Essential Things that do Not Come Under Personal Accident Insurance

In India, every minute a serious road accident occurs and 16 die due to the same in an hour. In a similar context, more than 1,200 road crashes are witnessed in India, and 377 individuals die, in a day. In most cases (25%), two-wheeler motor vehicles are accountable for road crashes. 

These accidents mostly occur in the urban regions where roads are busy and chaotic throughout weekdays. Cities that top the list of most numbers of road crashes are – Delhi, Chennai, Bangalore, Mumbai, Lucknow, Pune, etc. 

2013 recorded one of the worst years in respect to road crashes, where more than 1.37 Lakh individuals died due to road accidents. Such a health insurance policy has become a common financial product for urban dwellers, especially personal accident insurance

Personal accident insurance policies facilitate financial coverage on account of accidents and losses suffered by the insured individual. 

However, there are circumstances which are not considered for financial coverage under personal accident insurance policies. 

What are the things that do not come under personal accident insurance?

As per the mandate of Insurance Regulatory and Development Authority of India (IRDAI), there are certain specific circumstances which are discounted under the purview of standard personal accident insurance policies. 

A few of these are mentioned below – 

  1. Self-inflicted injury: In case an individual hurts himself or herself voluntarily under any circumstance, any monetary compensation is not facilitated by a personal accident insurance policy toward medical expenses. 
  2. Sexually transmitted diseases: Health insurance policies do not apply towards treatment of sexually transmitted diseases (STDs) such as HIV or AIDS. 
  3. Involvement in perilous activities: In case an individual decides to engage in dangerous activities which constitute joining the military, navy, air force, scuba diving, hang gliding, sky diving, racing, rock climbing, etc., he/she cannot enjoy the benefits of a personal accident insurance policy. 
  4. Substance abuse: If an individual is found to be in a state of intoxication during an accident occurring from abuse of toxic drugs, alcohol, or hallucinogens, he/she is not entitled to receive any financial coverage under a health insurance policy.
  5. Acts of subversion: An individual cannot avail monetary coverage for treatments for injuries which occurred in the course of any subversive activity. Subversive activities under the guidelines of IRDAI are – rebel, revolution, terrorism, war or warlike operations, riots, etc. 
  6. Criminality: In case an individual suffers an injury on account of any criminal activity or breach of the law, he/she will not be facilitated with financial coverage for treatment expenses under personal accident insurance policies. It is applicable if the individual is held accountable, proven guilty, or party to the aforementioned. 
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This list comprises the comprehensive set of exclusions made by the regulatory body under personal accident insurance. While this is the definitive list of exclusions, there are other instances, coverage of which varies from one institution to another. 

Regardless, personal accident insurance proves considerably beneficial in case of road accidents or any other cause of severe injury excluding the aforementioned. For instance, reputed insurance aggregators such as Bajaj Finserv offer an allowance to compensate for an individual’s income due to hospitalisation under their Personal Accident Insurance policy. 

There are several types of health insurance policy, apart from personal accident insurance, which allow you to avail financial coverage under various instances, clubbed according to their nature. 

These are – 

  • Individual insurance.
  • Family floater insurance. 
  • Critical Illness Insurance policy.
  • Senior citizen health insurance.
  • Maternity health insurance. 

Make sure to choose the best health insurance plans in India by comparing all the available products. 

Some institutions also offer a bonus on your policies if you do not apply for any claim during a particular year. These companies also offer health insurance online for better convenience.