What is Group Personal Accident Insurance?

Onsurity Editorial
October 8, 2024
14 min read

Table of Contents

Group Personal Accident Insurance 

In today’s unpredictable world, safeguarding against unforeseen accidents is paramount, especially for organisations and their employees. This is where group personal accident insurance steps in as a vital shield, offering financial protection against the uncertainties of accidents. Group Personal Accident (GPA) Insurance, is a specialised policy designed to provide a collective safety net for a group of individuals, particularly employees, against accidents.

In India, over one billion lives (including those under GPAs) were covered under personal accident insurance in the financial year 2021, with general insurers from the private sector commanding a large share of gross premiums worth over Rs 29 billion. Group personal accident insurance industry in India commands a large share, and is diverse, with companies of various sizes and sectors offering coverage to protect against accidental disability and death.

What Is Group Personal Accident Insurance? 

Group Personal Accident Insurance is a type of insurance policy that provides coverage to a group of individuals, typically employees of an organisation, against accidents leading to death or disability. Apart from this, it also covers medical expenses incurred due to accidents.

The policy pays out a lump sum to the insured person or their beneficiaries in case of accidental death, permanent or partial disability, medical expenses, and temporary total disablement. It is largely purchased by employers or organisations on behalf of their employees or members and is a valuable addition to any organisation’s employee benefits package.

Also, Read: What is Group Health Insurance?

How Does Group Personal Accident Insurance Work? 

Group personal accident insurance provides coverage to a group of individuals like employees of a company, members of an organisation, or participants in a specific event. Here’s how it generally works:

1. Lower Premiums

The group nature of the policy often allows for lower premiums compared to individual policies since the risk is spread across multiple individuals.

2. Accident Coverage

The GPA insurance provides financial protection in the event of accidental injuries or death. Covered accidents may include but are not limited to slips and falls, traffic accidents, sporting accidents, and other unforeseen events that result in bodily harm

3. Benefits Structure

The policy outlines the benefits payable in the event of an accident. These benefits typically include lump-sum payments for death or permanent disability, as well as reimbursements for medical expenses incurred due to covered accidents.

4. Exclusions and Limitations

Like any health insurance policy, group personal accident insurance may have exclusions and limitations. Common exclusions may include injuries sustained while under the influence of drugs or alcohol, self-inflicted injuries, or injuries sustained during illegal activities.

5. Premiums and Coverage Limits

The premium for group personal accident insurance is typically based on factors such as the size of the group, the nature of the work or activities involved, and the desired coverage limits.

6. Claims Process

In the event of an accident or death due to an accident, the insured individual or their beneficiaries must file a claim with the GPA insurance provider. The claims process typically involves providing documentation such as medical records, police reports (if applicable), and proof of the accident.

Also, Read: Group Health Insurance for Employees

Why Do You Need Group Personal Accident Insurance?

Here are some reasons why group personal accident insurance is needed:

importance of group personal accident insurance

1. Financial Protection

The lump-sum payments and reimbursements for medical expenses can help cover medical bills, lost income, and other expenses resulting from an accident, thus giving financial protection.

2. Risk Management for Employers

Employers can offer group personal accident insurance as part of their employee benefits package to attract and retain talent. It demonstrates a commitment to employee well-being and can help mitigate financial risks for the organisation if employees are injured on the job.

3. Complements Other Health Insurance

While health insurance may cover medical expenses related to illness or non-accidental injuries, group personal accident insurance specifically focuses on accidents. Having both types of coverage ensures comprehensive protection from health as well as accident related risks.

4. Coverage for Activities Outside of Work

Group personal accident insurance can extend coverage to accidents that occur outside of the workplace, such as during leisure activities, sports events, or commuting to and from work. This provides individuals with round-the-clock protection against accidental injuries.

5. Affordability

Group personal accident insurance typically offers lower premiums compared to individual policies since the risk is spread across a larger pool of insured individuals. This makes it a cost-effective option for both employers and individuals seeking accident coverage.

Also, Read: What is Group Term Life Insurance?

Who Needs Group Personal Accident Insurance?

Group personal accident insurance can be beneficial for various groups of people, including:

1. Employees

Employees in industries with higher risk of accidents, such as construction, manufacturing, or transportation, may find this coverage particularly valuable, especially in case of permanent total disability.

2. Organisations and Associations

Groups, clubs, associations, or organisations may purchase group personal accident insurance to provide coverage for their members. This can include sports teams, community groups, volunteer organisations, or professional associations

3. Event Organisers

Organisers of events, conferences, exhibitions, or festivals may opt for group personal accident insurance to cover participants, volunteers, staff, and attendees against accidental injuries during the event.

4. Educational Institutions

Schools, colleges, and universities may provide group personal accident insurance for students, faculty, and staff. This coverage can protect individuals against accidents that occur on campus, during field trips, or while participating in extracurricular activities.

5. Business Partnerships

Business partners or co-owners of a company should consider group personal accident insurance to protect each other in case of accidents that affect the business operations or financial stability of the company.

Types of Accidents Covered Under Group Personal Accident Insurance 

Group personal accident insurance typically covers a wide range of accidents resulting in bodily injury or death. Here are common types of accidents that are typically covered:

types of accident covered under group personal accident insurance

1. Work-Related Accidents

Group personal accident insurance can cover injuries sustained while performing work-related duties, including slips, falls, machinery accidents, and other incidents that occur on the job site.

2. Traffic Accidents

It can also cover injuries caused in automobile accidents, whether as a driver, passenger, cyclist, or pedestrian. This includes accidents occurring during commutes to and from work.

3. Sports and Recreational Accidents

Group personal accident insurance can be taken for those participating in organised sports activities, recreational pursuits, or fitness exercises. This may include injuries from team sports, individual sports, or outdoor adventures.

4. Travel Accidents

Group personal accident insurance can be used for coverage for injuries sustained while travelling, whether domestically or internationally. This includes accidents occurring during flights, train journeys, cruises, or other modes of transportation.

5. Slips, Trips, and Falls

Accidents resulting from slipping on wet floors, tripping over obstacles, or falling from heights can be covered by Group Personal Accident insurance. These accidents can occur in various settings, including workplaces, public spaces, or private residences.

6. Assaults and Violent Acts

GPA Insurance can be used for coverage for injuries arising from assaults, physical altercations, or acts of violence. This coverage may extend to incidents occurring both inside and outside the workplace.

7. Natural Disasters

Injuries sustained as a direct result of natural disasters, such as earthquakes, floods, hurricanes, or wildfires, depending on the policy’s coverage provisions.

8. Occupational Hazards

Injuries resulting from exposure to occupational hazards, such as chemical spills, electrical accidents, or repetitive strain injuries can also be covered under GPA insurance.

Also, Read: Types of Group Insurance in India

Key Features of Group Personal Accident Policy 

Key features of a group personal accident policy typically include:

1. Group Coverage:

Provides coverage for a specified group of individuals, such as employees of a company, members of an organisation, or participants in an event.

2. Accident Coverage:

Offers financial protection in the event of accidental injuries or death, which is highly beneficial in case of permanent total disability.

3. Death Benefit:

Pays a lump-sum benefit to the insured’s beneficiaries in the event of the insured’s death due to a covered accident.

4. Permanent Disability Benefit:

Provides a lump-sum benefit if the insured suffers permanent total disability or permanent partial disability due to a covered accident.

5. Temporary Disability Benefit:

Offers income replacement benefits if the insured is temporarily disabled and unable to work due to a covered accident. This benefit helps cover lost wages during the period of permanent total disability or permanent partial disability.

6. Medical Expense Coverage:

Reimburses the insured for medical expenses incurred as a result of a covered accident, including permanent total disability.

7. Exclusions and Limitations:

Specifies the accidents, injuries, or circumstances that are not covered by the policy.

8. Coverage Limits:

Sets the maximum amount payable for various benefits under the policy, such as the death benefit, permanent total disability benefits, and medical expenses coverage.

9. Claims Process:

Outlines the procedures and requirements for filing a claim with the GPA insurance provider in the event of an accident. This includes providing documentation such as medical records, police reports, and proof of the accident.

Quick Read: Group Health Insurance Policy

Benefits of Group Personal Accident Insurance Policy

Group personal accident insurance offers valuable advantages and protections, including financial security, peace of mind, cost-effective coverage, and comprehensive protection against accidental injuries or death.

Benefits for Employees

Financial Protection: Group personal accident insurance offers financial security to employees in the event of accidental injuries or death.

Workplace Coverage: Employees are covered for accidents that occur during work hours, on the job site, or while performing work-related duties.

Off-the-Job Coverage: Group accident insurance often extends coverage to accidents that occur outside of the workplace, including during leisure activities, commuting to and from work, or while running errands.

Supplemental Coverage: Group accident insurance serves as a supplemental coverage option alongside other insurance policies, such as health insurance.

No Health Screening Required: Group accident insurance typically does not require employees to undergo health screenings or provide medical evidence to qualify for coverage.

Family Coverage Options: Some group accident insurance policies offer the option to extend coverage to employees’ spouses and dependents, thus broadening the coverage.

Also read: Benefits of Personal Accident Insurance

What Is Covered in Group Personal Accident Insurance?

The coverage provided by Group Personal Accident Insurance includes accidental death, permanent total disability or permanent partial disablement due to accident, temporary total disablement, medical expenses, and hospitalisation expenses due to accidents.

Some policies may also include additional benefits such as coverage for temporary disablement, transportation costs, and education benefits for the children of the insured in case of accidental death or permanent disability.

What Is Not Covered in Group Personal Accident Insurance? 

Some common exclusions in group personal accident insurance include:

Injuries or deaths that occur when under the influence of drugs or alcohol.
Injuries due to sports or activities not included in the policy.
Pre-existing medical conditions.
Self-inflicted injuries or suicide attempts.
Convulsions, strokes, mental illnesses, psychiatric diseases, and fits.
Bacterial illnesses, except for pyogenic infections from cuts or wounds.
Injuries or disabilities resulting from criminal acts committed by the insured person.
Disabilities or fatalities caused by war, acts of terrorism, or other acts of violence.
Injuries or disabilities caused by intoxication or drug use.
Disabilities or fatalities resulting from labour or pregnancy, unless specified.

Also, Read: Group Health Insurance Exclusions

Group Personal Accident Insurance Claim Process

The claim process for group personal accident insurance typically involves several steps. Some of these are as follows:

Notify the Insurance Provider: The insured individual or their beneficiary should notify the insurance provider as soon as possible after the accident occurs.

Submit Claim Forms: The insurance provider will typically require the claimant to complete and submit claim forms.

Provide Supporting Documentation: Along with the claim forms, the claimant may need to submit supporting documentation to substantiate the claim.

Medical Examination (if required): In some cases, the insurance provider may require the insured individual to undergo a medical examination to assess the extent of their injuries or permanent partial disabilities.

Claim Assessment: Once the insurance provider receives all necessary documentation, they will assess the claim to determine its validity and eligibility for benefits under the policy.

Benefit Disbursement: If the claim is approved, the insurance provider will arrange for the disbursement of benefits to the insured individual or their beneficiary. This typically involves issuing a lump-sum payment for death or permanent disability benefits, reimbursement for medical expenses, or periodic payments for disability benefits.

Appeals Process (if necessary): If the claim is denied or if the claimant disagrees with the outcome of the claim assessment, they may have the option to appeal the decision.

Relevant Read: Health Insurance Claim Process

Documents Required for Group Accident Insurance Claim 

a) For Accidental Death Claims

To file a claim under a Group Personal Accident Insurance policy for accidental death, the following documents are typically required:

Death certificate: A copy of the death certificate is required to confirm the death of the insured person.

Original policy documents: The original policy documents are required to initiate the claim process.

ID proof of the beneficiary: The beneficiary’s ID proof is required to establish their identity and relationship with the insured person.

Age proof of the insured: Age proof of the insured is required to confirm their age at the time of death.

Discharge form (executed and witnessed): This form is required to confirm that the insured person has been discharged from the hospital or medical facility

Medical certificate: A medical certificate is required as proof of the cause of death.

Police FIR: A copy of the police FIR is required in case of unnatural death.

Hospital records/certificate: Hospital records or a certificate from the hospital are required if the insured person dies due to an illness.

Cremation certificate and employer certificate: These documents are required in case of early death.

Also, Read: Documents Required for Health Insurance

b) For Accidental Disability Claims 

For group accidental disability claims, including permanent partial disability the following documents are typically required:

Duly filled claim form: This is the standard document required for filing a claim and should be completed and signed by the insured.

Police FIR copy or Police Panchanama: This document provides details about the accident and any legal proceedings related to it.

Medical reports (X-ray, Pathology reports, etc., as applicable): These documents provide details about the medical treatment received by the insured.

Disability Certificate from a reputed government office or surgeon (for permanent disability claims): This document confirms the insured’s disability, including permanent partial disability.

Sick leave letter from the organisation (for permanent and temporary disability claims): This document provides details about the insured’s leave of absence due to the injury.

Attending physician’s statement: This document provides details about the insured’s injuries and medical treatment.

Also, Read: Differences Between Group and Individual Health Insurance

How Does Group Personal Accident Insurance Differ from Individual Insurance? 

The main differences between group personal accident insurance and individual insurance are:

Group coverage: Group Personal Accident insurance covers a group of individuals, while individual insurance covers only one person.

Cost: GPA insurance is generally more cost-effective for organisations, as the premium is spread across a larger group, while individual insurance is more expensive.

Customisation: GPA insurance policies can be tailored to meet the specific needs of the group, while individual insurance policies are more standardised.

Eligibility: GPA insurance is typically offered to employees or members of an organisation, while individual insurance is available to anyone who meets the eligibility requirements.

Benefits: Group Personal Accident Insurance typically offers comprehensive coverage, including accidental death, permanent total or partial disablement, temporary total disablement, medical expenses, and hospitalisation expenses.

Claims: GPA insurance claims are typically filed by the organisation on behalf of the insured, while individual insurance claims are filed by the insured themselves.

Factor to Consider When Choosing Group Personal Accident Insurance

When choosing Group Personal Accident Insurance, there are several factors to consider to ensure that the policy meets the needs of the organisation and its employees. These factors include:

Coverage: The policy should cover both injury and property damage, and provide comprehensive coverage for accidental death, disability, and medical expenses.

Cost: It is important to consider the cost and ensure that it aligns with the employees’ income.

Policy Comparison: Compare policies from different companies to find the best one for the organisation’s needs.

Claim Settlement: Ensure that the claims are settled on a priority basis and within a short span of time.

Inclusions: Check for inclusions such as accidental death, permanent total disability, permanent partial disability, weekly benefits, and ambulance costs.

Exclusions: Be aware of exclusions such as self-inflicted injuries, illegal activities, intoxicants, maternity-related complications, and war-like situations.

Eligibility: Check the eligibility age for buying and renewing the policy.

Network Hospitals: Ensure that the insurance provider has reliable and accessible network hospitals for cashless treatment.

Claim Settlement Ratio: Consider the insurer’s claim settlement ratio and reputation to ensure quality service.

Why Choose Onsurity as Your Group Personal Accident Insurance Partner?

Choose Onsurity as your group personal accident insurance partner because they offer comprehensive coverage and benefits tailored to the needs of the insured group. Onsurity provides a range of group insurance plans, including group personal accident insurance, that offers financial protection against accidental injuries, death, or disability. Their policies cover hospitalisation expenses, and loss of income due to accidents, and provide financial security to insured individuals and their families.

Additionally, Onsurity settles claims on a priority basis and within a short span of time, ensuring that admissible expenses or death benefits are disbursed promptly to the insured or nominee. With a focus on providing extensive coverage, financial security, and efficient claim settlement, Onsurity is a reliable choice for group personal accident insurance.

Conclusion 

In conclusion, group personal accident insurance is a crucial insurance policy that offers financial protection to a group of individuals in the event of an accident. It covers accidental death, permanent or partial disability, medical expenses, and temporary total disablement.

Group personal accident insurance is typically purchased by employers or organisations on behalf of their employees or members and is a valuable addition to any organisation’s employee benefits package. This type of insurance policy can be customised to meet the needs of the organisation and its employees, providing a competitive advantage in the job market, improving employee retention and productivity, and ensuring compliance with legal requirements.

FAQs:

1.What is a group personal accident plan?

This type of insurance covers various aspects such as accidental death, permanent or partial disability, medical expenses, temporary total disablement, ambulance costs, hospitalisation expenses, and more.

2: What is covered under group personal accident insurance?

The coverage includes a lump sum or monthly amount in case of accidental death or permanent disability due to an accident, medical expenses, and temporary total disablement.

3: What is the difference between group life and group personal accident insurance?

Group Personal Accident Insurance provides coverage for accidents, while Group Life Insurance provides coverage for death, regardless of the cause.

4.What are the benefits of GPA?

The benefits of GPA insurance include financial protection for the insured person and their dependents in case of accidents, risk management for employers, complementing other insurance policies, coverage for activities outside of work, peace of mind, and affordability.

5: Can I obtain tax benefits from group personal accident insurance?

Yes, you can obtain tax benefits from group personal accident insurance in India. Under Section 80C of the Income Tax Act, 1961, the premium paid towards group personal accident insurance for employees is eligible for tax deduction up to a maximum limit of Rs. 1.5 lakh per annum.

6: Which factors play a role in determining premiums for group personal accident insurance?

Factors that play a role in determining premiums for group personal accident insurance include occupation and nature of work, past claim history, industry-specific risks, group size, coverage and add-ons, features and benefits.

7: What additional advantages do group personal accident plans provide?

Group personal accident insurance provides additional advantages beyond accidental coverage for death and disability. These benefits can include coverage for ambulance charges related to accidental treatments, transportation of the body after accidental death, funeral costs, transportation of mortal remains, medical treatment allowances, allowances for specific modifications required at home after accidents etc.

8: Should I consider group accident insurance if I already possess health and life insurance?

Yes, considering group accident insurance even if you already have health and life insurance can be beneficial. Group accident insurance provides specific coverage for accidental injuries, offering a lump sum payout in case of covered accidental injuries.

9: Will my family members be covered under my group personal accident insurance?

Yes, family members can be covered under group personal accident insurance, but this depends on the specific terms and conditions of the policy.

10: Is a higher premium necessary to access group personal accident cover?

A higher premium is not necessarily required to access group personal accident cover. In fact, group personal accident insurance is typically provided by employers to employees at no additional cost to the employees.