FAQs on Guidelines on Standard Personal Accident Insurance Product: Saral Suraksha Bima
Whether all the insurers shall offer “Saral Suraksha Bima”?
All the General and Standalone Health insurers are mandated to offer Standard personal accident insurance product “Saral Suraksha Bima” from 1st April,2021.
What is the entry age in “Saral Suraksha Bima”?
Minimum entry age is 18 years and maximum age at entry is at least 70 years. Dependent Child / children will be covered from age 3 months to 25 years.
Can the policy be taken for the entire family?
Yes. “Saral Suraksha Bima” can be availed by a family on individual basis which means that the chosen sum insured shall apply to each family member separately. Family consists of the proposer and any one or more of the family members as mentioned below:
(i) Legally wedded spouse.
(ii) Parents and Parents-in-law.
(iii) Dependent Children (i.e. natural or legally adopted) between the ages 3 months to 25 years. If the child above 18 years of age is financially independent, he or she shall be ineligible for coverage in the subsequent renewals.
How long will the coverage be available under the policy?
The policy period of “Saral Suraksha Bima” is one year.
What is the coverage available under the policy?
The policy has three base covers which are mandatory covers and three optional covers which can be chosen by the policyholder based on the requirement. These covers are listed below:
b) Permanent Total Disablement
c) Permanent Partial Disablement
a) Temporary total disablement
b) Hospitalisation expenses due to accident
c) Education grant
What is the benefit offered under the death cover?
Benefit equal to 100% of Sum Insured is payable on death of the insured person, due to an Injury sustained in an Accident during the Policy Period, provided that the Insured Person’s death occurs within 12 months from the date of the Accident.
What is the benefit offered under permanent total disablement cover?
Benefit equal to 100% of Sum Insured is payable, if the insured person suffers permanent total disablement of the nature specified below, provided that the permanent total disablement occurs within 12 months from the date of the Accident and is a result of the accident.
a) Total and irrecoverable loss of sight of both eyes or
b) Physical separation or loss of use of both hands or feet or
c) Physical separation or loss of use of one hand and one foot or
d) loss of sight of one eye and Physical separation or loss of use of hand or foot
e) If such Injury shall as a direct consequence thereof, permanently, and totally, disables the Insured Person from engaging in any employment or occupation of any description whatsoever.
What is the benefit offered under permanent partial disablement cover?
Within 12 months from the date of accident, if the insured person suffers partial disablement of the nature specified in the policy terms and conditions which is attributable to the accident, the percentage of the sum insured as applicable to such permanent partial disablement is payable.
The following is the benefit table applicable to permanent partial disablement cover.
|Loss Covered||Percentage of Sum Insured|
|1.||Loss of Use/ Physical Separation:
One entire hand
One entire foot
Loss of Sight of one eye
Loss of toes – all
Great both phalanges
Great – one phalanx
Other than great if more than one toe lost
|2.||Loss of Use of both ears||50%|
|3.||Loss of Use of one ear||20%|
|4.||Loss of four fingers and thumb of one hand||40%|
|5.||Loss of four fingers||35%|
|6.||Loss of thumb
- both phalanges
- one phalanx
|7.||Loss of Index finger -
|8.||Loss of middle finger –
|9.||Loss of ring finger -
|10.||Loss of little finger –
|11.||Loss of metacarpus -
first or second (additional)
third, fourth or fifth (additional)
|12.||Any other permanent partial disablement||Percentage as assessed by the independent Medical Practitioner|
What is the coverage available under the optional cover “Temporary Total Disablement”?
The cover compensates the insured person at the rate of 0.2% of the base sum insured per week if the insured person is completely incapacitated from engaging in any employment or occupation, due to accident. The minimum period of the disablement shall be four weeks, for the benefit to be payable under this cover. After completion of minimum four weeks the policyholder is entitled to the benefit from the date of temporary disablement.
What is the coverage available under the optional cover “Hospitalisation Expenses due to Accident”?
The hospitalization expenses arising due to accident shall be payable under this cover, up to the limit of 10% of base sum insured. The expenses related to hospitalization including cost of prosthetic and other devices or equipment if implanted internally during a surgical procedure, are covered under this optional cover. Further, expenses related to dental treatment, plastic surgery and all the day-care treatments necessitated due to injury are covered under this policy.
What are the benefits available under the optional cover “Education grant”?
If the insured person meets death or permanent total disability due to accident, a one-time Educational Grant of 10% of the base sum insured, per child, shall be payable, to all dependent children of the insured if:
a. Dependent child/ children is/are pursuing an educational course as a full time student in an educational institution.
b. Age of the child or children is/are not be more than 25 completed years.
Whether this policy continues after payment of 100% sum insured under the policy?
This policy will automatically terminate upon the Insured Person's death or payment of 100% Sum Insured. However, the cover will continue for the remaining Insured Persons till the end of Policy Period.
What are the Sum Insured options available in this product?
The minimum sum insured available is Rs. 2.5 lakhs and maximum limit is Rs. 1 Crore. The policyholder may choose any Sum Insured within these limits in the multiples of fifty thousand.
Will the policyholder be eligible for Cumulative Bonus (CB) under this product?
Yes. Cumulative bonus is applicable only in respect of base cover. Sum insured (excluding CB) will be increased by 5% of sum insured in respect of each claim free policy year subject to maximum of 50% of the sum insured, provided the policy is renewed without a break. If a claim is made in any particular year, the cumulative bonus accrued will be reduced at the same rate at which it has accrued.
What is Cumulative Bonus and how does it work?
Cumulative Bonus means any increase or addition in the Sum Insured granted by the insurer without associated increase in premium. The following is the illustration of working of Cumulative Bonus:
If Mr. A has bought an insurance plan with sum insured Rs. One Lakh and he did not register any claim in the first policy year; at the time of renewal he will get a cumulative bonus of 5%. Thus, his total sum insured for next year will be Rs. 1,05,000/- (Rs. One Lakh Base Sum Insured + Rs Five Thousand Cumulative Bonus). Similarly, in the second year if he does not register a claim, he gets a cumulative bonus of 5% of base sum insured so that the Sum Insured will get increased to Rs1,10,000/- (Rs. One Lakh Base Sum Insured + Rs Ten Thousand Cumulative Bonus). The bonus can go up to 50% of sum insured; that is Mr. A can accrue a cumulative bonus of Rs. 50,000 (total coverage of 1,50,000/-) if he does not make any claim for ten years. Hence he available sum insured at the end of ten years is Rs.1,50,000/-(Base sum insured of Rs.1,00,000/- and cumulative bonus of Rs. 50,000/-). Assuming that there is a claim (other than Death and Permanent Total disablement where 100% Sum insured is payable) in the eleventh year, the cumulative bonus will get reduced at the rate at which it has accrued. In this case, as the rate of accrual is 5% of base sum insured i.e, Rs.5000/- per year, the cumulative bonus gets reduced by Rs.5000/-.
What are the modes of premium payment allowed in Saral Suraksha Bima?
A policyholder can pay premium on Yearly, Half-yearly, Quarterly and Monthly basis.
Whether grace period is available for payment of premium?
For Yearly payment of mode, a fixed period of 30 days is allowed as Grace Period and for all other modes of payment a fixed period of 15 days is allowed as Grace Period.
Where can I find complete details of Saral Suraksha Bima?
Complete details are available in IRDAI website www.irdai.gov.in (Home>>Legal>>Guidelines>>Health).Link to the same is provided below:
.How can I take the policy of “Saral Suraksha Bima” Product?
You may approach any of the insurers who are offering the product. All general and health insurers shall mandatorily sell the product online.