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Group Personal Accident

Lump-sum benefits for accidental death, permanent disability and, where taken, temporary disablement of covered employees.

Also calledGPA · Group Personal Accident

File/Claims library/People and employee benefits/Injury and accident

First thing, todayReport to the police where the death or injury is accidental, and intimate the insurer immediately.

Three deadlines
  • Tell the insurer now, not after the assessment.
  • The statutory notice to whoever the law requires, within the time it sets.
  • Every document within the time the insurer asks for it.
A site where a ladder has fallen, a hard hat left on the ground
A site where a ladder has fallen, a hard hat left on the ground. An illustration.

When you would claim

  • Accidental death of a covered employee, at work or otherwise
  • Permanent total or partial disability from an accident
  • Temporary disablement where the weekly benefit is taken
  • Accidental injury requiring hospitalisation, where extended

What insurers most often rely on

  • Death or injury not accidental within the policy's meaning
  • The member not on the declared list at the date of loss
  • Self-inflicted injury, intoxication or an excluded activity
  • Disability percentage disputed on the certificate produced
  • Nomination unclear, delaying rather than defeating the claim

Most of them turn on a record kept long before anybody was hurt, which is why the wage and attendance registers decide these claims.

The documents

from three places at once

9 items, arriving from a hospital, an employer and sometimes a police station, on three timetables that do not co-operate. Start all three on the same day.

  • Claim form and the intimation
  • FIR, panchnama and post-mortem report in a death claim
  • Death certificate and the nominee's identity and bank details
  • Disability certificate from a government hospital where required
  • Complete treatment records
  • Employment proof and the declared list of members
  • Salary record where the benefit is a multiple of it
  • Details of any other insurance covering the same risk
  • The benefit claimed, read against the capital sum insured and the disablement table in the policy
Two clocks, not oneThere is the policy's clock and there is the statute's, and they run at different speeds. Keep one page with both on it: what was reported to the insurer, and what was filed where the law required.

Next

Employee Injury Claim: What to Do First, and what it shares with this

Open the employee injury playbook. The first hours are about treatment and the record of it, and the commonest way this claim is lost is a private settlement reached before the insurer was told.

Call 92514 56334

Read the benefit table

This pays a benefit, not a loss. The capital sum insured and the policy's own table decide the figure, and no amount of receipts moves it. What is worth reading before a claim is which events are on that table and what each is worth.

Filed under: People and employee benefits · Injury and accident

Claims that sit next to this one

the same people, on another policy

Employees' Compensation

the statutory cover for the same injury

Group Health

hospitalisation rather than disablement

Group Term Life

death benefit for the same group

Somebody hurt at work and the paperwork already behind? Report a loss or call 92514 56334.