If I die in an accident, does my family get money from both my life insurance and my PA policy?

Yes. Personal Accident insurance and life insurance operate independently — a claim on one does not affect the other. If you hold ₹1 crore of life cover and ₹50 lakh of PA cover and die in an accident, your family receives ₹1.5 crore in total: ₹1 crore from the life policy and ₹50 lakh from the PA policy. This is one of the strongest reasons to hold a standalone PA policy alongside term life.

My employer provides ₹30 lakh group accident cover. Is that enough?

Usually not. For a professional earning ₹10–25 lakh a year, ₹30 lakh covers barely one to three years of income — far short of the 10–15× income benchmark. More importantly, employer group PA ends the day you resign or are laid off, leaving you uninsured during any job gap. Treat group cover as a top-up, and hold your own ₹1–2 crore individual PA policy as a permanent, portable base.

Can I claim Section 80D for my Personal Accident premium?

No — this is the most common misconception. A standalone PA policy is a benefit-based general insurance product, not health insurance, so its premium does not qualify under Section 80D (which covers mediclaim and preventive health check-ups) or under Section 80C. There is no income-tax deduction for an individual buyer. GST is charged at 18% on the premium. Only a business buying Group PA for employees can deduct the premium — as a business expense under Section 37(1).

Conceptual · Article 7.3.9

Personal Accident Insurance.

Q: Does PA insurance cover injuries during cricket, trekking, or adventure sports?

Standard PA policies typically cover injuries during routine recreation such as playing cricket or amateur running. But most exclude defined hazardous or competitive activities — motorsport, high-altitude mountaineering, skydiving, bungee jumping — unless you add a specific endorsement. If you pursue adventure sports regularly, read the exclusions clause and buy an endorsement or specialist cover; assuming you are covered can void a claim.

The One Cover That Pays You When an Accident Stops Your Income.

Published as on 15 July 2026

Personal Accident Insurance is an IRDAI-regulated general insurance policy that pays a fixed lump sum — or a weekly benefit — if an accident kills you, permanently disables you, or temporarily keeps you from working. It does the one thing no other cover does: it replaces the income an accident takes away. Your health policy pays the surgeon; your life policy pays only if you die. Neither writes you a cheque while a shattered pelvis keeps you off work for three months. Sized at 10–15× annual income, a standalone PA policy is the missing layer in most earning Indians' protection — and, unlike health cover, its premium earns no Section 80D deduction.

10–15×

Income → Sum Insured

₹2.5L–₹1Cr

Saral Suraksha SI

100% CSI

Accidental Death

No 80D

Not Deductible

Executive Summary · Page 2

Executive Summary · 6 Findings

Personal Accident Insurance answers a question no other policy does: what pays you when an accident — not an illness — stops your income? Health insurance settles the hospital bill. Life insurance pays only if you die. Between them sits the largest uninsured risk most earners carry: permanent or temporary disability that ends a salary while every EMI keeps arriving. A PA policy fills exactly that gap, paying a fixed benefit for death, disablement, or weeks lost to injury. The catch most buyers miss — it is a benefit cover, not health insurance, so the premium earns no 80D deduction, and it must be sized to your income, not your hospital bills.

Covers what PA insurance is and how it differs from health and life cover, the IRDAI-standard Saral Suraksha Bima, the four covers (Accidental Death, Permanent Total and Partial Disability, and optional Temporary Total Disability) and what each pays, the standard exclusions, occupation-based risk classes, how to size cover at 10–15× income, the individual-vs-group-vs-ADB-rider choice, the tax position (no 80D, no 80C; GST at 18%; payouts generally tax-free), and six questions Indian buyers ask.

Key Findings

Income protection, not a hospital bill.

PA insurance pays a fixed, pre-agreed benefit when an accident causes death, disability, or time off work. It is not indemnity — there is no bill to reconcile. If a road accident leaves you bedridden for three months, your health policy pays the hospital; your PA policy pays you a weekly allowance while your salary stops. That income risk is what no other product covers.

Saral Suraksha Bima — the IRDAI standard.

Since 1 April 2021 every general and standalone health insurer must offer Saral Suraksha Bima, a standardised PA product with uniform wording. Sum insured runs from ₹2.5 lakh to ₹1 crore (in ₹50,000 steps), entry age 18 to at least 70, dependent children 3 months to 25 years. For cover above ₹1 crore, comprehensive non-standard policies go higher.

Four covers, four payout structures.

Accidental Death pays 100% of the Capital Sum Insured to the nominee. Permanent Total Disability also pays 100%. Permanent Partial Disability pays a set percentage from a schedule (one eye 50%, for example). Temporary Total Disability — an optional cover — pays a weekly benefit of 0.2% of CSI, up to 100 weeks, after a four-week wait.

Size it at 10–15× annual income.

Permanent disability ends your future earning capacity as surely as early death, so PA cover should mirror the logic of life insurance — a minimum of 10–15× annual income, not 1×. The most common and costly mistake is a ₹10–20 lakh policy on a ₹15–20 lakh salary. A PTD event takes away all future income, not one year's worth.

Not health insurance — so no Section 80D.

A standalone PA premium earns no income-tax deduction for an individual — not under 80D (mediclaim only) and not under 80C. GST is charged at 18%. Only a business buying Group PA for staff can deduct the premium, under Section 37(1). Claim payouts — death, disability, weekly benefit — are generally treated as non-taxable capital receipts.

Individual is the portable base; group ends with the job.

Most professionals rely on employer group PA and an accidental-death rider on a life policy. Both leave gaps: group cover ends the day you resign, and an ADB rider pays only on death — never for disability or lost income. A standalone individual PA policy is the permanent, portable foundation; everything else is a top-up.

At A Glance

Metric	Value	Detail
Regulator	IRDAI	General insurance
Type	Benefit cover	Fixed payout
Saral SI	₹2.5L–₹1Cr	₹50k multiples
Sizing rule	10–15× income	Underwriting norm
AD / PTD payout	100% CSI	To nominee
TTD benefit	0.2%/week	Max 100 weeks
Tax	No 80D	GST 18%
Best use	Every earner	Portable base

Exhibit 01: What Each Cover Pays

Event	Payout	Note
Accidental Death	100% CSI	Within 12 months
Perm. Total Disability	100% CSI	Both limbs / sight
Perm. Partial Disability	% per table	One eye 50%
Temp. Total Disability	0.2% / week	Max 100 weeks

Illustrative, based on Saral Suraksha Bima standard wording. Comprehensive non-standard policies may differ — verify your policy schedule. TTD is an optional cover with a four-week waiting period. CSI = Capital Sum Insured.

The Opening · Page 3

The Opening

Personal Accident Insurance is the simplest promise in general insurance: if an accident kills you, disables you, or stops you working, the insurer pays a fixed, pre-agreed sum. There is no hospital bill to reconcile, no reimbursement to negotiate — the payout is a defined benefit, not an indemnity. That single design choice is what separates PA from every mediclaim policy you hold. Mediclaim reacts to expenses; PA reacts to the event and to the income it destroys.

"Your health policy pays the surgeon. Your life policy pays only if you die. Neither writes you a cheque while a broken back keeps you off work for six months — and that lost income, not the hospital bill, is often the larger financial blow."
Income, Not Indemnity

The mechanics. A PA policy defines a Capital Sum Insured and a schedule of outcomes. Accidental death and permanent total disability each pay the full sum; a partial permanent loss pays a fixed percentage; and, if you add the temporary cover, a weekly benefit replaces income during recovery. Because the amounts are agreed in advance, claims are cleaner than indemnity mediclaim — the insurer verifies the event and the disability, not a stack of invoices.

The gap most people carry. Ask a salaried professional if they are covered for an accident and they will point to employer group PA and an accidental-death rider on a life policy. Both are real, and both are incomplete: the group cover vanishes the day they leave the company, and the rider pays only on death. The disability that ends a career — but not a life — is precisely the risk left uninsured.

What PA is NOT: it is NOT health insurance — it pays no routine hospital bills and earns no Section 80D deduction. It is NOT a substitute for life cover — its death benefit is narrow, triggered only by accidents. It is NOT the ₹15 lakh CPA cover bundled with your car — that pays only for accidents in that vehicle. It IS the one policy that replaces lost earning capacity when an accident, not an illness, takes your income away.

Structure

Part I

What PA Is, Why It's Not Health Insurance & Where It Fits

Part II

The Four Covers, the PPD Schedule & the Exclusions

Part III

How Much You Need, Occupation Class & Which Policy to Buy

Part IV

The Verdict: The Tax Truth & the Bottom Line

You Need Standalone PA If

✓ Others depend on your income

✓ Your only cover is employer group PA

✓ You carry EMIs or dependents

✓ Your work has field or travel risk

The Gaps to Watch

✕ Group cover ends the day you resign

✕ An ADB rider pays only on death

✕ The ₹15L CPA covers one vehicle

✕ Health cover pays no lost income

Part I

What Personal Accident Insurance Is, Why It Is Not Health Insurance, and Where It Fits

The benefit-based mechanics that pay for lost income rather than hospital bills; the three ways Indians hold accident cover — individual, group, and life-policy rider; and the IRDAI-standard Saral Suraksha Bima that sets a uniform baseline across every insurer.

Part I · Page 4

Three Ways to Hold Cover

Route	Covers	Portable
Individual PA	AD + PTD + PPD + TTD	Fully
Group PA (employer)	Usually all	Ends at exit
ADB rider (life)	Death only	With life policy

An individual policy is bought by and follows the person; group PA is bought by an employer or association and lapses when the relationship ends; an Accidental Death Benefit rider is an add-on to a life policy that pays extra only if death is accidental. The rider is the most limited — it never covers disability or income loss, which is where the greatest financial risk often lies.

Not Health Insurance

Two Different Risks

Health insurance is indemnity: it reimburses hospitalisation and treatment costs against bills. PA insurance is a defined benefit: it pays a fixed sum for a defined injury or death, regardless of medical spend. A spinal injury may cost ₹10–15 lakh in medical bills — covered by health insurance — yet erase ₹50 lakh to ₹1 crore-plus of future income, which only PA addresses. They are complements, not alternatives.

Saral Suraksha Bima — the IRDAI Standard

Feature	Detail
Sum insured	₹2.5 lakh – ₹1 crore
Steps	Multiples of ₹50,000
Entry age	18 to at least 70 yrs
Children	3 months – 25 yrs
Base covers	AD, PTD, PPD
Optional	TTD, hospital, education
Effective	1 April 2021

Saral Suraksha Bima is the PA equivalent of Bharat Griha Raksha (home) and Bharat Yatra Suraksha (travel) — a baseline product with identical coverage and wording across insurers, so buyers compare on price and service, not fine print. For cover above the ₹1 crore ceiling, comprehensive non-standard PA policies from individual insurers offer higher limits, typically to ₹2 crore or more.

Where it fits: a standalone individual PA policy is the permanent foundation for every earning adult — and for many non-earners too. Saral Suraksha Bima covers homemakers, students, and seniors up to at least 70; some insurers value a homemaker's cover on the notional economic worth of household services. The standard product is a clean starting point; the comprehensive versions add sum insured and add-ons.

Part II

What a PA Policy Pays — the Four Covers, the PPD Schedule, and What It Excludes

How Accidental Death, Permanent Total and Partial Disability, and the optional Temporary Total Disability benefit each pay out; the partial-loss compensation table that turns an injury into a percentage; and the standard exclusions every buyer must read before signing.

Part II · Page 6

The Four Covers

Accidental Death (AD)

The nominee receives 100% of the Capital Sum Insured, provided death follows the accident within 12 months. Example: Rohan, a 34-year-old engineer with ₹50 lakh CSI, dies in a road accident — his family receives ₹50 lakh, on top of any life insurance.

Permanent Total Disability (PTD)

Pays 100% of CSI where an accident permanently and totally removes the ability to work — loss of sight of both eyes, of both hands or feet, or any injury that permanently disables the insured from any occupation.

Permanent Partial Disability (PPD)

Pays a set percentage of CSI from a compensation schedule — 50% for loss of sight of one eye, 40% for four fingers and thumb of one hand, and so on. Anything unlisted is assessed by a qualified medical practitioner.

Temporary Total Disability (TTD) — Optional

A weekly benefit of 0.2% of base CSI, for up to 100 weeks, after a four-week waiting period. Example: Priya, with ₹20 lakh CSI, fractures her pelvis and misses 12 weeks — 0.2% × ₹20 lakh = ₹4,000/week, or ₹48,000 over the period.

Sample PPD Schedule (Saral Suraksha)

Type of Loss	% of CSI
Sight of one eye	50%
Both ears (hearing)	50%
Four fingers + thumb, one hand	40%
Four fingers, one hand	35%
Thumb (both phalanges)	25%
Great toe (both phalanges)	20%
One ear (hearing)	20%

Extract of the Saral Suraksha Bima standard table. Comprehensive non-standard policies may use different or more detailed schedules — payout for the same loss can vary 30–50% between policies, so read the schedule before buying.

What PA Does Not Cover

Standard Exclusions

Suicide or intentional self-harm; injury under the influence of alcohol or drugs; pregnancy and childbirth; war and nuclear risk; hazardous activities (motor racing, mountaineering, skydiving) without endorsement; pre-existing deformities; HIV/AIDS; mental or psychiatric disorders; and aviation other than as a fare-paying passenger on a scheduled flight.

A Note for Active Professionals

Routine recreation — cricket, amateur running — is generally covered. But if you ski, trek at altitude, or race, verify the sports-exclusion clause and buy a specific endorsement. Add-ons worth having: medical-expense reimbursement, education grant (10% of CSI per child under Saral Suraksha), hospital cash, and repatriation.

Part III

How Much Cover You Need, Occupation Class, and Which Policy to Buy

Why cover should be sized at 10–15× income rather than a token lakh or two; how comprehensive insurers price by occupation risk, and why an honest declaration matters; and the individual-vs-group-vs-rider choice that decides whether you stay insured when you change jobs.

Part III · Page 8

How Much: 10–15× Income

The working benchmark is a minimum of 10–15× annual gross income, mirroring life-insurance logic: permanent total disability eliminates future earnings just as effectively as early death. A ₹15 lakh policy on a ₹18 lakh salary insures a single year of income against a lifetime's loss.

Worked Example — Kaveri, 32, CA

Earning ₹18 lakh a year, Kaveri needs ₹1.8 crore of PA cover (10×). Her employer gives ₹30 lakh group PA, leaving a ₹1.5 crore gap. A comprehensive Class-A policy of ₹1.5 crore, no add-ons, runs an indicative ₹15,000–22,500 a year — a small outflow to protect an income stream worth ₹1.8 crore-plus annually. Since Saral Suraksha caps at ₹1 crore, she reaches ₹1.5 crore via a non-standard comprehensive policy.

Occupation Risk Classes

Class	Who	Risk
Class 1	Desk / IT / teachers	Lowest
Class 2	Supervisors / sales	Moderate
Class 3	Skilled manual	Higher
Class 4	Construction / mining	Highest

Saral Suraksha does not price by occupation; comprehensive policies do. Class-4 premiums can be 2–4× Class-1 for the same sum insured. Declaring a lower class to cut premium is material misrepresentation and voids the claim.

Individual vs Group vs ADB Rider

Feature	Individual	Group	ADB
AD cover	Yes	Yes	Yes
Disability	Yes	Usually	Rarely
TTD income	Optional	Often	No
Portable	Yes	No	With life
You set SI	Yes	No	No

Most working Indians hold an inadequate mix. Employer group PA is often just 2–3× salary, and it vanishes the day you resign or are laid off — if a new employer has not yet enrolled you, you are uninsured, sometimes for weeks. An ADB rider adds only accidental-death cover, never disability. Individual PA is the only layer you fully control.

The gap most professionals miss: the resignation cliff. Group PA ends with employment; there is no grace period. A permanent ₹1–2 crore individual PA policy eliminates that exposure entirely, and lets you set the sum insured to your income rather than your employer's HR policy. Use group cover and the CPA as top-ups on a base you own.

Part IV

The Verdict

Insure the income, not just the hospital bill.

Part IV: The Verdict · Page 10

30-Second Summary

Personal Accident Insurance is an IRDAI-regulated benefit cover that pays a fixed sum for accidental death or permanent disability, and — with the optional temporary cover — a weekly benefit while an injury keeps you off work. The IRDAI-standard Saral Suraksha Bima runs from ₹2.5 lakh to ₹1 crore; comprehensive policies go higher. It is the one product that replaces lost earning capacity, a risk neither health nor life insurance covers.

Size cover at 10–15× annual income, declare your occupation honestly, and read the PPD schedule and exclusions before buying. Hold an individual policy as your permanent, portable base; treat employer group PA and the ₹15 lakh motor CPA as top-ups. And be clear on tax: a standalone PA premium earns no 80D or 80C deduction, GST is 18%, and payouts are generally tax-free. The premium is trivial against the income it protects.

"A life policy answers what happens to your family if you die. A health policy answers who pays the hospital. Personal Accident answers the question the other two leave open — who pays you when an accident ends your ability to earn, but not your life. For most working Indians, that is the largest uninsured risk they carry."
The Missing Layer

The Bottom Line: Every earning adult should hold a standalone PA policy sized at 10–15× income — sovereign of your own protection, portable across jobs, and cheap relative to the income at stake. Start with Saral Suraksha Bima for simplicity, or a comprehensive policy for higher cover and add-ons like TTD, medical expense, and education grant. Declare your occupation truthfully; a false class voids the claim when it matters most. Do not lean on employer group cover or your car's CPA — both are narrow and impermanent. And do not expect a tax break: the value is the protection, not a deduction.

ADWIZR · July 2026

Decision Rules

Use Correctly As

✓ Income protection at 10–15×

✓ A permanent, portable base

✓ Disability + death cover, not just death

✓ A complement to health & life cover

Do Not Treat It As

✕ A health / mediclaim substitute

✕ A tax-saving instrument

✕ Covered by an ADB rider alone

✕ Replaced by employer group PA

Three Misconceptions

What Buyers Get Wrong

(1) "PA is just another health policy." No — it pays a fixed benefit for lost income, not hospital bills, and earns no 80D. (2) "My employer's cover is enough." It is usually 2–3× salary and ends the day you resign. (3) "My car insurance already covers accidents." The ₹15 lakh CPA covers only accidents in that vehicle — not at home, work, or on foot.

The Tax Position (FY 2025-26)

No Deduction for Individuals

An individual's PA premium qualifies for no income-tax deduction — not 80D (mediclaim only), not 80C. GST is charged at 18%. A business buying Group PA for employees deducts the premium under Section 37(1). Claim payouts — death, disability, weekly benefit — are generally treated as non-taxable capital receipts.

10–15×

Income

Sum-insured rule

100% CSI

Death / PTD

+ PPD % & weekly TTD

No 80D

Tax

GST 18%, payout tax-free

Investor FAQ

Questions Indian Buyers Ask

Six questions, answered directly.

Investor FAQ · Page 12

Frequently Asked Questions

Q1 Do my family get both my life insurance and my PA payout?

Yes. PA insurance and life insurance operate independently — a claim on one does not affect the other. Hold ₹1 crore of life cover and ₹50 lakh of PA cover, die in an accident, and your family receives ₹1.5 crore in total: ₹1 crore from the life policy and ₹50 lakh from the PA policy. This is one of the strongest reasons to hold a standalone PA policy alongside term life.

Q2 My employer gives ₹30 lakh group cover. Is that enough?

Usually not. For a professional earning ₹10–25 lakh a year, ₹30 lakh is barely one to three years of income — far short of the 10–15× benchmark. More importantly, group PA ends the day you resign or are laid off, leaving you uninsured during any job gap. Treat group cover as a top-up and hold your own ₹1–2 crore individual policy as a permanent, portable base.

Q3 Can I claim Section 80D for my PA premium?

No — this is the most common misconception. A standalone PA policy is a benefit-based general insurance product, not health insurance, so its premium does not qualify under Section 80D (mediclaim and preventive check-ups only) or under Section 80C. There is no income-tax deduction for an individual buyer, and GST is charged at 18%. Only a business buying Group PA for employees can deduct the premium — as a business expense under Section 37(1).

Q4 Does PA cover injuries during cricket, trekking, or adventure sports?

Standard policies typically cover routine recreation such as playing cricket or amateur running. But most exclude defined hazardous or competitive activities — motorsport, high-altitude mountaineering, skydiving, bungee jumping — unless you add a specific endorsement. If you pursue adventure sports regularly, read the exclusions clause and buy an endorsement or specialist cover; assuming you are covered can void a claim.

Q5 I already have health insurance. Do I still need PA cover?

Yes — they insure different risks. Health insurance pays hospitalisation and treatment costs. PA insurance compensates for lost earning capacity. A spinal injury might cost ₹10–15 lakh in medical bills (covered by health insurance) yet end your ability to work for years — a ₹50 lakh to ₹1 crore-plus loss of income that only a PA policy addresses. The second, larger risk is the one health cover leaves open.

Q6 Isn't the ₹15 lakh cover with my car insurance enough?

No. Every owner-driver in India carries a Compulsory Personal Accident (CPA) cover of ₹15 lakh through their motor policy, but it pays only for accidents while driving the insured vehicle. A standalone PA policy covers you across all circumstances — at home, at work, while travelling, on foot. The CPA is a narrow, vehicle-linked minimum, not a substitute for income-sized personal accident protection.

Key Terms & Definitions

Personal Accident (PA) Insurance

An IRDAI-regulated general insurance policy that pays a fixed, pre-agreed benefit for accidental death, permanent disability, or — optionally — temporary inability to work. Unlike indemnity health insurance, it compensates for lost income rather than reimbursing medical bills.

Capital Sum Insured (CSI)

The headline sum on a PA policy. Accidental death and permanent total disability each pay 100% of CSI; partial disability pays a scheduled percentage; the weekly temporary benefit is calculated as 0.2% of base CSI. Should be set at 10–15× annual income.

Permanent Total Disability (PTD)

An accident that permanently and completely removes the ability to work — such as loss of sight of both eyes or of both hands or feet. Pays 100% of the Capital Sum Insured, the same as accidental death.

Permanent Partial Disability (PPD)

A permanent but partial loss — of a finger, toe, eye, or ear — that pays a fixed percentage of CSI from a compensation schedule. Unlisted losses are assessed by a qualified medical practitioner; schedules vary 30–50% between policies.

Temporary Total Disability (TTD)

An optional cover paying a weekly income benefit — 0.2% of base CSI — while an accident keeps you off work, for up to 100 weeks, after a four-week waiting period. This is the cover that most directly replaces a stopped salary during recovery.

Compulsory Personal Accident (CPA) Cover

A mandatory ₹15 lakh accident cover bundled with every motor policy (or bought standalone), protecting the owner-driver — but only for accidents while driving the insured vehicle. Not a substitute for an all-circumstances standalone PA policy.