Sign In
For assistance with claim related queries in the CYCLONE affected regions of Tamil Nadu, Andhra Pradesh, and Kerala, please click here

Personal Accident Policy Covers Various Aspect Of Risk

​​“YAT BHAVATI TAT NASYATI” Whatever is created will be destroyed. Creation is inevitably followed by destruction & we insurer are here to cover the risk of destruction with the aim to protect the owner from the variety of risk which they anticipate against a small consideration called premium.

According to page 14 of the Helsbury Laws of England Personal Accident Insurance Business means: “The business of effecting and carrying out contracts of insurance against risks of the persons insured sustaining injury as the result of an accident if an accident of a specified class dying or becoming incapacitated in consequence of disease or of disease of a specified class not being contracts falling with in.”

Personal Accident Insurance​ can cover various aspect of risk coverage. This policy compensates individual against death, loss of limbs, loss of eye sight, permanent total disable​me​nt, permanent partial disablement, and temporary total disablement, solely and directly resulting from accidental injuries.

Unexpected event may be considered as an accident. It is well established that the word accident does not include disease and other natural causes and implies the intervention of some cause which brought into operation by the chance and which can be described as fortuitous.

A condition precedent for injury or death under the personal accident insurance is that the injury or death should have been caused by violent, external and visible means.
In India, there is no doubt about the existence of an inherent security aspect in the personal accident coverage, in England this is known as accident insurance and in USA it is named as Casualty Insurance.

The benefit of personal accident cover is only so long as he continues to be the owner of the insured car. The same has been explained in a land mark judgment as mentioned below.

In Tattersall Vs Drysdale   (1935)2 KB 174
Where the insurer sold away the insured car and thereafter while driving another car met with an accident and claimed indemnity from the insurer. It was held that the policy ceased to have effect on the sale of the insured car and he could no longer get any benefit of insurance under the policy.

In another leading judgment in Liverpool corporation Vs Marsh Ganthvaite  1942.
Where accident was due to defective breaks insurer was held not liable.

In India, as per GR-36 Personal Accident Cover, under motor policy, only the registered owner in person is entitled to have compulsory cover where person holds effective driving license. This kind of policy can’t be granted where a vehicle is owned by company, a partnership firm or a similar body corporate. If more than one vehicle is owned by owner, compulsory Personal Accident cover can be granted to only one vehicle.

In India by the amendment in 1968 to the Insurance Act 1938 the tariff advisory committee was established to control and regulate the rates and advantages terms and condition that may be offered by insurer in respect of general insurance business.

Key to successful business is mainly based on product development. This is the accepted fact in the entire industry and pricing and quoting premium is important parameter for the success of a product.

The exercise of de-tariffication of prices has been a major landmark in the pricing trends of general insurance products in India resulted into liberalized environment.

Personal Accident comes under miscellaneous insurance in India scenario. Some examples are Group policies, Janta Policy, Student safety etc.. The Janta Personal Accident Policy which has become popular in India because it is very inexpensive. Personal Accident is of mounting concern to all citizens and it also has great significance towards the development of any society.

Personal Accident Insurance while being simple in its coverage and contract obligation has its own share of contradictions and limitations also.

Group policies can be issued covering more than one person. Group Insurance may be defined as the insurance of a group of employees of a common employer under the contract between the employer and the insurance company. Thus, it is entered into with one contracting party may be an employer, a labour union or a voluntary association of any professionals like lawyers, doctors painters etc. There is no direct contractual relationship between the insurer and the insured. There must be at least 50 people to operate this scheme.

In various cases whether murder is an accident would depend on the proximity of cause of such murder. Death due to sudden stroke is not amounting to accident and claim would not be payable. Death due to electrocution would be payable.

Similarly, court also specifies that a person should make an effort to avoid a mishap and should act with reasonable diligence to ensure that he did not put himself in peril of an accident and if no attempt is made to avoid the danger or when the person acts negligently then the injury or harm that may be caused could not be said to have been caused by an accident. In such a scenario, the relatives of the insured may not get the accidental death benefit.

In a recent judgment​ passed by National commission on 17.Apr.2013. New India Vs Jatinder Kumar Sharma. Janta Personal Accident where in coverage of Rs. 4,00,000/- had been given. Claim repudiated by insurer as the FIR was not lodged after accident. NCDRC held that even though in absence of FIR insurer would be held responsible.

Before developing any product in Indian market a Company should consider the purpose for which the product is being developed, also it is necessary to see that product suits to the market. Because all individuals need some insurance but it is also essential to take into consideration the financial liabilities of the insured.

For an effective selling of this product the first step will be to identify a market. A proper sale approach is very important to the success. This would include how, when and where to approach a client and a client should always be approached at place time and in the manner that is most convenient to the client.

As of now for various other reasons the premium of Personal Accident insurance is considered to be reasonable in India but due to non awareness in the society lot many efforts need to be done in this regard. As a responsible citizen, one should buy an accident insurance policy. Buying the best accidental cover requires research and awareness.​

Smart intelligence in the market is required for the development of a new product.
It is very important that insurance companies keep track of the needs of potential clients. In order to develop a business, a good public relation is required at all times under any circumstances as there are unlimited opportunities in this product.

The concern sales team should be trained in such a way that the company gets proper feedback of the public needs an offer necessary data to develop new products.

Marketing strategies should be so designed that they appeal to all sections of the society which are alienated from each other by virtue of economic status, educational levels and income distribution should be covered. There is a great need to impress upon the rural masses as also the economically down trodden. Concept of TCF (Treating customer’s fairly) is a golden rule to be applied practically by the insurer in the best encapsulation of the treat their customer’s fairly philosophy.

Accident Claim handling needs to be attended with urgency in non life segment like Personal Accident Insurance. While processing claims, every insurance complaint shall have in place appropriate frame work to detect monitor and mitigate occurrence of fraud. Fraud involving finances poses a serious risk to all segment of financial sector including this product personal accident.

Article by Swati Sinha​

Similar Articles: