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Accidental Event
The injury or death must result from a covered accident, such as a road accident, fall, drowning or burn.
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Personal Accident Insurance, or personal accidental insurance, pays a fixed benefit for death, disability, or injury caused by an accident. It is separate from health insurance, which settles hospitalisation bills.
Personal Accident Insurance provides financial compensation if an accident causes death, permanent disability or other covered injuries. The benefit payable depends on the nature of the injury and the terms of the policy.
PA insurance covers accidental events, not illnesses or diseases. Depending on the policy, it can provide a lump-sum payout for accidental death or permanent disability and income support during temporary disability.
The injury or death must result from a covered accident, such as a road accident, fall, drowning or burn.
The nominee receives the benefit specified under the policy if the insured dies due to a covered accident.
The policy pays a percentage or the full sum insured depending on the type and extent of disability.
Some policies provide a weekly benefit when an accident temporarily prevents the insured from working.
This is the maximum amount available under the policy. The actual payout depends on the benefit being claimed and the policy terms.
Personal Accident Insurance can be bought as a standalone policy or, where available, as an add-on or rider with another insurance policy.
Coverage may differ from insurer to insurer, based on IRDAI guidelines and the terms and conditions of the policy.
Every general and standalone health insurer registered with the Insurance Regulatory and Development Authority of India (IRDAI) is required to offer a standard personal accident product called Saral Suraksha Bima. Under IRDAI's guidelines on this product, the sum insured ranges from ₹2.5 lakh to ₹1 crore, entry age runs from 18 to 70 years (dependent children from 3 months to 25 years), and the policy tenure is fixed at one year.
When you compare health insurance with personal accident insurance, each offers different types of financial protection.
A fracture or spinal injury can keep you off work for weeks. The temporary disability benefit provides financial compensation or financial support during the period of eligible temporary disability, subject to the policy terms and benefit limits.
If you are the primary earner, the death benefit gives dependants a financial cushion for EMIs, school fees, and daily expenses.
Term insurance, health insurance and employer-provided benefits each serve different purposes. A personal accident insurance policy can complement these covers by providing benefits for accidental death, disability or other covered outcomes, subject to the policy terms.
Get personal accident insurance with coverage designed around your needs.
Feature availability differs by insurer. Read the Personal Accident Insurance policy wording carefully before buying a plan.
Source - IRDAI
The below table provides a list of some personal accident insurance plans, their coverage amount, the waiting period before the coverage becomes active, and the requirement of a medical check-up before obtaining the policy.
| Plan Name | Coverage Amount | Waiting Period | Medical Check-up |
|---|---|---|---|
| SecureShield Personal Accident | Up to ₹25 Lakhs | None | Not Required |
| TotalProtect Plus Accident | Cover Up to ₹1 Crore | Immediate | Coverage Not Required |
| SafeGuard Accident Insurance | Up to ₹50 Lakhs | 15 Days | Optional |
| MyAccidentGuard Policy | Up to ₹75 Lakhs | None | Required for >₹50 Lakhs Coverage |
| HealthSecure Accident Plan | Up to ₹20 Lakhs | None | Not Required |
| QuickCover Accident Insurance | Up to ₹30 Lakhs | 7 Days | Not Required |
| PrimeProtect Personal Accident | Up to ₹40 Lakhs | None | Not Required |
| UltraSafety Personal Accident | Up to ₹60 Lakhs | None | Required for >₹40 Lakhs Coverage |
Disclaimer: This list covers standalone individual plans only. Group personal accident covers bought by employers, and PA riders bundled into health insurance policies, follow separate terms and are not included above. Sum insured limits change with policy revisions; confirm current figures on the insurer's site.
Accidental Death
The nominee receives the applicable sum insured if the insured dies due to a covered accident.
Permanent Total Disability
A lump-sum benefit is paid for qualifying permanent disabilities, as specified in the policy.
Permanent Partial Disability
A specified percentage of the sum insured is paid based on the type and extent of the disability.
Temporary Total Disability
A weekly benefit may be paid when an accidental injury temporarily prevents the insured from working, if included in the policy.
Accidental Hospitalisation
Eligible hospitalisation expenses resulting from a covered accident may be paid up to the policy limit, where this benefit is included.
Ambulance Expenses
Ambulance costs following a covered accident may be covered up to the applicable limit.
Children's Education
Some policies provide an additional benefit towards the education of dependent children following accidental death or qualifying disability.
Transportation of Mortal Remains
The cost of transporting mortal remains following accidental death may be covered up to the specified limit.
Cremation Expenses
Some policies provide a fixed amount towards cremation and last-rites expenses following accidental death.
Natural Death or Illness
Death or disability caused by illness or natural causes is not covered under accidental benefits.
Intentional Self-Injury
Injuries resulting from intentional self-harm or suicide attempts are excluded.
Alcohol or Drug Intoxication
Claims arising from accidents involving intoxication may be excluded under the policy.
Hazardous Activities
Injuries from specified adventure sports or hazardous activities may be excluded.
Criminal Acts
Injuries sustained while committing or attempting to commit an unlawful act may not be covered.
War and Military Activities
Accidents arising from war or specified military, naval or air-force activities may be excluded.
Pre-existing Conditions or Disabilities
Pre-existing conditions or disabilities may affect eligibility for certain benefits, depending on the policy terms and the circumstances of the claim.
Note: Benefits vary between Personal Accident Insurance policies. Disability payouts, hospitalisation cover and additional benefits are payable only when specified in the policy. The exclusions listed above can vary between Personal Accident Insurance policies. Refer to the policy wording for the exact exclusions and conditions applicable to your cover.
The right sum insured depends on your income, financial commitments and the level of protection your dependants may need after an accident.
Consider your income and the financial support your family would need if an accident prevents you from working or results in permanent disability.
Include existing home, car or other loan liabilities when assessing the amount of cover required.
Spouse, children or other financially dependent family members can increase the amount of protection you may need.
Check Personal Accident Insurance provided through your employer, bank account or other policies before deciding on additional cover.
Consider the nature of your work and the accident risks associated with it when selecting the sum insured.
Frequent commuting or travel may increase your exposure to accidents and can be considered while choosing the level of cover.
Factor in regular household expenses, children's education and other commitments that would continue even if an accident affects your earning capacity.
Note: There is no single sum insured that suits every individual. Choose the cover based on your financial responsibilities, existing protection and the benefits available under the policy. Personal Accident Insurance should also be assessed separately from life and health insurance, as each policy addresses different financial risks.
Personal accident insurance premiums can vary based on your risk profile and the coverage you choose.
Premiums and eligibility may vary based on the applicant's age.
Higher-risk occupations may attract higher premiums or specific coverage terms.
A higher sum insured generally results in a higher premium.
Hazardous activities or lifestyle-related risks may affect premiums, eligibility, or coverage terms.
Policies with broader benefits may cost more.
Adding optional benefits or riders can increase the premium.
Premiums and eligibility may differ depending on the insurer's underwriting criteria, your risk profile, and the coverage selected.
Explore personal accident insurance options based on your needs.
Comparing personal accident insurance with health, term, and critical illness insurance policies helps you understand how their coverage, payouts, and claim triggers differ.
| Parameter | Personal Accident Insurance | Health Insurance | Term Insurance | Critical Illness Insurance |
|---|---|---|---|---|
| Claim Trigger | Accidental death, injury, or disability | Hospitalisation for illness or injury | Death, any cause | Diagnosis of a listed illness |
| Covers Natural Death | No | Not applicable | Yes | Not applicable |
| Payout Type | Lump sum or weekly allowance | Reimbursement or cashless of actual bills | Lump sum | Lump sum |
| Waiting Period | None | 30 days to 4 years, depending on ailment and insurer | None, barring the suicide clause | Around 90 days, depending on insurer |
| Medical Test | Rarely required | Required above certain age or sum insured | Required for higher sum assured | Required |
The features, waiting periods, medical requirements, and claim conditions may vary by insurer and policy. Always check the specific policy wording before purchasing.
Steps to file a Personal Accident Insurance claim:
Most policies require intimation within 24 to 48 hours of the accident. Under IRDAI's guidelines for the standard PA productt, intimation must reach the insurer within 30 days of the event, so check your specific policy wording for the exact window.
The insurer logs the case and assigns an ID for tracking.
Include personal details and the date, time, and location of the accident.
Provide the documents relevant to your claim and the circumstances of the accident.
The claims team reviews the submitted documents and may request clarification or additional information before processing the claim.
The payout goes to the policyholder or nominee as a lump sum or in instalments, depending on the claim type.
Exact document requirements vary by insurer and claim type.
Pro Tip: If you need help with a personal accident insurance claim, you can contact us at help@coverfox.com
Compare plans on Coverfox, select a sum insured based on income and liabilities, enter personal and occupation details, and complete payment.
Yes. Health insurance reimburses hospitalisation costs from illness or injury. Personal accident insurance pays a fixed benefit for accidental death or disability, regardless of actual medical expenses incurred.
PA cover, when bundled with a health policy, is eligible for premiums that qualify for deduction under Section 80D of the Income Tax Act, 1961, within the overall limit applicable to health-related covers.
The insurer pays the full sum insured to the nominee named in the policy, providing immediate funds for daily expenses, outstanding loans, or dependants' education.
Individual plans cover one person. Family or group personal accident covers can include a spouse, children, and in some cases parents, under a single policy.
The sum insured is chosen when buying the policy based on your coverage needs and the insurer's available options. It is the maximum amount payable for covered benefits, subject to the policy terms. Under standard personal accident product guidelines, the sum insured ranges from ₹2.5 lakh to ₹1 crore, with insurers also permitted to offer other amounts under applicable conditions.
Coverage limits vary by insurer, ranging from around ₹1 lakh to upwards of ₹25 crore on select plans. There is no single industry-wide cap.
Personal accident insurance can cover the policyholder, spouse, dependent children and, in some policies, dependent parents. Eligibility, age limits and dependent definitions vary by insurer and policy.
Premiums depend on occupation risk class, sum insured, and add-ons chosen. High-risk occupations and higher sum insured amounts raise the premium; low-risk desk jobs with modest cover keep it affordable.
Yes. This is the core benefit of the policy. The full sum insured is paid to the nominee in case of death caused by an accident.
Occupation risk class carries the most weight, followed by sum insured, chosen riders, and policy tenure.
No. Coverage is active from day one of policy issuance, unlike health insurance, which often carries an initial waiting period.
Yes. You can hold multiple personal accident insurance policies. Since personal accident insurance pays fixed benefits based on the policy terms, a valid claim may be payable under more than one policy for the same accident. For example, if you have two policies with a ₹10 lakh sum insured each and the covered event qualifies for a 100% benefit under both policies, you may receive ₹10 lakh from each insurer, subject to the terms and conditions of both policies.