Group Personal Accident Insurance Part I

The GPA (Group Personal Accident) policy will cover for injury to employees 24 hours a day regardless of whether they were on official duty or pleasure. it caters for several aspects in event of an injury;

A) Temporary Disability :

based on the number of days off duty that a doctor has awarded the claimant as a result of the injury sustained proof of this are the sick of chits stamped by the doctor attending.

depending on how the policy was arranged, benefit shall be for;

1) the actual daily earnings of the employee per day multiplied by the number of days awarded for sick off

2) or a lump sum per week of injury.

usually the prior is arranged.

B) Permanent Total Disability

this is when the nature of injury is such that the claimant shall not fully recover back to the way they were, say a lost limb or such cases. again the degree of disability is determined by the attending doctor and is based on a percentage say 20% permanent disability.

death in this policy is treated as 100% disability.

C) Medical expenditure ( On reimbursement)

the policy can also reimburse any medical expenses incurred  as a result of the injury and is up to the limit capped by the policy. some policies do not have this feature.

note that the operative word here is reimbursement. spend then we pay you back. thus we shall require the original medical receipts for all payments made.

In summary the documents required are;

• completed claim form (stamped by your organization)
• completed medical certificate (issued by insurance company and written and stamped by the attending doctor)
• medical report copy or treatment notes
• copy of ID of claimant
• copy of three pay slips prior to accident
• original medical bills
• a statement from a witness if one is available ( if injury is result of a road accident then a police abstract)

If the claimant is still undergoing treatment then it is best to just report the claim then be issued with the medical certificate and claim form and submit all documentation once treatment is completed.

we shall discuss how to tabulate the premiums in the next post.