Common use of Broken Bones Clause in Contracts

Broken Bones. We will pay the amount as per percentage mentioned below in table of the Sum Insured as specified in the Policy Schedule / Certificate of Insurance if an Insured Person sustains Broken Bones directly due to an Accident that occurs during this Policy Period and which results in conditions specified in the table below: b) All spinous, transverse process or pedicle fractures 30% c) All other vertebral fractures 20% 9 Fractures of Rib or Ribs, Cheekbone, Coccyx, Upper Jaw, Nose, Toe and toes, finger or fingers: a) Multiple fractures (at least one compound & one complete) 16% b) All other compound fractures 12% c) Multiple fractures, at least one complete 8% d) All other fractures 4% The Benefit specified above will be payable provided that: (a) Any Fracture which results due to any Illness or disease (including malignancy) or due to osteoporosis shall not be payable under this benefit; (b) If an Insured Person suffers a Fracture not specified in the table above but the Fracture is due to an Injury that is suffered during the Policy Period solely and directly due to an Accident that occurs during the Policy Period, then Our medical advisors will determine the amount payable, if any (c) This benefit is applicable on an individual basis irrespective of type of policy (Individual/ Floater). Maximum amount payable in respect of multiple nature of fracture (more than 100%) would be restricted to Sum Insured opted by the Insured for this Benefit as mentioned in the Policy Schedule / Certificate of Insurance during the Policy Year.

Broken Bones. Sr. No. Particulars Percentage of Sum Insured payable 1) Fractures of the Skull: a) Compound fracture with damage to the brain tissue 100% b) Compound fracture without damage to the brain tissue 75% c) All other fractures 50% 2) Fractures of hip or pelvis (excluding thigh or coccyx): a) Multiple fractures (at least one compound & one complete) 100% We will pay the amount as per percentage mentioned below in table of the Sum Insured as specified in the Policy Schedule / Certificate of Insurance if an Insured Person sustains Broken Bones directly due to an Accident that occurs during this Policy Period and which results in conditions specified in the table below: b) All spinous, transverse process or pedicle fractures 30% c) All other vertebral fractures 20% 9 Fractures of Rib or Ribs, Cheekbone, Coccyx, Upper Jaw, Nose, Toe and toes, finger or fingers: a) Multiple fractures (at least one compound & one complete) 16% b) All other compound fractures 12% c) Multiple fractures, at least one complete 8% d) All other fractures 4% The Benefit specified above will be payable provided that: (a) Any Fracture which results due to any Illness or disease (including malignancy) or due to osteoporosis shall not be payable under this benefit; (b) If an Insured Person suffers a Fracture not specified in the table above but the Fracture is due to an Injury that is suffered during the Policy Period solely and directly due to an Accident that occurs during the Policy Period, then Our medical advisors will determine the amount payable, if any (c) This benefit is applicable on an individual basis irrespective of type of policy (Individual/ Floater). Maximum amount payable in respect of multiple nature of fracture (more than 100%) would be restricted to Sum Insured opted by the Insured for this Benefit as mentioned in the Policy Schedule / Certificate of Insurance during the Policy Year.