ACCIDENTCARE
An accident can exhaust the savings of a lifetime and even cause irreversible disability and loss of income. Our AccidentCare 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 insured.

PERMANENT TOTAL DISABILITY

In the unfortunate case of permanent total disability due to an accident, we pay 125% of the sum insured.

PERMANENT PARTIAL DISABILITY

If you incur a permanent partial disability through an accident, we pay up to 100% of the sum insured. 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, minimum of 5% of your sum insured or Rs. 50,000 (for sum insured up to 25 lacs) / Rs. 500,000 (for sum insured more than 25 lacs) per child, 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 (for sum insured up to 25 lacs) / Rs. 50,000 (for sum insured more than 25 lacs), in the case of the accidental death of any insured member.

TEMPORARY TOTAL DISABILITY (OPTIONAL)

In the unfortunate case of temporary total disability, 1% of Temporary Total Disability sum insured is payable per week. This weekly payout shall be made for a maximum of 100 continuous weeks. This benefit can be availed and renewed by salaried individuals only.

ACCIDENT HOSPITALIZATION (OPTIONAL)

In case of hospitalization due to an accident, medical expenses incurred towards such hospitalization shall be payable up to 2% of AccidentCare sum insured. This benefit shall be available for hospitalization in India only.

INDIVIDUAL AND FAMILY COVERAGE

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

When you are claiming your sum insured 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 (whichever is lower), and your children are entitled to 20% of the amount or Rs. 5 Lacs (whichever is lower).

Adults are eligible between the age of 18 to 65 years, while dependent children are eligible between the age of 2 to 21 years.

2 OR 3 YEAR POLICY TENURE OPTION

You can also opt for a 2 or 3 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. Your premium is only calculated basis your age and city of residence, and NOT your claim history.

FREE LOOK PERIOD

Your complete satisfaction is important to us. If you’re unsatisfied with your policy, you have a 15 day free look period during which you can cancel your policy simply by stating your reason. The free look period will be 30 days if the Policy is purchased through distance marketing mode and Policy Tenure is 3 years.

WORLDWIDE COVERAGE

No matter where you are in the world, or what time it is there, you are covered. However, the optional benefit of Accident Hospitalization shall be available for hospitalization in India only.

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

POLICY TERMS

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

Learn more here.

Download the prospectus here.

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 operation during peace time.
  • Any change of profession after inception of the Policy which results in the enhancement of our risk, if not accepted and endorsed by Us 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 Medical Practitioner other than the Policyholder or an Insured Person.
  • Death or disablement caused by ionizing radiation or contamination by radioactivity from any nuclear fuel.
  • Participation in aviation/marine including crew other than as a fare-paying passenger in an aircraft/water craft that is authorized by the relevant regulations to carry such passengers between established airports or ports.
  • Including but not limited to engaging in or taking part in professional/adventure sports or any hazardous pursuits, such as speed contest or racing of any kind (other than on foot), bungee jumping, parasailing, ballooning, parachuting, skydiving, paragliding, hang gliding, mountain or rock climbing necessitating the use of guides or ropes, potholing, abseiling, deep sea diving using hard helmet and breathing apparatus, polo, snow and ice sports, hunting etc;
  • Any disability arising out of pre-existing diseases if not accepted and endorsed by Us.
  • Body or mental infirmity or any disease except where such condition arises directly as a correspondence of an accident during the policy period. However this exclusion is not applicable to claims made under the PPD benefit
  • Any costs or expenses specified in the List of Expenses generally excluded at Annexure II of Policy document. This is applicable only for Accident Hospitalization 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 and KYC documents
  • Copy of Death Certificate (issued by the office of Registrar of Births and Deaths)
  • Copy of First Information Report (FIR) / Panchnama
  • Copy of Medico Legal Certificate duly attested by the concerned hospital, if applicable
  • Copy of hospital record, if applicable
  • Copy of Post Mortem report wherever applicable

Please note:

  • Coverage is provided for death occurred consequent to an Accident within 365 days of the Accident and the injuries should be the sole and direct cause of death.
  • The accident should occur while the policy is in force.
  • The maximum allowed sum insured for salaried is 12 times of gross annual income and for businessmen is 15 times of gross annual income. If the sum insured is more than the above prescribed limit 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 insured is less than the above prescribed limit, 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 and KYC documents
  • 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
  • Certificate of Disability issued by a Medical Board duly constituted by the Central and the State Government
  • Copy of First Information Report (FIR) / Panchnama, if applicable
  • Copy of Medico Legal Certificate duly attested by the concerned hospital, if applicable

Please note:

  • Disability should have been sustained consequent to an Accident and should have occurred within 365 days of the date of sustaining an injury.
  • Disability certificates only issued by a Medical Board are required in order to process the claim.
  • The accident should occur while the policy is in force.
  • The maximum allowed sum insured for salaried is 12 times of gross annual income and for businessmen is 15 times of gross annual income. If the sum insured is more than the above prescribed limit 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 insured is less than the above prescribed limit, then the claim will be subjected to further consideration by Us.

In case of Accidental Permanent Partial Disability

Documents Needed:

  • Duly filled and signed claim form and KYC documents
  • 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
  • Certificate of Disability issued by a Medical Board duly constituted by the Central and the State Government
  • Copy of First Information Report (FIR) / Panchnama, if applicable
  • Copy of Medico Legal Certificate duly attested by the concerned hospital, if applicable

Please note:

  • Disability should have been sustained consequent to an Accident and should have occurred within 365 days of the date of sustaining an injury.
  • Disability certificates only issued by a Medical Board are required in order to process the claim.
  • The accident should occur while the policy is in force.
  • The maximum allowed sum insured for salaried is 12 times of gross annual income and for businessmen is 15 times of gross annual income. If the sum insured is more than the above prescribed limit 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 insured is less than the above prescribed limit, then the claim will be subjected to further consideration by Us.

In case of Accidental Temporary Total Disability

Documents Needed:

  • Duly filled and signed claim form and KYC documents
  • 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.
  • Copy of First Information Report (FIR) / Panchnama / Inquest report if applicable.
  • Copy of Medico Legal Certificate duly attested by the concerned hospital if applicable.
  • Attendance record of employer / Certificate of employer confirming period of absence
  • Disability certificate from treating doctor with seal and stamp.
  • Medical certificate and Fitness certificate with seal and stamp.

Please note:

  • Disability should have been sustained consequent to an Accident and should have occurred within 365 days of the date of sustaining an injury due to accident.
  • The claim will be admissible only when the Insured rejoins work after his period of absence.
  • Period of hospitalization will be considered as valid period of absence for admitting the claim.
  • The accident should occur while the policy is in force.
  • In case of prolonged absence from work, interim on account payments may be considered every week.
  • Payouts will be admissible after three continuous days of absence from work and will be payable from Day 1.

In case of Accident Hospitalization

Documents Needed:

  • Duly filled and signed claim form and KYC documents
  • Hospital Discharge Summary (in original) / self attested copies if the originals are submitted with another insurer.
  • Copy of First Information Report (FIR) / Panchnama / Inquest report if applicable
  • Copy of Medico Legal Certificate duly attested by the concerned hospital if applicable.
  • Final Hospital bill with receipt /copies attested by other insurer if the originals are submitted with them.
  • Original bills with supporting prescriptions and reports for investigations done outside the hospital/ copies attested by other insurer if the originals are submitted with them.
  • Original bills with supporting prescriptions for medicines purchased from outside the hospital./ copies attested by other insurer if the originals are submitted with them.

Please note:

  • Benefits are admissible only if hospitalization occurs during the policy period solely and directly due to an injury sustained arising from an accident.
  • Contribution clause to be applied if insured is covered under multiple policies offering same benefit.
  • The accident should occur while the policy is in force.

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 instantly along with your policy kit and card. This is applicable for cases which do not require further underwriting or medical check-up.

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 select ‘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 or three years. You will be able to get discounts on purchase of a policy for two or three years. 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 80C. 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 checkup 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 enrollment so that when you need us, we‘re there to provide speedy and efficient support and faster settlement of claims.

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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