Personal Accident Claims Assistance

Personal accident policies may respond to covered accidental injury events according to their own definitions, tables of benefits and exclusions. Claim files frequently combine medical evidence with incident context and, where relevant, employer or authority records.

Claims Saathi helps customers organise these materials, identify commonly pending items and follow up on documentation queries. We do not assess disability percentages, certify injury causation or approve benefit payouts.

Exact benefit triggers—accidental death, permanent total or partial disability, temporary disability weekly benefits, or other listed covers—depend entirely on policy wording and insurer evaluation.

• Individuals intimating a PA claim after an accidental injury
• Families organising medical and hospital records for a PA benefit request
• Employees coordinating employer attendance or incident confirmations where asked
• Claimants gathering police or authority records when those apply to the incident
• Customers responding to insurer medical or disability documentation requests

• Road or workplace accidental injury with hospital treatment records
• Follow-up physiotherapy or disability assessment papers requested by the insurer
• Need to align accident date narratives across medical and incident documents
• Employer letter or attendance record sought for a weekly benefit claim
• Organising imaging reports, operative notes and discharge papers for review

1. 1

   Record the accident facts

   Capture date, place and a clear factual description of the accidental event.

2. 2

   Intimate the insurer

   Use the insurer’s prescribed intimation channel and retain the reference number.

3. 3

   Assemble medical records

   Collect consultation notes, diagnostics, prescriptions and discharge documents.

4. 4

   Add incident or authority papers

   Where applicable, include FIR extracts, employer notes or other requested confirmations.

5. 5

   Address disability-related requests

   If the insurer seeks disability certification, obtain it from authorised medical sources only.

6. 6

   Follow up on requirements

   Respond to pending lists while the insurer evaluates the claim under the PA policy.

• Policy number and covered person details
• Accident date, time and location stated factually
• Nature of injury as described in medical records (not as our opinion)
• Hospital or clinic names and treating doctor details from official papers
• Employer or authority reference details where those records are requested
• Bank details for benefit credit if the insurer requires them

Documents commonly requested may include the items below. Requirements vary based on the insurer, TPA, policy terms and claim circumstances.

• Inconsistent accident dates across forms and medical notes
• Missing specialist reports when the insurer specifically asked for them
• Unclear link between billed treatment and the reported accidental event
• Employer or authority letters that omit dates the insurer needs
• Late replies to medical examination appointments arranged by the insurer

• Building a PA-oriented document checklist from the insurer’s requirement letter
• Organising medical and incident records into a clear index
• Flagging apparent gaps before submission
• Helping structure factual accident descriptions without legal conclusions
• Supporting follow-up on pending documentation items
• Guiding secure sharing of sensitive medical files

• Intimate within the timelines stated in your policy or insurer guidance
• Obtain medical and disability documents only from authorised professionals
• Do not ask Claims Saathi to certify disability or fitness
• Keep copies of everything submitted
• Attend insurer-arranged medical exams when lawfully required under the claim process

The insurer decides whether the event meets the policy’s accident definition, which benefit table applies, any exclusions, and the payable amount.

Independent medical examinations or disability assessments, when required, are directed by the insurer—not by Claims Saathi.

Claims Saathi assists with documentation and coordination but does not determine claim approval.

You may also find these related assistance pages useful.