Student Personal Accident Insurance Policy Information Sheet

This document provides a clear overview of the Student Personal Accident Insurance (PAI) policy, designed specifically for learners in schools, colleges, and universities. It outlines coverage, exclusions, claim procedures, and key responsibilities of the insurer, the insured student, and the educational institution.

1. Who is Covered?

The policy covers:

• Fulltime and parttime students aged 1230 who are enrolled in an accredited academic programme.
• Students participating in approved extracurricular activities (sports, clubs, field trips) while under the supervision of the institution.
• Students on approved workstudy placements or internships that are part of the curriculum.

2. What is Covered?

The Personal Accident portion provides a lumpsum payment for accidental injuries that meet the definitions below. The benefit is payable once per incident, regardless of the number of injuries.

2.1 Accidental Death

A death that occurs as a direct result of an external, unforeseen, violent, and accidental event (e.g., road traffic accident, sports injury, fall).

2.2 Permanent Total Disablement (PTD)

A medical condition caused by an accident that permanently prevents the student from performing any gainful activity.

2.3 Permanent Partial Disablement (PPD)

Partial loss of a bodily part or loss of function (e.g., loss of a finger, vision in one eye) as a direct result of an accident.

2.4 Temporary Total Disablement (TTD)

Incapacity to attend classes or perform normal duties for a continuous period of at least 14 days, verified by a qualified medical practitioner.

2.5 Medical Expenses

Reimbursement for reasonable, medicallynecessary expenses directly resulting from an accident up to a specified limit (e.g., hospitalisation, surgery, emergency transport).

3. Benefit Amounts

4. Exclusions

The following situations are not covered:

• Injuries resulting from selfinflicted harm or attempted suicide.
• Acts of war, terrorism, or civil unrest.
• Incidents occurring while the student is under the influence of alcohol, illegal drugs, or nonprescribed medication.
• Preexisting medical conditions that were not declared at the time of enrolment.
• Injuries sustained while participating in nonapproved highrisk activities (e.g., extreme skydiving, motorbike racing).
• Consequences of criminal conduct or intentional wrongdoing.

5. How to Make a Claim

1. Notify the insurer: Contact the insurers 24hour claims line within 48hours of the accident.
2. Gather documentation:
   • Original accident report (police, school, or event organizer).
   • Medical certificates and detailed treatment records.
   • Proof of enrolment and attendance at the institution.
   • Any official receipts for medical expenses.
3. Submit the claim: Complete the Claim Form (available on the insurers website) and attach all required documents.
4. Assessment: The insurer will appoint a medical assessor to verify the nature and extent of the injury.
5. Decision: Within 30days of receiving a complete claim, the insurer will confirm the benefit amount or provide a written explanation for any denial.

6. Policy Term and Renewal

The policy is effective from the first day of the academic term and continues until the last day of the final term for which the student is enrolled, provided premiums are paid on time. Renewal is automatic each academic year unless the insurer or the institution provides at least 30days written notice of nonrenewal.

7. Premiums

Premiums are calculated on a perstudent basis and are typically billed to the educational institution, which may pass the cost to students or families. Premium rates depend on:

• Age of the student.
• Level of study (e.g., secondary, undergraduate, postgraduate).
• Risk profile of approved activities.

8. Responsibilities of the Student

• Provide truthful and complete information when applying.
• Immediately report any accident that could give rise to a claim.
• Cooperate fully with medical assessors and the insurer during the claim process.
• Maintain uptodate contact details with both the insurer and the institution.

9. Responsibilities of the Educational Institution

• Ensure that all enrolled students are aware of the policy coverage and exclusions.
• Provide the insurer with accurate student enrolment data each term.
• Assist students in gathering required documentation for claims.
• Maintain a list of approved extracurricular activities and associated risk assessments.

10. Dispute Resolution

Any disagreement regarding claim decisions shall first be addressed through the insurers internal appeals process. If unresolved, parties may refer the dispute to an independent ombudsman or court of competent jurisdiction, as dictated by the governing law specified in the policy contract.

11. Contact Information

Customer Service (24hrs): +18005550123

Email: claims@insureedu.com

Website: www.insureedu.com/personal-accident

For further details, consult the full policy wording or speak with your institutions student welfare officer.