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.
Indian residents who undertake bonafide trips abroad for:
» Business and Official purposes
» Holiday purpose
» 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.
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.
This policy offers coverage in the following sections:
Section (A): Medical Expenses and Repatriation
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.
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
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.
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.
·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):
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
proposal form elicits the following information:
» 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.
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
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.
The policy comprises two sections, viz. Section I and II as follows:
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
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.
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.
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.
new scheme includes add-on covers as follows:
» Loss of checked baggage
» Delayed baggage