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What is personal accident cover in health insurance?

Roocha KanadeJul 2, 2025

Accidents can significantly disrupt your life, both financially and physically. Understanding the personal accident insurance meaning will help you stay financially protected during death or accidental injury. It refers to an insurance policy that provides financial support to meet the expenses during your absence. Whether you are a frequent traveller or simply seeking an option to ensure your family’s financial protection, it is essential to obtain this cover as it provides enough financial support during unforeseen circumstances. The expenditure on healthcare services has grown from 21% in FY19 to 26% in FY23. The section below discusses what is personal accident insurance, its types, coverage, and benefits.

Contents

What is a personal accident cover?
Types of personal accident cover
- i) Individual personal accident insurance
- ii) Group personal accident insurance
What does personal accident insurance typically cover?
What's covered and what's not covered in a personal accident insurance
What's not covered?
Benefits of a personal accident insurance policy
How is the premium calculated for a personal accident insurance policy?
How does the claim process work in PA insurance?
Conclusion
Frequently asked questions

What is a personal accident cover?

To learn the benefits, you must first know what personal accident cover. It is a type of insurance policy designed to financially protect your family against your accidental death or permanent disability (whether partial or total). Upon your permanent disability or accidental death, the insurance company will pay the insured or their family. Note that they will pay up to the sum insured. The coverage depends on the severity of the disability.

Personal accident cover means it provides coverage for emergency medical expenses that arise from injuries during an accident. The cover is best suitable for individuals who travel frequently. One of the common questions among individuals is: what is personal accident cover, and what types of accidents are covered under it. This insurance cover considers the following types of accidents.

Road accidents
Air accidents
Train accidents
Household accidents
Work-related accidents

With this overview of what is personal accident insurance is, let’s review the types of this cover.

Types of personal accident cover

In addition to learning what is PA in insurance, let’s have a look at its types. There are two major categories of this insurance as explained below:

i) Individual personal accident insurance

It covers accidental death as well as the short- and long-term disability incurred due to accidents. It is intended for individuals and usually offers higher coverage than group insurance.

ii) Group personal accident insurance

Employers provide this insurance cover to their employees. Typically, they offer basic coverage, without additional benefits available in standalone policies. Some other types are listed below.

24-Hour PA Insurance: It offers 24*7 coverage, regardless of the location and time of the accident.
Family PA Insurance: It offers coverage for the whole family under a single policy.
Student PA Insurance: It is designed for students, and the coverage considers accidents that happen during school hours, commuting, or during extracurricular activities.

You now have enough familiarity with what is PA cover in insurance and its type, now let’s understand what it usually covers.

What does personal accident insurance typically cover?

Personal accident insurance covers the following.

Accidental death of the policyholder.
Partial or full disability due to an accident.
Hospitalisation expenses and other medications.
Child’s education expenses.
Burns, coves, and fractures related to accidents.
Daily cash allowance

What's covered and what's not covered in a personal accident insurance

Many individuals are aware of what is PA cover in insurance, but get confused with the features covered and exclusions. It covers the following.

One of the prime benefits of personal accident insurance is that it pays a lump sum to the nominee if the insured person dies due to an accident.
It covers permanent disability or loss of limbs caused by an accident.
It offers compensation for partial disabilities (like loss of a finger or loss of vision in an eye)
If the insured person is unable to work because of an accident, the cover offers financial support.
Some insurance policies provide accident insurance benefits that cover the costs of surgeries, hospitalisation, and rehabilitation related to an accident.

What's not covered?

The exclusions are as follows.

Claims made for intentional self-harm or suicide.
Injuries arise due to existing medical conditions before the policy purchase.
Accidents due to riots, wars, or terrorism.
Injuries due to the consumption of drugs or alcohol.
Complications related to pregnancy and childbirth.
Accidents arise during adventure sports, such as bungee jumping or skydiving.

The personal accident insurance benefits below justify how this cover provides significant financial support.

Benefits of a personal accident insurance policy

Here are some of the prominent personal accident insurance benefits.

One of the key accident insurance benefits is that it offers financial security to your family during your absence due to accidental death or permanent disability.
You need not undergo any medical tests before purchasing the policy.
If the insured person is hospitalised due to an accident, then the policy covers hospitalisation expenses.
In case of permanent disability or death of the insured person, the policy offers coverage for the children’s education (applicable for children's age below 18 years) of the insured.
One of the unique benefits of personal accident insurance is that it offers the option to avail customised coverage with a wide range of sum insured options.
The claim disbursal happens quickly once you notify the insurer within a stipulated period.
Certain insurers offer coverage for transporting the policyholder’s mortal remains.
An option is available to obtain a fixed amount for each day of hospitalisation (due to an accident).

How is the premium calculated for a personal accident insurance policy?

To calculate the premium of a personal accident insurance policy, one can visit an insurance company’s website and use its premium calculator. The details to be filled are age, occupation, sum insured coverage, and policy duration. Once you fill in all these details, the premium calculator will display the premium amount for your policy.

How does the claim process work in PA insurance?

The steps involved in the claim process are as follows.

First, immediately inform the insurance company after the accident. You can notify them via customer care number or the company's website.
Share all the policy documents with the insurance company.
Submit a filled claim form.
Submit other required documents based on the claim type (like total disability, partial disability, death, etc.).
The chosen insurance company will now review the claim.
If your claim gets approval, your account will be credited with the payment.

Note: The insurance company may request additional documentation if the claim is rejected.

Conclusion

A broad understanding of what is personal accident insurance is and its types will help you keep your family financially protected during unforeseen circumstances. The financial support it provides assists you in focusing on your well-being and recovery rather than lost income and paying medical bills. Remember to choose the right policy and carefully follow the claim process to ensure adequate financial protection for your family members in your absence.

Frequently asked questions

Here we have answered some commonly asked questions about personal accident cover in health insurance

Is personal accident insurance the same as term insurance?

Many individuals get confused about what is personal accident insurance cover and how it differs from term insurance. Personal accident insurance covers disability, accidental injuries, or death. On the other hand, term insurance ensures financial support to the nominee due to the insured person's death, irrespective of the cause.

Can I claim both health and personal accident insurance for the same accident?

Yes, you are eligible to claim both personal accident and health insurance if your health insurance covers the medical costs of the accident and your personal accident insurance provides disability or death benefits.

Does personal accident cover only for the owner?

No, the scope of coverage of personal accident insurance is not just limited to the policyholder. Certain insurance policies provide coverage for family members, dependents, or employees, based on the plan.

Can I add family members under the same personal accident policy?

Yes, several insurance companies provide family floater personal accident policies. Under these policies, you can include your parents, spouse, and children under one plan.

Will my personal accident cover work abroad?

Whether the personal accident cover works abroad or not depends on the policy. Worldwide coverage is available in some personal accident insurance plans. So, make sure to review the scope of coverage with your insurer before traveling abroad.