What Disablements Are Covered in Health Insurance Plans?

A disability caused by an accident can harm your financial stability and earning potential. The added expenses of treatment, therapy and rehabilitation can make it more difficult to deal with financially. To help individuals cope with this financial strain, personal accident insurance policies provide affordable coverage to those who have been disabled due to an accident. Care Health Insurance offers a Care Secure plan that covers medical expenses for individuals disabled due to an accident. This fixed-benefit personal accident insurance plan is similar to health insurance for disabled individuals in India. 

Keep reading to learn more about accidental disability and the Care Secure Plan. 

Meaning of Accidental Disability Under Health Insurance

Any incapacity due to a bodily injury caused directly by an accident is called accidental disability. It limits a person’s ability to do certain activities. There are three types of accidental disabilities covered under personal accident insurance, they are as follows:  

Permanent Total Disability (PTD)

Permanent total disability is when you lose a body function, or there is permanent damage due to an accident. Such a disability is irreversible and impacts your ability to earn a living.  For example, losing a hand or a leg,  losing both hands or legs or permanent blindness can be termed as permanent total disability. In case of such disabilities, a personal accident insurance cover pays 100% of the sum insured, provided the accident happens within the policy period. 

Permanent Partial Disability (PPD)

These disabilities are caused as a result of an accident but are not as serious as total disability. Such disabilities also can not be reversed with treatment such as the loss of a finger, loss of sight in one eye, loss of hearing in one ear, etc. Personal accident insurance pays a certain percentage of the sum insured for permanent partial disability as per the policy terms and conditions.

Temporary Total Disability

When an individual becomes disabled or bedridden for a limited period due to an accident and is unable to do his job, it is referred to as temporary total disability.  In such cases, the insurer pays a specific amount for each week of the disability, and the coverage is available for a specified number of weeks as per the policy. Many plans offer this as an optional benefit.

Care Secure: Personal Accident Insurance

Care Health Insurance offers the Care Secure plan which is a personal accident insurance that covers death and disability caused by an accident.  Here are the key features of the Care Secure plan.

What is Disability Benefit in Insurance?

Disability benefit in insurance refers to the insurance coverage for the loss of income and medical expenses due to a temporary or permanent disability. Care Secure plan offers many disability benefits as inbuilt benefits as well as optional covers.

Permanent Total Disablement Improvement Cover

Under this cover, an additional amount of up to 100% of the SI is paid to the insured in addition to the PTD benefit already paid, given that the accident has happened during the policy year. This amount is payable irrespective of any improvement in the disability.

Permanent Partial Disablement Improvement Cover

Under this cover, an additional amount of up to 75% of the SI is paid to the insured in addition to the PPD benefit already paid. This amount is payable irrespective of any improvement in the disability. This is applicable only if the accident has occurred in the policy year.

Fracture

The policy pays an amount chosen by the policyholder in accordance with the terms and limitations of the policy in case the policyholder suffers from a fracture due to an accidental injury. It covers different types of fractures like complete fracture, compound fracture, hairline fracture and simple fracture.

Burns

Second or third-degree burns caused by an accident are covered up to the sum insured as per policy terms and conditions. 

Mobility Cover

In the case of PTD, the plan pays reasonable and customary charges for medically necessary prosthetic devices, orthopaedic braces and medical equipment required by the insured as a result of the disability. Please note that the charges paid by the company might be lower than the actual cost incurred for these equipment.

Child Education

Child education is covered in personal accident insurance in case of accidental death or permanent total disability, up to a percentage of the sum insured as specified in the policy.

Important Points to Remember While Buying Personal Accident Insurance

The following are some important points to remember while buying personal accident insurance:

Check the Scope of Coverage

Before you finalise a plan check the inclusions and exclusions under the plan and the extent of the risk covered under the plan. Ask questions if you have doubts like Does health insurance cover permanent disability or not?

Sum Insured

Your personal accident plan will pay you an amount equal to the sum insured you opt for, any expenses beyond this amount will not be covered. Hence choose an adequate sum insured value. 

Plan Benefits

Check all the plan benefits and ensure that the plan covers all the possible concerns that may arise due to an accident and your family gets the maximum benefit in case of a disability. 

Network of Hospitals

Make sure your plan has an accessible network of hospitals where you can avail of cashless treatment in case of any medical emergency. Also, understand the claim procedure well so that you can easily file a claim. 

Conclusion

Accidents are unpredictable and can drain you financially. Investing in a personal accident cover will ensure that your family and you receive financial support in case you have an accident. Personal accident cover will not only pay compensation for accidental death but also pay for accidental disability and other expenses arising due to the disability. Care Health Insurance offers accidental disability benefits under its Care Secure plan. Visit our website to know more about the plan and get in touch with our representatives.

>> Also Read: Personal Accident Insurance: Expectations Vs Reality

Disclaimers: The above information is for reference purposes only. Kindly consult your general physician for verified medical advice. The health insurance benefits are subject to policy terms and conditions. Refer to your policy documents for more information.