Ask yourself one number before you shop. How many rupees would stop arriving every month if you could never work again? That figure, and not the premium, is what decides how much personal accident cover you should buy.
Most people buy this policy backwards. They start from a premium that feels comfortable, take whatever cover that premium happens to buy, and never test the result against their own salary slip.
Take a pen. Each answer feeds the next.
This is a rule of thumb, not a rule. No IRDAI regulation or circular tells you how much personal accident cover to buy. The method above is planning arithmetic, nothing more. A widely used planning benchmark is ten to fifteen times annual income, trimmed to what an insurer will underwrite. Expect to be asked for income proof, and expect a ceiling.
Illustrative only. Every rupee figure below is invented to show the method.
Devendra Sonawane, 34, runs a two person CAD drafting studio in Nashik.
An insurer is very unlikely to hand a ₹9 lakh earner ₹2.5 crore of accident cover. So he works down. Fifteen times income is ₹1,35,00,000, and the underwriting ceiling against his income proof lands lower still. He buys the largest sum insured on offer, adds the temporary total disablement option, and treats the rest of the gap as a reason to hold an emergency fund. The worksheet is not there to hit a theoretical number. It is there to stop you buying ₹5 lakh by reflex.
Personal accident is a benefit policy. It pays a stated sum on a stated event, not your hospital bill. Four heads matter.
| Benefit head | What triggers it | How it is normally shaped |
|---|---|---|
| Accidental death | Death from injury in an accident during the policy period | Full sum insured, usually only if death occurs within 12 months of the accident |
| Permanent total disablement | Injury that permanently stops you working, or a listed catastrophic loss such as sight of both eyes or use of both hands | Full sum insured, again on a 12 month link to the accident |
| Permanent partial disablement | A listed permanent loss, such as one hand, one foot, sight of one eye, fingers or toes | A fixed percentage of the sum insured per listed loss, on a published scale |
| Temporary total disablement | Injury that keeps you off work for a while, then you recover | Weekly cash while you cannot work, capped by weeks and by the sum insured |
That shape is not invented. It is the construct IRDAI set out in its 2021 standard personal accident guidelines, where the first three heads were base covers sharing one sum insured, and temporary total disablement, hospitalisation expenses due to accident and an education grant for dependent children were optional add ons. The weekly disability income a working person most needs was an optional cover, not a base one. If you do not ask for it, you may not have it.
From 1 April 2021 every general and standalone health insurer had to offer one identical standard personal accident product, Saral Suraksha Bima, under guidelines IRDA/HLT/GDL/MISC/036/02/2021 dated 25 February 2021, modified on 23 March 2021.
Both stand superseded. IRDAI's Master Circular on Health Insurance Business, Ref IRDAI/HLT/CIR/PRO/84/5/2024 dated 29 May 2024, says at paragraph IV that it supersedes every guideline and circular in its Annexure-6. Item 25 of that list is the Saral Suraksha Bima guidelines by name. Item 29 is the March 2021 modification. The 2024 master circular carries no standard personal accident mandate forward.
For a buyer that means three things:
This was part of a wider clean up. IRDAI's Master Circular on General Insurance Business repealed the guidelines for Bharat Griha Raksha and for Bharat Sookshma and Laghu Udyam Suraksha by name in its list of repealed circulars.
| Policy | Pays when | What it does not do |
|---|---|---|
| Term life | You die, from almost any cause | Nothing if you survive an accident but can never work again |
| Health indemnity | You are hospitalised, against actual bills | Pays the hospital, not your household. Stops at discharge |
| Personal accident | Accidental death, accident caused disability, or time off work after an accident | Ignores illness. A heart attack or cancer is not an accident |
Only personal accident cover fills the middle gap. A spinal injury that ends a career costs a family more than a death would, because the household loses the income and keeps the person to care for. Term life pays nothing. A health policy pays the surgeon and stops.
There is a second reason worth real money. IRDAI told motor insurers in circular Ref IRDAI/NL/CIR/MOTP/200/12/2018 dated 11 December 2018 that if an owner driver already holds a 24 hour personal accident cover against death and permanent disability, total and partial, for a capital sum insured of at least ₹15 lakh, no separate compulsory personal accident cover need be taken. That circular also allowed a standalone compulsory cover from 1 January 2019, running one year and covering every vehicle the owner driver owns. It sits in the annexure of court ordered circulars that the 2024 General Insurance master circular keeps in force. Check your motor policy so you are not paying twice.
The withdrawn 2021 template carried an exclusion list that most wordings still echo. Check your own schedule against it rather than assuming.
Two structural limits matter as much. The policy does not cover illness at all, and disability benefits are normally tied to the disablement arising within 12 months of the accident.
Keep these ready before you open the proposal form.
Then work down this list.
No. The guidelines that mandated it, IRDA/HLT/GDL/MISC/036/02/2021 dated 25 February 2021, appear at item 25 of Annexure-6 to IRDAI's Master Circular on Health Insurance Business dated 29 May 2024, which supersedes everything in that annexure. The March 2021 modification is item 29. Products built on that template may still be sold, but no rule now requires every insurer to offer one.
There is no regulated answer. Take annual income multiplied by the earning years left, add outstanding loans, subtract cover you already hold, and buy the largest sum insured the insurer will underwrite against that gap. Ten to fifteen times annual income is a common planning benchmark, and a rule of thumb only.
No. These policies respond to injury caused by an accident. Illness, however sudden, is not an accident. That is what health insurance and critical illness cover are for.
The IRDAI policyholder protection regulations of 2024 give 30 days from receipt of the policy document, electronic or otherwise, for life and new individual health insurance policies, except those with a tenure under a year. Personal accident sits inside the health insurance schedule of the Insurance Products Regulations, 2024. If unsure, ask the insurer to confirm your free look days in writing before you buy.
Usually yes, because that cover is built around the owner driver at a fixed capital sum insured. The rule runs the other way too. IRDAI's circular of 11 December 2018 says that if you already hold a 24 hour cover against death and permanent disability, total and partial, of at least ₹15 lakh, no separate compulsory personal accident cover need be taken.
Guaranteed renewability, migration and portability under the IRDAI Insurance Products Regulations, 2024 apply to health insurance policies but expressly exclude personal accident and travel policies. That guarantee does not carry over, so ask about renewal practice before you commit.
That is a documents problem, and it is where the Right to Information Act earns its keep. The FIR copy, post mortem report, inquest papers, disability certificate and government hospital record are all held by public authorities. Our guide to accident claims rejected over FIR and post mortem gaps covers the dispute itself. To pull the papers, draft with the AI RTI Drafter and track the clock on the Timeline Tracker under the RTI Act, 2005.
Written for RTI Wiki by Dr. Shrawan Kumar Pathak. Regulatory position checked against IRDAI primary documents on 6 August 2026. Insurance is a contract. Read your own policy schedule before you rely on any general description.