Employees are the most significant asset of a company, which is why people-first organisations focus a lot on attracting and retaining talent. One of the ways to do this is by offering employees financial assistance if they face a medical emergency due to an accident. With Group Personal Accident Insurance (GPA), you can provide comprehensive accidental coverage for your employees. Read on to understand how GPA insurance can benefit your employees and your organisation. 

What is Group Personal Accident Insurance?

Group Personal Accident or GPA Insurance protects policyholders and their families financially against loss of income due to accidental disablement or death. This policy is offered by commercial or industrial establishments as accident coverage for employees, workers, members, etc.

A Group Personal Accident Policy is generally customisable to match the size and requirements of a group. The coverage terms help to eliminate or reduce the hefty expenses related to accidental disablement. At the same time, it offers financial benefits to the nominated dependent family members in case of the policyholder’s demise. These benefits help the insured employees to feel secure from the financial anxieties and the uncertainties of life. 

While a Group Medical Cover (GMC) is a Group Health Insurance Policy that covers situations where the insured needs to be hospitalised due to a medical emergency, a GPA cover focuses on covering accidental injuries and death. To know more, read: Difference Between GMC and GPA Insurance Policy.

If you as an employer have purchased ACKO’s GMC policy to insure your employees, you can enhance its coverage by including the GPA as an group health add-on in your coverage. Note that the following sections pertain to a separate GPA policy and not specifically to the mentioned add-on.

Key features of ACKO Group Personal Accident Insurance Policy

Here are the key highlights of ACKO’s Group Personal Accident Insurance.

KEY GPA FEATURES	ACKO ADVANTAGE
Employee coverage	Group Personal Accident cover is for employees/workers of a commercial or industrial establishment.
Accidental expenses	Expenses related to accidents are covered under the GPA policy.
Permanent total disability	Total sum insured is paid for permanent total disability (such as irrecoverable loss of a limb or eyesight).
Permanent partial disability	The insured can receive a maximum of up to 50% of the sum insured for certain permanent partial disabilities (such as irreversible loss of hearing, loss of one foot, one hand, or sight in one eye). Note: Please refer to the policy wording for more information.
Temporary total disability	Certain percentage of the sum insured is given in case of temporary total disabilities caused by accident.
Medical reimbursements	Medical expenses are reimbursed if the insured person suffers from injuries in an accident that require hospitalisation or Day Care Treatment.
Education for children	Education cover is provided for up to two dependent children in case of the death of the insured person.
Physiotherapy	The expenses of physiotherapy for the insured is covered, given that the requirement arises as a result of an accident.
Funeral expenses	The Group Accidental Insurance Policy also covers the cost of the funeral in the event of the death of the insured in an accident.
Compassionate visits	The Group Personal Accident Cover reimburses the cost of travel to the location of hospitalisation for the immediate relative of the insured as per the terms of the policy.
Ambulance transportation	The ambulance expenses that arise after an accident are reimbursed under the Group Personal Accident Cover.
Disappearance cover	The nominee of the policy receives compensation if the insured disappears after an accident such as an earthquake, flood, forced plane landing, etc.
Modification or home/vehicle	Cost of any modifications to a vehicle or home required after an accident is reimbursed as per the limit mentioned in the policy.
OPD treatment	The Group Accidental Insurance Policy covers OPD treatment expenses that arise as a result of an accident.
Other accident-related expenses	Other accident-related expenses may also be covered as per the applicable terms and conditions of your policy.

What’s covered in a Group Personal Accident Insurance Policy?

Following are some of the major coverages included in GPA insurance. Please read the applicable policy wordings for details.

Accidental death

In the event of the death of the insured person due to an accident, the nominated family member receives the principal amount from the insurer. Hence, it is critically important for the insured person to provide nominee details when buying a policy. In case you forget to add nominee details initially, reach out to your insurer as soon as possible for the same.

Temporary total disability

The Group Personal Accident Insurance also provides coverage for accidental injuries that restrict the insured from engaging in employment for a limited period of time. An amount specified in the policy is paid to the insured until the temporary total disability continues.

Child education cover

The Group Personal Accident Insurance offers child education coverage in case of the permanent disability or death of the insured person. An amount specified in the policy is paid at a certain frequency to cover the educational expenses of the dependent child, given that the child is less than 25 years of age and doesn’t have any independent source of income.

Medical expenses

The cost of hospitalisation or day care treatment is reimbursed for the insured person in the Group Personal Accident Insurance. This coverage is solely for injuries that require either hospitalisation or daycare treatment. However, the policyholder can also receive reimbursement for certain post-hospitalisation medical expenses for up to 90 days.

Transportation of mortal remains

A GPA coverage can also include the expenses associated with the transportation of mortal remains. The insurer usually reimburses the cost of transporting the mortal remains of the insured person from the location of demise to the residential address.

Mobility support cover

The mobility support cover also comes under Group Personal Accident Insurance. It offers financial aid for the purchase of mobility support items as a consequence of an accident. The insurer reimburses the purchase of items like wheelchairs, artificial limbs, crutches, dentures, spectacles, etc.

Funeral expenses

The GPA coverage can allow the family of the insured to claim the cost of the funeral after the death of the policyholder in an accident. These expenses usually include transporting the body from the place of death to the location of the funeral, burial, cremation, etc.

OPD treatment

The Outpatient Department Treatment or OPD treatment of the policyholder after an accident is covered under GPA. The policy may cover the consultations, tests and treatments as per the terms of the policy.

Physiotherapy

The Group Personal Accident Insurance covers a policyholder’s physiotherapy expenses (as per the applicable terms) if required to recover from accidental injuries.

Permanent partial/total disability

The GPA coverage includes permanent partial and total disabilities that permanently prevent the ability to engage in employment. The insured person may receive the full or certain percentage of the sum insured depending on the type of injury he or she suffers in an accident. 

See the table below for a few examples of the nature of permanent partial and total disabilities covered under Group Personal Accident Insurance.

Permanent partial disability and Permanent total disability

PERMANENT PARTIAL DISABILITY	PERMANENT TOTAL DISABILITY
Total and irreversible loss of sight in an eye	Total and irreversible loss of sight in both eyes
Loss of a hand or foot	Total and permanent loss of both hands or feet
Total and irreversible loss of hearing in one ear	Total and irreversible loss of hearing in both ears

General exclusions of a Group Accident Insurance Policy

While the exact details will be mentioned in the respective policy wordings, a GPA policy usually doesn’t provide coverage in the following conditions.

GENERAL EXCLUSIONS	EXPLANATION
Pre-existing diseases	A GPA policy does not cover any pre-existing diseases or a disability/injury caused as a result of a pre-existing disease.
Self-inflicted injuries	The policy does not cover injuries caused due to self-destructing acts like suicide or attempted suicide.
Mental illness	A GPA insurance policy excludes mental disorders, psychiatric conditions, strokes, convulsions or fits. Consequently, the policy does not cover any pathological or bodily disturbances caused due to a mental illness.
Hazardous activities	Activities such as working with explosives, underground mines, high tension electrical installations, etc., are not included in Group Personal Accident Insurance.
Bacterial infections	All bacterial infections are excluded except pyogenic infections that happen due to a wound or cut that may occur during an accident.
Non-accidental medical treatments	The GPA coverage does not include surgical or medical treatments related to non-accidental causes.
Sexually transmitted diseases	The GPA policy excludes disabilities or death caused directly/indirectly by a sexually transmitted disease.
Substance abuse	The policy does not provide coverage for disability or death caused as a result of substance abuse like alcohol, intoxicant, hallucinogens, drugs, etc.
Criminal activities	A disability or death caused during an illegal activity, participation in a riot, felony, etc., are excluded from the Group Personal Accident Insurance coverage.
Pregnancy/Childbirth	Disability or death resulting indirectly or directly due to childbirth or pregnancy is excluded from the GPA policy unless arising specifically after an accident.
War/Attacks	Disability or death occurring in relation to foreign invasion, warlike operations, chemical attacks, biological attacks etc., are not covered under the GPA insurance.

Benefits of Group Personal Accident Insurance

Here are some of the common Group Personal Accident Insurance benefits for employees.

1. Coverage against accidental death

Employees included in the Group Personal Accident Insurance receive financial coverage against accidental deaths. The nominee or nominees of the policy receive the sum insured in the event of the insured person’s accidental death.

2. Coverage against disabilities

In case of permanent partial or total disabilities, the Group Personal Accident Insurance provides financial support to the insured and their family. The compensation helps to survive financially in situations when the insured is unable to work due to a disability caused after an accident.

3. Educational benefits for children

Another exceptional advantage of Group Personal Accident Insurance is the educational benefits it offers for children of the insured. The policy covers the education cost for up to two children in the event of unfortunate demise or permanent disability of the insured employee.

4. Coverage for ambulance charges

The GPA policy takes care of the financial aspect of the ambulance service for the insured employee when required after an accident.

5. Medical reimbursements

Employees can request reimbursements for medical expenses required after an accident. These reimbursements cover post-accident hospitalisation, daily hospital allowance, and post-hospitalisation medical expenses as well.

How to buy an ACKO Group Personal Accident Insurance Policy

You can simply contact us by sending an email to health@acko.com. Send us your GPA requirements along with the following details.

• The name of your company
• Number of full-time employees working at your company
• Location of your company

Our support team will contact you to take the process ahead.

Group Personal Accident Insurance Policy claim process at ACKO

Following are the steps to claim under ACKO Group Personal Accident Insurance Policy.

Step 1

Send an email to ACKO regarding your claim request at health@acko.com.

Step 2

Our team will connect with you to further understand the claim request.

Step 3

Provide the required documents and necessary information within 30 days of the accident.

Our claim settlement team will conduct the verification process to issue the claim payment as per the policy.

Documents required for the claim process

The GPA insurance claim process involves the following documents. Note that the number of documents required at the time of raising a claim can vary on a case-by-case basis. 

Documents required for accidental death claims

Here are the documents necessary for accidental death claims under GPA insurance.

• Duly filled claim form
• Police FIR copy or Police Panchanama
• Death Certificate (attested from the relevant authority)
• Post-mortem report
• Copies of KYC documents of the claimant/nominee
• Legal heir certificate (in case of death claim when the nominee is already deceased)

Documents required for accidental disability claims

Here are the documents necessary for accidental disability claims under GPA insurance.

• Duly filled claim form
• Police FIR copy (if an accident case is filed)
• Medical reports (X-ray, Pathology reports, etc., as applicable)
• Disability Certificate from a reputed government office or surgeon (for permanent disability claims)
• Sick leave letter from the organisation (for permanent and temporary disability claims)
• Attending physician’s statement

Who is eligible for Group Personal Accident Insurance cover in India?

All kinds of small and large business groups or institutions can get Group Personal Accident Insurance in India for their employees/co-owners/members, etc. Some of the eligible groups for GPA insurance are as follows.

• Employee-employer corporations
• Banks and firms
• Academic institutions
• Professional associations
• Clubs

How are Group Personal Accident Insurance premiums calculated?

Here are the factors and steps usually involved in the calculation of GPA insurance premiums.

FACTORS	STEPS INVOLVED
Sum insured	Provide the sum insured for each employee working for your organisation.
Number of dependents	If coverage is required for kids as well, then you need to know the number of dependants each employee has.
Date of birth of employees and their dependents	You need to provide the date of birth for each employee and the date of birth of their dependents as well.
Risk exposure	The risk factor is calculated depending on the category of occupation of each employee, which helps to set an optimum premium.

How to compare and buy the best GPA policy in India

You can compare Group Personal Accident Insurance in India based on coverage, premium costs, add-ons, etc. A thorough comparison will help you choose the best GPA policy for your employees. Here are the key factors you should consider while choosing GPA insurance.

Coverage range

While analysing policies, you should prefer wider coverages to help your employees attain the maximum benefit of the insurance policy. A regular GPA policy will include accidental demise, accidental permanent total/partial disability and temporary total disability. However, certain insurers also offer child education benefits, post-hospitalisation medical reimbursement, etc. Thus, you must go through the policy terms and look for maximum coverage benefits.

Sub-limits

Different coverages included in a single policy might also come with applicable sub-limits on the payable sum insured in case of claims. Make sure to go through the details to make an informed choice.

Coverage extensions

Depending on the policy you choose, GPA insurance may include extensions like funeral expenses, ambulance service costs, and the cost of transporting mortal remains. You can choose a policy with these extensions to provide better financial protection for your employees.

Premium cost

Premium is definitely one of the most important factors to consider when comparing policies. You must ensure that the premium cost aligns with an employee’s occupation, group size, sum insured etc. For example, you will have a high premium when buying a GPA policy for high-risk jobs like pilots, drivers, etc. 

However, you can negotiate the premium with an insurer based on the group size and duration of the policy. Additionally, you can prioritise certain coverages over non-essential ones to save cost on the premium.

Exclusions

It is imperative to understand all exclusions of Group Personal Accident Insurance. Even the most comprehensive policy will also have conditions that aren’t covered. Such exclusions may include self-inflicted injuries, natural death, pregnancy-related injuries, sexually transmitted diseases, etc. So, check the exclusions carefully with your insurer before choosing a GPA policy.

Frequently asked questions

Here are some of the common questions and answers related to Group Personal Accident Insurance in India.

Does Group Personal Accident Insurance offer tax benefits?

A GPA policy doesn’t offer tax benefits to the insured person because the premium is paid by the employer. Thus, only the organisation can leverage tax benefits by showing the premium as business expenses. 

What are the common factors that decide the GPA policy premium?

There are several factors involved in the process of calculating the GPA policy. Some of the major factors include the category of employment, risk exposure, etc. Other secondary factors include the income and age of the insured person. 

Are there any additional benefits to Group Personal Accident Policy?

The primary benefits of a Group Personal Accident Insurance Policy for employees include accidental coverage for death and permanent total/partial disabilities. However, the following additional benefits can also be available based on the insurance provider. 

• Ambulance charges related to accidental treatments
• Transportation of the body after accidental death
• Cost of funeral 
• Cost of transporting mortal remains
• Medical treatment allowance
• Allowance for specific modifications required at home after accidents

Will the employees receive GPA coverage for accidents occurring outside India?

It is possible to get coverage for accidents occurring outside India if global coverage of the Group Personal Accident Insurance is a policy inclusion. 

If an employee already holds a health insurance policy, do they still need Group Personal Accident Insurance?

A health insurance policy provides coverage against medical emergencies to the insured. This covers pre-hospitalisation, during hospitalisation and even post-hospitalisation medical expenses. On the other hand, an accidental cover through GPA policy takes care of the financial risks associated with accidental death or disability. It saves from the financial burdens if the earning insured person is unable to work due to accidental disability. Similarly, it helps to support the family of the insured financially in case of unfortunate demise in an accident.

Does an employee have to pay the premium for Group Personal Accident Insurance?

The Group Personal Accident Insurance is provided by an employer to the employees for accidental coverages. Hence, usually, an employee doesn’t have to pay any premium to avail of the benefits of the policy. Like other Group Health Insurance Policies, it is likely that the employer pays the premium for GPA. 

Do the employees need to take a medical test to get a Group Personal Accident Policy?

Group Personal Accident Insurance doesn’t include any health-related conditions. It only provides coverage for uncertain accidental injuries, disabilities and death. Thus, there is no pre-policy medical test required to get insured. 

What is the benefit of Group Personal Accident Insurance for an employer?

Employee retention is one of the important factors employers need to work towards. Among other benefits, employers can also over Group Personal Accident Insurance as a perk for their employees. Apart from that, employers can also benefit from this policy in the following ways.

• An employer can present the premium paid for the GPA as under business expense to obtain tax benefits.
• Employers don’t have to take the financial burden if an employee meets with an accident. The insurance company takes care of the compensation on the organisation’s behalf.
• Employers can show their concern for the well-being of their employees, which in turn can improve productivity.

Does GPA insurance cover all kinds of injuries?

No, a Group Personal Accident Insurance only provides coverage for accidental injuries or death. It doesn’t include natural deaths, illnesses and self-inflicted injuries, deaths or injuries due to suicide, alcohol consumption, etc. Thus, you must check with your insurer regarding all exclusions before choosing a policy for your employees. 

What is included in the permanent disability clause of Group Personal Accident Insurance?

Some of the major inclusions of permanent disability under GPA insurance are:

• Losing both legs in an accident
• Losing both hands in an accident
• Losing vision in both eyes after an accident
• Losing one hand/foot in an accident
• Losing vision in one eye 

I am the only earning member of my family. Would GPA policy cover my death?

Yes, a Group Personal Accident Insurance Policy for employees covers death, given that the cause of death is an accident. You need to provide the names of nominees in your policy. In an event of the demise of the insured, compensation as per the policy is paid to the nominee. 

Does Group Personal Accident Insurance provide coverage for a natural death?

Group Personal Accident Insurance doesn’t cover natural deaths. This policy offers coverage only for accidental injuries or death.

Are plane crashes covered under Group Personal Accident Insurance?

Yes, plane crashes are covered under Group Personal Accident Insurance as they fall under the category of accidents.