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Planning an international trip from India? An Overseas Mediclaim Policy is a comprehensive travel insurance plan designed to protect Indian residents from unexpected medical expenses and other travel-related emergencies while abroad. This policy provides financial compensation for sudden accidents or illnesses that occur during your overseas journey for various purposes, offering peace of mind so you can focus on your travel.

What is an Overseas Mediclaim Policy?

An Overseas Mediclaim Policy offers financial compensation to Indian residents for medical expenses incurred due to sudden accidents or illnesses during their international travels for specified purposes. It acts as a safety net, covering various unforeseen circumstances that could arise outside of India.

Who is Eligible for an Overseas Mediclaim Policy?

Indian residents undertaking legitimate trips abroad are generally eligible. This includes individuals traveling for:

Business and official purposes
Holiday or leisure
Employment
Studies
Spouses and children accompanying the primary traveler (typically covered under holiday travel)
Foreign Nationals working in India for Indian employers of multinational corporations (MNCs) who travel abroad on official visits for their employers.

Specific age considerations apply: the policy is particularly designed for children aged 6 months to 5 years, and for adults over 70 years of age, indicating special provisions for these age groups.

How Long Does Coverage Last?

The period of insurance generally begins on the earlier of the "First Day of Insurance" or the "Date and time of departure from India" as specified in your policy schedule. Coverage typically terminates on the earliest of the following events:

The last day of the number of days specified in your policy schedule.
Your return to India.

In cases of public transport disruptions, the insurance period may be extended for an additional 7 days.

What Does the Policy Cover?

This policy offers coverage across several key sections:

Section A: Medical Expenses and Repatriation

This section provides medical coverage for sudden accidents or illnesses occurring when the insured person is outside the Republic of India. Covered expenses typically include:

Physician fees, hospital expenses, and local transportation expenses.
Dental expenses, specifically when dental care is necessary due to an accident, subject to policy terms and conditions.
Transportation expenses incurred for returning to a hospital or residence in India.
If the insured person dies outside Indian Territory, transportation expenses for repatriation of the body to India or for local cremation in the country where death occurred.

Exclusions under Section A:

Expenditure on treatments that can be reasonably delayed until the insured returns to India.
Cosmetic surgery, unless deemed medically necessary.
Routine check-ups or any other examinations where no impairment of normal health is indicated.
Pregnancy-related expenses.
If the proposer is unable to present themselves for a medical examination when requested by the insurance company, the limit of indemnity may be reduced to US$ 10,000.

Section B: Personal Accident

This section provides coverage for death, bodily injury, permanent total disablement, or loss of eye(s) or limb(s), up to the limits specified in the policy schedule. For insured individuals under 16 years of age, a reimbursement of US$ 2,000 is provided in case of death.

Section C: Loss of Checked Baggage

This section offers compensation for the loss of baggage checked with an International Airline.

Exclusions under Section C:

No claim is paid for valuables such as telecommunication and electronic equipment, photographic gear, audio devices, computers, antiques, jewelry, telescopes, spectacles, sunglasses, binoculars, furs, and articles made of precious metals.

Section D: Delay of Checked Baggage

If your checked baggage is not delivered within 12 hours of your scheduled arrival time, this cover will pay for necessary emergency purchases of replacement items. To claim under this section, a non-delivery certificate from the airline and proof of purchase for the replacement items must be submitted.

Section E: Loss of Passport

This section covers the actual expenses incurred by the insured to obtain emergency travel documents due to a lost passport while outside India.

Exclusions under Section E:

Loss of passport if confiscated by customs, police, or other authorities.
An official report obtained on theft without the knowledge of the police.

Section F: Personal Liability

This policy provides coverage for accidental bodily injury to third parties or accidental damage to third-party property that occurs during your trip.

Are There General Exclusions?

The following general exclusions apply to all sections of the policy:

When the insured person travels without a physician's permission, waits for special medical treatment, travels specifically to get medical treatment, or receives a diagnosis for a medical condition that could have been addressed before travel.
Suicide, self-inflicted injuries, venereal diseases, and HIV-related illnesses.
Medical services obtained within India.
The insured person being in Naval, Military, or Air Force service.
Claims arising from participation in professional or hazardous sports events.
The insured person working in an aviation department.

What Are the General Conditions?

Several general conditions apply to all sections of the policy:

The policy is valid only if the insured's journey starts within 14 days of the "First Day of Insurance" as indicated in the policy schedule.
The policy can be canceled ONLY if a journey is not undertaken and upon production of the Insured Person’s passport.
Any claim made by the insured or their representative must be notified immediately to the Local Medical Advisors.
If the insured stays away from India continuously for more than 180 days, the policy ceases to be effective, unless the insurer has agreed to an extended arrangement.
Disputes should be handled according to the conditions outlined in the Indian Arbitration and Conciliation Act, 1996.
The sum insured will not accrue interest.

How is the Premium Determined?

The premium amount is calculated based on several factors, including the age of the traveler, the intended period of stay abroad, and the specific type of plan selected.

What Information is Needed for the Proposal Form?

The proposal form typically requests the following information:

Age
Type of plan desired
Passport Number
Name, address, and registration number of your physician
Future countries to visit, purpose of trip, planned date of departure, and number of days of stay
Detailed information on the proposer's medical condition
A declaration that includes consent for the insurer/Medical Advisor to seek medical information from any doctor who has attended to the proposer.

Other Overseas Travel Insurance Policies

Corporate Group Overseas Mediclaim Policy

This is a group policy designed for employers who regularly send their employees abroad for business, training, project work, or similar purposes. It is a declaration-based policy where an advance deposit premium is charged for a specified number of days. The employer must submit details of employees traveling abroad, and a separate certificate of insurance is issued for each trip upon intimation to the insurers. Individuals over 70 years of age at the policy's inception are generally not covered. Those over 60 may need to submit medical reports (e.g., Blood/Urine Strip Test, ECG, and/or Stress Tests). Any significant change in an insured's health condition must be reported to the insurers. Certificates are typically not issued for periods exceeding 180 days. The premium is charged on a per-day basis, depending on the plan type, with a retention period of 500 days used for calculation. The terms and conditions are generally similar to the standard Overseas Mediclaim Policy.

Corporate Frequent Travelers Policy

This is an annual policy tailored for individuals who frequently travel abroad for official purposes. It is also available to partners of registered firms. Each individual trip under this policy should not exceed 60 days. If the insured is traveling abroad on the last day of the policy, coverage may extend to include the duration of that trip, provided they anticipate returning to India within 59 days of the policy's expiry date. This policy does not cover individuals above 65 years of age and is issued to individuals only.