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Life is unpredictable and there is no way of knowing what might happen next. An unexpected accident can have a severe impact on your life, leaving you with permanent physical disability, affecting your financial situation, and disrupting your life plans. This is where a mobility cover comes in handy, as it provides financial aid for mobility support required by the insured, because of an accidental injury. This blog will discuss mobility coverage in detail and how it is covered under health insurance.
How Does Health Insurance Cover Mobility?
Mobility benefits are provided under personal accident cover, which compensates for the expenses incurred in procuring medically necessary prosthetic devices, orthopaedic braces, and medical equipment required by the insured due to an accident. Such a cover provides financial aid to fulfil your mobility needs. A mobility cover is payable under permanent total disablement. However, there are certain conditions to be fulfilled for a mobility cover claim to be accepted:
- The prosthetics or medical equipment are covered only if advised by the treating medical practitioner.
- Expenses for prosthetics or medical equipment should not exceed the amount specified in the Policy Certificate..
- Spectacles, contact lenses, hearing aids, blood pressure and blood sugar monitoring machines are not covered under mobility benefits.
Care Health Insurance offers mobility coverage for individuals under personal accident insurance through the Care Secure plan. Let’s know more about this plan.
Care Secure: A Comprehensive Personal Accident Insurance
Care Secure is a comprehensive health insurance plan that covers a medical emergency caused due to an accident. The key features of the plan are:
- The sum insured starts from ₹ 10 lakhs and can go up to ₹ 25 cr.depending upon the plan option you choose. (*Claim amount is subject to underwriter’s discretion only)
- The entry age for children is 91 days to 24 years, and for adults is 18 years to 70 years.
- The plan has lifelong renewability.
- Care Secure is available for a tenure of 1 year, 2 years and 3 years.
- The plan also offers a loyalty benefit of a 5% increase in the sum insured per policy year, maximum up to 50% increase in the sum insured.
Coverage Under Personal Accident Plan
Accidents can happen anywhere, anytime. An unforeseen event can have a long-lasting impact. Having a personal accident cover can financially protect you and your family in case of any mishap. Here are the coverage benefits available under the Care Secure plan:
Accidental Death
In case of the death of the insured due to an accident within the policy term, the beneficiary gets 100% of the sum insured amount as death compensation. This claim is payable provided that the death of the insured member occurs within 12 months of the date of accident. Further, this is only applicable if the accident has happened in the policy year.
Permanent Total Disablement
Permanent total disablement due to an accident during the policy term is covered as per the policy terms and conditions. Here is a list of disability and the corresponding sum insured payout:
| Insured Event | % of Sum Insured Payable |
|---|---|
|
Total irrecoverable loss of both eyes/ one eye Physical separation of pair of limbs/one limb |
100% |
|
Total irrecoverable loss of
|
100% |
| Total irrecoverable loss of eye-sight of one eye or dismemberment of one foot or hand | 50% |
| Total irrecoverable loss of use of one hand or one foot | 50% |
|
Complete and irrecoverable paralysis of the lower half of the body Complete and irrecoverable paralysis of four limbs Complete and irrecoverable paralysis of one side of the body including the arm, leg and trunk |
100% |
Permanent Partial Disablement
If the insured person happens to suffer from any partial but permanent disablement due to an accident during the policy term, the coverage is available as per the policy terms. Check the policy document for the detailed list of partial disablement and the payable sum insured.
Mobility Cover
If the insured loses body parts due to an accident and needs artificial body parts as a replacement or assistive devices such as a wheelchair, the cost of procuring mobility support is covered up to the limit specified in the policy. Note that mobility cover in health insurance is available only under permanent total disablement.
Fractures
The policy has a list of fractures that are covered in case the insured suffers from a fracture due to an accident like a hip fracture or leg fracture. If there are multiple fractures the maximum payable amount is 100% of the sum insured.
Burns
Second and third-degree burns due to an accident are covered up to the sum insured. However, the percentage of the sum insured payable varies according to the extent of the burn injury. You should go through the policy documents to understand the extent of coverage you will receive.
Reconstructive Surgery
If the insured has an impairment in the body due to an accident for which reconstructive surgery is ruled to be medically required, the same will be covered under the policy. The cost of reconstructive surgery is covered up to the limit specified in the policy documents. Such surgery is covered only if it is performed within 30 days of the accident or injury.
Major Diagnostic Tests
Major diagnostic tests such as CT scan or MRI required to be conducted due to an accident are also covered provided these tests are prescribed by a medical practitioner within 3 months of the injury.
Child Education
In case of the accidental death or disability of the insured, the education expenses of the dependent children are covered up to the limit specified in the policy. ‘Child’ in the policy documents refers to a child who is dependent on the policyholder, has not attained the age of 25 years, and does not have an independent source of income.
Final Thoughts
Mobility cover is specially designed to cover the mobility needs of the insured arising due to an accidental injury. It is important as it provides financial support and reduces the expenses of disability treatment. The plan is essential for people engaged in hazardous professions such as mining, product manufacturing, etc. It supports individuals suffering from a permanent disability due to an accident to regain their independence and confidence. Care Secure plan is an affordable personal accident policy that offers lifelong comprehensive coverage.
>> Also Read: Personal Accident Insurance vs. Health Insurance
Disclaimers: All plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.
