A Look At Claim Payment Under PA Cover In Bharat Sookshma Udyam Suraksha Shopkeepers Package Policy

The Bharat Sookshma Udyam Suraksha Shopkeepers Package Policy is an MSME insurance policy designed to help micro-level organisations get the right financial protection. For the uninitiated, MSME refers to Micro, Small and Medium Enterprises. Since these enterprises function on a micro level, it is important for them to get the right financial protection against unforeseen events to achieve stable growth. One important coverage provided by this general insurance plan is Personal Accident Cover or PA cover. Under this cover, the insured member (or the nominee) receives pre-determined financial compensation if the insured passes away or suffers a permanent partial/total disability or temporary total disability due to an accident. * Claims are subject to terms and conditions set forth under commercial insurance policy. To claim compensation in case of such an unfortunate event, one must know their responsibilities and duties regarding making a claim and receiving payment.

Making a Claim under PA Cover

If the insured person meets with any accidental bodily injury that can lead to a claim, then the following conditions must be met before the insurer’s liability is applicable: *

1. The insured or someone on their behalf must inform the insurer in writing of the event immediately within 14 days.
2. The insured must immediately consult a doctor or medical practitioner and follow their advice/ treatment.
3. The insured must take reasonable steps to reduce the effects of their bodily injury.
4. The insured must have themselves examined by the insurer’s medical advisors (at the insurer’s cost) as many times as the latter considers it to be necessary.
5. The insured or someone on their behalf must provide the insurer with the documents and other information as requested by the latter, regarding claim investigation or the insurer’s obligation to make the payment.
6. If the insured suffers an unfortunate demise, the person claiming on their behalf must inform the insurer in writing immediately. A copy of the post-mortem report (if any) must also be sent within 14 days.

The conditions listed as 1st and 6th in the above list can be waived off in extreme cases of hardship where it is proved (to the insurer’s satisfaction) that it was not possible for the insured or someone else to give notice or file a claim within the claim limit, due to the circumstances at the time. Claims are subject to terms and conditions set forth under commercial insurance policy. Now that the above may be clear, let’s look at some important points for claim payments under the Bharat Sookshma Udyam Suraksha Shopkeepers Package Policy.

Payment of a Claim under the PA Cover 

The following points must be kept in mind in regard to the insurer’s liability to pay the claim under the PA cover of the plan: *

1. The insured agrees the insurer needs to pay the claim only when the insured or someone on their behalf has provided the insurer with the required documents and information.
2. The insurer shall pay the claim to the insured or their nominee. In the absence of the latter and the passing away of the former, the insurer shall pay the insured person’s heir, executor, or legal representative. Any payment made thus shall be the complete and final discharge of the insurer’s liability.
3. Once the documents have been received satisfactorily by the insurer, they shall offer a settlement of the claim within 30 days. Once the offer is accepted by the insured, the payment shall be made within 7 days from the acceptance date. If the payment is delayed, the insurer shall pay interest at a 2% rate above the bank rate prevalent at the beginning of the financial year in which the claim was reviewed.
4. If the claim under this general insurance policy requires an investigation, the insurer shall take 30 days for the process from the date of receipt of the last necessary document. The claim settlement shall take not more than 45 days in such cases. In case of a delay, the insurer shall pay interest at a 2% rate above the bank rate from the date of receipt of the last necessary document to the date of payment of the claim.
5. If the insurer rejects the claim for any reason, the reason shall be communicated to the insured person in writing within 30 days of the receipt of documents. In case of any grievances, the insured can take recourse to the Grievance Redressal procedure specified in the policy documents.

Claims are subject to terms and conditions set forth under commercial insurance policy. The Bharat Sookshma Udyam Suraksha Shopkeepers Package Policy can be beneficial for MSMEs in securing their finances. Additionally, the owners and important person/s related to the enterprise can also ensure their financial protection against accidental injuries and passing away with the PA cover under this MSME insurance policy. This can lead to better peace of mind which can translate into better growth for the enterprise.   * Standard T&C apply. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.