Endorsement
LIFE INSURANCE CORPORATION OF INDIA
(Established by the Life Insurance Corporation Act, 1956)
Registration Number: 512
LIC’s Accident Benefit Rider (UIN: 512B203V03)
(A Non-linked, Non-participating, Individual, Health Rider)
PART – A
FORWARDING LETTER
As per the Base Policy.
PREAMBLE
This document of LIC’s Accident Benefit Rider, details of which are given in the Schedule below, and which shall be deemed as
part of the Policy, is an endorsement to the Base Policy.
The premium mentioned in the Schedule and all the terms and conditions printed in this Endorsement are specific to this Rider.
Terms and conditions of this Rider are to be read in conjunction with the terms and conditions of the Base Policy. The continuance
of risk cover under the Base Policy is necessary precondition for continuance of cover under this Rider. The benefits under the Base
Plan shall be governed by the terms and conditions of the Base Policy independent of terms and conditions of the Rider mentioned
in this Endorsement .
SCHEDULE
DIVISIONAL OFFICE: BRANCH OFFICE:
Policy Number: Date of commencement of LIC’s Accident Benefit Rider:
Name of the Proposer: Date of commencement of risk for the Rider:
Name of Life Assured: Rider Term:
Accident Benefit Sum Assured (Rs): Due Date of payment of Last premium for LIC’s Accident
Benefit Rider:
Accident Benefit Rider Premium (Rs):
Date of expiry of LIC’s Accident Benefit Rider:
Date of Birth:
Age:
Whether Age Admitted:
Date:
Examined by:
Form No: p. Chief/ Sr./ Branch Manager
PART – B: DEFINITIONS
The definitions of terms/words used in this Rider Document are as under:
1. Accident is a sudden, unforeseen and involuntary event caused by external, violent and visible means.
2. Age is the age nearer birthday of the Life Assured at the time of commencement of this Rider except for age 18 yrs for which
the age is in completed year.
3. Base Policy refers to the Policy to which this Rider Document is attached.
4. Date of commencement of LIC’s Accident Benefit Rider is the start date of this Rider.
5. Date of commencement of risk for Rider is the date on which the Corporation accepts the risk for insurance (cover) for the
Base Policy along with this Rider as evidenced in the Schedule of the Rider.
6. Life Assured is the person on whose life the insurance cover has been accepted for the Base Policy along with this Rider.
7. Policyholder is the legal owner of this policy.
8. Proposer is a person who proposes the life insurance proposal for the Base Policy along with this Rider.
9. Rider is an additional cover which can be opted for along with Base Policy.
10. Rider Term is the period, in years, as chosen by the policyholder and mentioned in the Schedule, commencing from the Date
of commencement till the Date of expiry of LIC’s Accident Benefit Rider.
11. Schedule is the part of this Rider document that gives the specific details of your Rider.
12. Accident Benefit Rider Premium is the premium payable by the policyholder along with the premium under Base Policy
towards the additional cover/benefit opted under the Rider, if opted.
13. Accident Benefit Sum Assured means the amount specified in the Schedule as opted by the Policyholder at the time of taking
therider.
Note: For definitions of other terms/words used anywhere in this endorsement, the definitions given in the Base Policy may be
referred to.
PART – C: BENEFITS
1. The following benefits are payable under an in-force Rider:
A. Death Benefit:
If the Life assured is involved in an accident at any time when this Rider is in-force and such injury shall within 180 days
of its occurrence solely, directly and independently of all other causes result in death of the Life Assured and the same is
proved to the satisfaction of the Corporation, a sum equal to the Accident Benefit Sum Assured shall be payable under this
Rider subject to the following:
i) The Rider shall have to be in-force at the time of accident (i.e. all due premiums should have been paid as on the date
of accident).
ii) Conditions and Restrictions mentioned in Condition 4 of Part C of this Endorsement.
B. Maturity Benefit: No maturity benefit is payable under this Rider.
2. Payment of Premium:
(a) The Accident Benefit Rider premium, including taxes as applicable from time to time, is payable only along with the
premium for the Base Policy and cannot be paid separately.
(b) In case of accident under an in-force policy, wherein all the premiums due till the date of accident have been paid and
subsequent premiums till date of death for admissible death claim have not been paid, in such a case premium(s) in
respect of this Rider falling due on or after the date of accident till the policy anniversary following the date of death
shall be deducted from the Death Benefit payable under this Rider.
(c) The additional premium paid in respect of this Rider shall not be taken into account for determination of Death Benefit of
the Base Policy and in calculating the surrender value of the Base Policy.
3. Grace Period: As per Base Policy
4. Conditions and Restrictions:
A. An Accident for the purpose of this policy is as defined in Part B of this Endorsement.
B. This Rider will not be available under the policy on the life of minors, during minority of the Life Assured. However,
Accident Benefit will be available from the policy anniversary following completion of age 18 years on receipt of
specific request and payment of additional premium, if found eligible for Accident Benefit as per the rules of the
Corporation.
LIC’s Accident Benefit Rider (UIN: 512B203V03) Page 2 of 5
C. Subject to stated above, under an in-force policy the LIC’s Accidental Benefit Rider can be opted for, by payment of
additional premium, at any time within the premium paying term of the Base Policy provided the outstanding
premium paying term of the Base Policy as well as Rider is atleast five years but before the policy anniversary on
which the age nearer birthday of Life Assured is 65 years. The benefit covered under this rider will be available
during the outstanding premium paying term of the Base Policy or upto the policy anniversary on which the age
nearer birthday of the Life Assured is 70 years, whichever is earlier, provided the policy is in-force on date of
accident.
D. The additional premium for this benefit will not be required to be paid after all premiums under the Base Policy have
been paid or on and after the policy anniversary on which the age nearer birthday of the Life Assured is 70 years,
whichever is earlier. However, the premium under the Base Policy shall continue to be paid beyond age 70 years till
the end of policy term, wherever applicable. In case, if premium for Accident benefit cover is paid beyond the
stipulated period, then same will be refunded without interest with claim amount payable under the policy.
E. The maximum aggregate limit of Accident Benefit cover shall be as under:
(i) For LIC’s Jeevan Shiromani with minimum Basic Sum Assured of Rs. 100 lakhs
The maximum aggregate limit of assurance under all policies including policies with in-built Accident Benefit taken
with Life Insurance Corporation of India under individual policies as well as group policies on the same life to which
following benefits apply shall not in any event exceed Rs.200 lakhs of Accident Benefit Sum Assured (including
LIC’s Jeevan Shiromani). If there be more policies than one and if the total Accident Benefit Sum Assured exceeds
Rs. 200 lakhs (including a minimum of 100 lakhs under LIC’s Jeevan Shiromani) the benefits shall apply to the first
Rs. 200 lakhs Accident Benefit Sum Assured in order of date of policies issued.
(ii) For all other plans (excluding LIC’s Jeevan Shiromani):
The maximum aggregate limit of assurance under all policies including policies with in-built Accident Benefit taken
with Life Insurance Corporation of India under individual policies as well as group policies on the same life to which
following benefits apply shall not in any event exceed Rs.100 lakhs of Accident Benefit Sum Assured. If there be
more policies than one and if the total Accident Benefit Sum Assured exceeds Rs. 100 lakhs, the benefits shall apply
to the first Rs. 100 lakhs Accident Benefit Sum Assured in order of date of policies issued.
In any case, the maximum Accident Benefit cover offered to an individual including the policies taken under
Condition 4.E.(i) above, will not exceed Rs. 200 lakhs.
F. Exclusions:
The Corporation shall not be liable to pay the benefits as specified in Condition 1.A of Part C above, if the death of
the Life Assured shall:
(i) be caused by intentional self injury, attempted suicide, insanity or immorality or whilst the Life Assured is under
the influence or consumption of intoxicating liquor, narcotic or drug (unless prescribed by doctor as a part of
treatment); or
(ii) be caused by injuries resulting from taking any part in riots, civil commotion, rebellion, war (whether war be
declared or not), invasion, hunting, mountaineering, steeple chasing, racing of any kind, paragliding or
parachuting, taking part in adventurous sports; or
(iii) result from the Life Assured committing any criminal act with criminal intent; or
(iv) a) arise from employment of the Life Assured in the armed forces or military service. This exclusion is not
applicable if the Life Assured was involved in an accident when he is not on duty or was involved in any
rescue operations while combating natural calamities in our country; or
b) arise from being engaged in police duty (which excludes administrative assignments) in any police
organization other than paramilitary forces. This exclusion is not applicable where the option to cover
Accident Benefit arising on accident while engaged in police duty, has been chosen; or
(v) occur after 180 days from the date of accident of the Life Assured.
PART – D: CONDITIONS RELATED TO SERVICING ASPECTS
1. Proof of Age: Same as mentioned under the Base Policy.
2. Forfeiture and Non-forfeiture Regulations:
Forfeiture in Certain Other Events: Same as mentioned under the Base Policy.
Non-forfeiture Regulations: These provisions do not apply to this Rider as it does not acquire any paid up value and the
Rider benefit ceases to apply, if Base Policy is in lapsed condition.
3. Revival of lapsed Policies: The revival of the Rider will be considered along with the revival of the Base Policy and shall be
revived in accordance with the Underwriting policy of the Corporation. The terms and conditions are as mentioned under
“Revival of Lapsed Policies” in Part D of the Base Policy Document.
LIC’s Accident Benefit Rider (UIN: 512B203V03) Page 3 of 5
4. Surrender Value: No surrender value will be available under this Rider.
5. Loan: No loan will be granted under this Rider
6. Termination of LIC’s Accident Benefit Rider:
The cover under LIC’s Accident Benefit Rider will terminate on the earliest of:
a) On death of the Life Assured.
b) The date of expiry of the LIC’s Accident Benefit Rider (as mentioned in the Schedule).
c) The date on which the Base Policy to which the Rider is attached terminates or is converted into a paid up policy.
d) On payment of Free Look cancellation amount for this Rider.
7. Free Look period:
During the Free Look period, if the policyholder is not satisfied with the “Terms and Conditions” of the Rider, the Rider
Endorsement along with the Base Policy may be returned to the Corporation within 15 days (30 days if the policy is purchased
online) from the date of receipt of the policy stating the reason of objections. On receipt of the same the Corporation shall
cancel the Rider and return the amount of premium deposited for this Rider after deducting the proportionate risk premium
(for this Rider) for the period of cover, charges for medical examination, special reports, if any, on account of Rider
inclusion and stamp duty charges.
PART E
Not Applicable.
PART – F: OTHER TERMS AND CONDITIONS
1. Assignments and Nominations: Same as mentioned under the Base Policy.
2. Tax:
Statutory Taxes, if any, imposed on such insurance Riders by the Government of India or any other Constitutional Tax
Authority of India shall be as per the Tax laws and the rate of tax as applicable from time to time.
The amount of applicable taxes payable as per the prevailing rates, shall be payable by the policyholder on premiums including
extra premiums, which shall be collected separately over and above in addition to the premiums payable by the policyholder.
The amount of Tax paid shall not be considered for the calculation of benefits payable under the Rider.
3. Normal requirements for accidental claim:
In addition to the Claim provisions as stated in the Base Policy, for considering accidental death claim, the applicable
statements from the following list may be called to ascertain circumstances under which death took place:-
1) A certified copy of first information report (FIR).
2) A certified copy of police inquest report.
3) Copy of panchanama.
4) Post mortem report to know the probable cause of death. If viscera is preserved in post mortem, then chemical analyzer
report to know the contents i.e. whether life assured has consumed liquor, drugs, narcotics or poison.
5) News paper cuttings where accident is reported.
6) If death is due to vehicle accident, then copy of driving licence, if life assured was driving the vehicle.
7) Sub-divisional magistrate final verdict about death- this will give classification of death as ‘natural/suicide/accidental’
8) When accident is not reported to police authorities, like death due to dog or snake bite, then alternate proofs such as
statement of eye witness, affidavit of gramsevak or govt. officials, our own enquiry report, attending physician or hospital
reports may be sufficient.
9) Hospital treatment records, etc.
Within 90 days from the date of death, intimation of death along with death certificate must be notified in writing to the office
of the Corporation where the policy is serviced for any claims to be admissible. However, delay in intimation of the genuine
claim by the claimant may be condoned by the Corporation on merit and where delay is proved to be for the reasons beyond
his/her control.
The Corporation reserves the right to call for any additional requirement for the assessment of Rider claim.
4. Legislative Changes:
The Terms and Conditions including the premiums and benefits payable under this Rider are subject to variation in accordance
with the relevant Legislation & Regulations .
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PART-G: STATUTORY PROVISIONS
Section 45 of Insurance Act, 1938: Same as mentioned under the Base Policy.
Grievance Redressal Mechanism: Same as mentioned under the Base Policy.
Note:
• In case of dispute in respect of interpretation of terms and conditions mentioned in this Document, the English version
shall stand valid.
• The conditions mentioned in this endorsement are not to be read in isolation but in agreement with the conditions
mentioned in the Base Policy.
YOU ARE REQUESTED TO EXAMINE THIS POLICY, AND IF ANY MISTAKE BE FOUND THEREIN, RETURN IT
IMMEDIATELY FOR CORRECTION.
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