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Group Affinity

Members’ Protection

The success of Affinity Group depends on the welfare of all its members. 

With the increasing uncertainty of life, it is important for you to protect your valuable group members against any adverse eventuality due to accident or sickness and the financial strain it brings.

 

Keeping your needs in mind, MetLife brings to you a new Group Insurance Plan – Group Affinity, which provides your members 24 hours a day and 365 days a year worldwide protection against financial loss due to accident & sickness.

 

Group Affinity is a pure protection and yearly renewable term policy that includes Group Life, Group Personal Accident & Health (GPA) and Group Critical Illness benefits. The Policy comprises the following types of coverage which are customizable for the needs of your Affinity Group. 

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Group Life

i. Loss of Life (Death due to Accident or Sickness)
In the event of the insured member's death due to any cause - accident or sickness occurring anywhere in the world, except for death resulting from active participation in war or war like operations, and suicide, the benefit amount shall be paid in a lump-sum to his/her beneficiary

Group Personal Accident & Health

i. Accidental Death (AD)
If an accidental injury results in the death of an insured member within One hundred eighty three (183) days from the date of the accident, the insured amount shall be paid to his/her beneficiary.

ii. Dismemberment, Loss of Sight, Hearing, and Speech Indemnity
If an accidental injury results in any of the following losses to an insured member within One hundred eighty three (183) days from the date of the accident, the payment shall be made in one lump sum to the insured member in accordance with the applicable percentage indicated here below to be applied to the insured amount.

Disability Applicable Percentage Disability Applicable Percentage Disability Applicable Percentage
Loss of Both Hands or Both Feets 100% Loss of either Hand or Foot and Sight in one eye 100% Loss of either Hand or Foot 50%
Loss of sight in both eyes 100% Loss of Speech 100% Loss of Sight in one Eye 50%
Loss of one Hand and one Foot 100% Loss of Hearing in Both Ears 100% Loss of Thumb & Index Finger 25%

iii. Total and Permanent Disability (PTD)
If, as the result of an accidental injury an insured member becomes Totally Disabled within One hundred eighty three (183) days from the date of the accident and such disability has continued for a period of twelve (12) consecutive months, the benefit amount shall be paid in a lump-sum to such insured member.

iv. Accidental Medical Expenses Reimbursement (AMR)
If, as a result of an accidental injury, an insured member shall require treatment by a physician, use of hospital facilities, or the employment of a licensed nurse while at the hospital within the thirty (30) days after the date of the Accident, the Reasonable, Customary and Necessary medical expenses incurred within one (1) Year from the date of the accident for such physician treatment, hospital charges and nurses fees, which are in excess of the deductible (Rs. 500) and up to insured amount limit stated in the Policy shall be paid.

v. In-Hospital Weekly Income - Accident (IH- A)
If, as the result of accidental injury except pre-existing conditions, an insured member shall be necessarily confined within a hospital as an in-patient for at least 24 hours under the continuous attendance of a physician, the Weekly Benefit stated in the Policy shall be paid, for each week that the insured person shall be confined therein, up to fifty two (52) successive weeks. If an insured person is confined for a portion of week, one seventh (1/7) of the Weekly Benefit shall be paid for each day of the confinement.

vi In-Hospital Weekly Income – Accident or  Sickness (IH-A/S)
If, as the result of commencement of accidental injury or sickness, except pre-existing conditions, an insured member shall be necessarily confined within a hospital as an in-patient for at least 24 hours under the continuous attendance of a physician, the Weekly Benefit stated in the Policy shall be paid, for each week that the insured person shall be confined therein, up to fifty two (52) weeks, commencing immediately following the Elimination period one (1) day. If the Insured member is confined for a portion of a week, one seventh (1/7) of the Weekly Benefit shall be paid for each day of the confinement commencing immediately following the Elimination period, if any. Waiting Period is 31 days and for injury or sickness related to tonsils, hernia or female organs of reproduction Waiting Period is 120 days as stated in the Policy. 

Group Critical Illness

Critical Illness provides a lump sum payment to an insured member when the insured member is diagnosed to be suffering from the following critical illnesses, except pre-existing conditions, as listed and defined in the Policy commencing immediately following the Waiting Period (60 days). Insured members can be covered under one of the following three (3) plans:

Plan 1:   Major Cancers Only.

Plan 2:   Major Cancers, Stroke, First Heart Attack, Serious Coronary Artery Disease, Heart Valve Surgery, Primary Pulmonary Hypertension.

Plan 3:   Major Cancers, Stroke, First Heart Attack, Serious Coronary Artery Disease, Heart Valve Surgery, Primary Pulmonary Hypertension, End Stage Lung Disease, End Stage Liver Failure, Fulminant Hepatitis, Kidney  Failure, Coma,  Aplastic Anaemia, Major Organ/Bone Marrow Transplantation. 

NIA Product Code: NIA/LI005/2073/074/GP/0006

Group Affinity Policy Wording