Paragliding Association of India Paragliding in India

Paragliding Accident Insurance Policy





GPGP brochure cover

 

Group Personal Accident Policy for Paragliding / Powered paragliding

PAI Bajaj Allianz GPGP

 

About the new insurance (Introduced 17 October 2016)

The existing insurance cover with NIA is found lacking in terms of claim as it is limiting the claim to least of Actual hospitalisation /Medical spend amount OR 20% of Sum Insured OR Admissible amount. Typically this gets restricted to a very low actual admissible amount to total spent amount ratio. Hence PAI has been in talks with various Insurance providers to get a better deal for its members.

After long deliberations with various Insurance providers and agencies PAI found ‘Group Personal Accident’ Product from Bajaj Allianz as the most suitable option.

 

The Policy

Provider: Bajaj Allianz General Insurance Company Ltd.
Baja Allianz Logo
Policy No.: OG-17-9906-9902-00000006

Product: Group Personal Accident

Period of Insurance: From 00:01:00 15-OCT-16 To 14-OCT-17 Midnight

Insured Name: PARAGLIDING ASSOCIATION OF INDIA

Description: Global Personal Guard Policy (GROUP), Risk Class I

 

Why Bajaj Allianz?

Bajaj Allianz GPGP(Global Personal Guard Policy) provides for a flat hospitalisation coverage subject to valid documents and fitness certificates in place.

Bajaj’s GPGP product has been found to be effectively addressing the current hospitalisation and allied charges in case of an accident. Also the claim process has been tweaked for the PAI members so that claims can be settled effectively.

  1. Covers Paragliding and also other adventure sports. This can also backup for non adventure sports accident claims (Not Health Insurance).

  2. Provides good basic covers for Death and more importantly “comprehensive Hospitalisation Charges”.

  3. Benefit of 10% discount for PAI members under this policy vis a vis their printed premium.

 

Who can get insured?

All PAI members who do not earn their livelihood from paragliding/powered paragliding sport or run a commercial business involving Paragliding.

All PAI members who are professionals having their main income from PG/ Adventure activities will not be covered by this policy. This is a limitation from Bajaj Allianz/IRDA and we are trying to convince them to do away with this clause in future.

The existing NIA policy will be available for all such members who cannot enrol for Bajaj Allianz policy.

Please note, all existing NIA policies will be in effect till the end of the policy subscription and PAI membership status.

 

Policy features:

Policy covers basically the following:

  1. Accidental Death

  2. Permanent Total Disability

  3. Permanent Partial Disability

  4. And 12 optional covers.

    However we recommend going for the Accidental Hospitalization Cover plus the Road and Air Ambulance Cover in combination with the above first 3 covers as it will cover the entire risk involved in a practical manner as enumerated below. This is so as the Hospitalization cover covers the entire gamut of expenses involved right from Hospitalisation to Discharge.

Extract from Hospitalisation Optional Cover of Bajaj GPG Policy

In consideration of payment of additional premium by the Insured to the Company and realization thereof by the Company, it is hereby agreed and declared that Global Personal Guard Policy is extended to cover the Insured Person, if he/ she is Hospitalized for a minimum period of 24 hours on the advice of a Doctor/ Medical Practitioner because of Accidental Bodily Injury sustained during the Policy Period, then the Company will pay the In-patient Treatment- Medical Expenses for the below listed items up to the Sum Insured stated under the heading ‘Accidental Hospitalization Expenses’, in the Policy Schedule, subject otherwise to all other terms, conditions and exclusions of the Policy:

  • Room rent, boarding expenses
  • Nursing
  • Intensive care unit
  • Consultation fees
  • Anesthesia, blood, oxygen, operation theatre charges, surgical appliances
  • Medicines, drugs and consumables,
  • Diagnostic procedures,
  • The Cost of prosthetic and other devices or equipment if implanted internally during a Surgical Procedure.
  • Physiotherapy expenses as recommended by the treating Doctor

Day Care procedure coverage

Waiver of 24 hours hospitalization would be considered under Accidental Hospitalization Expenses for the surgeries/procedures due to technological advancement provided such procedures comply with the standard definition of Day Care Centre and Day Care treatment mentioned in the Policy definitions.

The Pre and Post Hospitalisation expenses payable under day care procedure shall include expenses incurred on Physiotherapy also.

If the claim under Accidental Hospitalization Expenses (including day care procedure) due to Accident of the Insured Person is accepted, then the Company will also pay below expenses:

i. Pre Hospitalization

If the Company has accepted an inpatient Hospitalization claim under Accidental hospitalization Expenses then the Company will also reimburse the Medical Expenses incurred during the 60 days immediately before the Insured Person was Hospitalized for Accidental Bodily Injury, provided that such Medical Expenses were incurred for the same injury for which subsequent Hospitalization was required.

ii. Post-Hospitalization

If the Company has accepted an inpatient Hospitalization claim under Accidental Hospitalization Expenses then the Company will also reimburse the Medical Expenses incurred during the 90 days immediately after the Insured was discharged post Hospitalization provided that, such costs are incurred in respect of the same injury for which the earlier Hospitalization was required.

Specific Exclusion Applicable to Accidental Hospitalization Expenses Cover:

  1. Any Hospitalization for an existing disability from a previous Accident which has occurred prior to the first inception of this Policy.
  2. Any stay in Hospital for an Injury due to Accident without undertaking any treatment.
  3. Any Hospitalization for Accidental Injury aggravated by an existing disability or pre-existing illness / condition / injury.
  4. Any Hospitalization due to an Accidental Injury where the treatment is undertaken by a family member and self medication or any treatment that is not scientifically recognized.
  5. Vaccination and inoculation of any kind unless forming part of treatment for Injury due to an Accident as prescribed by the Medical Practitioner.
  6. Vitamins and tonics unless forming part of treatment for Injury due to an Accident as prescribed by the Medical Practitioner.
  7. Aesthetic treatment, cosmetic surgery and plastic surgery unless necessitated due to Accident or as a part of any Injury.
  8. Treatment taken from persons not registered as Medical Practitioners under respective Medical Councils. .
  9. Any other medical or surgical treatment except as may be necessary solely as a result of Injury.
  10. Any treatment taken outside India.
  11. Whilst engaged in adventure sports, unless specifically covered under the base policy.
  12. Dental treatment or surgery of any kind unless as a result of Accidental Bodily Injury to natural teeth and also requiring hospitalization.
  13. Experimental, unproven or non-standard treatment.

Bajaj Allianz GPGP Brochure - [PDF]

Bajaj Allianz GPGP Plicy Wordings - [PDF]

 

How to apply?

  1. Before you apply you are advised to go through the information available on this page and the linked policy documents. Your decision to apply for the membership confirms that you have read all details and are in agreement with the terms and conditions related to the policy.

  1. Choose the Sum Insured figure from detailed premium sheet.

  1. Download this excel sheet and fill in the personal details. Email the filled excel sheet to insurance@pgaoi.org with subject: New Insurance Request - BAJAJ
  1. PAI Insurance coordinator will respond to your request with premium amount details

  1. Since this is a Group Policy for PAI, the validity of your policy will be as per the Period Of Insurance of the policy and not annual basis. Hence the premium will be on a pro rata basis from date of application till expiry date (i.e. 14th October 2017 for the current policy). The exact amount will be communicated before the payment has to be made.

  1. After getting the confirmation from PAI Insurance coordinator, you must make the payment to PAI account by NEFT/RTGS.

    Account details
    Beneficiary - Paragliding Association of India
    Account No - 60044954528
    Account Type - Savings
    IFSC / RTGS code - MAHB0000084
    MICR Code - 403014002
    Bank - Bank of Maharashtra
    Branch - Panaji Branch, Panaji, Goa.

  2. Please note, it is mandatory to fill up the Payment Confirmation Form after making the payment (applicable for any and all payments made to PAI).

  1. PAI will inform you once the policy is issued by Bajaj Allianz. You will receive the insurance card with your details directly from Bajaj Allianz by post.

 

Claim process

If the Insured Person meets with any Accidental Bodily Injury that may result in a claim, then as a condition precedent to our liability:

a. Policyholder or the Insured Person or someone claiming on his/her behalf must inform us in writing immediately and in any event within 30 days from the date of the accident and submit all documents to us within 30 days from the date of intimation.

b. Insured Person must immediately consult a Doctor and follow the advice and treatment that he recommends.

c. Insured Person must take reasonable steps to lessen the consequence of Bodily injury.

d. Insured Person should allow examination by our medical advisors if we ask for this.

e. Policyholder or Insured Person or someone claiming on his/her behalf must promptly give us documentation and other information we ask for to investigate the claim or our obligation to make payment for it.

f. In case of the Insured Person’s death, someone claiming on his/her behalf must inform us in writing immediately and send us a copy of the post mortem report (if conducted) within 30 days.

*Note: Waiver of conditions (a) and (f) may be considered in extreme cases of hardship where it is proved to Our satisfaction that under the circumstances in which the Insured Person was placed, it was not possible for the Insured Person or any other person claiming on his/her behalf to give notice or file claim within the prescribed time limit.

In case of any claim, please contact Bajaj Allianz 24 Hour Call Centre at 1800-22-5858, 1800-102-5858 (Toll Free) / 91-020-30305858 (chargeable, add area code before this number in case of mobile call) or email at customercare@bajajallianz.co.in with cc to insurance@pgaoi.org

Bajaj Allianz GPGP Claim Form

List of Claim documents in case for Death

  • Duly Completed Claim Form signed by Nominee/ legal heir of the Insured Person.
  • Copy of address proof (Ration card or electricity bill copy).
  • Attested copy of Death Certificate.
  • Burial Certificate (wherever applicable).
  • Attested copy of Statement of Witness, if any lodged with police authorities.
  • Attested copy of FIR / Panchanama / Inquest Panchanama.
  • Attested copy of Post Mortem Report (only if conducted).
  • Attested copy of Viscera report if any (Only if Post Mortem is conducted).
  • NEFT details & cancelled cheque of the Nominee/ legal heir of the insured Person
  • Original Policy copy along with Original Assignment endorsement (if any)

List of Claim documents for Disappearance

  • Duly Completed Claim Form signed by Nominee/ legal heir of the Insured Person.
  • Copy of address proof (Ration card or electricity bill copy).
  • Attested copy confirming disappearance from appropriate authority following a forced landing, stranding, sinking or wrecking of a conveyance
  • Documentary proof of fare paying passenger of a conveyance as an occupant
  • Attested copy of Statement of Witness, if any lodged with police authorities.
  • Attested copy of FIR / Panchanama / Inquest Panchanama.
  • NEFT details & cancelled cheque of the Nominee/ legal heir of the insured Person
  • Original Policy copy along with Original Assignment endorsement (if any)

List of Claim Documents Specific for Accidental Hospitalization Expenses

  • First Consultation letter from the Doctor
  • Duly completed claim form signed by the Claimant
  • Hospital Discharge Card
  • Hospital Bill giving detailed break up of all expense heads mentioned in the bill. Clear break ups have to be mentioned for OT Charges, Doctor’s Consul tation and Visit Charges, OT Consumables, Transfusions, Room Rent, etc.
  • Money Receipt, duly signed with a Revenue Stamp
  • All original Laboratory and Diagnostic Test Reports. E.g. X-Ray, E.C.G, USG, MRI Scan, Haemogram etc.
  • Other documents as may be required by the Company to process the claim

List of Claim Document Specific to Adventure Sports Benefit

  • Certificate of participation from Sports event organizer, only in case of accident arising when participating in any competition / event.
  • Pre participation fitness certificate (very important to procure and keep), and certificate from the treating doctor mentioning the nature of the Injury
  • All Investigation reports
  • Discharge summary (If hospitalized)
  • Documents as listed for claim under Death / Permanent Total Disability
  • PAI Incident report
PLEASE NOTE - PAI is neither the service provider, insurance agent or authority in issuing the policies or settling the claim. PAI is simply extending a facility to PAI members. Acceptance of your request to issue an insurance policy or a claim is at the sole discretion of Bajaj Allianz General Insurance Company Ltd.

For more information or follow up on insurance matters, email insurance@pgaoi.org