Med-Insure

(Group Policy)


About Us


Medindure is a group accidental insurance policy for school children. The policy is specifically tailored for school going children. The policy is a school system-established benefit that provides coverage for accidental injuries that occur during normal school hours or during any school sponsored and supervised activity. The benefit works as a supplement to fill the gaps in existing plans that may not cover all expenses including deductibles, coinsurance and other high out-of-pocket costs. This benefit can also work as the primary insurance in the event there is no other coverage.


Table of Benefits

Accidental Death

This provides payment of the policy sum insured in the unfortunate event of accidental death of the Insured Person. The Company will pay an amount as compensation 100% of the Capital Sum Insured.

Disablement

1. Permanent Total Disablement 150%#
1. Total and irrevocable loss *of
(i) Sight of both eyes 100%
(ii) Physical separation of two entire hands 100%
(iii) Physical separation of two entire foot 100%
(iv) One entire hand and one entire foot 100%
(v) Sight of one eye and loss of one hand 100%
(vi) Sight of one eye and loss of one entire foot 100%
(vii) Use of two hands 100%
(viii) Use of two foot 100%
(ix) Use of one hand and one foot 100%
(x) Sight of one eye and use of one hand 100%
(xi) Sight of one eye and use of one foot 100%
(xii) Sight of one eye 50%
(xiv) Physical separation of one entire foot 50%
(xv) Use of one hand without physical separation 50%
(xvi) Use of one foot without physical separation 50%

*Loss of foot / hand means total severance through or above the ankle/ wrist joints respectively. Loss of eye means entire and irrevocable loss of sight. Thumb and index finger means severance through or above the joint that meets the hand at the palm.

# payable only when the insured person, following accidental injuries is unable to engage in each and every occupation or employment for compensation or profit for which he is reasonably qualified by education, training or experience for the rest of his life. If at the time of loss the insured person is unemployed, Permanent Total Disability shall mean the total and permanent inability to perform all of the usual and customary duties and activities of a person of like age and sex even with the use of special equipment routinely available to help and having taken any appropriate prescribed medication.

Permanent Partial Disablement Table of Benefits
Benefits Percentage Of Sum Insured
1 Loss of toes all All 20
Loss of Great toe both phalanges 5
Loss of Great toe one phalanx 2
Other than Great, if more than
One toe lost, for each toe For each toe 1
2 Loss of hearing both ears Both ears 75
Loss of hearing one ear One ear 30
3 Loss of four fingers and thumbs of One hand 40
4 Loss of four fingers 35
Loss of thumb both phalanges Both phalanges 25
One phalanx 10
5 Loss of index finger three phalanges Three phalanges 10
Two phalanges Two phalanges 8
One phalanx One phalanx 4
6 Loss of middle finger Three phalanges 6
Two phalanges 4
One phalanx 2
7 Loss of ring finger Three phalanges 5
Two phalanges 4
One phalanx 2
8 Loss of little finger 4
Two phalanges 3
One phalanx 2
9 Loss of metacarpals First or second 3
Additional (third fourth or fifth) 2
10 Any other Permanent partial disablement Percentage as assessed by the Medical Board or by the government doctor

Additional Benefits (at no extra premium) :

1. Ambulance charges / Transportation Expenses of mortal remains

Following an admissible claim under the policy due to an Accident outside the place of the insured's residence the Company shall pay during the policy period as a lump sum Either

  • a) Towards ambulance charges for emergency treatment to go to the hospital in case of injury Or in case of Death
  • b) Towards transportation of the mortal remains of the insured person (including the cost of embalming and coffin charges) to the residence of the insured,
  • The limit of Company's liability towards either Ambulance charges or Transportation of mortal remains is Rs.5,000/- only during the policy period ,per insured person. This lump sum amount is payable in addition to the sum insured.

    2. Travel Expenses for One Relative (Applicable for Death claims only)

    The Company will pay 1% of Total Sum insured up to Rs.50,000/-, subject to actual, for the transport expenses to one relative of the Insured Person following an admissible claim under the policy for Accidental Death. This amount is payable in addition to the sum insured and applicable for each person covered under the policy

    3. Vehicle and / or Residence Modification:

    The Company will pay up to 10% of Table B sum insured subject to a maximum of Rs.50,000/- towards the expenses incurred to modify the Insured Person's residential accommodation or vehicle as long as the modification have been carried out in India and certified by a Doctor to be necessary and directly required as a result of the Accident for which there is an admissible claim.

    This benefit is applicable only where there is an admissible claim for Permanent Total Disablement. This amount is payable in addition to the sum insured. This benefit is per insured person.

    4. Purchase of Blood :

    The Company will pay up to 5% of the sum insured under relevant table/tables opted subject to a maximum of Rs.10,000/- whichever is less towards the expenses incurred in purchasing blood through a Hospital or Government approved blood bank for the purpose of the Insured Person's medical or surgical treatment provided there is an admissible claim under this policy. This amount is payable in addition to the sum insured

    5. Transportation of Imported Medicines:

    The Company will pay up to 5% of Total sum insured subject to a maximum of Rs.20,000/- towards the expenses incurred on freight charges for importing medicines to India, provided that:

  • a. There is an admissible claim under the policy.
  • b. The medicines, formulations or alternatives of the imported medicines are not available in India, and
  • c. The medicines are necessary for the medical/surgical treatment of the Insured person in a Hospital following the Accident.
  • d. The medicines which are imported should be permissible under Government Regulation
  • e. The medicines shall not include any drugs under clinical trial or medicines, formulations or molecules of unproven efficacy.
  • This amount is payable in addition to the sum insured.

    Claims Procedure:

    1. Document to be submitted in case of Accidental Death Claims

  • Completed Claim form
  • Death certificate, Panchanama
  • FIR, wherever applicable
  • In the absence of assignment, Legal Heir ship Certificate/Succession Certificate / Will duly probated
  • Original Policy, if issued for Individual
  • Coroner's Report/Police Inquest Report

  • 2. Document to be submitted in case of Disability Claims

  • Original Policy
  • Disability Certificate from the attending Doctor confirming the %age of disability.
  • Photo of the person indicating the disability.
  • Completed claim form
  • FIR, Wherever applicable

  • Note : Claims will be settled by in-house claims team.