GROUP PERSONAL ACCIDENT INSURANCE
SCHEME
Sub:- Group Personal Accident Insurance Scheme to
our employees
Through Kerala State Insurance Department.
AD1/16-A
06.01.93
We have arranged a Group Personal
Accident Insurance Scheme to the employees of this Corporation through Kerala
State Insurance Department, Thiruvananthapuram. The policy has come into force with effect from 1st
July, 1992. At present 384 employees
who are out of ESI coverage as on 1st July are covered under the
scheme.
The benefits as per the above scheme
are based on the schedule attached to the policy, a copy of which is
enclosed. Since the reimbursement of
medical expenses is also covered under the scheme, medical expenses incurred by
the Corporation/individual meeting with accidents at the work-pot or even
otherwise and the financial losses connected to the absence, if any, can be
claimed from the Insurance Department.
The
Corporation has to make the claim with the Insurance Department within 14 days
from the date of accident. Two claim
forms are to be submitted to the Insurance Department as per specimen
enclosed. As the Corporation is the
insured, the claim has to be made by the Corporation to the Insurance
Department and on getting reimbursement from them, the same will be passed on to the employee subject to his
eligibility, ie., if the Corporation has made reimbursement of medical claims
to be employees as per the available medical reimbursement scheme, the said
expenses reimbursed by the Insurance Department will be credited to the
Corporation account and the financial losses incurred by the employee due to
availing of leave etc. will be paid to him if he has availed any leave on
account of the accident. In case the
Corporation has given any special leave on this account, the wages paid for the
said period will be credited to the Corporation’s account. The treatment can be availed from any
hospital. The claim form along
with the medical bills duly certified
by the Medical Attendant has to be submitted to the Admn. Department within 10
days from the date of accident. The
prescribed claim forms will be available with the Admn. Department.
All are requested to co-operate and submit the claim relating to the
accident, if any, in time so that belated claims can be avoided.
|
Item |
Result |
Compensation payable |
|
1. |
DEATH – (occuring within six calendar months of the happening of bodily
Injury as aforesaid) |
1. The
Capital Sum |
|
2. |
LOSS
OF LIMBS OR EYES, i.e., loss by actual physical separation at or above the
wrist or ankle of:
i) both hands
or both feet, or ii)
one hand and
one foot, or
iii) one hand or one foot and the complete and
irrecoverable loss of
all sight of
one eye, or iv)
complete and irrecoverable loss of all sight of both eyes (occurring within six calendar months of the happening of Bodily
Injury as aforesaid) |
2. The
Capital Sum |
|
3. |
LOSS OF LIMB OR EYE,i.e., loss by actual physical separation at or above the wrist or ankle of: i) one hand or one foot, or ii) the complete and irrecoverable loss of all sight of both eyes (occuring within six calendar months of the happening of Bodily Injury as aforesaid). |
3. 50% of
the Capital Sum |
|
4. |
PERMANENT TOTAL DISABLEMENT, Accident
Bodily Injury as defined in the
policy which while not resulting in Loss of limbs or Eyes as stated in Item 2 Or 3 sub-sections thereof shall solely and Directly, totally, absolutely and
permanently disable and prevent the Life Assured from engaging in or being occupied with or
giving attention to
employment or occupation business of any kind what- so ever . (occurring
within twelve months of the Injury as
aforesaid). |
4. A sum
for a period not exceeding ten years at rate
of 10% per annum of the Capital Sum. Sum stated
in the Schedule – payable after Expiry of each completed- year of
disablement. OR A lumpsum at the option of the insured not
happening of Bodily Exceeding 50%
of the capital Sum stated
in the schedule payable
after expiry of one year from the date happening of
bodily
injury. |
|
PROVIDED: Always that proof satisfactory to the
Government that such Disablement has continued for a period of one year from
the date of happening of Bodily Injury and will continue thereafter for the
remainder of the Life shall be furnished by the Life Assured at the time when
each annual payment becomes due. |
||
|
5. |
TEMPORARY
TOTAL DISABLEMENT i.e.,
Accidental Bodily Injury as
defined in the Policy which shall
solely and directly totally disable
and prevent the Life assured from
engaging in or being occupied with or
giving attention to the Life
Assured’s employment or occupation or business
during such total disablement. |
5. Compensation per
week at rate of 1% of
the Capital sum stated in the Schedule (subject
however to a maximum sum of Rs.1,000/- per
week) |
|
6. |
TEMPORARY PARTIAL DISABLEMENT
i.e., Accidental Bodily Injury as defined in the policy which shall solely and directly partially disable and
prevent the Life Assured from
engaging in or being occupied with or giving attention to a substantial part of the Life Assured’s
employment or occupation or Business during such partial
disablement. |
6. Compensation per
week at the rate of .03% of the Capital sum stated in the Schedule, (subject however, to a maximum sum of s.330/- per week). |
Subject to the maximum period of compensation in respect of items 5 and or 6 in respect of any one accident being 104 consecutive weeks from the date of happening of Bodily Injury.
The
compensation payable under Items 1,2or 3shall be doubled if the Bodily Injury
for which a valid claim exists is caused by an accident to a Passenger Lift,
Railway Train, Tram, Car, Omnibus or other licensed vehicle (plying in the
streets for public hire) in which the life Assured at the time of the Injury is
travelling as an ordinary passenger or is sustained as a direct result of the
Life Assured being lawfully within a burning building from the time when the
fire commenced until the happening of the Bodily Injury.