Page 180 - IC38 GENERAL INSURANCE

4. Scope of cover

These policies are often extended to cover medical expenses, which reimburses
the hospitalization and other medical costs incurred following the accident.
Today we have health policies which are issued to cover medical/
hospitalization expenses incurred consequent to an accident. Such policies do
not cover diseases and their treatment and instead cover only accident related
medical costs.

5. Value added benefits

Along with personal accident, many insurers also offer value added benefits like
hospital cash on account of hospitalization due to accident, cost of
transportation of mortal remains, education benefit for a fixed sum and
ambulance charges on the basis of actual or fixed limit whichever is lower.

6. Exclusions

Common exclusions under personal accident cover are:

i. Any existing disability prior to the inception of policy

ii. Death or disability due to mental disorders or any sickness

iii. Directly or indirectly caused by venereal disease, sexually transmitted
diseases, AIDS or insanity.

iv. Death or disability caused by radiation, infection, poisoning except
where these arise from an accident.

v. Any injury arising or resulting from the Insured or any of his family
members committing any breach of law with criminal intent.

vi. Death or disability or Injury due to accidental injury arising out of or
directly or indirectly connected with or traceable to war, invasion, act
of foreign enemy, hostilities (whether war be declared or not), civil war,
rebellion, revolution, insurrection, mutiny, military or usurped power,
seizure, capture, arrests, restraints and detainments.

vii. In the event the insured person is a victim of culpable homicide, i.e.
murder. However, in most policies, in case of murder where the insured
is not himself involved in criminal activity, it is treated as an accident
and covered under the policy.

viii.Death/Disablement/Hospitalization resulting, directly or indirectly,
caused by, contributed to or aggravated or prolonged by child birth or
from pregnancy or in consequence thereof.

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