What does the policy cover?
1. Death:
We shall pay the benefit equal to 100% of Sum Insured, specified in the policy schedule, on death of the insured person, due to an Injury sustained in an Accident during the Policy Period, provided that the Insured Person's death occurs within 12 months from the date of the Accident.
2. Permanent Total Disablement:
We shall pay the benefit equal to 100% of Sum Insured, specified in the policy schedule, if an insured Person suffers Permanent Total Disablement of the nature specified below, solely and directly due to an Accident during the Policy Period, provided that the Permanent Total Disablement occurs within 12 months from the date of the Accident
- Total and irrecoverable loss of sight of both eyes or
- Physical separation or loss of use of both hands or feet or
- Physical separation or loss of use of one hand and one foot or
- loss of sight of one eye and Physical separation or loss of use of hand or foot
- If such Injury shall as a direct consequence thereof, permanently, and totally, disables the Insured Person from engaging in any employment or occupation of any description whatsoever
3. Permanent Partial Disablement:
We shall pay allocated percentage of Sum Insured, specified in the policy schedule, if the Insured Person suffers Permanent Partial Disablement solely and directly due to an Accident during the Policy Period provided that the Permanent Partial Disablement shall occur within 12 months of the date of the Accident. For the sum-insured coverage of partial disability refer to the policy wording for more details.
Note:
- The base sum insured chosen and cumulative bonus, if any, is applicable cumulatively for all the three base covers specified above i.e, there is a single sum insured for all the three covers namely, Accidental death, Permanent total disability and Permanent Partial Disability.
- If the accident occurs during the policy period, benefits covered under base covers above are payable, even if death or Permanent Total Disablement or Permanent Partial Disablement or any combination thereof occurs after the completion of policy period, but within 12 months from the date of accident.
Policy offers Add-on Covers for:
1. Temporary Total Disablement*:
If the Insured Person sustains an Injury in an Accident during the Policy Period which completely incapacitates the Insured Person from engaging in any employment or occupation, which the Insured Person was otherwise capable of performing at the time of the Accident, the company shall pay the benefit as specified in the policy schedule, till the time the insured person is able to return to work.
2. Hospitalisation Expenses due to Accident*:
We shall pay medical expenses incurred for hospitalisation arising due to accident during the policy period, up to the limit of 10% of the base sum insured, specified in the policy schedule.
3. Education Grant*:
Following an admissible claim of the insured person under the policy towards Death or Permanent Total Disability of the insured person, the company shall pay a one-time educational grant of 10% of the Base Sum insured (specified in the policy schedule), each, per child to all dependent children of the Insured
*Refer to policy wordings for more details on coverage
Sum-Insured offered in the policy:
₹2,50,000/- to ₹1,00,00,000/- (in the multiples of ₹50,000)**
**On Individual basis – SI shall apply to each individual family member
Cumulative Bonus offered in the policy:
Chosen Sum insured shall be increased by 5% in respect of each claim free policy year, provided the policy is renewed without a break subject to maximum of 50% of the sum insured. If a claim is made in any particular year, the cumulative bonus accrued may be reduced at the same rate at which it has accrued.
Who is eligible to buy the policy:
Minimum entry age shall be 18 years and maximum age is 70 years for the policy proposer. Policy can be availed for self and the following family members
- legally wedded spouse
- Parents and Parents-in-law
- Dependent Children (i.e. natural or legally adopted) between the age of 3 months to 25 years. If the child above 18 years of age is financially independent, he or she shall be ineligible for coverage in the subsequent renewals
How is the policy premium calculated (Premium illustration of a single member for ₹50,000 Sum-Insured):
Customer Profile |
Proposer
| Age 50 |
No of member
| 1
|
Occupation
| Doctor
|
Mode of Purchase
| Digital
|
Basic Cover Sum Insured Opted
| 5,00,000 |
Optional Cover |
Temporary Total Disablement Cover |
Opted
| No |
SI Opted
| NA
|
Hospitalisation Expenses due to Accident Cover |
Opted
| Yes
|
Accident SI (10% of Base SI)
| 50,000
|
Education Grant Cover |
Opted
| Yes |
Education Grant SI (10% of base SI)
| 50,000
|
No of children covered
| 1
|
Basic Cover Premium (A): Base Cover Premium per Lakh SI * SI opted / 1,00,000 * Lives covered
| 205 |
Temporary Total Disablement Cover Premium (B): TTD Cover Premium per 1000 SI * SI opted / 1,000 * Lives covered
| 0
|
Hospitalisation Expenses due to Accident Cover Premium (C): Hospitalisation Cover Premium * Lives covered
| 374 |
Education Grant Cover Premium (D): Education Grant Premium per Child per Lakh SI * No of Children *Lives covered* SI / 1,00,000
| 1.3
|
Total Premium (E) = (A + B + C + D) | 580
|
Occupation Rating (E1=0.75*E) | 435
|
Discounts | |
Digital Discount (F)
| 5% |
Section Discount (G) | 5%
|
Family Discount (H) | 0%
|
Premium before taxes (F) = (E1 * (1-F) * (1-G)*(1-H)) | 391.5 |
Note: The Premium may vary as per the coverage’s opted, risk group, number of lives/children and discounts applicable
Waiting Periods in the Policy
No Waiting Periods are applicable for the policy
What we don't cover#
(i) Any claim for death or disablement, hospitalisation of the insured person, directly or indirectly due to War and war like occurrence or invasion, acts of foreign enemies, hostilities, civil war, rebellion, revolutions, insurrections, mutiny, military or usurped power, seizure, capture, arrest, restraints and detainment of all kinds.
(ii) Any claim for death, disablement, hospitalization of Insured Person
- from intentional self-injury unless in self-defense or to save life, suicide or attempted suicide;
- whilst under the influence of intoxicating liquor or drugs or other intoxicants except where the insured is not directly responsible for the injury/accident through under influence of intoxication;
- whilst engaging in aviation or ballooning, or whilst mounting into, or dismounting from or travelling in any balloon or aircraft other than as a passenger (fare-paying or otherwise) in any Scheduled Airlines in the world, or engaging in any kind of adventure sports for personal gratification. [Standard type of aircraft means any aircraft duly licensed to carry passengers (for hire or otherwise) by appropriate authority irrespective of whether such an aircraft is privately owned or chartered or operated by a regular airline or whether such an aircraft has a single engine or multiengine;]
- arising or resulting from the Insured Person committing any breach of law with criminal intent.
(iii) Any claim for death, disablement, Hospitalization of Insured Person, from participation as a professional in hazardous or adventure sports, including but not limited to, para-jumping, rock climbing, mountaineering, rafting, motor racing, horse racing or scuba diving, hand gliding, sky diving, deep-sea diving.
(iv) Any claim resulting or arising from or any consequential loss directly or indirectly caused by or contributed to or arising from:
- Ionizing radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel or from any nuclear waste from combustion (including any self-sustaining process of nuclear fission) of nuclear fuel.
- Nuclear weapons material
- The radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof.
- Nuclear, chemical and biological terrorism
(v) Any loss arising out of the Insured Person's actual or attempted commission of or wilful participation in an illegal act or any violation or attempted violation of the law.
Exclusions related to the 'Hospitalisation Expenses due to Accident' add-on cover#:
1. Investigation & Evaluation
- Expenses related to any admission primarily for diagnostics and evaluation purposes.
- Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment
2. Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a medical practitioner as part of hospitalization claim or day care procedure
3. Expenses incurred for treatment of accidental injuries by systems of medicines other than Allopathy.
4. Expenses incurred for treatment of accidental injuries which does not warrant hospitalization.
5. Treatment taken outside the geographical limits of India.
#For complete list of exclusions refer to the
policy wordings
Free-look period and Policy Cancellation:
The insured will be allowed a period of fifteen days from date of receipt of the Policy to review the terms and conditions of the Policy, and to return the same if not acceptable. If there has been no claim in the 15 day period, a complete refund of the premium will be given to the policyholder.
The policyholder may also cancel this policy later by giving 15 days written notice and the Company shall refund the premium for the unexpired policy period as detailed below:
Refund of Premium (basis Policy Period) |
Risk Period (Policy in force) |
Refund % |
Up to 30 days | 75.0% |
31 to 90 days | 50.0% |
3 to 6 months | 25.0%
|
6 to 12 months | 0.00% |
T&C apply. For more details on risk factors, terms & conditions, brochure, and exclusions, please read the
policy wording carefully before concluding a sale. The details mentioned above are for Saral Surksha Bima, Reliance General - UIN-RELPAIP21641V012021.