Group Personal Accident (GPA) Policy

Financial protection for you and your family against the financial impact of accidental death

Accidents can have a significant financial impact on individuals and their families. Group Personal Accident is designed to provide financial protection against unforeseen accidents by offering a lump sum benefit in the unfortunate event of an accidental death during the policy period, subject to the policy terms and conditions.

The benefit is intended to help replace the loss of income and support the financial needs of the insured person’s family. The claim amount can be used at the nominee’s discretion to meet household expenses, repay financial liabilities, fund children’s education, or meet any other immediate financial commitments.

Key features include:

• Financial protection against accidental death.
• Lump sum payout to the nominee upon an admissible claim.
• Helps reduce the financial burden on the family following an unforeseen accident.
• Provides financial continuity by supporting essential living expenses and other commitments.
• Coverage is available for the policy period as specified in the Certificate of Insurance and is subject to the applicable terms, conditions and exclusions.

This insurance cover is underwritten by Kshema General Insurance Limited. For complete details on eligibility, coverage, exclusions, claim procedure and policy terms, please refer to the Policy Wordings and Certificate of Insurance.

Detailed Terms & Conditions

The Group Personal Accident Policy is underwritten by Kshema General Insurance Limited and is governed by the terms, conditions, exclusions and definitions contained in the Policy Wordings and Certificate of Insurance.

The following are the key terms applicable to the policy:

Coverage:

• The policy provides financial protection in the event of Accidental Death occurring during the policy period, subject to the policy terms and conditions.

Eligibility:

• Coverage is available only to eligible persons enrolled under the Group Personal Accident Policy.
• Insurance coverage commences and expires as specified in the Certificate of Insurance.

Policy Period

The insurance cover is valid only during the policy period mentioned in the Certificate of Insurance. Claims are admissible only for covered events occurring during the policy period, subject to the policy terms.

Major Exclusions

No benefit shall be payable for claims arising directly or indirectly from, including but not limited to:

• Natural death.
• Suicide or attempted suicide.
• Self-inflicted injury.
• War, invasion, civil war, rebellion or military operations.
• Alcohol or drug abuse.
• Participation in hazardous or professional sports.
• Criminal or unlawful acts.
• Nuclear, chemical or biological incidents.
• Any claim arising beyond 12 months from the date of the accident.
• Animal bites, snake bites, insect bites and perils of the sea.

Claim Intimation:

Claims should be intimated to Kshema General Insurance as soon as reasonably possible following the accident. The insured/nominee may be required to submit the prescribed claim form, identity proof, medical records, police documents (where applicable) and any other supporting documents required for claim assessment.

Claim Settlement

Claims shall be processed in accordance with the applicable IRDAI regulations and the policy terms upon receipt of all required documents.

General Conditions:

• Benefits are subject to the Sum Insured specified in the Certificate of Insurance.
• The policy is subject to all applicable definitions, terms, conditions, limitations and exclusions contained in the Policy Wordings.
• Any misrepresentation, fraud or non-disclosure of material facts may result in cancellation of the policy or rejection of the claim.

Disclaimer:

This webpage is intended to provide a brief overview of the insurance cover. The insurance contract is governed solely by the Policy Wordings, Certificate of Insurance, applicable endorsements and the provisions of the Insurance Act, 1938, IRDAI regulations and other applicable laws. In the event of any inconsistency, the policy documents shall prevail.

Customer Support

For any queries regarding policy coverage, claims or policy servicing, please contact Kshema General Insurance Limited:

Toll-Free: 1800 572 3013

Email: support@kshema.co

Website: www.kshema.co

Group Hospital Cash Policy

Unexpected hospitalization can place a financial burden on individuals and their families beyond medical expenses. A Group Hospital Cash Policy provides a fixed daily cash benefit during eligible hospitalization, helping manage incidental expenses that may arise during the course of treatment.

Unlike traditional health insurance, which reimburses medical expenses, a Group Hospital Cash Policy pays a pre-defined daily benefit as specified in the Certificate of Insurance. The benefit can be used at the insured person’s discretion to meet expenses such as travel, food, accommodation for attendants, temporary loss of income, or any other financial commitments during hospitalization.

Key Features

• Fixed daily cash benefit during eligible hospitalization.
• Financial support for incidental hospitalization-related expenses.
• Helps reduce the financial impact of hospitalization on individuals and their families.
• Benefit amount and coverage are as specified in the Certificate of Insurance.
• Coverage is subject to the policy terms, conditions and exclusions.

For complete details on eligibility, benefits, exclusions and claims process, please refer to the Policy Wordings and Certificate of Insurance.

Detailed Terms & Conditions

The Group Hospital Cash Policy is underwritten by Kshema General Insurance Limited and is governed by the Policy Wordings, Certificate of Insurance, applicable endorsements and the terms and conditions of the policy.

Coverage:

• The policy provides a fixed daily Hospital Cash Benefit for eligible hospitalization arising due to illness or accidental injury during the policy period.
• The benefit is intended to provide financial assistance towards incidental expenses associated with hospitalization, including travel, food, attendant expenses, temporary loss of income and other day-to-day financial commitments.
• Benefits are payable in accordance with the limits specified in the Certificate of Insurance and subject to the applicable policy terms and conditions.

Eligibility:

• Coverage is available only to eligible members enrolled under the Group Hospital Cash Policy.
• Insurance cover is valid for the period specified in the Certificate of Insurance.

Exclusions:

• Deductible: 0 days
• Initial Waiting Period: Waived
• Specific Disease Waiting Period: Waived
• Pre-Existing Disease (PED) Waiting Period: Waived
• Claims Payout: Reimbursement Only
• The premium quoted is strictly in respect of the coverages described above. No other coverages are included unless specifically agreed.
• Coverage: Hospitalization expenses incurred due to illness or accidental injury.
• Policy Type: Group Health Insurance Policy.
• All benefits are subject to the terms, conditions, exclusions and limits specified in the Policy Wordings and Certificate of Insurance issued by Kshema General Insurance Limited.

Claim Intimation:

Claims should be intimated to Kshema General Insurance Limited as soon as reasonably possible after hospitalization. The insured person may be required to submit the prescribed claim form along with supporting documents, including hospital records, discharge summary and any other documents requested by the insurer for claim assessment.

General Conditions:

• Benefits are payable only for admissible claims covered under the policy.
• Any misrepresentation, fraud or non-disclosure of material facts may result in cancellation of the policy or rejection of the claim.
• The policy is subject to all applicable definitions, terms, conditions, limitations and exclusions contained in the Policy Wordings.

Disclaimer:

This webpage is intended to provide a brief overview of the Group Hospital Cash Policy. The insurance contract is governed solely by the Policy Wordings, Certificate of Insurance, applicable endorsements and the provisions of the Insurance Act, 1938 and IRDAI regulations. In the event of any inconsistency, the policy documents shall prevail.

Customer Support

For any queries regarding your Group Hospital Cash Policy, coverage, claims or policy servicing, please contact Kshema General Insurance Limited:

Toll-Free: 1800 572 3013

Email: support@kshema.co

Website: www.kshema.co

Escalation Matrix

SPOC: Devendra Sharma

Email: devendra.sharma@kshema.co

Mobile: 8879993437

Level 1:

Operations AVP: Ms Niharika Reddy

Email: niharika.m@kshema.co

Mobile: 7981804663

Level 2:

Vamshi Krishna

Email: vamshikrishna.k@kshema.co

Mobile: 9966016341

Kshema General Insurance Toll free number:

For any queries regarding your Group Personal Accident Policy, coverage, claims or policy servicing, please contact Kshema General Insurance’s Customer Support at Toll-Free: 1800 572 3013