Twenty-Four-Hour Worldwide Cover

Employees are protected all day, every day, wherever they are. The cover applies whether they are on duty or off duty, in India or abroad.

No Medical Tests Needed

Insurers allow employers to add employees in bulk without asking for medical checks. This means the cover can start quickly, even for large teams.

Easy Add–Delete Process

HR teams simply upload a monthly list of new joiners and leavers. The insurer updates the cover accordingly by issuing an endorsement. This keeps the group list accurate with little effort.

Flexible Sum-Insured Method

Employers can choose how much coverage to give. They may set the same sum insured for everyone or link the amount to job level or salary. This helps balance protection with cost.

Businesses of Every Size

Micro, Small, and Medium Enterprises (MSMEs) benefit from GPA as it protects them from sudden compensation payouts that they may not be able to manage. Large companies use it to strengthen their employee benefits and show their commitment to staff welfare.

High-Risk Industries

Sectors such as construction, manufacturing, mining, logistics, oil and gas, power utilities, and agriculture involve frequent exposure to travel, machinery, or site work. These industries must protect their workforce from job-related accidents.

Service-Sector Employers with Mobile Staff

IT companies, sales teams, e-commerce platforms, courier services, banking agents, healthcare workers, and hospitality staff often travel for work. Road accidents and outdoor exposure increase their risk, making GPA essential.

Gig-Economy Platforms and Staffing Agencies

Cab aggregators, food delivery apps, and manpower suppliers can offer GPA to drivers and contract workers. This helps build loyalty and fills a key protection gap for temporary staff.

Educational Institutions and Training Centres

Schools, colleges, coaching classes, and vocational centres can use GPA to protect students, teachers, and staff during lab work, sports events, industrial visits, or trips.

Clubs, Associations, and Societies

Resident welfare associations, sports clubs, trade groups, and professional bodies can arrange group cover for their members. Pooling risk makes the policy affordable and inclusive.

Government Departments and Public-Sector Units

Central, state, and local authorities with field staff—such as police, health inspectors, or sanitation workers—use GPA to meet welfare standards and provide protection on duty.

Non-Governmental Organisations (NGOs) and Charities

Field volunteers, social workers, and medical teams often serve in remote or risky areas. GPA offers financial protection to them and peace of mind to the organisation.

Start-Ups Offering Modern Benefits

New-age companies in tech, D2C, and services can add GPA to their benefit plans. It adds value along with health insurance and stock options, helping attract and retain talent.

Any Employer Seeking Goodwill and Compliance Support

Even when not required by law, GPA shows the company takes its duty of care seriously. It builds goodwill, improves retention, and protects against sudden financial loss from accidents.

Illness or Natural (Non-Accidental) Death

The policy only pays when death or injury is caused by a sudden, external, and visible accident. It does not cover death due to illness, disease, or natural causes such as a heart attack.

Example: An employee at a factory in Hyderabad passed away in his sleep due to a stroke. As there was no accident involved, the insurer did not pay the claim under the Group Accident Policy.

Suicide or Intentional Self-Injury

If the injury or death is the result of self-harm or suicide, the claim is excluded. The insurer does not cover deliberate acts that cause harm to oneself.

Example: An office employee in Delhi was hospitalised after an intentional overdose. Since the injury was self-inflicted, the Group Personal Accident Insurance claim was rejected.

Accidents Under the Influence of Alcohol or Drugs

If the insured person is under the influence of alcohol, drugs, or banned substances at the time of the accident, the policy does not provide any benefit.

Example: A marketing executive in Pune met with a bike accident while riding under the influence of alcohol. The insurer denied the Group Personal Accident Insurance claim after the hospital report showed alcohol in his system.

War, Civil Unrest, or Terrorism (Including Nuclear, Chemical, or Biological Weapons)

Standard GPA policies do not cover events related to war, riots, rebellion, or terrorist attacks. Injuries caused by nuclear or chemical exposure are also excluded.

Example: A security guard was injured during a violent protest outside a government building in Kolkata. As the situation was linked to civil unrest, the Group Personal Accident Insurance claim was not payable under the Group Accident Policy.

Hazardous or Adventure Sports, Racing, or Non-Commercial Aviation

Accidents during high-risk activities such as skydiving, paragliding, motor racing, or flying as a non-paying passenger in a private aircraft are not covered—unless the employer has added special coverage.

Example: An employee from a travel agency in Manali went bungee jumping during a weekend trip and suffered a spinal injury. Since the activity was classified as hazardous, the Group Personal Accident Insurance Policy did not cover it.

Criminal or Illegal Acts

If the employee is injured while committing a crime or participating in any illegal activity, the policy excludes the claim.

Example: A delivery agent in Bengaluru was involved in a road accident while evading police during an unauthorised late-night delivery. As the act was against company policy and considered unlawful, the insurer declined the Group Personal Accident Insurance claim.

Pre-Existing Disabilities or Diseases

If an existing medical condition contributes to the injury or worsens the outcome, the claim may be denied. Group Personal Accident Insurance is designed to cover new and sudden accidents—not complications from old issues.

Example: A worker in Indore slipped at the workplace. However, the hospital report stated that a prior leg condition had worsened the fall. The insurer paid only for the fresh injury and denied the rest related to the pre-existing condition.

Pregnancy, Childbirth, or Related Medical Complications

Any accident or medical emergency that arises from pregnancy, childbirth, miscarriage, or abortion is excluded. These are considered medical issues, not accidental events.

Example: A receptionist in a Mumbai clinic was admitted for pregnancy-related complications. Even though the situation was sudden, the insurer did not pay, as the Group Personal Accident Insurance Policy does not cover maternity-related issues.

Ionising Radiation or Nuclear Contamination

Exposure to nuclear radiation or radioactive materials is not covered. These risks are typically handled by government disaster funds or special policies.

Example: A worker at a scientific lab in Gujarat developed radiation-related illness after an accidental exposure. The Group Personal Accident Insurance claim was not admitted, since such events fall outside the policy’s scope.

1. Company Registration Proof

Any valid document confirming the legal status of the business:

• GST registration certificate
• Shops and Establishment licence
• MSME registration
• CIN from the Ministry of Corporate Affairs (MCA)

Why it is needed

To confirm that the employer is a registered business eligible for group insurance.

2. PAN Card and Premium-Payment Proof

Insurers always ask for the company’s PAN and a receipt or transaction record of the premium payment.

Why it is needed

For tax compliance and to initiate policy processing after payment.

3. Employee List with Details

A census in Excel format, including:

• Full name
• Gender
• Date of birth
• Employee ID or code
• Designation or job role
• Monthly salary or CTC
• Work location

Why it is needed

To enrol members, fix coverage levels, and calculate the total premium—especially for salary-linked plans.

4. Claim or Loss History (if available)

Details of previous accident claims or GPA losses made under any earlier policy.

Why it is needed

To help the insurer assess risk and decide on pricing or coverage terms.

5. Occupation Split (usually requested)

A breakdown of the employee group by job role—such as drivers, site workers, sales staff, and office workers.

Why it is needed

To apply the correct premium rates and assess risk across different job categories.

6. Address Proof of the Company

Only required if the KYC documents provided earlier do not clearly show the current business address. Accepted documents include utility bills, rental agreements, or trade licences.

Why it is needed

For accurate policy documentation and communication, if not already covered under KYC.

7. Board Resolution or Authorisation Letter (if applicable)

Needed only if the policy is being managed by a third-party HR firm or consultant.

Why it is needed

To confirm that the person handling the insurance has been authorised by the employer.

8. Past Policy Copy (if renewing or switching insurer)

Required if the company is continuing or migrating an existing GPA Policy.

Why it is needed

To ensure continuity of cover and reference for matching existing terms or claim history.

9. Proposal Form

A standard form provided by the insurer that includes policy details, sum insured, coverage options, and declarations.

Why it is needed

To formally request and activate the group policy.

1. Incident or Accident Report

A written report prepared by the employer or safety officer describing how, when, and where the accident occurred.

• For road accidents or public-place injuries, a Police FIR or medico-legal certificate (MLC) must also be submitted.

Why it is needed

To confirm that the event qualifies as an accidental injury under the policy.

2. Medical Reports and Treating Doctor’s Certificate

Includes admission records, X-rays, MRI or CT scan results, discharge summary, and a certificate from the attending doctor stating:

• The nature and cause of the injury
• The extent of disability
• Recovery timeline or confirmation of permanent damage

Why it is needed

To validate the claim medically and confirm whether the disability is total, partial, or temporary.

3. Disability Certificate

Issued by a registered medical practitioner or authorised government doctor. It must clearly state the type and percentage of disablement.

Why it is needed

To grade the injury (TTD, PPD, or PTD) and support the claim amount calculation.

4. Basic KYC Documents and Policy Copy

Submit the following:

• A government-issued photo ID (such as Aadhaar, PAN, or Voter ID)
• A copy of the active GPA Policy

Why it is needed

To establish identity and confirm that the employee was covered at the time of the accident.

5. Employee ID and Salary Proof

Submit the following:

• Official employee ID card issued by the company
• Latest payslip or salary certificate

Why it is needed

To confirm that the claimant is part of the insured group and determine the sum insured, especially under salary-linked plans.

6. Leave Records or Attendance Statement (for Temporary Total Disablement only)

Shows the number of workdays missed due to the injury, usually issued by the HR or payroll department.

Why it is needed

To calculate weekly payouts during the recovery period.

7. Bank Account Details

Submit any one of the following:

• Cancelled cheque
• Bank passbook copy or account statement with account number and IFSC code

Why it is needed

To transfer the claim amount directly to the employee’s or nominee’s bank account.

Submit Documents at the Hospital

Go to the hospital’s cashless desk and give them the following:

• Your insurance card
• Your employee ID
• A valid government ID (such as Aadhaar or PAN card)

Fill the Cashless Request Form

The form will ask for basic details such as:

• Insurance card number
• Employee code
• Policy number
• Your name and patient’s name
• Age and contact number

Doctor Completes Medical Details

The attending doctor will fill in the diagnosis, suggested treatment, estimated cost, and number of days of hospital stay. The hospital will then send this form to the insurance company for approval.

Approval from Insurer

The insurance company usually responds within three hours. The hospital will receive either an approval or a query via email or fax. If there is any delay, you can follow up with the hospital’s cashless helpdesk.

During Hospital Stay

If the doctor advises you to stay longer than planned, inform the hospital’s cashless team. They will request additional approval from the insurer.

At the Time of Discharge

When treatment is complete, the hospital will prepare the final bill and send it to the insurance company. The insurer will directly pay the approved amount to the hospital. You only need to settle charges that are not covered under the policy, such as registration fees or non-medical items.

Step 1: Intimation of Hospitalisation

You must inform BimaKavach within 24 hours of admission. If it is a planned hospital visit, you can also give advance intimation before admission. This can be done through the BimaKavach portal or by sending an email to claims@bimakavach.com, with your HR in copy (cc).

• Employee Name
• Employee Code
• Company Name
• Patient Name
• Relationship with the Patient
• Reason for Admission
• Date of Admission
• Hospital Name
• Hospital Address
• Approximate Claim Amount

Step 2: Submit Claim Documents After Discharge

After you are discharged from the hospital, you must submit all the required claim documents within 30 days. These documents will include your hospital bills, discharge summary, prescription, medical reports, and any other required proofs. BimaKavach will also send three reminders to make sure the documents are submitted on time.

Step 3: Claim Acknowledgement

Once your claim is received and registered, you will get an email confirming the same. This email will acknowledge receipt and confirm that the documents are under review.

Step 4: Claim Status Update

Within five working days, you will receive an update about your claim. The update will either confirm approval or request additional documents if something is missing or unclear. If any further information is needed, you will get a clear query mail. You will have seven days to submit the missing or extra documents.

Step 5: Claim Settlement

If everything is in order and your claim is approved, the approved amount will be credited to your bank account within seven to ten working days. You will also receive an email with the claim settlement details.

Step 6: Feedback Request

After the claim is settled, BimaKavach will send you a feedback email to understand your experience. This helps us improve our service and support other employees better in the future.

Fracture Claim for a Warehouse Assistant

In 2025, a logistics company in Indore faced a workplace incident where a warehouse assistant slipped while unloading goods. He fractured his right ankle and required hospitalisation and a plaster cast. The company’s Group Personal Accident Insurance covered the treatment and paid ₹30,000 for medical bills and follow-up visits. The assistant received weekly income for three weeks while he rested at home. He resumed duty without facing income loss.

Road Accident Claim for a Delivery Executive

In 2023, a food delivery platform in Nagpur reported an accident involving one of its delivery partners. The executive was hit by a car while on duty, suffering injuries to his shoulder and leg. The Group Personal Accident Policy paid ₹1.2 lakhs—covering hospitalisation, surgery, and physiotherapy. The insurer also paid for ambulance costs and daily hospital cash for four days. The financial support helped the rider recover fully and return to work with confidence.

Permanent Partial Disability Claim for a Site Engineer

In 2021, a construction firm in Ahmedabad had a site engineer injured during routine inspection. A fall from scaffolding resulted in permanent loss of mobility in one arm. Based on the disability percentage, the Group Personal Accident Insurance paid ₹5 lakhs under the permanent partial disability benefit. The policy also covered home modifications to support his condition. The engineer shifted to a planning role within the company, supported by both employer and insurer.