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OVERSEAS MEDICLAIM POLICY
This policy gives full compensation to Indian residents for medical expenses incurred by them on sudden accident or illness during their overseas trip for specified purpose.
Eligibility:
Indian residents who undertake bonafide trips abroad for:
» Business
and Official purposes
» Holiday
purpose
» Employment
» Studies
» Spouse
and children accompanying the person who is going abroad,
will be treated under holiday travel
» Foreign
Nationals working in India for Indian Employers of MNCs going
abroad on official visits on behalf of their employers.
Age limit – The policy is specially meant for children from 6 months to 5 years of age, and for adults above 70.
Period
of insurance:
The period of insurance is valid till any of the following
two periods occur first:
1.First Day of Insurance
2.Date and time of departure from India
It terminates if any of the following occurs first:
» The
last day of the number of days specified in the policy schedule
» On return
to India
Note: If there is any hindrance in the public transport services,
the period of insurance shall be extended for 7 days.
Coverage:
This policy offers coverage in the following sections:
Section (A): Medical Expenses and Repatriation
It
offers medical coverage on sudden accident or illness, when
the insured person is outside the Republic of India. The expenses
include the following:
» Physician
fee, hospital expenses and transportation expenses.
» Dental
expenses because dental care is necessary as the accident
cover shall be restricted to terms and conditions.
» Transportation
expenses incurred in the hospital or residence in India.
» If the
death of the insured occurs outside Indian Territory, the
transportation expenses for repatriation to India or for local
cremation in the country where the death occurred.
Exclusions
under this section:
» Expenditure
on treatment that can be delayed till the Insured returns
to India
» Cosmetic
surgery unless necessary
» Routine
check-up or any other examination where no impairment of normal
health is indicated.
» Pregnancy
Expenses
» Restricted
cover: If the proposer is unable to present himself for medical
examination where called for by the Insurance Company, the
limit of indemnity stands reduced to US $ 10000.
Section (B): Personal Accident
This
section provides coverage for death, bodily injury, permanent
total-disablement, or loss of eye(s) or limb(s), as per the
limits provided in the schedule attached.
If the insured is under 16, he or she will be reimbursed by
US$ 2,000 in case of death.
Section (C): Loss of checked baggage
It gives full compensation for the loss of the baggage checked by an International Airline.
Exclusions:
No claim paid for valuables such as telecommunication and
electronic equipments, photographic, audio, computer, antiques,
jewellery, telescopes, spectacles, sunglasses, binoculars,
furs and articles made of precious metals.
Section (D): Delay of Checked Baggage
If the Baggage is not delivered within 12 hours from the scheduled arrival time, this cover will pay for the necessary emergency purchase of replacement items. In this section, a non-delivery certificate and a proof of purchase must be submitted.
Section (E): Loss of passport
This section provides coverage for the actual expenses incurred by the Insured to obtain emergency travel documents in view of lost passport, outside India.
Exclusions:
·Loss to the passport if confiscated by customs, police,
or other authority.
·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, during the trip.
General Exclusions (applicable to all sections):
a)
When the insured person:
» Travels
without taking the permission of a physician
» Waits
for his turn to come for special medical treatment
» Travels
to get medical treatment
» Receives
a diagnosis for a medical condition
b) Suicide, vulnerable diseases & HIV
related illness.
c) Medical services obtained within India.
d) Insured in Naval, Military or Air force
service.
e) Arising from participation in some professional
or hazardous sports events.
f) Insured working in aviation department.
General Conditions applicable to all sections:
»
The policy will stand valid only if the journey
of the insured starts within 14 days of the First Day of Insurance,
as indicated in the policy schedule.
» The
policy will be canceled ONLY if a journey is not undertaken
and on production of the Insured Person’s PASSPORT.
» Any
claim made by the Insured or his representative must be notified
to the Local Medical Advisors immediately.
» If the
insured stays away from India continuously for more than 180
days, the policy ceases to be effective, unless the insurer
has agreed for such an arrangement.
» Disputes
should be handled as per the conditions under the Indian Arbitration
and Conciliation Act, 1996.
» The
sum insured will not carry interest.
The Proposal Form
The
proposal form elicits the following information:
» Age
» Type
of Plan
» Passport
Number
» Name,
address, and registration number of the physician
» Future
countries to visit, purpose of trip, planned date of departure,
number of days of stay
» Detailed
information on the medical condition of the proposer
» The
declaration in the form includes consent to the insurer/Medical
Advisor to seek medical information from ant doctor who has
attended on the proposer.
Premium
The amount of premium is fixed on the basis of age, period
of stay, and the type of plan selected.
CORPORATE GROUP OVERSEAS MEDICLAIM POLICY
It
is a group policy for the employers, who regularly send their
employees abroad for business purpose, training, project work,
etc. It is a declaration-based policy, which charges an advance
deposit premium for a specified number of days. The insured
will have to submit details of the persons who go abroad.
A separate certificate of insurance is to be issued for employees
going abroad on intimation of the trip to the insurers.
Those who are above 70 at the inception of the policy shall
not be covered. Those who are over 60 have to submit medical
reports (i.e. Blood/Urine Strip Test and ECG and /or Stress
Tests).
Any material change in the health condition of the insured
has to be intimated to the insurers. The certificate will
not be issued beyond 180 days. There is a retention period
of 500 days based on which the premium is calculated. The
terms and conditions will be the same as in the case of Overseas
Mediclaim Policy. The Premium is charged on per day basis
and according to the type of plan.
CORPORATE FREQUENT TRAVELERS
This is an Annual policy. It is specially meant for those who frequently travel abroad for official purpose. It is also available to partners of registered firms. The period of one trip should not go beyond 60 days. If the insured is traveling abroad on the last day of the policy, the cover shall include his duration of trip in anticipation of his return to India within 59 days of the expiry date. The policy does not cover persons who are above 65 years of age. This Policy is issued to individuals only.
EMPLOYMENT AND STUDY POLICY
This Policy is designed for Indian citizens temporarily posted abroad in a sedentary non-manual work or students prosecuting studies or engaging in research activities abroad. The scheme is offered across the world, including USA/Canada.
Coverage:
The policy comprises two sections, viz. Section I and II as
follows:
Section
I
Sub-Section A
Medical
Expenses incurred in respect of diseases/injury contracted
during the policy period limited to maximum liability:
» Under
the policy
» 52 weeks
after the onset of injury/sickness
» 12 weeks
after the expiry date of the policy
Sub
Section B
This section provides coverage for the medical expenses of
the insured evacuating to India, subject to the limits as
provided under Sub-Section A and in addition, maximum limit
being US $ 5,00,000.
Sub
Section C
Repatriation and Alternative Expenses:
If the insured dies, the expenditure on the preparation and
transportation of his body to India or funeral expenses incurred
in the Country of posting, will be paid by the Insurers.
Sub
Section D
Medical Emergency Reunion Expenses:
The traveling expenses incurred by parents or spouse of the
insured person, when it becomes necessary for the insured
to be medically evacuated to India as soon as possible. The
following are the expenses covered under this section:
» ·Cost
of an Economy-class Air Ticket per person
» Travel
and accommodation expenses.
» Maximum
limit: US$ 5,000
Section II: Contingency Insurance
It is meant to cover the sponsors providing financial support to the insured person for studies in the country mentioned in the policy schedule. In case of inability of the insured person to complete his studies abroad due to happening of covered injury or sickness, the cover will reimburse at a rate of US$ 750 capital sum for each month of study completed, to the nominated sponsor. In case insured cannot continue his course of studies due to mental nervous or emotional disorder, this benefit is limited to 25% of the amount due. The proposal form, underwriting procedure, and the policy exclusions are quite similar to Overseas Mediclaim Policy.
The
new scheme includes add-on covers as follows:
» Loss
of checked baggage
» Delayed
baggage
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