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Medisure Personal Accident Plan

Accidents strike at most random times. In spite of being careful, odds of you getting into situations that can seriously affect your life cannot be ignored. The only way is to be ready to tackle such adverse incidents that bring about enormous financial implications.

L&T Insurance's Personal Accident Policy is one such step towards protecting your family's financial well-being during those trying times.

Please Note: From August 23 2017, L&T General Insurance is HDFC ERGO General Insurance

Highlights of Personal Accident Plan

In addition to the primary benefits that any personal accident policy offers, L&T my:health Personal Accident Insurance provides added advantages like:

  • Benefits worth Rs. 46,000 without any extra premium such as coverage for transportation cost, ambulance charges, out-patient costs, education fund and compensation on loss of employment resulting from the disability.
  • 10% discount on premium on family package cover or individual cover for minimum three members covered under this policy.
  • Covers the cost of support items like the artificial limb, crutches, stretcher, tricycle, and so forth

Scope of cover

Indivdual Plan

Entry Age

For children : 5 years

Adults :

Minimum : 18 years

Maximum : 70 years

Number of Members Covered

Maximum Members : 6

Maximum Adults : 4

Maximum Children : 2

Sum Insured

Based on Underwriting & product guideline.


discount

Family discount

Policy Periods Available

1 year


Pre-Policy Medical Check-up

N/A

Family Floater Plan

Entry Age

For children : 5 years

Adults :

Minimum : 18 years

Maximum : 70 years

Number of Members Covered

Maximum Members : 4

Maximum Adults : 4

Maximum Children : 2

Sum Insured

Based on Underwriting & product guideline.


discount

Family discount

Policy Periods Available

1 year


Pre-Policy Medical Check-up

N/A

Important Features

Day Care Treatments
Definition
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Day Care Treatments

Includes surgical processes conducted using local or general anaesthesia which requires less than 24 hours of hospitalization because of technological advancement in healthcare. Each company has a specific list of processes which are covered under this category.

In a case of an accident, under this benefit the cost of out-patient treatment is covered up to Rs. 1,000 per person and a maximum of Rs. 2,500 per policy period.

No-Claim Benefits
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No-Claim Benefits

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In this policy no-claim bonus equal to 5% of basic sum insured up to a maximum of 50% is available. However, the bonus amount is reduced to zero once you make any claim. Rest assured, your sum insured will not be affected.

ACCIDENTAL DEATH
Definition
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ACCIDENTAL DEATH

In case an insured on this policy expires within 12 calendar months from the date of an accident, he/she would get a compensation equal to 100% of sum insured irrespective of any hospitalization expenses. You can get the details on coverage in the in the policy wordings of the plan.

PERMANENT TOTAL DISABILITY
Definition
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PERMANENT TOTAL DISABILITY

In case an insured on this policy is permanently impaired within 12 calendar months from the date of an accident, he/she would get a compensation equal to 100% of sum insured irrespective of any hospitalization expenses. You can get the details on coverage in the in the policy wordings of the plan.

PERMANENT PARTIAL DISABILITY
Definition
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PERMANENT PARTIAL DISABILITY

In case an insured owning a personal accident policy gets partially disabled on a permanent basis as a result of an accident within 12 calendar months post its occurrence then, he/she would get compensation in the range of 1% to 50% of sum insured irrespective of any hospitalization expenses. The payment amount depends on the part of the body impaired. You can get the details on coverage in the in the policy wordings of the plan.

TEMPORARY TOTAL DISABILITY
Definition
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TEMPORARY TOTAL DISABILITY

In case an insured owning a personal accident policy gets totally impaired on a temporary basis as a result of an accident within 12 calendar months post its occurrence then, he/she would get a compensation equal to 1% of sum insured up to a maximum of Rs. 6,000 per week. You can get the details on coverage in the in the policy wordings of the plan.

Good to Have Benefits

OPD Expense Cover
Definition
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OPD Expense Cover

Includes coverage for expenses on treatments which do not require 24 hours of hospitalization.

In the case of an accident, under this allowance the cost of out-patient treatment is covered up to Rs. 1,000 per person and a maximum of Rs. 2,500 per policy period.

TRANSPORTATION
Definition
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TRANSPORTATION

In case you meet with an accident outside the city/town of your residence, you can claim for the transport charges to get you back to your town. Following are the conditions.

  • 2% of Capital Sum Insured or Rs. 2,500 (whichever is lower)
  • Expenses incurred on transportation of the mortal remains is also covered up to 2% of the Sum Insured or Rs. 2,500/- whichever is lower.
EDUCATION FUND
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EDUCATION FUND

Your accident, in any way, should not make your children suffer. Thus, the plan compensates you 10% of your sum insured or a maximum of Rs. 12,500 in the case of one child or a maximum of Rs. 25,000 in the case of more than one child. The highest age of child/children should not exceed 23 years.

LOSS OF EMPLOYMENT
Definition
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LOSS OF EMPLOYMENT

In an intense situation, your accident could lead to losing your job. In such a case, you can claim a compensation up to Rs. 15,000 or 1% of your capital sum insured, whichever is lower. In a financially tighter situation, this amount will be a great relief.

Emergency Ambulance
Definition
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Emergency Ambulance

Includes coverage for expenses on ambulance for hospitalization of the insured.

In the case of an accident of insured, ambulance charges for transporting him/her to the hospital are covered up to Rs. 1,000.

Value Adds

FREE LOOK PERIOD
Definition
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FREE LOOK PERIOD

For any reason, should you decide not to proceed with the policy, you can return the same and request for a refund within 15 days from the date of receipt of the policy document.

Add-on Covers

L&T's Personal Accident Insurance offers the below value added features at an additional premium. With few extra bucks, these add-ons are undoubtedly exciting.

COVERAGE ON EXPENSES FOR SUPPORTING ITEMS
Definition
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COVERAGE ON EXPENSES FOR SUPPORTING ITEMS

Your accident can leave you in a state where you need to be reliant on special things to support your living such as crutches, artificial limb, stretcher, tricycle, wheelchair, spectacles, and so forth. You can claim up to Rs. 10,000 or 2% of capital sum insured or actual expenses, whichever is lesser.

COVERAGE FOR COST OF TRAVEL
Definition
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COVERAGE FOR COST OF TRAVEL

Under this add-on cover, along with your expense of transportation (to your city of residence if you meet with an accident anywhere else), you can also choose to claim for the cost of travel of accompanying relative, friend, colleague or any other person.

  • The maximum liability is 2% of capital sum insured or Rs. 10,000 or the actual cost, whichever is lesser.
ACCIDENTAL HOSPITALIZATION EXTENSION
Definition
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ACCIDENTAL HOSPITALIZATION EXTENSION

To claim for this cover, you need to pick any one of the two choices:

  • Option A: You will be reimbursed an amount up to 50% of the compensation paid in settlement of a valid claim or 20% of the capital sum insured or actual medical expenses, whichever is lesser.
  • Option B: You will be reimbursed an amount up to 100% of the compensation paid in settlement of a valid claim or 50% of the capital sum insured or actual medical expenses, whichever is lesser.

Permanent Exclusions

There are certain scenarios listed in L&T's Personal Accident Insurance that you cannot claim.

  • Any existing disability before the inception of this policy
  • Compensation/Claim under more than one of the categories mentioned in the policy which exceeds the Capital Sum Insured
  • Claims arising from sickness/illness
  • Death or Disablement caused due to
    • Intentional self-injury, suicide or attempted suicide;
    • While under the influence of alcohol or drugs;
    • While engaging in any sort or form of adventurous sport
    • Committing any breach of law with criminal intent
    • Childbirth, pregnancy or related ailments
    • Trespassing on any public or private property

Review of L&T Medisure Personal Accident Plan

L&T Insurance brings to table a reliable brand and financial stability along with quality and trusted approach. Moreover, when they propose a product that stands by you in a case of an ill-fated accident, it is surely worth considering. With an excellent post-sales service and entirely convenient and hassle-free claim processing, the features offered by the plan are quite helpful. So, a secured peace of mind and a confirmed financial backing to support your loved ones is what you are looking for, consider the plan.

**Reviews and ratings are based only on Benefits and Conditions. Things like Claim Settlement Ratio, Hospital Network have not been covered under product ratings. These are covered under Company ratings.

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