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THE NEW INDIA ASSURANCE
COMPANY LIMITED
Mount Casa Blanca Building, 2nd Floor, 260 Anna Salai, CHENNAI-600 006 Phone 044-23456824, 23456826, 23456827 Fax : 044-23456825 Email : nia25@vsnl.com Registered & Head Office : New India Assurance Building, 87 Mahatma Gandhi Road, Fort, Mumbai.- 400 001. |
GOOD HEALTH PERSONAL ACCIDENT POLICY
Policy Benefits | Plan Options & Premium Rates | Age Limit | Insured/Insured Person | Claims Procedure| Nomination | Buy this policy
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This policy provides for the following benefits to insured persons, arising out of an accident, subject to policy terms, conditions, and exclusions :
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Benefit (% of Sum Insured) |
Description of Accidental Loss |
| 100% | Death. |
| 100% | Loss of sight of both eyes |
| 100% | Loss of two entire hands or two entire feet |
| 100% | Loss of one entire hand and one entire foot |
| 100% | Loss of sight of one eye and either one entire hand or one entire foot |
| 50% | Loss of one eye or one entire hand or one entire foot |
| 50% | Loss of use of a hand or a foot without physical separation. |
| Varying % | Permanent total disablement other than those named above. |
| Varying % | Certain specified permanent partial disablement |
| Medical expenses arising out of an accident resulting in death/permanent disablement, subject to a maximum of 10% of the sum insured. | |
| Expenses incurred for transportation of the mortal remains of the fatal accident victim (insured person) to the place of residence subject to a maximum of 2% of the Capital Sum Insured or Rs.2,500/- whichever is less. | |
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Good Health Personal
Accident Insurance
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Good Health Plan |
Sum Insured |
Citibank
Customer Rate |
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| Personal Accident Cover (Rs.) |
Medical
Expenses Reimbursement (arising
out of an accident resulting in death or permanent total disablement of
the insured person) |
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1 |
2,00,000 |
20,000 |
250 |
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Those who are less than 21 years are eligible to apply only for Plan 1. |
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2 |
3,00,000 |
30,000 |
375 |
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3 |
4,00,000 |
40,000 |
500 |
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4 |
5,00,000 |
50,000 |
620 |
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13 |
7,50,000 |
75,000 |
940 |
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14 |
10,00,000 |
1,00,000 |
1260 |
Citibank customers need pay only the premium amount indicated in the Citibank customer rate column plus the transaction fee charged by Citibank, according to the plan option selected by them. The limits indicated for Medical Expenses Reimbursement under the various plan options is forming part of the Personal Accident Cover sum insured for such plan options. The Sum Insured and Premium indicated above are per person. Premium includes 10.3% service tax but does not include the Transaction fee charged by Citibank. Those who are less than 21 years are eligible to apply only for Plan 1.
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<< This
insurance is available to persons between ages of 5 yrs and 70 yrs only.
<< Persons
between 5 years and 21 years of age are eligible to apply for
plan option
1 only.
The right to accept or reject for coverage any person proposed for this Personal Accident Insurance, whether for fresh or renewal, shall rest solely with the Company.
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INSURED means Citibank Credit Card Members / Customers who have proposed for this insurance.
INSURED PERSON means Citibank Credit Card Members / Customers and/or their family members covered by this policy.
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What is the procedure for availing this Policy ? Go Top |
<< Fill up the Proposal Form for Good Health Policy
Being a Citibank card member all you have to do is, simply call up your local Citiphone Officer for a Good Health Policy Proposal form. Fresh applicants aged 60 years and above for Mediclaim insurance have to submit a Medical Practitioner's Report Form together with the reports of specified diagnostic tests, in addition to the proposal form.
Each proposal form is designed to accommodate only 6 persons. Therefore if you wish to cover more than 6 persons, you may kindly fill up additional proposal forms.
<< Send in the completed Proposal form
Kindly send in the duly completed proposal form(s) along with the Medical Practitioner's Report and the reports of specified diagnostic tests (wherever applicable) to CITIBANK CARD CENTRE, No.2 Club House Road, Anna Salai, CHENNAI-600 002, so as to reach on or before 20th of the month previous to the month in which you wish your Good Health policy to commence. For example, if you want coverage from 1st August, your application should reach above Citibank Card Centre on or before 20th July. Applications received after 20th July but before 20th August, will be taken up for coverage from 1st September only.
For the convenience of Citibank card members, we have 12 Good Health Policies in a year, one policy for every month, each commencing from the 1st day of the month. Each Good Health Policy is of 12 months duration.
<<Payment of Premium
The premium for Good Health Policy in respect of eligible persons will be debited to the Card/Account of the customers by Citibank. Premium rates for Good Health Mediclaim Policy and Good Health Personal Accident Policy are given separately.
<<Issuance of Good Health Policy Certificate
Good Health Policy certificates will normally be despatched within 45 days of the commencement of the policy, by courier
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1) Preliminary notice of claim should be sent to the Company within 30 days from the date of death of the insured card member. 2) The completed claim form duly signed by the claimant, who shall necessarily be one of the legal heirs, together with the following documents should be submitted to the Company at the earliest and in any case not later than 6 months from the date of death of the card member or within such further time as may be granted by the Company in this regard. 3) Documents to be submitted along with the claim form :
b) FIR of Police Authorities (Original or xerox copy duly notarised or duly attested by an Officer of the Company) c) Post Mortem Report along with Chemical Analysis Report (Original or xerox copy duly notarised or duly attested by an Officer of the Company) d) Police Inquest Report or Panchanama /Accident Reports (Original or xerox copy duly notarised or duly attested by an Officer of NIA) e) Admission cum Death Summary from the Hospital in case of Hospitalisation following accident. f) Copies of any document translated into English from any other language should be duly attested by the official language translator approved by the Govt. and duly notarised)
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4) While sending xerox copies to the Company kindly ensure that they are of readable quality. This is very important, especially in cases where such documents are in any language other than English, to facilitate easy and quick translation into English and faster claims processing.
5) While sending xerox copies to the Company kindly ensure that they are duly verified and attested by a Class I officer of NIA on all pages with Signature, Name, Designation and Office Address of the Official.
6) Upon approval of the claim, an approval letter will be sent by the Company calling for the submission of the following documents to evidence the legal entitlement of the claimant to the insurance compensation payable under this policy.
Nomination
If nomination is not available, then Legal Heirship Certificate issued by Competent Revenue Authority by Tahsildar or District Collector or District/Divisional/Sub-Divisional Magistrate and Indemnity Bond.
If Legal Heir Certificate is not available, then Succession Certificate issued by Court.
If Succession Certificate issued by Court is not available, then following set of documents should be produced.:-
An Affidavit from the claimant(s) that he/she/they is/are the Legal Heir(s) of the deceased.
An Affidavit from other near relatives of the deceased that they have no objection if the claim amount is paid to the claimant(s).
Surety Bond executed by persons of reasonable standing.
Indemnity Bond to be executed by all Legal Heir(s).
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Nomination facility is available for persons covered under this Group Personal Accident Insurance. You may nominate the person of your choice to receive the personal accident compensation on your behalf. Nominations would help the nominee to receive the claim monies without any delay. To avoid any legal dispute it is always advisable that the nominee may be one of the legal heirs.
Nomination form is available in the Good Health policy salient features brochure. Filled in nominations should be sent to us in duplicate so that we can return one copy to you after duly registering your nomination in our records
Policy Benefits | Plan Options & Premium Rates | Age Limit | Insured/Insured Person | Claims Procedure| Nomination | Buy this policy