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Thread: Claim under group Personal Accident after after working hours?

  1. #1
    PolicyWala Member
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    Default Claim under group Personal Accident after after working hours?

    All the employees of our company are covered under group Personal Accident as well as group Mediclaim policy. One employee met with road accident, while performing domestic work outside the company premises and also after working hours. His medical expenses are covered under the Medicalim Policy hence there is no issue on this front.
    Query -

    Whether the above employee will be entitled to get the benefit under the scope of Personal Accident Policy though the accident has no connection with duty or company’s work? (I suppose as there is coverage of 24 hours there shall be compensation from Insurance Company towards the absent days of employee and medical expenses)



  2. #2
    PW Stalwart Master's Avatar
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    Yes, 24 hours coverage is there, subject to exclusions. Please read the policy wording for exclusions. Some important exclusions -
    1. suicide, attempted suicide (whether sane or insane) or intentionally self-inflicted Injury or Illness, or sexually transmitted conditions, mental or nervous disorder, anxiety, stress or depression, Acquired Immune Deficiency Syndrome (AIDS), Human Immune deficiency Virus (HIV) infection; or
    2. being under the influence of drugs, alcohol, or other intoxicants or hallucinogens unless properly prescribed by a Physician and taken as prescribed; or
    3. participation in winter sports, skydiving/parachuting, hang gliding, bungee jumping, scuba diving, mountain climbing (where ropes or guides are customarily used), riding or driving in races or rallies using a motorized vehicle or bicycle, caving or pot-holing, hunting or equestrian activities, skin diving or other underwater activity, rafting or canoeing involving white water rapids, yachting or boating outside coastal waters (2 miles), participation in any Professional Sports, any bodily contact sport or any other hazardous or potentially dangerous sport for which You are untrained.
    4. for any loss of which a contributing cause was Your actual or attempted commission of, or willful participation in, an illegal act or any violation or attempted violation of the law or Your resistance to arrest.

  3. #3
    PolicyWala Fan
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    Default

    Personal Accident Policy has 24 Hours coverage (even internationally), So I think he is covered.

  4. #4
    PolicyWala NewBie
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    Sep 2011
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    New Delhi
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    Default

    Pls also check with your corporate, is this policy for 24 hrs. cover or they had taken it either On duty cover or Off duty cover?


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