PERSONAL ACCIDENT
An accident can exhaust the savings of a lifetime and even cause irreversible disability and loss of income. Our Personal Accident Insurance Plan provides cover not just in the case of accidental death but also for Permanent Total or Partial Disability, along with a host of other benefits.

Features

ACCIDENTAL DEATH

Accidents cannot be predicted, but they can be prepared for. In the case of accidental death of any insured person, we pay 100% of the sum assured.

PERMANENT TOTAL DISABILITY

In the unfortunate case of permanent total disability, we pay 125% of the sum assured.

PERMANENT PARTIAL DISABILITY

If you incur a permanent partial disability through an accident, we pay up to 100% of the sum assured. To find out more, read more here.

CHILD EDUCATION BENEFIT

Prepare for your child's future - even when you're not around. In case of accidental death or permanent total disability, 5% of your sum assured, or Rs. 50,000 (whichever is lower) is paid toward your child's education. This is only applicable for plans where children are covered.

FUNERAL EXPENSES

Any funeral expenses are covered up to Rs. 5000, in the case of the accidental death of any insured member.

INDIVIDUAL AND FAMILY COVERAGE

If you are claiming your insurance as an individual, you are entitled to 100% of the sum assured promised.

When you are claiming your sum assured on a family plan that covers yourself, a spouse and up to 2 children, you are entitled to 100% of the amount, your spouse is entitled to 50% or Rs. 10 Lacs, and your children are entitled to 20% of the amount or Rs. 2 Lacs.

Adults are eligible between the age of 18 to 60, while children are eligible between the age of 5 to 21.

GUARANTEED CASH BENEFIT

If your claim is admissible, you are entitled to a guaranteed cash benefit.

2 YEAR POLICY TENURE OPTION

Opt for a 2 year tenure on your insurance plan and get attractive discounts on your premium.

DIRECT CLAIM SETTLEMENT

We believe you should focus on the treatment of your loved ones rather than running after claim settlement. Therefore, all claims are processed directly by our own customer services team without the need for any third-party involvement.

ASSURED POLICY RENEWAL

Guarantee your policy renewals for life, with no increase in premium even if you make a claim. Your premium is only calculated basis your age and city of residence, and NOT your claim history.

FREE TRIAL PERIOD

Your complete satisfaction is important to us. If you're unsatisfied with your policy, you have a 15 day free trial period during which you can cancel your policy simply by stating your reason.

WORLDWIDE COVERAGE

No matter where you are in the world, or what time it is there, you are covered.

UAN No. : MB/BR/2012-2013/154

POLICY TERMS

We provide coverage from the policy start date with no waiting period.

Learn more here.

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Download the prospectus here.

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PERMANENT EXCLUSIONS

  • Suicide or self-inflicted injury, whether the Insured Person is medically sane or insane.
  • War (whether declared or not), invasion, act of foreign enemy, hostilities, civil war, martial law, rebellion, revolution, insurrection, military or usurper power, riot or civil commotion.
  • Service in the armed forces, or any police organization, of any country at war or at peace; or service in any force of an international body; or participation in any of the naval, military or air force operations during peace time.
  • Any change of profession after inception of the Policy which results in the enhancement of your risk, if not accepted and endorsed by Max Bupa on the Schedule of Insurance Certificate.
  • Committing an assault, a criminal offence or any breach of law with criminal intent.
  • Taking or absorbing, accidentally or otherwise, any intoxicating liquor, drug, narcotic, medicine, sedative or poison, except as prescribed by a licensed doctor other than the Policyholder or an Insured Person.
  • Inhaling any gas or fumes, accidentally or otherwise, except accidentally in the course of duty.
  • Participation in aviation other than as a fare-paying passenger in an aircraft that is authorized by the relevant regulations to carry such passengers between established aerodromes.
  • Engaging in or taking part in professional sports or any hazardous pursuits, such as diving or riding or any kind of race; underwater activities whether involving the use of breathing apparatus or not; martial arts; hunting; mountaineering; parachuting; bungee-jumping.
  • Any disability arising out of Pre-existing Conditions if not accepted and endorsed by Max Bupa.
  • Bodily or mental infirmity or any disease except where such condition arises directly as a result of an Accident during the Policy Period. However this exclusion is not applicable to claims made under the PPD benefit.

CLAIM PROCESS

We provide the best services to ensure that the claim process is as easy and straightforward as possible. In order to process the claim, the following documents are needed:

In case of Accidental Death

Documents Needed:

  • Duly filled and signed claim form
  • Original Death Certificate (issued by the office of Registrar of Births and Deaths)
  • Copy of First Information Report (FIR) / Panchnama duly attested by the concerned police station
  • Copy of Medico Legal Certificate duly attested by the concerned hospital
  • Copy of Post Mortem report wherever applicable
  • Income proof of the Proposer
    • Last three months Salary Slip
    • Last year's ITR / Form 16
    • Employer's Certificate
    • Audited Accounts

Please note:

  • Coverage is provided for death consequent to and within 90 days of the Accident. The injuries should be the sole and direct cause of death.
  • The Sum Assured can be upto eight times your annual income. If the Sum Assured is more than eight times your annual income then the claim is to be investigated for the annual income of the Insured Person at the time of taking the policy. If the Sum Assured is less than eight times the annual income, then the claim will be subjected to further consideration by us.

In case of Accidental Permanent Total Disability

Documents Needed:

  • Duly filled and signed claim form
  • Hospital Discharge Summary (in original) / self attested copies if the originals are submitted with another insurer
  • Final Hospital Bill (in original) / self attested copies if the originals are submitted with another insurer
  • Medical consultations and investigations done from outside the hospital
  • Original certificate of Disability issued by a Medical Board duly constituted by the Central and the State Government
  • Copy of First Information Report (FIR) / Panchnama duly attested by the concerned police station
  • Copy of Medico Legal Certificate duly attested by the concerned hospital
  • Income proof of the Proposer
    • Last three months Salary Slip
    • Last year's ITR / Form 16
    • Employer's Certificate
    • Audited Accounts

Please note:

  • Disability should have been sustained consequent to an Accident and should have occurred within 90 days of the date of the Accident.
  • A Disability certificate issued by a Medical Board is required in order to process the claim.
  • The Sum Assured should be upto eight times of the annual income. If the Sum Assured is more than eight times the annual income then the claim is to be investigated for the annual income of the Insured Person at the time of taking the policy. If the Sum Assured is less than eight times the annual income, then the claim will be subjected to further consideration by us.

FAQs

HOW CAN I BUY THIS POLICY?

There are various ways in which you can purchase this policy:

Online: On purchase of this plan online, your policy will be generated almost instantly along with your policy kit and card. This is applicable for cases which do not require further underwriting or medical checkup. While all our plans including Heartbeat and Health Assurance are available for purchase through this mode, our online special plan Health Companion Health Insurance Plan - Health Companion can be bought only through this mode.

Telephone: If you wish to know more about Max Bupa's Health Insurance Plans, please speak to our specially trained sales team or your local advisor. Call us on Phone 1800 3010 3333 (Toll Free) between 9 am and 6 pm India time (Monday to Saturday) and click on 'Click to arrange a call' to buy the policy over the phone or to fix up an appointment.

Branch: Please visit our branch in your city. The complete list of branch locations is available in the Contact Us section of the website

WHAT ARE THE MINIMUM AND MAXIMUM POLICY DURATIONS?

You have the option of buying a health insurance policy for a period of one year or two years. You will be able to get discounts on purchase of a policy for two years. This is applicable for Heartbeat and Health Companion Health Insurance plans on the premium for the second year only. At the end of your insurance period you need to renew your policy if you wish to continue being covered, without a break.

IS THERE ANY TAX BENEFIT THAT ONE CAN AVAIL OF WHILE PURCHASING HEALTH INSURANCE?

Yes. You can avail a tax benefit available under Section 80D of the Income Tax Act 1961 by buying a health insurance policy. Section 80D benefit is over and above rebate under Section 80 C). Tax benefits are subject to changes in the tax laws; please consult your tax advisor for more details

IS A MEDICAL CHECK-UP NECESSARY BEFORE BUYING A POLICY?

A medical check-up may be necessary when you sign up for a new health insurance policy. However, medical checkups are not usually needed for renewal of policies. It is in your best interests to undergo a medical check-up at the time of enrolment so that when you need us, we're there to provide speedy and efficient support and faster settlement of claims.

WHAT IS ANNUAL INSURANCE COVER?

The Annual Insurance Cover amount is the maximum amount payable during the year in the event of one or more claims. It is also known as 'sum insured' and 'sum assured'. The premium of the policy is also dependent on the annual insurance amount that you choose.

MY WIFE AND CHILDREN RESIDE IN ANOTHER CITY. CAN I COVER ALL OF
US IN ONE POLICY?

Yes, you can cover your family residing in India under one policy. Your health insurance policy can be used by you all across India. For cashless facility, all you need to do is check for a Max Bupa network hospital near your place of residence. You can also get your claims reimbursed if you get treated at a hospital which is not in Max Bupa's hospital network.

UAN no.: MB/BR/2014-2015/303
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