Personal insurance covers personal accident insurance, medi-claim hospitalization, overseas medi-claim policy, students, safety insurance, urban child welfare insurance and cancer medical expenses policy.

(i) Personal Accident Insurance:

Personal accident insurance covers death, total or partial disablement due to accident. The insurable age is 12 to 70 years.

The capital sum-insured is generally Rs. 10,000 wherein the sum assured is payable at death or at loss of two limbs, two eyes or one limb and one eye. Rs. 5,000 is paid at loss of one limb or one eye, Rs. 10,000 is paid at the permanent total disablement from injuries other than those named above.

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Medicaid expenses arising out of an accident upto 10 per cent of the capital sum insured or 25 per cent of the admissible claim whichever is lower at additional premium at the rate of 10 per cent of basic premium.

The normal premium is Rs. 6.00 for Rs. 10,000 sum assured to be paid at death. Rs. 12.50 is charged for the benefits of death loss of two limbs, two eyes or one limb and one eye or loss of one limb or one eye permanent total disablement and permanent partial disablement.

The normal risks and heavy risks are required to pay Rs. 6.00 and Rs. 9.00 respectively for death and Rs. 12.50 and Rs. 19.00 respectively for death and other benefits as given above.

Heavy risks include persons working in underground mines, explosives, magazines, jockeys circus personnel, big game hunting mountaineering, winter sports, skiing or ice hockey, ballooning or polo and persons engaged in occupation of similar nature, due to the very nature of their profession. The cover is worldwide. Normal risks are others than those given in heavy risks.

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(ii) Personal Accident Insurance (family):

The family package cover is granted on the following pattern. The personal accident insurance family package incorporates all the conditions as mentioned in the personal accident insurance (individual).

The cover for earning member (person insured) and spouse if earning will be 100 per cent of the capital sum insured for each i.e., Rs. 10,000 (base figure).

The cover is 50 per cent of the capital sum insured or Rs. 1 lakh whichever is lower if spouse is not earning member. 25 per cent of the capital sum insured or Rs. 50,000 whichever is lower per child, will be insured for children between age of 5 years and 19 years.

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For children the cover shall be limited to Death and Permanent Disablement (total and partial) only and premium payable will be at table II benefits and corresponding rates.

Premium payable for husband and wife will be on the total Sum Insured at table III benefits and corresponding rates. A discount of 5 per cent may be granted on the gross premium under the Family Package Cover. It is applicable for the proposal exceeding Rs. 1, 00,000 also.

(iii) Medi-claim Hospitalisation and Domiciliary Hospitalisation Insurance:

The policy insures payment of 80 per cent of medical expenses actually and necessarily incurred in India by or on behalf of insured person. The age of insurable person “is 12 to 70 years.

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Hospitabsation cover starts after 30 days for diseases from the commencement of the policy. It is not applicable to renewal policy.

The categories of expenses to be reimbursed are mentioned in the table of benefits which are generally room, board and nursing expenses, surgeon and anesthetist fees, oxygen and blood expenses, X-ray, medicines end drugs.

The annual premium rates vary with the benefits required and categories of insurance. Personal accident insurance can also be sought along with this policy wherein the insured amount is paid at death or at loss of two limbs, loss of sight of two eyes or loss of one limb and loss of sight of one eye or loss of one limb or loss of sight of one eye or permanent total disablement from injuries other than the insured diseases.

Mediclaim policy to persons above the age of 70 years subject to reduced limits of liability is being introduced.

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For the benefits of Mediclaim policyholder, tie up arrangements have been finalised with two hospitals in Bombay, and one each in Calcutta, Madras, Hyderabad and Pune. The subsidiary companies are negotiating such tie up arrangements in other centers also.

(iv) Overseas Medi-claim, Policy:

Overseas medi-claim policy insures reimbursement of medical expenses incurred in connection with sickness/accident/disease/death outside India subject to applicable deductible.

The persons eligible for this policy are persons undertaking bonged trips abroad for business, official, professional purposes including training assignment officially sponsored; for holiday either in groups or as an individual and accompanying spouse and children of persons eligible as above.

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The maximum cover is 180 days for business tour, 60 days for plan A and 30 days under plan B for holiday travel. The proposals in excess of this are to be referred to GIC with medical reports. Plan A is worldwide excluding USA and Canada and plan B is worldwide including USA and Canada.

The sum assured is $ 50,000 under Plan A and $ 1, 00,000 under Plan B. The adults are insurable upto 70 years and children are insurable above 5 years. Claims are settled in foreign currency through authorised agents of G.I.C.

(v) Student’s Safety Insurance:

The student’s safety insurance is intended to be issued to the schools/colleges or any other educational institution for the benefit of the student studying therein. The students are covered against death, total loss of two limbs, two eyes or one limb and one eye, total loss of one limb or one eye and permanent total or partial disablement.

The benefits per student are Rs. 10,000 at death, Rs. 10,000 at loss of two limbs, two eyes or one limb and one eye or at permanent total disablement from injuries other than those mentioned above and Rs. 5,000 at the loss of one limb or one eye.

There are other compensations verify from one per cent at the loss of more than one toe to 50 per cent at the loss of two ears. In addition to the above, the policy will provide for reimbursement of medical expenses subject to limb of Rs. 500. Claims are payable to parent or guardian of the student as mentioned in the school register.

The premium is Rs. 6.00 per thousand of sum assured if students are 500 and Rs. 1.50 per thousand if students are 5000. The premium rates vary from Rs. 1.50 per thousand to Rs. 6.00 per thousand as per number of students included under this policies.

(vi) Unborn Child Welfare Insurance:

The unborn child welfare insurance policy is applicable for expectant mothers in the age group of 18 to 40 years with pregnancy up to 3 months. The scheme provides for reimbursement of medical expenses for treating a child born with congenital anomalies and for its maintenance if the anomalies are certified as permanent total disablement.

For permanent partial disablement, a proportion of the sum insured is payable as the percentage of disability certified by the doctor. Medical expenses are reimbursed upto 50 per cent of the capital sum insured as per table of benefits in case of congenital anomalies which are curable.

Medical expenses are reimbursed as per Table of Benefits besides a certain percentage of the balance (unspent) amount will be paid as deposit in a bank or Unit Trust in case of congenital anomalies which are certified by a qualified doctor as ‘Permanent Partial Disability’.

Medical expenses are reimbursed and the balance unspent amount is put in a Bank or Unit Trust in case of congenital anomalies which are certified as ‘Permanent

Total Disability’. On the death of the insured, the monthly benefits will be paid to the legally appointed guardian or failing that to the legally appointed guardian under whose care the child is placed.

The premium rate is 2 per cent for capital sum insured and so on upto Rs. 75,000 sum assured. Claims under this policy is payable in Indian currency.

All medical treatment for the purpose of this insurance will have to be taken in India only. The limit of liability in respect of hospitalisation is as for table of Hospitalisation and Domiciliary Hospitalisation Benefits.

(vii) Cancer Medical Expenses Policy:

The cancer medical expenses policy covers medical expenses due to cancer for insured person or spouse. The sum assured is Rs. 50,000 at the premium of Rs. 100. The period covers treatment expenses started during the policy period till the sum assured is exhausted. Cover starts after 30 days of the issue of the policy.

It is not applicable for renewals. Cumulative bonus at the rate of 5 per cent on continuous claim free medical renewal subject to maximum sum insured of Rs. 75,000. This cumulative bonus is not applicable to group policy. The group discounting applicable at the rate of 15 per cent if persons insured are below 100 and above 25.

This discount is 66.7 per cent if persons covered increased 25,000. The Indian Cancer Society allows the above group discount on the membership fees for the number of persons covered by the Group.

The group policy is issued to the member of the Indian Cancer Society. The members of Indian Cancer Society, Ratan Tata Medical and Research Centre, Bombay are benefited one free check up at Cancer Society, Detection Centre.

The members are required to pay Rs. 200 per annum. The premium is paid by the Indian Cancer Society for its members under group insurance.