Overseas mediclaim insurance coverage details

Medical Benefits/Benefits: The list of coverage details can be also called as benefits or medical benefits. Some insurers would simply call it as benefits or others could have them under coverage details sections.

Insurance Brochure: The hard copy or soft copy document which contains the medical benefits, inclusions, exclusions, sum assured, terms and conditions, claims procedure… of overseas travel insurance policy. Normally the plan brochure is sent to customers along with the insurance policy document. It can be also downloaded online in PDF format and printed.

Hospitalization: The coverage offered for medical expenses incurred by the insured in case of admitting to the hospital for 24 hours or more in a foreign country during medical emergency situation.

Cashless Hospitalization: There are some travel insurance policies which can cover the policy holder for benefit of not paying a single dollar from their pocket to the hospital. The insurance company will pay the medical cost incurred by the insured at the hospital. This is also called as ‘cashless settlement’ by few insurers.

Pre-existing condition: The health condition or disease that was existed for the insurance customer during the time of buying overseas travel insurance policy. The definition of pre-existing condition and the types of diseases included can vary from insurer to insurer. Read plan brochure to get accurate definition of pre-existing condition from your insurer.

Evacuation: It is also called as medical evacuation and is covered by most Indian insurance companies. In case if the insured is abroad and stranded in a country where there is no medical facility or treatment available for the particular injury or ailment then the insured will be evacuated in chopper or aircraft to another country or home country for treatment. In such situations the insurance company will bear the expenses incurred as per the terms and conditions.

Repatriation: In the event of death of insured person the insurance company will facilitate and pay expenses incurred for getting the dead body to the home country. The sum assured could be different from insurer to insurer and the facilities can also largely vary.

TPA: Third Party Administrator, approved by Insurance Regulatory & Development Authority of India (IRDAI). TPA provides service for insurance policy holders with respect to coordination of treatment in hospitals/settlement of bills on behalf of Insurance Companies.

Accidental Death & Dismemberment (AD&D): This benefit will pay for preventive services, medical expenses and catastrophic care in case of accidental injury or accidental death and related health expenses. There can be limits for the sum assured which will be explained in detail on the plan brochure.

Claim: The payment request or contractual benefits by the insurance company as soon as the eventuality covered under the policy arises. The insured or the nominee can make a written request to the insurance company to cover the incurred loss which will be submitted as per the standard form of the insurance provider. Often, the reputation of the insurance company is evaluated based on the effectiveness of the claims settlement to customers.

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