expenses due to Accident

The company shall compensate the medical expenses if incurred for hospitalization due to an accident. And the coverage is subject to a maximum of 10% of the base sum insured. The hospitalization expenses shall be available for the following:

  • Room, Boarding, Nursing Expenses
  • Fees of Surgeons, Anesthetists, Medical Practitioners, Consultants, Specialists
  • Cost of anesthesia, blood, oxygen, operation, theater charges, surgical appliances, medicines and drugs, costs towards diagnostics, diagnostics, diagnostic imaging modalities, and such other similar expenses
  • Intensive Care Unit (ICU) or Intensive Cardiac Care Unit (ICCU) expenses
  • Prosthetic and other devices or equipment implanted internally during a surgical procedure
  • AYUSH treatment

The insurer covers the following treatments in case you have to undergo the same due to an injury –

• Dental treatment
• Plastic surgery
• Daycare treatments
• Road Ambulance up to INR 2,000 per hospitalization

What’s Education Grant All About?

Following an admissible claim under the base cover of death or PTD, the company shall pay a one-time education grant of 10% of the base sum insured. Any dependent children pursuing an educational course as a full-time student in an educational institution, not more than 25 years will get this benefit. The benefits payable under TTD, hospitalization and education grant are independent and over and above the base sum insured. In case of an admissible claim under the optional covers, TTD and hospitalization due to accident are independent of a claim.

How Does the Cumulative Bonus Help Boost Your Coverage?

The sum insured shall increase by 5% after each claim-free policy year, subject to a maximum of 50%. In the case of a claim in any particular year, the cumulative bonus reduces the same as its accrual. The cumulative bonus applies only on base covers for death, PTD, and PPD. The addition or reduction of the cumulative bonus will depend on the filing of a claim under the base cover. The bonus amount shall add and remain available individually to each member covered under the policy.

Your bonus shall reduce only in case the same insured person files a claim more than once in a policy year. This benefit applies only if you renew the policy by paying the premium on the due date or do so during the grace period. In the case of a claim during the expiring policy year, after the acceptance of the renewal premium, any available bonus shall be withdrawn.

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