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8)
Version History
Annual renewal of policy. Option to top-up the base cover and / or purchase
V 1.5
spouse policy cover
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Contents
1. Overview ....................................................................................................................... 3
2. Scope ............................................................................................................................ 3
3. Definitions .................................................................................................................... 3
4. Eligibility ....................................................................................................................... 6
5. Approvals ..................................................................................................................... 6
6. Procedure ..................................................................................................................... 7
8. Exceptions Handling.................................................................................................... 7
Annexure A.......................................................................................................................... 8
Annexure B .......................................................................................................................... 9
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GROUP PERSONAL ACCIDENT INSURANCE POLICY
1. Overview
1.1 The Personal Accident Insurance policy provides basic coverage for all associates for the risk
of disablement due to accidents. This is administered through TATA AIG
2. Scope
2.1 The policy covers
2.1.2 It also covers the associates, who may not be on India payroll, to whom it has
been communicated via their assignment letter/ related benefits statement /
employee handbook, about their coverage under Cognizant India Group
Personal Accident Insurance policy
2.1.3 Associates who are on assignment outside India, who may not be on India
payroll and benefiting from Group Personal Accident Insurance policy, provided
by a non-India Cognizant affiliate directly or through any other benefit plan, will
not be covered within the scope of this policy.
3. Definitions
Coverage: The extent of the protection provided by insurance under base cover
Similar to PTD with the only difference being that the disablement is partial E.g.
loss of a toe or a finger.
The applicable compensation is payable on the % of loss, which is mentioned in
Annexure A. Doctor’s assessment will be used in case of non-availability of
information in Annexure A.
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3.1.3 TTD (Temporary Total Disablement)
Disablement is total but for a temporary period. E.g. Fracture, where there is a
disablement, but for a temporary period.
Eligibility: Temporary Total Disablement (TTD) benefit based on level as per the
below table to maximum of 104 weeks (as long as the associate is not able to
resume his duties).
Medical expenses arising solely and directly out of the accident will be covered to
a maximum limit of 40% of claim amount (as assessed under PPD/ PTD/TTD) or
10% of base cover or actual medical expenses whichever is less.
In the event of death of the associate due to accident, INR 10,000 per child
(restricted to 2 children) will be paid as education grant for dependent children.
In the event of death of the Insured person due to accident insurance company
shall reimburse the expense incurred for transportation of Insured’s dead body to
the place of residence subject to a maximum of 2% of base cover or INR 2,500/-
whichever is less.
Policy does not provide benefits for any loss resulting in whole or in part from, or expenses
incurred, directly or indirectly in respect of:
3.3.1 Any Pre-existing Condition and any complication arising from the same; or
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Human Immune-deficiency Virus (HIV) infection; or
3.3.3 Serving in any branch of the Military or Armed Forces of any country, whether in
peace or War, and in such an event We, upon written notification by the
Policyholder, shall return the pro rata premium for any such Insured Period of
service under the circumstances described in a Hazard; or
3.3.4 Being under the influence of drugs, alcohol, or other intoxicants or hallucinogens
unless properly prescribed by a Physician and taken as prescribed
3.3.7 War, civil war, invasion, insurrection, revolution, act of foreign enemy, hostilities
(whether War be declared or not), rebellion, mutiny, use of military power or
usurpation of government or military power; or
3.3.8 Any loss, damage cost or expense of whatsoever nature directly or indirectly
caused by, resulting from or in connection with any Act of Terrorism regardless of
any other cause or event contributing concurrently or in any other sequence to
the loss. The warranty also excludes loss, damage, cost or expenses of
whatsoever nature directly or indirectly caused by, resulting from or in connection
with any action taken in controlling, preventing, suppressing or in any way relating
to action taken in respect of any act of terrorism. If the Company alleges that by
reason of this Exclusion, any loss, damage, cost or expenses is not covered by
this insurance the burden of proving the contrary shall be upon the Insured; or
3.3.9 The intentional use of military force to intercept, prevent, or mitigate any known
or suspected Terrorist Act; or
3.3.10 Ionizing radiation or contamination by radioactivity from any nuclear fuel or from
any nuclear waste from burning nuclear fuel; or
3.3.11 The radioactive, toxic, explosive or other dangerous properties of any explosive
nuclear equipment or any part of that equipment; or
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any bodily contact sport or any other hazardous or potentially dangerous sport for
which you are trained or untrained; or
3.3.15 Is caused by osteoporosis (porosity and brittleness of the bones due to loss of
protein from the bones matrix) or pathological fracture (any fracture in an area
where pre-existing Disease has caused the weakening of the bone) if
osteoporosis or bone Disease diagnosed prior to the Policy Effective Date; or
3.3.16 For any loss of which a contributing cause was your actual or attempted
commission of, or willful participation in, an illegal act or any violation or attempted
violation of the law or your resistance to arrest; or
4. Eligibility
4.1 The following table describes the base coverage limits based on the level of an associate.
For more information click FAQs and type “Personal Accident” in the Navigator Search
Note: Cognizant provides benefits from a perspective of complete employee welfare to our
associates under the Group Medical, Group Personal Accident and Group Life benefit
programs. Associates to note that should there be any workplace incident or a statutory
obligation, any payout under these above benefit programs (where it is higher) will be in lieu of
or adjusted against any statutory liabilities that cognizant may be required to provide.
5. Approvals
Not Applicable
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6. Procedure
6.1 The Employee/Supervisor/Concerned TM as the case may be, must intimate the claim within
90 days of occurrence of the event, on the following email id:Insuranceindia@cognizant.com
6.2 The Employee/Supervisor/Concerned TM as the case may be, must submit the required
document within 90 days of the occurrence of the event, as per the requirement of the
insurance agency to the Benefits HRSS representative for claim processing on the above
mentioned email id
6.3 The Benefits HRSS representative verifies the documents and submits the same to the
insurance agency for processing the claims
6.4 Please refer Annexure B for details regarding the documents required for Claim Processing
7. Responsibility Matrix
7.1 Associate: Complete all the formalities at the time of joining
7.1.2 Submit the documents for claim reimbursement within 90 days from the date of
accident
8. Exceptions Handling
8.1 The benefits of this policy are governed by the terms and conditions of employment in practice
at Cognizant. This is subject to change from time to time. Cognizant reserves the right to
amend its policies as necessitated. All statutory requirements are applicable as mandated by
law
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Annexure A
A. Permanent Partial Disablement (PPD)
If such injury shall within twelve calendar months of its occurrence be the sole and direct cause of the
total and/or partial irrecoverable loss of use or the actual loss by physical separation of the following
then the percentage of the Insured Sum payable to the concerned associate is in the manner indicated
below.
c) One Joint 5%
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6 Either Hand or Foot and Sight of One Eye 100%
8 Speech 50%
Annexure B
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Mandatory Document required for processing the
Type of Claim
claim.
Any certificate specifying the parent –child relationship
between the child and the employee (Birth certificate
or Ration card )
Completely filled GPA claim Form with Company
Stamp & Covering Letter From Employer
Attested Copy Of FIR ( If Reported to police authority)
Disability Certificate (Authorized medical officer/civil
surgeon of civil hospital / govt. hospital of the district /
units concerned, (certificate) stating percentage of
disablement)
PTD
Reports like , X-rays and reports essential of
confirmation of the type and percentage of disability
Letter from the Employer stating the Description of
accident and leave record
Color Photograph of the injured reflecting disability.
Original medical bills with prescriptions/treatment
papers.
Completely filled GPA claim Form with Company
Stamp & Covering Letter From Employer
PPD disablement)
Reports like , X-rays and reports essential of
confirmation of the type and percentage of disability
Letter from the Employer stating the Description of
accident and leave record
Color Photograph of the injured reflecting disability.
Original medical bills with prescriptions/treatment
papers.
Completely filled GPA claim Form with Company
TTD
Stamp & Covering Letter From Employer
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Mandatory Document required for processing the
Type of Claim
claim.
Medical Practitioner’s certificate confirming the Injury
and advising rest/ unfit to work for specified number of
day’s fitness certificate from treating doctor.
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