Every organisation owes its workforce more than a salary. When an accident strikes — on the road, at the worksite, or anywhere — the financial consequences for the employee’s family can be devastating. Group Personal Accident Insurance provides structured financial protection for your entire workforce: accidental death, permanent disability, temporary disability, hospitalisation, reconstructive surgery, education benefit for children, and more — all under a single group policy with no individual medical examination required.
Commercial Insurance · Group Benefits · Employee Welfare · All Industries
Group Personal Accident (Group PA) Insurance is a commercial insurance policy issued to an organisation (the policyholder) that provides financial protection to a defined group of insured persons — typically employees and their families — against the financial consequences of accidental death, permanent disability, temporary disability, and related expenses. Unlike individual personal accident policies, Group PA insurance is issued on a group basis, enabling employers to cover their entire workforce under a single policy with a single premium payment, significant cost advantages over individual policies, and no requirement for individual medical examinations.
Full sum insured paid to the employee's nominee or legal representative in the event of death caused by an accident. Provides immediate financial security for the bereaved family.
BENEFIT 1Total or partial permanent disability from an accident — loss of limbs, sight, or bodily function — covered with structured payment per the disability schedule.
BENEFITS 2–3Weekly benefit paid when the employee is temporarily unable to work due to accident-related injury. Replaces lost income during the recovery period.
BENEFIT 4Reimbursement of medical expenses and daily cash benefit for hospitalisation following an accident — covering the direct cost of treatment and recovery.
BENEFITS 5–6Education fees for the employee's dependent children paid in the event of accidental death — ensuring the children's schooling continues despite the family's loss.
BENEFIT 7Cost of reconstructive surgery required following an accident — covering the restoration of function and appearance after severe traumatic injury.
BENEFIT 8Comprehensive Protection Against All Accident-Related Financial Losses
Group PA insurance covers the full spectrum of financial losses that arise from accidental injury to the insured employees. Coverage is operative 24 hours a day, 365 days a year, anywhere in India (or worldwide, as per policy).
Group Personal Accident Insurance is an all-time, all-place policy. Coverage is operative 24 hours a day, 365 days a year — not just during working hours or at the workplace. Whether the accident occurs during the morning commute, on a work trip, at a weekend sporting event, or on a family holiday, the policy responds. This is a critical distinction from workmen’s compensation, which covers only workplace accidents during working hours. Note: specific geographic limits (India-only or worldwide) are declared in the policy schedule.
Structured Financial Protection Across Every Accident Outcome
Group PA insurance is structured around nine distinct benefit heads, each covering a different financial consequence of accidental injury. Here is the full detail of each benefit as available under the insurer and other leading group PA insurers.
If the insured employee dies as a direct and sole result of a bodily injury caused by an accident, the insurer pays the full sum insured to the employee’s designated nominee or legal representative. Death must occur within 12 months of the date of accident. The sum insured is typically set at a multiple of the annual salary (e.g., 2×, 3×, or 5× annual CTC) depending on the employee grade and employer’s benefit design. This benefit provides the most immediate and impactful financial relief for the bereaved family.
If an accident causes permanent, complete, and irrecoverable loss of bodily function that permanently prevents the employee from engaging in any occupation or work for remuneration or profit, the insurer pays 100% of the sum insured. Common PTD scenarios: loss of both hands, loss of both eyes, loss of both legs, or loss of one hand and one foot. The disability must be certified as permanent and total by a qualified medical practitioner. PTD is the most severe non-fatal accident outcome and demands the highest benefit response.
If an accident causes permanent loss or permanent loss of use of a specific body part, the insurer pays a defined percentage of the sum insured per the standard PPD schedule. Representative schedule:
• Loss of one arm at shoulder: 70% | Loss of one arm at elbow: 65%
• Loss of one hand: 60% | Loss of one leg above knee: 70%
• Loss of one leg below knee: 50% | Loss of one eye: 50%
• Loss of one thumb: 20% | Loss of one index finger: 10%
• Loss of hearing (one ear): 30% | Loss of hearing (both ears): 75%
The PPD benefit provides proportionate compensation for the loss of specific bodily functions, reflecting the degree of the disability’s impact on the employee’s earning capacity.
If an accident causes the employee to be completely and temporarily unable to carry out their occupation or any work for a period, the policy pays a weekly benefit. Typically 1% of the sum insured per week, subject to a maximum of 100 weeks (approximately 2 years). The weekly benefit replaces a portion of the employee’s income during their recovery period. TTD is particularly valuable for blue-collar and manual-labour employees whose income entirely depends on physical ability to work. The employer benefits too — the TTD benefit reduces the moral obligation to continue paying the salary of an absent employee.
Reimburses all medical expenses incurred by the insured employee arising from treatment of injuries sustained in an accident. Covered expenses: hospital room and boarding charges, surgeon’s fees, anaesthesiologist, diagnostic tests and imaging, medicines and pharmaceuticals, and all other medically necessary treatment costs. Reimbursement is available for expenses incurred within 12 months of the date of the accident. The limit is typically a stated sum or a percentage of the sum insured as declared in the policy schedule.
Pays a fixed daily cash benefit for each day the insured employee is admitted as an in-patient in a hospital following an accident. The daily cash benefit compensates for incidental expenses associated with hospitalisation that fall outside of actual medical reimbursement — food, travel for family members visiting the hospital, attendant charges, and other out-of-pocket costs. The daily benefit amount and maximum number of days are declared in the policy schedule. The hospitalisation must be medically necessary and directly caused by the accident.
In the event of death of the insured person due to bodily injury or sickness, the insurer pays a fixed benefit toward the cost of last rites and funeral expenses. This benefit provides for the immediate logistical expenses associated with the employee’s death, independent of the accidental death sum insured which may take time to settle. The amount is declared in the policy schedule and is typically a modest fixed sum (e.g., ₹10,000–₹25,000) paid promptly to the legal representative.
Covers the cost of reconstructive surgery required as a direct medical consequence of the accidental injury. Reconstructive surgery following severe trauma — skin grafting after burns, limb reconstruction after crushing injuries, facial reconstruction after road accidents — can cost lakhs and is not always fully covered by health insurance. This benefit specifically covers the reconstructive surgical component of accident treatment and is available up to the declared limit in the policy schedule.
If accidental death of the insured employee occurs within 12 months of the date of the accident, the insurer pays the education fees for the insured employee’s dependent children. This benefit ensures the education of the employee’s children continues uninterrupted despite the sudden loss of the family’s primary earner. The benefit is paid per dependent child and covers tuition and education fees up to the declared limit and the children’s age specified in the policy.
In the event of accidental death of the insured employee, some Group PA policies include a benefit to pay the health insurance premiums for the surviving spouse and dependent children for a defined period (typically 2–3 years). This benefit addresses a practical and immediate need: the surviving spouse’s health coverage, which may have been provided through the deceased employee’s employer health plan, would otherwise lapse. The insurer pays the renewal premiums directly so the family retains health insurance during their most vulnerable period.
Which Organisations Benefit Most From Group PA Insurance
Group PA insurance is relevant for every organisation with employees, but certain industries and workforce profiles benefit most from comprehensive group accident coverage.
Most insurers require a minimum of 5 employees to issue a Group Personal Accident policy. There is no practical upper limit — groups of thousands of employees can be covered under a single master policy. For very large groups (500+ employees), premium negotiations with insurers can yield significantly better rates due to the statistical diversification of risk across a large population. Organisations with fewer than 5 employees can explore individual personal accident policies. Call 022 4302 0000 — Probitas will advise on the best structure for your specific group size and industry.
How to Raise a Group PA Claim for Your Employee
Group PA claims are managed by both the employer (as policyholder) and the employee (as insured person). As your broker, Probitas manages the claim process on behalf of the organisation and guides the affected employee or family through every step.
Notify Probitas Insurance Brokers on 022 4302 0000 immediately upon the accident or as soon as the employer is made aware of it. We will notify the insurer, issue a claim reference number, and provide the list of documents required for the specific claim type. For accidental death: notify within 24–48 hours. For disability claims: notify as soon as the permanent nature of the disability is medically established. For hospitalisation/TTD: notify within the first week of hospitalisation.
The employer’s HR department collects the necessary accident documentation: FIR or Medico-Legal Case (MLC) report from the hospital (for accidents where police are involved); medical reports from the treating doctor; hospital admission and discharge summary; employer’s accident report; leave and attendance records showing the employee’s status; and the employee’s policy certificate number from the master group policy. All documents are submitted through Probitas to the insurer.
The affected employee (or their legal representative for death claims) completes the insurer’s claim form, which is countersigned by the employer (HR or management). The complete document set is submitted to the insurer through Probitas. Probitas reviews the submission for completeness before dispatch — reducing the risk of rejection or delay due to missing documents.
For straightforward claims (accidental death with clear documentation, hospitalisation reimbursement), the insurer typically settles within 15–30 days of complete document submission. For disability claims, the insurer may require an independent medical examination to confirm the nature and permanence of the disability. Probitas follows up with the insurer on the organisation’s behalf and expedites the settlement process. All payments are made directly to the insured employee or their nominee by the insurer.
What Is NOT Covered
Group PA covers accidental injuries only. The following events and circumstances are excluded from the standard policy.
Any injury deliberately inflicted by the insured upon themselves — including suicide, attempted suicide, or any intentional self-harm — is excluded from all benefit heads under the Group PA policy.
Injuries sustained while the insured is participating in or committing a criminal or illegal act are excluded. The policy provides protection for accidental injury, not for consequences of unlawful behaviour.
Injuries from participation in adventure sports (skydiving, bungee jumping, racing, mountaineering), hazardous activities, naval or military operations, or aviation other than as a fare-paying passenger are excluded unless specifically endorsed.
Injuries arising while the insured is under the influence of alcohol, drugs, narcotics, or any other intoxicant (unless prescribed by a qualified doctor) are excluded from all benefit heads of the Group PA policy.
Treatment expenses and disability arising from HIV/AIDS or any HIV-related illness are excluded from the Group Personal Accident policy. Medical expenses for HIV/AIDS treatment fall outside the scope of this policy.
Death or disability arising from war, warlike operations, civil war, invasion, rebellion, terrorism, or nuclear events is excluded from the Group PA policy. War risk is a standard exclusion across all personal accident policies.
Claims arising from or aggravated by a pre-existing physical condition, congenital abnormality, or disease are excluded. The policy covers sudden, accidental, external injury — not health conditions that existed before the policy.
Death, disability, or medical expenses arising from pregnancy, childbirth, miscarriage, or complications thereof are excluded from the Group Personal Accident policy. These are covered under group health or maternity insurance.
The information and product comparisons displayed on this platform are intended solely for general informational and evaluation purposes, and do not constitute a legal offer or binding insurance contract. Specific policy features, premium rates, riders, and underwriting guidelines are determined exclusively by the respective general insurance carriers and may vary significantly based on the insurer, product tier, and location across multiple Indian states. All quotes and premium calculations generated on this website are indicative estimates based on preliminary data and do not guarantee final underwriting approval or policy issuance by the insurer. For comprehensive details regarding specific coverage terms, limits, and permanent exclusions, please refer directly to the official sales brochure and policy wording issued by the respective insurance company, which will take absolute legal precedence in the event of any discrepancy or dispute.
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By submitting you agree to our Privacy Policy and Terms & Conditions. Group Personal Accident Insurance is a commercial insurance product subject to insurer underwriting and acceptance. Minimum group size: 5 persons. Benefits and premium are indicative. Refer to the policy wording for complete terms. Probitas Insurance Brokers Pvt. Ltd. · IRDAI Lic. No. 528.