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Group Personal Accident & Health Coverage

MetLife's group personal accident coverage enables employers to provide accident coverage and health benefits for employees

MetLife's Group Personal Accident & Health Insurance is an important means of providing group insurance coverage to your employees. It is designed for companies to give employers and employees peace of mind. It also allows to employtees to reduce the financial impact of their employees’ accidents. Major features include death, disability (both permanent and partial), and medical expenses incurred due to accident only.

Group personal accident coverage (for employees only)

  • In addition to group life, accidental death along with accidental disabilities whether it is partial or total together can be incorporated in the policy
  • AMR can be taken along with group life and accidental death and disability as an additional rider which cover the reimbursement of accidental medical expenses.
  • Group critical illness coverage applicable for employees provides lump sum pay-out to an insured employee for specific 13 deadly diseases. 
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Coverage Details

Accidental Death (AD) Coverage

This coverage provides a lump-sum payment in the event of an employee’s death due to an accident. The insured amount of Accidental Death will be equal to Group Life coverage.

Accidental Permanent Total Disability (APTD)

This rider provides a benefit when an employee is totally disabled on a permanent basis due to an accidental injury. Under this type of coverage, the face amount is paid to the employee in monthly instalments for up to 60 months or in a lump sum if the type of disability warrants so.

Accidental Permanent Partial Disability (APPD)

This benefit is payable if an employee becomes partially disabled on a permanent basis as a result of an accidental bodily injury. A percentage of the coverage is paid based on the extent of disability.

You can add the following supplementary rider to the basic Group Personal Accident coverage:

Accidental Medical Reimbursement (AMR):

This rider provides an expense reimbursement benefit to cover the cost of medical care that is received as a result of a covered accident. It is a 24-hour and year-round coverage. The company will reimburse reasonable, customary and necessary medical expenses that are incurred within fifty two (52) weeks from the date of the accident, if they are the result of a covered injury, and commencing within thirty (30) days after the date of the injury. This includes a doctor treatment, hospital charges and the employment fees of a licensed or graduate nurse while at the hospital, which are in excess of the deductible (if any) stated in the schedule of benefits. The payable amount to the insured person is in accordance with and will not exceed the classification of the insured person and the schedule of benefits as the result of any one accident.

Critical Illness:

Group Critical Illness provides lump sum pay-out flat monetary benefits for certain terminal illnesses to an insured employee. These covered terminal illnesses are:

  1. Cancer
  2. Stroke
  3. Heart Attack
  4. Serious Coronary Disease
  5. Heart Valve Replacement
  6. Pulmonary Arterial Hypertension
  7. End Stage Lung Disease
  8. End Stage Liver Disease
  9. Fulminated Hepatitis
  10. Kidney Failure
  11. Coma
  12. Aplastic Anemia
  13. Major Organ / Bone Marrow Transplant

A minimum of 25 employees is required, while 100% of the employees should be included.

Eligibility Criteria

All full-time permanent employees, who have not reached their sixtieth- (60th) birthday, and are actively at work in the policyholder’s offices in the country of coverage. The Age limit may be extended on case to case basis especially when coverage is renewed. Employees engaged in some risky occupations or industries are not covered.

 

Participation Requirements

100% of all eligible employees must be enrolled.

Payment Modes

Flexible payment modes are available ranging from annual to quarterly.

Glossary of Insurance Terms

This PDF file provides a glossary of insurance terms and definitions that are commonly used in the insurance business. Click Here