1.0 Objective
1.1 The Group Personal Accident Insurance Scheme is a welfare measure formulated to insure the employees against the consequences of personal accidents and provide appropriate relief to the affected employee or the nominees through an Insurance Cover.

2.0 Policy
2.1 The Scheme is framed entirely as a welfare measure and does not confer any right or benefit on the employees, nor imposes any obligation or liability, whatsoever on the Company and shall not be deemed to be any contract or condition of service between the Company and its employees.

2.2 SJVNL will take an Insurance Policy and the employees shall be entitled to get the benefits only as admissible under the provisions of the said Insurance Policy.

3.0 Scope
3.1 The Scheme shall cover all employees borne on the regular establishment of SJVNL, (including deputationists from HPSEB) and will also include/cover Board level appointees, deputationists, trainees of the Company, but shall not cover:

Apprentices under the Apprentices Act, Muster Roll/Daily Rated/Casual/ Badli/ Substitute employees or employees appointed on contract basis.

5.0 Benefits
5.1 The Insurance Policy will provide coverage by way of payment of compensation to the extent specified in this Scheme to the covered employees round the clock, whether he is on Company's duty or not, on any location in India or abroad; against a bodily injury resulting solely and directly from accidents caused by violent, external and visible means which shall solely, and independent of any cause, result in death or disablement (as per the provision/Schedule in the Policy). The benefits under the Policy in brief are as follows:

5.2 Death
In case of death of a covered employee, caused by accident as at para 5.1, the nominee(s) of the employee will be paid a compensation by the Insurers to the extent of 100% of the Capital Sum Assured, which will be 50 months pay (i.e. Basic Pay and Dearness Allowance) of the employee determined with reference to the position as on 1st March of the financial year during which the death takes place.

5.3 Permanent Disablement
In case of permanent disablement (total or partial) of a covered employee, caused by accident as at para 5.1 above, the employee will be paid compensation by the Insurers as indicated at Annexure-I and Annexure-II.

5.4 Temporary Disablement
In case of temporary disablement of a covered employee caused by an accident as at para 5.1, the employee will be paid compensation by the Insurers at the rate of 1% of Capital Sum Assured per week only during the period the employee is on leave subject to the condition that this weekly benefit does not exceed Rs. 5000/- per week. The compensation payable for temporary disablement shall not be paid for more than 104 weeks in respect of anyone injury calculated from the date of commencement of the disablement and in no case shall exceed the Capital Sum Assured.

5.5 The compensation under more than one of the sub-clause 5.2,5.3 and 5.4 in respect of the same period of disablement shall not be payable. In other words, the covered employee will be entitled to compensation under only one of them in case of the same accident.

5.6 Any payment in case of more than one claim in respect of such insured person under the Policy during anyone period of Insurance by which the maximum liability of the Insurer, applicable to the covered employee, exceeds the total sum assured under the Policy, shall not be payable.

6.0 Employees covered by the provisions of the Workmen's Compensation Act, 1923:
6.1 Where a covered employee is governed by the provisions of the Workmen's Compensation Act, 1923 and certain compensation becomes payable under the Act, the compensation under this Scheme shall be in lieu of the compensation payable under the provisions of the Workmen's Compensation Act, 1923. Where in a particular case, the amount payable under this scheme falls short of the amount payable under the said Act, the difference will be paid by the company. In other cases, where the payment is higher under the Scheme than the amount admissible under the Act, the higher of the two will be admissible. However, in no case, compensation will be paid under both i.e. this Scheme and the Workmen's Compensation Act.

7.0 Administration of the Scheme
7.1 The Group Personal Accident Insurance Policy shall be taken from an Insurance Company and same shall be notified.

7.2 The Group Personal Accident Insurance Policy No. for the Policy taken by SJVNL shall be notified by P&A department as and when there is a change.

7.3 All correspondence pertaining to renewal of the Policy, additions of manpower and claims under the Policy may be made to the insurers, quoting the GPAI Policy Number.

7.4 The responsibility for renewal of the Policy w.e.f. 29th March of each year shall be of the Corporate Personnel Establishment Group, Shimla, who shall send to the Insurers a consolidated list of employees to be covered under the Scheme, alongwith the requisite details and the premium payable under the Policy.

7.5 In case of additions in manpower during the validity period of the Policy, the concerned P & A departments shall send to the Insurers, on a monthly basis, an intimation to this effect, under intimation to the Corporate Personnel Establishment Group, Shimla. Thereafter, the Insurers shall intimate the premium to be paid for the said additions, which shall then be paid to the insurers.

7.6 The claims under the Policy may be preferred by the concerned P&A departments directly with the Insurers. It shall be the responsibility of the said P&A departments to follow-up and expeditiously get the claims cleared by the Insurers.

8.0 Conditions and Procedures of Claims under the Scheme
8.1 If a covered employee sustains any bodily injury in respect of which a claim is or may be made under this Scheme, prompt written notice thereof shall be given by the employee to the concerned Personnel department, who will inform the Insurers as soon as possible. If, however, the covered employee dies, notice of death shall be given forthwith by the employee's legal representative/nominee to the Insurance Company/the concerned Personnel Department. A copy of this will also be required to be sent to the Corporate Personnel Establishment Group, Shimla by the concerned Personnel Department.

8.2 All certificates, information and evidence required by the Insurers shall be furnished at the expense of the covered employee or his legal representative/ nominee and shall be in such form and of such nature as the Insurers may prescribe from time to time.

8.3 Upon the happening of any event, which may give rise to a claim under this Policy, written notice with full particulars must be given to the Insurer immediately. In case of death, written notice of the death must, unless reasonable cause is shown, be given before internment/cremation, and in any case, within one calendar month of the death, as also in the event of loss of sight or amputation.

8.4 The insured employee must, immediately after the occurrence of an accident, which may be the subject of a claim under this Policy, obtain and follow the advice of a registered medical practitioner, failing which the insurers shall not be liable for any consequence arising from such failure by the covered employee to obtain and follow such medical advice.

8.5 The formalities to be observed for claiming compensation from the insurers in the happening of any of the events mentioned hereinabove shall be as under. It shall be the responsibility of the concerned Personnel Department to ensure that the claims are preferred only after observing the requisite formalities.

a) Claims pertaining to Death
The covered employee's legal representative/nominee will submit the claim in the prescribed form for this purpose alongwith the following documents:

• Claim in prescribed form;
• Attested copy of Death Certificate;
• Attested copy of Post Mortem Report; and
• Hospitalization Certificate in case of hospitalization and subsequent death.

b) Claims pertaining to Permanent (Total and Partial) Disablement
The covered employee shall submit the claim in the prescribed form for this purpose alongwith the following documents:

• Claim Form/Attending Doctor's Report;
• Medical Fitness Certificate;
• Leave Sanction Certificate by P & A Department; and
• Documents pertaining to the medical treatment.

c) Claims pertaining to Temporary Total Disablement:
The covered employee shall submit the claim in the prescribed form for this purpose alongwith the following documents:

• Claim Form/Attending Doctor's Report;
• Leave Sanction Certificate by P & A Department;
• Medical Fitness Certificate except in case of claim for interim payment; and
• Documents pertaining to the medical treatment.

9.0 Inadmissibility for Compensation under the Scheme
9.1 The Insurers shall not be liable for death/disablement, directly or indirectly, caused by/arising out of or resulting from or traceable to certain contingencies of which an illustration is given below:

1. Intentional self-injury, whether criminal or not, suicide or attempted suicide;

2. The covered employee being under the influence of or being affected by intoxicating liquor or drugs;

3. Child birth or pregnancy or other physical causes peculiar to the female sex (in the case of female insured employee);

4. Hunting, Mountaineering, Aviation (other than as a Passenger on a Scheduled Flight) etc.

5. Any physical defect or infirmity, which existed prior to the date of affecting this Insurance.

Note: These conditions are subject to change without notice at the instance of the Insurers.

10.0 General
10.1 With the introduction of the Scheme, the facility of taking Air Travel Insurance by the entitled employees under the SJVNL Traveling & Daily Allowance Rules stands withdrawn.

10.2 A compensation under this Scheme shall be paid to the covered employee or his nominee, as the case may be, and to the extent the compensation in settlement of the claim is received from the Insurers.

10.3 In respect of matters which are not specifically covered in the above Scheme, the provisions of the Policy taken from the Insurers will be followed. Further, in case of differences, if any, in the provisions of the Scheme and that of the Insurance Policy, the latter shall prevail.

10.4 The management reserves the right to modify or amend or withdraw the Scheme, at any time, without notice.