Group vs. Individual Personal Accident Cover: Unravelling the Differences

Feature & Benefit

1. Coverage

Group Accidental Cover provides coverage for accidental death, permanent total disability, permanent partial disability, and temporary total disability for insured group members.

Individual Personal Accident cover provides coverage for accidental death, permanent total disability, permanent partial disability, and temporary total disability. Some policies also cover accidental hospitalisation expenses and ambulance charges.

2. Premium

The premium for Group Accidental Cover varies depending on the sum insured, the number of insured members, and other factors.

The premium for Individual Personal Accident Cover varies depending on the sum insured, age, occupation, and other factors of the insured person.

3. Benefit

In the event of an accidental death or disability of the insured member, the insurance company pays a lump sum amount to the nominee or legal heir of the insured person. The amount of compensation depends on the type of disability and the sum insured.

In the event of an accidental death or disability, the insurance company pays a lump sum amount to the insured person or their nominee. The amount of compensation depends on the type of disability and the sum insured.

4. Exclusion 

Group Accidental Cover policies may have some exclusions, such as injuries due to war or terrorist activities, self-harm, or pre-existing medical conditions.

Personal Accident Insurance policies may have some exclusions, such as injuries due to war or terrorist activities, self-harm, or pre-existing medical conditions.

5. Claim Process

In case of an accident, the insured member or their nominee can file a claim with the insurance company by submitting the necessary documents, such as medical reports, police reports, and claim forms.

In case of an accident, the insured person or their nominee can file a claim with the insurance company by submitting the necessary documents, such as medical reports, police reports, and claim forms.

Primary Difference 

Group PA cover, on the other hand, is designed to protect a group of people against accidental injury, disability, or death. The group can be formed by an employer for their employees, a trade association for its members, or any other group that has a common bond. The premium is usually paid by the group or the employer on behalf of the group members.

Individual PA cover is designed to protect an individual against the financial impact of accidental injury, disability, or death. The policyholder pays a premium, and in the event of an accident resulting in one of the covered events, the insurance company pays a predetermined sum insured to the policyholder or the beneficiary.

Key Difference

1. Coverage 

Group PA cover provides coverage to all the members of the group.

Whereas Individual PA coverage provides coverage only to the policyholder.

2. Premium

The premium for Group PA cover is usually lower as the risk is spread across multiple individuals in the group.

Whereas Individual PA cover premium is higher than Group PA cover.

3. Benefit

In the case of Group PA cover, the benefits are paid to the group member or their nominee.

In the case of Individual PA cover, the benefits are paid to the policyholder or their nominee.

4. Flexibility

Group PA cover offers limited flexibility as the coverage and sum insured are determined by the group policy.

Individual PA cover offers more flexibility in terms of coverage and sum insured.