Benefits of SME Employee Package

Group Life 4 (Death due to – Accident & Sickness)

In the event of the insured employee’s death due to accident or sickness occurring anywhere in the world, except for death resulting from active participation in war or war-like operations and suicide, in the first year of coverage, the benefit amount shall be paid in a lump sum to his/her beneficiary.

Accidental Death

If an accidental injury results in the death of an insured employee, the insured amount shall be paid to his/her beneficiary.

Dismemberment, Loss of Sight, Hearing, and Speech Indemnity

If an accidental injury results in any of the following losses to an insured employee, the payment shall be made in one lump sum to the insured employee in accordance with the applicable percentage indicated here below to be applied to the insured amount.

 Total and Permanent Disability

If, as the result of an accidental injury, an insured employee becomes Totally Disabled, which disability has continued for a period of twelve (12) consecutive months and is unable to engage in any gainful occupation or employment for the remainder of the Insured employee’s life, the benefit amount shall be paid in a lump-sum to such Insured employee.

Accidental Medical Expenses Reimbursement (AMR)

If, as a result of an accidental injury, an insured employee shall require treatment by a physician, use of hospital facilities, or the employment of a licensed or graduate nurse while at the hospital, the Reasonable, Customary and Necessary medical expenses incurred within fifty two (52) weeks 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.

Accidental Weekly Disability Indemnity (AWI)

If, as the result of an accidental injury, an insured employee is Totally Disabled and remains so continuously for a period in excess of the Elimination Period i.e. 1 week (7 days), the Weekly Accidental Disability Indemnity applicable to such Insured employee not exceeding 75% of weekly earned income shall be paid periodically beginning with the first day following such Elimination Period, for the continuous duration of Total Disability, but not to exceed the maximum period of fifty two (52) weeks.

In-Hospital Weekly Income – Accident & Sickness (IH- A&S)

When, as the result of accidental Injury or commencement of sickness, an insured employee 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 (1 day) and Sickness In-Hospital Waiting Period (31 days) stated in the Policy.

Occupational Classification

Class A: Individuals in non-hazardous Occupations with office or travel duties, such as executives, senior management of companies with mostly administrative functions, bankers, accountants, lawyers and similar occupations.

Class B: Individuals facing limited exposure to occupational hazards with superintending, engineering or medical duties, such as plant superintendents, engineers, foremen, physicians, nurses, inspectors, outdoor salesmen and similar occupations.

Class C: Individuals with occupational hazards, such as industrial workers, most of whom are skilled or semi-skilled workers using machinery. Also in this group will be found filling station attendants, farmers, tradesmen, retail delivery clerks, veterinarians, drivers, masons, carpenters and policemen not using motorcycles.

Class D: Individuals with occupational hazards, such as industrial workers using heavy machinery or unskilled laborers, off-shore, oil & gas fields, etc.

First policy issue date: 01/06/2011

MetLife Group Insurance Policies contain certain exclusions, deductibles, limitations. Contact MetLife representative or call us for more information.

NIA Product Code: NIA/LI005/2067/068/GP/0011

SME Policy Wording