Acko General Insurance Limited

Key Terms - Group Health & Accident Care

Terms & Conditions

This is a summary of the key terms under the Group Health & Accident Care Insurance Policy (“Policy”) offered by Acko General Insurance Limited (“Acko”) to Zomato Media Private Limited (“Zomato”) subject to the receipt of premium in full in respect of the Insured Persons and the terms, conditions and exclusions of underlying Policy. The covers available under the Policy can be availed by registered delivery executives of Zomato.

The Insurance coverage period starts as soon as the delivery partner goes active with Zomato and is valid till the time he is an active partner.

1. Key Benefits

Key benefits available under the Policy for Zomato delivery executives as specified in the Certificate of Insurance:

Table 1: Schedule of Coverage

Coverage Sum Insured (INR) Additional Conditions
Accidental Death Benefit or Permanent Total Disability and/or Permanent Partial Disability 10,00,000
Additional Temporary Total Disability INR 525 per day of disability for a maximum upto INR 50,000 The benefit will be payable only if the total disability period exceeds 7 days. The total benefit under the cover will be paid at one go to the insured when he/she will provide the required disability certificate as per Terms & Conditions of the Cover. Alternatively, at the request of the insured, he/she will be paid the benefit under this cover, at the end of every month if the total period of disability exceed one month.
Ambulance and Emergency Transportation Cover 2,500 Applicable for Ambulance transportation only in case of Accidental injury
Repatriation of Mortal Remains 50,000 Applicable only in case of Accidental death
Child Education Cover 20,000 Payable in the case of accidental death only
Mobility Cover 5,000 Provides coverage for accidental disability requiring wheelchair
Funeral Expenses 50,000 Applicable only in case of Accidental death
OPD treatment 5,000 Coverage only provided only in case of Accidental injury
Deductible: INR 1,000 on each claim
Loan Protector 50,000 Payable only in case of accidental death and where loan is taken from authorized NBFCs and Scheduled Banks
Loss of Baggage and Personal Effects 500 Provides coverage for only helmet damage due to accident and when the insured member is hospitalized due to such accident.
Electronic Equipment Cover 2,500 Provides coverage for only damage to Mobile phone due to an accident and when the insured member is hospitalized due to such accident. (Theft or loss of Mobile phone or damage to mobile phone due to any other reason is not covered. Electronic equipment other than mobile phone are excluded)

2. Special Conditions:

3. General Conditions:

4. General Exclusions:

Acko shall not be liable to make any payment for any claim under the Policy in respect of an Insured Person, directly or indirectly for, caused by, arising from or in any way attributable to any of the following, except where provided to the contrary under any Benefit(s) within the Policy:

  1. Any Pre-Existing Disease or any Injury or disability arising out of a Pre-Existing Disease or any complication arising therefrom.
  2. Suicide or attempted suicide, intentional self-inflicted Injury or acts of self-destruction, whether the Insured Person is medically sane or insane.
  3. Working in underground mines, tunnelling or explosives, or involving electrical installation with high tension supply, or as jockeys or circus personnel, or engaging in Hazardous Activities.
  4. Any change of profession after inception of the Policy which results in the enhancement of Our risk under the Policy, if not accepted and endorsed by Us on the Certificate of Insurance.
  5. Bacterial infections (except pyogenic infection which occurs through a cut or wound due to Accident).
  6. Medical or surgical treatment except as necessary solely and directly as a result of an Accident.
  7. Death or disability resulting directly or indirectly, contributed or aggravated or prolonged by childbirth or from pregnancy or a consequence thereof including ectopic pregnancy unless specifically arising due to Accident.
  8. Any Illness or Critical Illness arising within the Waiting Periods specified in the Policy or in the Schedule or Certificate of Insurance.
  9. All Waiting Periods shall commence concurrently, and would be considered to have been served to the extent that the Insured Person was insured continuously and without interruption under another Indian insurer’s individual health / Family Health insurance policy for the reimbursement of medical costs for inpatient treatment in a Hospital.
  10. Any External Congenital Anomalies or in consequence thereof.
  11. Any certification provided by a Medical Practitioner who shares the same residence as the Insured Person or who is an Immediate Relative.
  12. Any claim directly or indirectly caused by or associated with any venereal disease or sexually transmitted disease.
  13. Hospitalization, if applicable, for the following treatments:
    1. Laser treatment for correction of eye due to refractive error;
    2. Aesthetic or change-of-life treatments of any description such as sex transformation operations, treatment towards changes in appearance or any procedure which is aimed to improve physical appearance;
    3. Cosmetic treatments (including any complications arising out of cosmetic treatments) unless necessitated by traumatic Injury, or Illness;
    4. Vaccination or inoculation unless forming a part of post-animal bite treatment;
    5. Treatment of obesity (including morbid obesity) and any other weight control program, general debility, convalescence, run—down conditions, rest cure, treatment of sleep apnea.
    6. Naturopathy Treatments.
    7. Sterility, treatment whether to effect or to treat infertility; any fertility, sub—fertility or assisted conception procedure; surrogate or vicarious pregnancy; birth control, contraceptive supplies or services including complications arising due to supplying services;
    8. Any dental treatment or Surgery of a corrective, cosmetic or aesthetic nature unless carried out under general anaesthesia and is necessitated by Illness or Injury during the Coverage Period.
  14. Any claim arising from or caused due to use, abuse or a consequence or influence of an abuse of any substance, intoxicant, drug, alcohol or hallucinogen.
  15. Any claim arising or resulting from the Insured Person committing any breach of law or participating in an actual or attempted felony, riot, crime, misdemeanour or civil commotion with criminal intent.
  16. Any claim caused by participation of the Insured Person in any flying activity, except as a bona fide, fare-paying passenger of a recognized airline on regular routes and on a scheduled timetable.
  17. Any claim arising out of or attributable to foreign invasion, act of foreign enemies, hostilities, warlike operations (whether war be declared or not or while performing duties in the armed forces of any country during war or at peace time), participation in any naval, military or air-force operation, civil war, public defence, rebellion, revolution, insurrection, military or usurped power.
  18. Any claim arising from or caused by ionizing radiation or contamination by radioactivity from any nuclear fuel (explosive or hazardous form) or resulting from or from any other cause or event contributing concurrently or in any other sequence to the loss, claim or expense from any nuclear waste from the combustion of nuclear fuel, nuclear, Chemical attack or weapons, or Biological attack or weapons.
    1. Chemical attack or weapons means the emission, discharge, dispersal, release or escape of any solid, liquid or gaseous chemical compound which, when suitably distributed, is capable of causing any Illness, incapacitating disability or death.
    2. Biological attack or weapons means the emission, discharge, dispersal, release or escape of any pathogenic (disease producing) microorganisms and/or biologically produced toxins (including genetically modified organisms and chemically synthesized toxins) which are capable of causing any Illness, incapacitating disability or death.

5. Claim & Documents:

The delivery executive can file a claim for any of these coverages by emailing [email protected] or reach Acko at the Contact number provided below for registration of claim:

Acko: 1800 266 2256

Delivery executive needs to submit following documents in case of a claim:

The below list of documents, required for processing claims, are indicative and not exhaustive. Claims are subject to investigation & in case there is an additional requirement of documents, Acko will inform the claimant & Zomato in writing (email & phone). Any mandatory documents can be waived off at the discretion of Acko based on the nature, extent & information available about the loss.

Common Documents:

Accidental Death Benefit:

Permanent Total Disability or Permanent Partial Disability:

Temporary Total Disability:

OPD Treatment:

Ambulance Transportation Cover:

Loan Protector:

Loss of Baggage and Personal Effects or Electronic Equipment Cover

6. Definition

6.1. Accidental Death Benefit:

If an Insured Person suffers an Injury due to an Accident that occurs during the Coverage Period and that Injury solely and directly results in the Insured Person’s death within 365 days from the date of the Accident, We will pay the Sum Insured.

6.2. Permanent Total Disability

If an Insured Person suffers an Injury due to an Accident that occurs during the Coverage Period and that Injury solely and directly results in the Permanent Total Disability of the Insured Person which is of the nature specified in the table below, within 365 days from the date of the Accident, Acko will pay the Sum Insured:

Nature of Permanent Total Disability
Total and irrecoverable loss of sight in both eyes
Loss by physical separation or total and permanent loss of use of both hands or both feet
Loss by physical separation or total and permanent loss of use of one hand and one foot
Total and irrecoverable loss of sight in one eye and loss of a Limb
Total and irrecoverable loss of hearing in both ears and loss of one Limb/ loss of sight in one eye
Total and irrecoverable loss of hearing in both ears and loss of speech
Total and irrecoverable loss of speech and loss of one Limb/ loss of sight in one eye
Permanent, total and absolute disability (not falling under any one the above) which results in the Insured Person being unable to engage in any employment or occupation or business for remuneration or profit, of any description whatsoever which results in Loss of Independent Living

6.3. Permanent Partial Disability

If an Insured Person suffers an Injury due to an Accident that occurs during the Coverage Period and that Injury solely and directly results in the Permanent Partial Disability of the Insured Person which is of the nature specified in the table below within 365 days from the date of the Accident, Acko will pay the amount specified in the table below:

Nature of Permanent Partial Disability Percentage of the Sum Insured payable
i. Total and irrecoverable loss of sight in one eye 50%
ii. Loss of one hand or one foot 50%
iii. Loss of all toes - any one foot 10%
iv. Loss of toe great - any one foot 5%
v. Loss of toes other than great, if more than one toe lost, each 2%
vi. Total and irrecoverable loss of hearing in both ears 50%
vii. Total and irrecoverable loss of hearing in one ear 15%
viii. Total and irrecoverable loss of speech 50%
ix. Loss of four fingers and thumb of one hand 40%
x. Loss of four fingers 35%
xi. Loss of thumb- both phalanges 25%
xii. Loss of thumb- one phalanx 10%
xiii. Loss of index finger-three phalanges 10%
xiv. Loss of index finger-two phalanges 8%
xv. Loss of index finger-one phalanx 4%
xvi. Loss of middle/ring/little finger-three phalanges 6%
xvii. Loss of middle/ring/little finger-two phalanges 4%
xviii. Loss of middle/ring/little finger-one phalanx 2%

6.4. Temporary Total Disability

If an Insured Person suffers an Injury due to an Accident that occurs during the Coverage Period and that Injury solely and directly results in the disability of the Insured Person which prevents the Insured Person from engaging in any employment or occupation on a temporary basis, then We will pay the amount specified in the Certificate of Insurance at the frequency specified in the Certificate of Insurance for the duration that the Temporary Total Disability continues.

6.5. Child Education Cover

We will pay the amount specified in the Certificate of Insurance at the frequency specified in the Certificate of Insurance in respect of each surviving Dependent Child, irrespective of whether the Dependent Child is an Insured Person under this Policy.

6.6. Repatriation of Mortal Remains

We will reimburse the expenses incurred up to the limit specified in the Certificate of Insurance for transportation of mortal remains from the place of death to the residence of the Insured Person.

6.7. Mobility Cover

We will reimburse the expenses incurred up to the limit specified in the Certificate of Insurance on the purchase of support items including but not limited to crutches, artificial limbs, wheelchairs, tri-cycles intra-ocular lenses, spectacles, hearing aids, dentures, artificial teeth, imported medicines or any other item which in the opinion of the treating Medical Practitioner is necessary for the Insured Person to resume normal living following the Injury sustained in the Accident during the Coverage Period.

6.8. Funeral Expenses

We will pay the amount specified in the Certificate of Insurance towards expenses on the funeral, cremation/ or burial and transportation of the body to the place of the funeral ceremony for the Insured Person.

6.9. Ambulance and Emergency Transportation Cover

If an Insured Person suffers from an Injury or Illness specified in the Schedule / Certificate of Insurance, during the Coverage Period. If an Insured Person contracts an Illness/Critical Illness or suffers an Injury due to an Accident specified in the Schedule / Certificate of Insurance that occurs during the Coverage Period and that Illness/Critical Illness/Injury solely and directly requires the Insured Person to be transported to the Hospital by an Ambulance or any public transport, then We shall reimburse the costs incurred up to the limits as specified in the Certificate of Insurance.

6.10. OPD treatment:

If an Insured Person requires OPD Treatment for any of the treatments/tests/consultations specified in the Certificate of Insurance, due to an Injury or Illness specified in the Schedule / Certificate of Insurance, suffered or contracted during the Coverage Period, If an Insured Person contracts an Illness or suffers an Injury due to an Accident specified in the Schedule / Certificate of Insurance that occurs during the Coverage Period and that Illness/Injury solely and directly requires the Insured Person to undergo OPD Treatment for any of the treatments/tests/consultations specified in the Certificate of Insurance then We will reimburse the costs incurred on Medical Expenses up to the limit specified Certificate of Insurance.

6.11. Loan Protector

If an Insured Person suffers an Injury due to an Accident that occurs during the Coverage Period, We will pay an amount equal to the outstanding loan principal amount in respect of the Insured Person’s outstanding Loan, subject to this amount not exceeding the amount specified in the Certificate of Insurance.

6.12. Loss of Baggage and Personal Effects

We will reimburse the actual loss upto the limit specified in the Certificate of Insurance incurred in relation to the permanent and total loss of the Insured Person’s luggage and personal possessions during the Coverage Period.

6.13. Electronic Equipment Cover

We will reimburse the actual loss incurred up to the amount specified in the Certificate of Insurance in relation to the permanent and total loss of the Insured Person’s Portable Electronic Equipment due to physical damage, destruction, loss or theft during the Coverage Period.

7. Grievance Redressal:

For resolution of any query or grievance, insured may write an e-mail at [email protected].. In case the insured is not satisfied with the response of the office, insured may contact the Grievance Officer of the Company at the following address:

Grievance Redressal Officer
2nd Floor, Acko General Insurance
36/5 Hustlehub One East, Somasandrapalya .
27th Main Rd, Sector 2, HSR Layout, 
Bengaluru, Karnataka 560102
[email protected]

In the event of unsatisfactory response from the Grievance Officer, he/she may, register a complaint in the Integrated Grievance Management System (IGMS) of the IRDAI.

Where the grievance is not resolved, the insured may, subject to vested jurisdiction, approach the Insurance Ombudsman for the redressal of grievance.

Please note that these terms and conditions are only indicative, and the full list of policy conditions and exclusions are available at: http://www.acko.com/download

Once you have opted for cover, you will receive a Certificate of Insurance from Acko which will contain complete details of your cover under the Policy, and the applicable conditions and exclusions.

Acko General Insurance Limited

36/5, Hustlehub One East, Somasandrapalya, 27th Main Rd, Sector 2, HSR Layout, Karnataka 560102

IRDAI Reg No: 157 | CIN: U66000MH2016PLC287385 | UIN: ACKHLGP19122V011819

www.acko.com | Insurance Helpline Number: 1800 266 2256 | Mail: [email protected]