bob Government Employee Salary Account (Salary Solutions for Central/State Govt. employees)

Scope of cover/Definitions

Death - The Insurance Company will pay the bank(insured) 100% of the sum assured plus eligible add on covers eligible add on covers if during the Policy Period the Insured Person (s) meets with Accidental Bodily Injury that causes death within policy period.

Permanent Total Disability -In event of injury occurring to the Insured Account holder, solely and directly from accident caused by external, violent and visible means within 12 calendar months of its occurrence resulting in total and irrecoverable loss as total permanent disablement, the claim will be settled as per IRDA guidelines.

Permanent Partial Disability (PPD) - In event of injury occurring to the Insured Account holder, solely and directly from accident caused by external, violent and visible means within 12 calendar months of its occurrence resulting in total and or partial irrecoverable loss of use or the actual loss by physical separation where a part of the body becomes permanently disabled (i.e. partial loss as defined by IRDA)

Air Accident Insurance - In the event of sustain death resulting solely directly from accident caused by external, violent and visible means in Air Accident occurring while undertaking journey by Airlines as well as Service Aircraft( Wherever and as applicable as per policy coverage)

Girl Child Marriage Cover (18 - 25 years) - If a claim is accepted as a valid claim, then this benefit is extended to a Girl Child of the insured person, whose age is between 18-25 years as on date of death of insured person. No marriage certificate on proof of marriage to be sought for providing the cover under this addon cover.

Higher Education Cover - If a claim is accepted as a valid claim, then this benefit is extended to Children of the insured person, pursuing any education above "Higher Secondary School will fall under the Higher Education Cover.

Transportation of dead body /Ambulance Cover - If a PAI claim is accepted as a valid claim, actual expenses (not exceeding limits specified under the policy) incurred on Ambulance expenses for transporting the Accident injured to hospital or transporting the dead body of the insured person from the place of hospital to his/her residence in India.(as per actual upto specified limit)

Cost of Plastic Surgery/Burn - In case the Salary Account Holder (or Insured Person) dies/get disabled partially or totally due to accident tenable under terms and conditions of the policy, the Insurance Company will reimburse the actual costs of plastic surgery incurred in India due to burn following the Accident, insured prior to death/disability of Insured person.

Cost and Transportation of Imported Medicine - If a PAI claim is accepted as a valid claim, actual expenses incurred on purchasing and transporting imported medicine used for the treatment of the accident injured to his treating hospital; from the country of purchase to India the Insurance company will reimburse the actual cost (up to the specified limit as per policy).

• Such medicines, formulations or their alternatives are not available in India, and
• Such medicines are necessary for the medical or surgical treatment of the Insured Person in a Hospital following the Accident.
• Such medicines shall not include any drugs under clinical trial or medicines, formulations or molecules of unproven efficacy

Purchase of Blood - If we have accepted a valid claim under AD, PTD and PPD we will reimburse actual expenses in purchasing blood through a Hospital or lawful blood bank for the required medical or surgical treatment of the Insured Person following the Accident.

Family Transportation - If a claim under AD, PTD and PPD is accepted, we will reimburse actual expenses (not exceeding limits specified under the policy) incurred in transporting two Immediate Family Member to the Hospital, provided that such Hospital is located at least 200 km from the Insured Person’s residence.

Modification of Residence/Vehicle - If we have accepted a claim under AD, PTD and PPD actual expenses (not exceeding limits specified under the policy) incurred to modify the Insured Person’s residential accommodation or the Insured Person’s vehicle necessitated by the accident leading to claim under the policy.

Hospital Confinement Allowance - The per day allowance of INR 2000 with a maximum coverage for 15 days for the entire policy period, if insured is admitted in a hospital due to Injury or Accident that occurs within the Republic of India.

Travel Expenses for 1 relative (in death cases) - The insurer would pay the actual transportation expenses (not exceeding limits specified under the policy) of one relative of the policy holder.

Home convalescence benefit -In some cases a registered doctors recommend one attendant at residence immediately after getting discharged from the hospital, so these actual expenses (not exceeding limits specified under the policy) is covered.

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STANDARD EXCLUSIONS UNDER THE POLICY:

THE FOLLOWING EXCLUSIONS NEED TO BE TAKEN NOTE OF BESIDES THE OTHERS AS PER THE STANDARD GROUP PERSONAL ACCIDENT POLICY: The Company shall not be liable under the policy in respect of payment of compensation in connection with:

• A. Payment of compensation in respect of Death, injury of Disablement of the Insured person a) from intentional self-injury, suicide or attempted suicide, b) whilst under the influence of intoxicating liquor or drugs, alcohol, intoxicating substances c) directly or indirectly caused by venereal diseases, aids or insanity, d) arising or resulting from the insured person committing or attempting to commit any breach of law with criminal intent, e) Whilst engaging in Aviation or Ballooning whilst mounting into, dismounting from or traveling in any balloon or aircraft as per the option chosen.
• B. Payment of compensation in respect of Death, Injury or Disablement of the Insured person due to or arising out of or directly or indirectly connected with or traceable to or caused by or arising from or attributable to: War, Invasion, Act or foreign enemy, Hostilities (whether war be declared or not), Civil War, commotion, unrest, Rebellion, Revolution, Insurrection, Mutiny, Military or Usurped Power Seizure, confiscation or nationalisation or requisition of or damage by or under the order of any government or public local authority, Capture, Arrests, Restraints and Detainments of all kings, princes and people of whatsoever nation condition or quality.
• C. Payment of Compensation in respect of death of, or bodily injury or any disease or illness to the Insured person – a) Directly or indirectly caused by or contributed to, by nuclear weapons/materials or arising from ionising radiations or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel. For the purpose of this exception, combustion shall include any self-sustaining process of nuclear fission. b) Directly or indirectly caused by or contributed to, by or arising from nuclear weapons material. D. The Insurance under this Policy shall not extend to cover death or disablement resulting directly or Indirectly caused, contributed to or aggravated or prolonged by childbirth or pregnancy or in consequence thereof. E. Other than coverages mentioned in policy, any injury while the insured person is mounting into, dismounting from or travelling in any aircraft other than as a passenger (fare paying or otherwise) in any duly licensed standard type of aircraft anywhere in the world. F. Covid and Pandemic/epidemic exclusion. G. All prior acts, pending litigations and known losses are excluded.

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BREAKUP UP OF INSURANCE:

Personal Accident Benefit through the Non-Defence/Civilian Account holders in BOB as mentioned below.

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Annexure I: CLAIMS PROCESS

CLAIM INTIMATION

The claims of the Insured will be intimated through the AON Risk Insurance Brokers India Pvt Ltd, who will co-ordinate with Insurer.

Nodal officer for Insurance Broker will be Mr Abdhesh Thakur & for Insurance Co will be Mr Lalit Kumar.

On receipt of the intimation, the Claim will be registered, and the Insurance Company will be provided with a Letter of Requirements

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The notification of claim shall include:

• Name of the deceased Civilian/Pensioner Salary Package Account Holder
• Salary Account No
• Date of Accident
• Date of Death
• Place of accident
• Details of accident
• Name of the Claimant, their Mobile No. and Email ID
• Name of Bank and Branch/es where salary account is maintained.

Claim intimation should be within one hundred eighty (180) days from the date of accident.

Dept. - Personal Accident for Bank of Baroda A/c holders through Civilian Salary and Pensioners Account Holders.

It is agreed and understood that documentation forms an important component of any insurance claim.

Branch Manager of the Bank where the account exists will send duly filled, signed & stamped claim form along with all the relevant claim documents required to the address mentioned below:

Mr. Abdhesh Thakur
Aon
Aon Risk Insurance Brokers India Pvt Ltd
Tower B, 4th Floor, Pushkar Powercon,
plot – 8, Sector–127, Noida Expressway,
Noida – 201301.

Claim Documents once received will be scrutinized by Aon Risk Insurance Brokers India Pvt Ltd team and the same will be submitted to Insurer. ARIBI will send an acknowledgment of claim receipt to the branch over mail under copy to retail liability.

The Claimant/Nominee shall arrange for submission of the following documents towards substantiation of the claim within 180 days from date of intimation of claim for onward submission to ARIBI:

• All supporting documents relating to the claim must be submitted within one eighty (180) days from the date of accident.
• Bank shall share account opening date at the time of claim
• The eligible claims will be settled in thirty (30) working days from the date of receiving the complete documents set.
• In case documents are not received within one thirty five (135) days of accident, 1st reminder in hard copy letter or email communication shall be issued to Member Bank
• In case of no concrete response/requisite documents 2nd reminder in hard copy letter/email communication will be sent after 15 (Fifteen) days from the date of 1st reminder.
• In case of no concrete response/requisite documents 3rd and Final reminder in hard copy letter/email communication will be sent after (15) days from the date of 2nd reminder

In case of no concrete response and complete requisite documents received within the 180 days from the date of accident, Claim Closure letter/repudiation letter shall be sent to the Bank through email as well as in hard copy.

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INVESTIGATOR APPOINTMENT (SPECIFIC CASES THAT NEED DETAILED INVESTIGATION)

• Based on the merit of the claim, Insurer’s investigation team shall be appointed. TAT: T + 15 working days (T is the day on which the claim documents received from the Bank).
• In 30 working days, Investigation report will be finalized. If there is a delay because of the some more facts, an interim report will be requested.
• In case of any genuine difficulty the above period may be extended with mutual discussion.

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CLAIMS FOLLOW UP / PROCESSING

The reminders shall be sent by AON Risk Insurance Brokers India Pvt Ltd to Bank at regular intervals for pending claim documents, a communication via letter in hard copy / email will be sent to client with defined timeline.

Reminder process would be same for the document’s deficiency also.

1^st reminder T+135 days

2^nd reminder T+150 days

Closure Letter T+165 days

T is Date of Intimation

CLAIM PAYMENT

Once the claim is approved insurance company will release the payment of claim to the Master Policy holder or through the bank's branch nodal account.

• Click Here for Document Check List & Escalation Matrix.

Insurance company : NATIONAL INSURANCE COMPANY LTD

Policy Number : 340100422410000046

Policy effective from 00.00 hours, on 12-08-2024 to midnight of 11-08-2025

Contact : https://nationalinsurance.nic.co.in/contact-us

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