Max Bupa Personal Accident Insurance Policy
Max Bupa health accidental plan is a fixed benefit policy that covers unforeseen circumstances leading to disability or sudden deaths. The Max Bupa Personal Accident Plan, known as AccidentCare, is designed to cover the hospital expenses due to accidents and also to provide financial protection to the nominee on the death of the policyholder. When compared online with various policies, Max Bupa has one of the best accident insurance plans.
What is Max Bupa Health Personal Accident Plan?
Max Bupa Personal Accident Plan is a policy that covers a host of risks associated with accidents. The plan compensates for the cost of hospitalization due to the accident of the policyholder. The plan is created, keeping in mind the family of the person insured, which is also affected financially and mentally due to an accident. On the death of a policyholder due to an accident, it provides financial protection to the nominee. The plan covers costs and various expenses due to funerals of the person insured and child education of the policyholder's family if insured. In case of accidental death, the nominee gets 100% of the sum insured. The policy can be availed as individual and floater basis.
Features of the Max Bupa Health Personal Accident Plan
Some of the salient features of this policy are:
- This plan offers guaranteed cash benefit on accident due to hospitalization.
- It provides coverage from the first day of the policy.
- Policy period is 2 years.
- Claims are processed by the company’s dedicated claim settlement team.
- Lifetime renewability is available under the personal accident plan.
- In comparison with other accident plans, it is seen that accident plans by Max Bupa are quite affordable.
- In this plan, the coverage can be availed worldwide.
- 15 days of free look period is available.
- The sum insured starts from Rs 5 lakh to 2 cr, where 2 adults and 2 children are to be covered.
Benefits or Scope of Coverage of the Max Bupa Health Personal Accident Plan
Various coverage under the plan are:
- Accidental Death
- Funeral Expenses
- Child Education Benefit
- Permanent Total Disability
- Permanent Partial Disability
The nominee is paid the sum insured in a lump-sum on the death of the policyholder within 90 days from the date on which the accident occurred. But the death must have occurred due to accidental bodily injury
Permanent Total Disability
On permanent disability of the policyholder due to an accident, the plan pays a maximum of 125% of the sum insured. Permanent total disability in this policy means that the person insured is unable to perform one of or all of the below tasks. It includes:
- Inability to work: It means that the policyholder won't be able to work in any profession or occupation during his/her lifetime
- Loss of limbs or sight: The person insured has an unrecoverable loss of use of two limbs. If the person insured is incapable of using both limbs or eyesight or one limb & eyesight, he/she will be eligible for the claim
- Loss of independent living: This includes when the person insured is unable to perform these tasks independently. The tasks can be classified as:
Permanent Partial Disability
In case the policyholder has permanent partial disability due to an accident, the policy provider will pay a specific amount within 90 days of the accident. The amount paid will depend on the nature of disablement. But the claim will only be processed if the person insured has a permanent partial disability for at least 6 months from the date of the accident.
Child Education Benefit
This benefit is applicable only when children are covered in the policy. On the accidental death or permanent disablement of the parents, the policy provider will pay Rs 5,00,000 or 5% of the sum insured, whichever is less.
The policy will also pay for the funeral expenses in the accidental death of the policyholder, which is equal to Rs 5,000-50,000.
Inclusions of the Max Bupa Health Personal Accident Plan
It covers the loss or total and permanent loss of the following:
- loss of speech
- loss of one eyesight
- loss of sight in one eye
- one foot from the ankle joint
- both feet from the ankle joint
- one hand from the wrist joint
- both the hands from the wrist joint
- loss of use of one foot from the ankle joint and total and permanent loss of one eyesight
Exclusions of the Max Bupa Health Personal Accident Plan
The list of exclusions usually includes the following:
- Any kind of unlawful act
- Additional hospital charges
- Any kind of laser treatment
- All type of sleeping disorders
- Any kind of non-medical expenses
- All kind of auto-immune disorders
- Any type of experimental treatments
- Any medical aid that is taken outside
- Any alternative medicine or complementary medication
- Cosmetic and plastic surgeries
- Consumption of alcohol and overdose of drugs or any kind of intoxication
- Dental care and oral care treatment
- External devices required for eyesight and vision support
- HIV and AIDS-related complications
- Hereditary diseases or genetic disorders
- Hospitalization due to hazardous occupation or activities
- Mental disorders and neurological ailments
- Obesity and weight loss programs
- Rehabilitation expenses
- Routine diagnostic procedures
- Reproductive treatment or maternity-related complications
- Treatment for menopause and puberty disorders
- Treatment for STDs
Eligibility Criteria to Buy the Max Bupa Health Personal Accident Plan
Adults: 18 years-65 years
Child – 5-21 years
Sum Insured Option
Rs 5 lakh to 2 cr
For individuals - 100% of sum insured
For Family - On accident, the policy pays:
· For Self - 100% of sum insured
· For Spouse - 50% of sum insured or Rs 10 lakh, whichever is lower
· It can include up to 2 children - 20% of sum insured or Rs 5 lakh whichever is lower
1, 2 , 3 years
*Note: If the policyholder has a permanent partial disability due to an accident and dies before the claim is processed, no amount will be paid. No further claim will be processed after this claim.
Claim Process of Max Bupa Health Personal Accident Plan
The claim process of Max Bupa Personal Accident Policy is as follows:
- The policyholder must contact the health insurance helpdesk at any network hospital of Max Bupa, in order to avail cashless services in case of an accidental emergency.
- After reporting to the hospital, contact Max Bupa's personalized team.
- Submit a claim form which can be fetched from the helpdesk of the network hospital.
- Max Bupa will convey its decision to the concerned hospital via mail and SMS
- In case of a reimbursement claim, avail the healthcare services from a non-linked hospital and pay the medical bills on your own.
- Register the claim by intimating the insurer and submitting the required documents along with the claim form.
- The insurer will settle the claim up to an admissible amount after verifying everything.
Required Documents in Case of a Claim
The person insured must submit the below documents within 30 days for hospitalization due to accidents.
- Filled-up claim form
- A certificate confirming that the claim does not relate to pre-existing cancer diagnosed within the first 90 days
- Medical certificate that confirms the diagnosis of cancer
- Xerox of prescriptions and first consultation letter
- Photocopy of indoor case papers, if applicable
- Any other document as required like FIR copy of the accident
Documents Required for Death Claim
The list of documents required includes:
- Copy of post mortem report
- Copy of medical, legal certificate duly attested
- Copy of FIR by the respective police station
- Duly filled claim form
- Original death certificate
- Income proof of proposer of last 3 months, form 16, last year’s ITR, salary slip, or employer’s certificate and audited accounts.
Once Max Bupa has received the required documents, the lump sum will be paid out within a few days.
Renewal Process of the Max Bupa Health Personal Accident Plan
Max Bupa Health Personal Accident Policy is issued for one, two, or three years. For joint policy, the plan is renewable up to 30 years. If one wants to increase the sum insured, it can be done at the time of renewal. The policyholder gets 30 days from the date of expiry as a grace period to renew the policy. The renewal process is as follows:
For renewing the policy, follow the below steps:
- For renewing the policy, visit the official website of Paisawiki.
- Step I: Go to the Max Bupa health Insurance
- Step II: Select the 'renew policy option.' Enter the policy number.
- Step III: On the next page, check for various details like name, age of family members, email, and mobile number. Click on the 'continue' option.
- Step IV: Here, a person can renew the policy or terminate it. Click on 'renew the plan.'
- Step V: There will be multiple riders shown, which can be added to the policy for added coverage. The policyholder can either choose to add them or remove them. Choose the required option. After selection, the above click the 'proceed.'
- Step VI: Click the proceed option.
- Step VII: Pay the premiums online using credit and debit card.
On payment, new policy documents will be mailed. A person can also renew the policy by visiting the nearest Max Bupa branch.
How to Buy the Max Bupa Health Personal Accident Plan?
For purchasing the Max Bupa Health plan, various options are available.
- Step I: Visit the Max Bupa health insurance at Paisawiki.com.
- Step II: Choose Max Bupa Health Personal Accident plan to buy. Click on 'Buy Now.'
- Step III: Enter personal details like name, age, contact number, etc. Select the sum insured, policy tenure, and other details. After selecting all, the website's premium calculator will calculate the premium. After the selection of the above, click 'proceed.'
- Step VII: Choose additional covers for extra protection. Click 'Proceed Selection.'
- Step VIII: Upload the necessary documents.
- Step IX: Agree to the terms & conditions of the policy.
- Step X: Enter bank details.
- Step XI: Continue with the payment process.
- The policy documents will be mail and sent to the registered address.
If not, one can visit the nearest Max Bupa branch for buying the policy offline.
Required Documents to Buy the Max Bupa Health Personal Accident Plan
The documents required to buy Max Bupa Health Personal Accident are:
- Age Proof: Birth Certificate, School/College Certificate, PAN card, Voter Card, Adhaar Card, Passport, Driving License and such documents
- Address Proof: Ration Card, Electricity Bill, Bank A/C statement, Passport, Utility Bill, Telephone Bill, Postpaid Bill or Letter from Recognized Public Authority
- Photo Identity Proof: Aadhar Card, Voter ID, PAN Card, Driving License, Passport or Public Servant with Photograph
- Recent passport size photograph
Ans: There are 4 ways in which premium payment can be made. They are:
- DST payment
- Tele Payment
- Challan Payment
- Cash payment at the branch
- Online Payment - Credit card, debit card, and net banking
Ans: To check policy status, visit the website, go to the login portal, enter username and password. After logging in, a person can see their policy status.
Ans: For canceling the policy, visit the nearest Max Bupa branch with policy documents and surrender the policy. Their payment will be refunded within a week.
Ans: The details required for buying Max Bupa Policy are:
- Name of the person to be insured
- Address of residence
- Date of birth
- Medical history
- Pre-existing illness disclosure
- Height BMI and weight
Ans: In the following conditions, the policyholder is entitled to 50% of sum insured:
Total or permanent loss of
- hearing in both ears
- one hand from wrist joint
- one foot from ankle joint
- loss of sight in one eye
Written By: Paisawiki - Updated: 22 September 2020