Insurance FAQ's, Indian travel insurance FAQ

Sublimits are extra limitations in an insurance policy's coverage of certain losses, primarily Sickness Medical expenses. They are part of the original limit, that is, they do not provide extra coverage, but set a maximum limit to cover a specific loss or for a specific medical expense. Sublimits can be expressed as a dollar amount or as a percentage of the coverage available. Typically they are part of the policy for insureds with advancing age.

For example, in a travel policy which has an Accident & Sickness Expense coverage of $100,000, it might have a sublimit of $10,000 to cover Surgery Expenses in the case of a Sickness. This means that only $10,000 of the total coverage can go toward paying for Surgery Expenses. The insured cannot receive an insurance payout of an amount exceeding the sublimit for the types of loss specified.

It is important to note that most insurance companies have a medical sublimit in place only for Sickness Medical expenses and this means that for any Accident related expenses, the maximum Sum insured is available to the insured for treatment.

The deductible is a cost sharing requirement that the Insurer will not be liable to pay/indemnify/reimburse in case of travel insurance policies for Accident & Sickness and for a specified number of days/hours in case of hospital cash/non medical benefits which will apply before any benefits are payable by the Insurer. A deductible does not reduce the sum insured. The deductible is applicable per event.

For example, the deductible under Accident & Sickness is $100. This means for every medical claim, the insurance company will not settle the first $100 of the claim. So if the medical claim is $250, then the insured will get a reimbursement of $150 (Claim amount $250 – Deductible of $100). Similarly if the claim amount is $90, then the insured will not get any reimbursement since the claim amount is less than the deductible limit of $100.

Another example of a deductible is for a benefit like Trip/Flight Delay. The deductible in this case is 12 hours. This means that if the insured’s Trip/Flight is delayed due to Inclement Weather or Equipment Failure beyond 12 hours, then the insured will get a compensation from the insurance company as per the terms of the policy. However, if the flight is delayed for 8 hours, then there will be no compensation to the traveller since the delay is less than the deductible of 12 hours.

The deductible under the Accident & Sickness is normally USD $100 .The policy deductible is applicable for each instance of sickness/ailment. For continuous treatments relating to the same sickness, the deductible will only be applicable once. The insured is required to quote the Claim reference number when contacting the assistance company while undergoing follow up / re-revisit treatments. The deductible will need to be paid by the insured in each instance of a new/ different ailment / sickness. If the insured is claiming a reimbursement for incurred medical expenses, then the insurance company will reimburse the expenses less the deductible amount.

During discharge of the patient and on preparation of the final bill, the deductible mentioned in the policy schedule is payable by the insured. Apart from this, all expenses that are not payable under the terms and conditions of the policy will also have to be paid by the insured to the hospital / medical facilities. The Assistance/Insurance company will directly pay the allowed expenses to the hospital.

For example assuming that the deductible is $100, and if the medical expense incurred at $8500, then the insurance company will give a guarantee to the hospital to the extent of $8400 and instruct the hospital to collect the $100 directly from the insured at the time of discharge.

A pre existing condition means any condition, ailment or injury or related condition(s) for which the insured had signs or symptoms, and / or were diagnosed, and / or received medical advice/ treatment, within 48 months prior to commencement of the first Policy issued by the Insurer. This means that if the insured is traveling abroad with a pre existing condition and avails of any treatment abroad, the insurance company will not be liable for paying the claim.

The insurance company normally goes by the guidance of the attending physician in the medical facility abroad while deciding whether a condition is pre existing or not. If the attending physician declares that the cause of the treatment is a pre existing condition carried by the insured, then the treatment costs will not be reimbursed under the policy. Some insurance companies offer a limited coverage for medical expenses arising due to pre existing conditions, when the situation is Life threatening in nature.

A Life threatening condition is an unforeseen medical emergency, which puts the life of the insured at extreme risk. In such event, measures solely designed to relieve acute pain, provided to the Insured by the Physician for Disease/accident arising out of a pre-existing condition would be reimbursed upto a limit specified in the policy terms and conditions. The treatment for these emergency measures would be paid till the insured becomes medically stable or is relieved from acute pain. All further medical cost to improve or maintain medically stable state or to prevent the onset of acute pain would have borne by the Insured.

It is important to be noted that all plans displayed on the eIndiaInsurance website do not offer coverage for pre existing conditions. Hence the traveller should review the plan prior to purchasing the same, if they are looking for such a cover. If the traveller still has clarifications regarding the same, it is better to speak to our customer service executive.

Single Trip Insurance policies do not have a free look period. However an Annual Multi Trip period has a free look period of 15 days from the date of receipt of the Policy document to review the terms and conditions of this Policy provided no trip has been commenced. If the insured has any objections to any of the terms and conditions, the insured has the option of cancelling the Policy stating the reasons for cancellation and he/she will be refunded the premium paid for the policy, after adjusting the amounts spent on stamp duty charges and proportionate risk premium. The insured can cancel the policy only if the insured has not made any claims under the Policy.

The Insurance Company is committed to extend the best possible services to its customers. But there could be some situation wherein the insured may not be fully satisfied with the level of service or the decision made by an insurance company on a particular claim. If this is the case, then the insured, can lodge a complaint with the insurance company at their 24X7 Toll free number provided on the policy certificate, policy wordings (terms and conditions) or available on the company website. The insured can also choose to send an email to the customer service desk at the email id specified. After investigating the matter internally and subsequent closure, the insurance company will ideally send a response within a period of 10 days from the date of receipt of the complaint by the Company at its Head office or any of the branches. In case the resolution is likely to take longer time, the insurer will inform the insured of the same through an interim reply.

For lack of a response or if the resolution still does not meet the insured’s expectations, they can write to the Head - Customer Services at the insurance company. After examining the matter, they will send their final response within a period of 7 days from the date of receipt of your complaint. Within 30 days of lodging a complaint with the insurance company, if the insured still does not get a satisfactory response from the insurer, they can pursue other avenues for redressal of grievances, as well as directly approach Insurance Ombudsman appointed by IRDA under the Insurance Ombudsman Scheme.

The Insurance Ombudsman operates underTerritorial jurisdictionand hence the insured will have to approach the appropriate Ombudsman with the details of grievance. The details are in the link here...

No. Any complainant, whose complaint on the same subject matter is or was before a Court/Consumer Forum or an Arbitrator cannot approach an Insurance Ombudsman.

The Ombudsman will receive and consider complaints or disputes relating to:

• Delay in settlement of claims, beyond the time specified in the regulations, framed under the Insurance Regulatory and Development Authority of India Act, 1999;
• Any partial or total repudiation of claims by the life insurer, General insurer or the Health insurer ;
• Disputes over premium paid or payable in terms of insurance policy;
• Misrepresentation of policy terms and conditions at any time in the policy document or policy contract;
• Legal construction of insurance policies in so far as the dispute relates to claim;
• Policy servicing related grievances against insurers and their agents and intermediaries;
• Issuance of life insurance policy, general insurance policy including health insurance policy which is not in conformity with the proposal form submitted by the proposer;
• Non-issuance of insurance policy after receipt of premium in life insurance and general insurance including health insurance; and
• Any other matter resulting from the violation of provisions of the Insurance Act, 1938 or the regulations, circulars, guidelines or instructions issued by the IRDAI from time to time or the terms and conditions of the policy contract, in so far as they relate to issues mentioned at clauses (a) to (f) .

Yes. No complaint to the Insurance Ombudsman shall lie unless the complaint is made within one year:

• From the date of receipt of the order of the insurer rejecting the representation.
• From the date of receipt of decision of the insurer which is not to the satisfaction of the complainant;
• After expiry of a period of one month from the date of sending the written representation to the insurer if the insurer named fails to furnish reply to the complainant.

Yes, IRDA has implemented the Integrated Grievance Management System (IGMS). IGMS provides a gateway for policyholders to register complaints with insurance companies first and if need be escalate them to the IRDA Grievance Cells. It uses Web interface to ensure that it is accessible at all places and is on real time. It has also a mechanism to capture complaints received in physical as well as email form or voice calls received by IRDA Grievance Call centre (IGCC).

Also IRDA Grievance Call Centre (IGCC) can be accessed through

• Call : Toll free number 1800 4254 732
• Email: complaints@irda.gov.in
• Post: Write to
  Insurance Regulatory and Development Authority of India
  Consumer Affairs Department – Grievance Redressal Cell.
  Sy.No.115/1, Financial District, Nanakramguda,
  Gachibowli, Hyderabad – 500 032

Some of the typical exclusions under the Travel policy will include:

• any Pre-existing Condition or any complication arising from it (unless specifically covered under certain plans that are purchased by the insured)
• services, supplies, or treatment, including any period of Hospital confinement, which were not recommended or approved, and certified as Medically Necessary by a Physician
• routine physicals or other examinations where there are no objective indications or impairment in normal health, and laboratory diagnostic or X-ray examinations except in the course of a disability established by the prior call or attendance of a Physician (an example could be a person visiting the hospital to check their blood pressure or their cholesterol levels, just for their information)
• elective, cosmetic, or plastic surgery, except as a result of an Injury caused by a covered Accident
• suicide, attempted suicide (whether sane or insane) or intentionally self inflicted Injury or Illness, or sexually transmitted conditions, mental or nervous disorder, anxiety, stress or depression, Acquired Immune Deficiency Syndrome (AIDS), Human Immune deficiency Virus (HIV) infection
• being under the influence of drugs, alcohol, or other intoxicants or hallucinogens unless properly prescribed by a Physician and taken as prescribed
• any loss arising out of War, civil war, invasion, insurrection, revolution, act of foreign enemy, hostilities (whether War be declared or not), rebellion, mutiny, use of military power or usurpation of government or military power, Terrorism
• congenital anomalies or any complications or conditions arising therefrom
• participation in winter sports, skydiving/parachuting, hang gliding, bungee jumping, scuba diving, mountain climbing (where ropes or guides are customarily used), riding or driving in races or rallies using a motorized vehicle or bicycle, caving or pot-holing, hunting or equestrian activities, skin diving or other underwater activity, rafting or canoeing involving white water rapids, yachting or boating outside coastal waters (2 miles), participation in any Professional Sports, any bodily contact sport or potentially dangerous sport for which You are untrained (please note that on our eIndiaInsurance website, we offer some insurance plans that cover Adventure sports…so if the insured is likely to participate in any of these activities, it’s best to buy a plan that covers Adventure Sports)
• pregnancy and all related conditions, including services and supplies related to the diagnosis or treatment of infertility or other problems related to inability to conceive a child; birth control, including surgical procedures and devices

Please note that this is not the complete list of exclusions. Please refer to the terms and conditions (policy wordings) that have been shared with the insured along with the policy certificate for the exhaustive list.

The Assistance Company is the partner abroad who is available to assist the insured during any medical or non medical emergency. They are normally referred to as the Third Party Administrator (TPA). Most insureds assume that the Assistance Company is only there for support during medical emergencies, but they do also support in many non medical situations as well. They normally provide the following services:

• Medical Assistance- As soon as the Assistance Company is notified of a medical emergency resulting from an Accident or Sickness, they will contact the medical facility or location where the insured is located, confer with the Physician to determine the best course of action to be taken. If possible and if appropriate, the insured’s family Physician (in India) will be contacted to help arrive at a decision. The Assistance Company will then organize in securing the availability of services of a local Physician and arranging Hospital admission and monitor the insured whilst in hospital.
• Medical Evacuation– When the Assistance Company’s medical panel, judges that it is medically appropriate to shift the insured to another location abroad for treatment or return the insured to India, the Assistance Company will arrange the evacuation, through appropriate mode of transport
• Repatriation– They agree to make the necessary arrangements for the return of the insured’s mortal remains to India in the event of the unfortunate death of the insured whilst abroad and while this policy is in effect.
• Legal Assistance- If the insured is arrested or is in danger of being arrested as the result of any non-criminal action against charges attributed to the insured, the Assistance Company will, if required, provide the insured with the name of an attorney who can represent the insured in any necessary legal matters.
• Lost Luggage or Lost Passport- If the insured, outside India, notifies the Assistance Company that the insured’s luggage or passport has been lost, the Assistance Company will assist the insured by contacting the appropriate authorities involved and provide direction for replacement.
• General Assistance- The Assistance Company will serve as a central point for translation and communication for the insured during emergencies. The Assistance Company agrees to provide the insured advice using services available from consulates, government agencies, translators and other service providers that can help with travel problems.
• Pre-Departure Services- prior to the insured’s departure, the Assistance Company can provide hazard information about foreign locations, information about immunization requirements and passport or visa requirements, general information about weather at locations of travel. The Assistance Company will also arrange for special medical care en-route (i.e. dialysis, wheelchairs, etc.) if required.
• Emergency Travel Agency- the Assistance Company will also provide the insured with 24 hour travel agency service for airline and hotel reservations. The Assistance Company will also arrange payment for the insured’s airline tickets and other travel services, using the insured’s credit cards. Prepaid ticket pickup at airline counters or ticket delivery by mail or courier will also be arranged by the Assistance Company.

Some of the unique coverages include:

• Study Interruption- In the event of hospitalization of the insured person for more than one consecutive month from a covered Injury or Sickness or in the case of Terminal Sickness or in the case of the death of an immediate family member, which prohibits the Insured Person from continuing his/her studies for the remaining part of a school semester for which Tuition has been paid, the Company shall reimburse the Insured Person the Tuition fees which has already been advanced to the educational institution, up to the amount stated in the Policy Schedule
• For example if an insured student has already paid the study fees of $50,000 but unfortunately is unable to continue their education because of the death of a family member half way through the semester, then the insurance company will refund the unutilised part of the fees, half of the fees paid, which is $25,000 – this is subject to the policy of the University to arrive at the unutilised part of the fees that can be refunded
• Sponsor Protection- The Term “Sponsor” is any individual responsible for paying the Tuition fees of the student of his full-time study in a registered educational institution outside of his home country. In the event of injury to the Insured student’s Sponsor (as stated in the Enrolment Form of the University) resulting in Death or Permanent Disablement, the Insurance company shall reimburse the insured student the Tuition Fee incurred for the remaining period of this education upto the maximum limit stated in the Schedule of benefits.
• An insured person cannot claim under Study interruption and Sponsor Protection for the same event.
• Compassion Visit (2 way)- In the event the Insured Student is Hospitalized for more than Seven (7) consecutive days, and his medical condition forbids his evacuation (and no adult member of his immediate family is present), the Assistance Company , will provide a round trip economy class air ticket, or first class railway ticket, to allow the Immediate Family Member be at his bedside for the duration of his stay in the hospital. Additionally, the company will refund for the costs of the stay, of the immediate family member, upto the amount stated in the policy schedule. Similarly, in the event of death, or hospitalisation of the Insured student’s parent(s), spouse/child for more than Seven (7) consecutive days due to injury or sickness, the Assistance Company ,will provide a round trip economy class air ticket, or first class railway ticket, to allow the Insured student to be at his bedside of his parent’s)/spouse/child, upto the amount stated in the policy schedule.
• Bail Bond- The insurance company will pay bail bond costs incurred by the Insured student, as a result of false arrest or wrongful detention by any government or foreign power up to the amount stated in the Policy Schedule.

Some of the insurance company’s Student programs have unique Special Extensions specifically provided in the schedule of benefits:

• Only Inpatient Medical expenses related to pregnancy, termination of pregnancy only as a result of physician’s advice to terminate pregnancy due to medical reasons and not due to insured person’s choice to terminate pregnancy subject to waiting period of 10 months
• Medical expenses related to treatment for mental and nervous disorders, including alcoholism and drug dependency are covered subject to maximum amount as provided in the schedule of benefits
• Medical Expenses related to Cancer Screening and Mammographic examination on recommendation from a physician is covered subject to maximum amount as provided in the schedule of benefits. Any tests done as a part of preventive health check-up are not included under this benefit
• Medical expenses due to Pre-existing Condition in case of Life threatening unforeseen emergency subject to maximum amount as provided in the schedule of benefits. In such event, measures solely designed to relieve acute pain, provided to the Insured by the Physician for Disease/accident arising out of a pre-existing condition would be reimbursed. The treatment for these emergency measures would be paid till the insured becomes medically stable or is relieved from acute pain
• For ongoing physiotherapy to treat a disablement due to an accident, unless this is recommended in writing by the treating registered medical practitioner, upto the amount as stated in the policy schedule
• Childcare benefits – We will pay upto the maximum amount as provided in the schedule of benefits, if the child is in between the age of 7 days - 90 days, and is hospitalized for 2 days or more for any ailment.

A traveller must first realise that there are many insurance companies offering Travel Insurance plans in the India market today. They should also understand that in Travel Insurance, one size doesn’t fit all…this means that just buying a Travel Insurance product for the sake of obtaining a visa, or buying a policy because someone suggested it, is not the right way to approach the purchase of Travel Insurance. One must consider the following aspects of the insurance company before choosing a plan:

• Destination Country– some insurance companies are strong in certain geographies (like Tata AIG in Americas or Bajaj Allianz in Germany) because of their parent organisations being very strong in those markets. Also if the insured is likely to travel to multiple countries (purchasing an Annual Multi Trip) in a year, it is better to opt for an insurance partner who has a worldwide presence
• Duration of Travel– the longer the duration of travel, the more comprehensive the policy conditions need to be
• Age– Given the age of the insured, they could likely have a pre existing medical condition, it is ideal to opt for a plan that covers the same
• Activities during the Trip– if one intends to participate in any adventure activities like bungee jumping, scuba diving, snorkelling, skiing etc, it is better to buy a plan that has a coverage of Adventure Sports

Given that there are so many factors to be considered prior to buying a Travel insurance policy, it is critical for the traveller to evaluate all options before choosing the right insurance company and ideal plan. This is facilitated by an online distribution partner like eIndiaInsurance where there are multiple options available to choose from. eIndiaInsurance also provides a comparison facility that allows the traveller to compare options of insurance plans before making an informed decision on the most suitable plan. The traveller can also search for specific coverages like Pre Existing and Adventure Sports to ensure they don’t miss out on these critical coverages. While an agent promotes just one insurance company, the traveller may not be presented with all available options in the market to choose from and that is where a partner like eIndiaInsurance comes in handy. Post choosing of the plan, the buying process is made even more simple with multiple payment options to choose from and instant receipt of the policy certificate.

This is most prevalent in Health Policies, although a few insurers offer this benefit under Travel Insurance. A floater policy is one that is issued with a single sum insured covering number of individuals of a family. The cover can be used by any member of the family any number of times during the policy period. If a person wants a health/travel insurance for himself, his spouse & their children, the Family Floater plan is ideal and offers insurance coverage to the entire family under one premium payment.

LLet’s take an example wherein the person insures himself, his spouse & the two dependent children with the individual insurance plans with a sum insured of Rs 1 lac each, he ends up paying an average premium of Rs X for each family member, which amounts of Rs 4X. If the person opted for the family floater plan with the sum insured of Rs 3 lacs, the total premium would ideally be less than the separate premium payments in individual health insurance plans, ie less than Rs 4X. Moreover the individual plan has coverage of only Rs 1 lac for each member as against Rs 3 lacs in case of the Floater plan( in case the medical treatment exceed Rs 1 lac). This Rs 3 lacs is available for each of the family members individually as well as collectively.

It is recommended that as a general rule, at younger ages of all family members, opting for a floater cover is ideal. As the members grow older, they should go for an individual cover. But ultimately buying an individual cover or a floater cover is an individual’s preference.

The purpose of any Travel Insurance policy is to ensure peace of mind to the traveller when they leave home for a holiday or on business. It is also required to cover any unforeseen expense that may come up due to medical or non medical reasons during the trip. One must realise and acknowledge that such exigencies are as likely to happen abroad as in India. This suggests that every traveller should protect themselves from financial loss even during their travels within India.

The most common excuses for not buying Travel Insurance for trips within India are:

1. Nothing will happen, I’m traveling for just 2-3 days and within India
2. I don’t know where to buy a Domestic Travel insurance policy from
3. The premium may to be too high and I’m already over budget for this trip
4. Are there any claims actually paid for losses during Domestic trips? The claims process will be too complicated for such a small claim

The traveller could have an unfortunate accident and need medical assistance or even evacuation to a hospital from a remote location…the common carrier they are traveling with could lose or delay delivering their bags…their unattended home could be burgled when they are on vacation…you could miss your flight or train for genuine reasons while reaching the airport / railway station…there could be an untimely passing away of a family member and his/her remains will need to be transported back home…your flight could be delayed indefinitely due to technical snags of the aircraft…your trip could be cancelled or curtailed due to illness or hospitalisation…accidental coverage for Adventure Sports while vacationing…DOMESTIC TRAVEL INSURANCE plans offer coverage for all of these unforeseen emergencies…>

It is important for all travellers to note that the Travel Insurance policies are not just coverage for Medical Expenses, both Accident and Sickness…there are many important non medical covearges, most of which are listed below:

• Baggage Delay- Compensation for reasonable expenses incurred, whilst overseas, for purchase of emergency personal effects like toiletries, clothing, medication etc. due to late arrival of checked in baggage on account delay or misdirection by the common carrier
• Baggage Loss– This benefit will reimburse the insured for loss of checked in baggage in the custody of the common carrier subject to the policy limits in the chosen plan
• Loss of Passport– This benefit will reimburse reasonable expenses incurred by the insured to obtain a duplicate passport from the Indian embassy abroad.
• Personal Liability- If due to an act of negligence or otherwise, any property damage caused by you to a third party resulting in the said party filing a suit against you, the said claim is payable under the Personal Liability section of the policy. Similarly, if as a result of an accident any bodily injury caused to a third party, resulting in a law suit, then the medical expenses incurred by the third party is paid for by the policy under the Personal Liability section, upto the policy limits specified in the policy.
• Hijack Distress Allowance- If the common carrier in which the insured person aboard is hijacked, the company agrees to pay to a Distress Allowance in excess of the deductible.
• Flight/Trip Delay– The insured will be reimbursed reasonable expenses (subject to the maximum shown in the policy schedule), if your Trip is delayed for more than 6-12 (deductible) hours due to 1) delay of a Common Carrier caused by Inclement Weather; or 2) delay due to a strike or other job action by employees of the Common Carrier or 3) delay caused by Equipment Failure
• Trip Cancellation- The Insurer will pay loss of deposits/advances (unused, non-refundable cancellation portion ) already paid to the hotel/airline/cruise etc if prior to the departure date, your trip is cancelled and you are prevented from taking the trip due to a sickness, injury or death to: you; your traveling companion; your immediate family member; or your traveling companion's immediate family member
• Trip Curtailment- If your trip has already commenced and you have to return to your country/city of residence due to 1) the aircraft which you boarded as a passenger is hijacked or 2) due to unexpected death of your immediate family member or 3) due to natural disaster (in the destination country/city) or 4) due to unexpected strike, riot or civil commotion beyond your control or 5) due to a serious sickness, serious injury or death to you; your traveling companion; your immediate family member; or your traveling companion's immediate family member, the insurer will reimburse the deposits/advances (unused, non-refundable cancellation portion ) already paid to the hotel/airline/cruise on account of the curtailment (shortening and/or alteration)
• Missed Departure/Connection- the insured will be reimbursed reasonable expenses due to Missed Connections/Departure by airline/train, on your return journey, during the course of an insured trip. The delay needs to be on account of 1) inclement weather or 2) strike by employees of a common carrier or 3) equipment failure of the common carrier.
• Bounced Booking of Hotel/Airline- The Insurance company will reimburse the insured the hotel booking / airline ticket difference if the same is bounced due to over booking. Wait listed booking will not be compensated.
  • For hotel overbooking, the overbooked portion of the hotel stay must include the first night stay; the overbooking must happen at check-in. The insurer will reimburse the difference between the original booking amount and the new booking amount less any refund/compensation given by the hotel for the number of nights that are overbooked. There will be no reimbursement for nights on the original booking that were not overbooked.
  • For airline overbooking, an option of a free replacement flight within 6 hours from the departure of the original overbooked original flight must not be available to the insured and you must cancel your originally booked flight and purchase a new flight at the same class of service. The insured will be reimbursed the difference between the original airfare amount and the reasonable new airfare amount, less any refund/compensation given by the airline.

If an Insured Person requires Hospitalization, following an accident or sickness or undergoes Day Care Treatment due to Injury or Illness, as specified in the Policy Schedule / Certificate of Insurance, suffered or contracted during the Travel Period, then the insurance company will reimburse the costs incurred on Medical Expenses, including the Post Hospitalization Medical Expenses (incurred for up to 90 days) following the Insured Person’s discharge from Hospital. If the insured member is admitted as an inpatient, and has informed the Assistance company abroad, cashless treatment can be organised as well.

Medical Expenses incurred towards the Day Care Treatment or Surgery undertaken that requires less than 24 hours Hospitalization due to advancement in technology and which is undertaken by an Insured Person in a Hospital / Nursing Home / Day Care Centre for the Illness or Injury, as specified in the Policy Schedule / Certificate of Insurance. Some Insurers offer coverage for OPD expenses as well, while some insurers do not offer this cover.

Insurance company will pay the amount specified in the Policy Schedule / Certificate of Insurance, towards purchasing essential medication, toiletries or clothing if the delivery of the Insured Person’s accompanying Checked-in Luggage is delayed for more than the number of hours (deductible) specified in the Policy Schedule / Certificate of Insurance, by the Common Carrier on which the Insured Person was travelling as a passenger, during the Travel Period.

Insurance company will pay the amount specified in the Policy Schedule / Certificate of Insurance, if the entire piece of the insured’s Checked-in Baggage, which was in the custody of the common carrier gets lost and does not reach the place of destination. This could happen due to misdirection by the common carrier or theft. The reimbursement amount of the entire lost baggage or its contents is subject to deductibles and partial loss of the Baggage and/or its contents is not covered. Normally, there are certain restrictions in the reimbursement amount; as follows:

• The maximum reimbursement limit per bag is 50% of the Sum Insured amount mentioned in the policy schedule
• The maximum reimbursement amount per article in any bag is 10% of the amount stated in the policy schedule

Insurance company will pay the legal cost incurred by the insured person up to the fixed amount as specified in the policy schedule / certificate of insurance towards obtaining a duplicate or new passport in lieu of the original passport lost during the Travel Period. Expenses reimbursed will also include Incidental expenses directly related to obtaining the duplicate passport.

If an Insured Person requires Hospitalization due to Injury or Illness, as specified in the Policy Schedule / Certificate of Insurance, suffered or contracted during the Travel Period, then the insurance company will pay the amount incurred for direct route return (two way) economy class tickets or a fixed amount, as specified in the Policy Schedule / Certificate of Insurance for an Immediate Relative of the Insured Person, to travel from the City of Residence to the place of Hospitalization of the Insured Person. In some insurance plans, this cover is also applicable when the insured’s immediate relative is hospitalised in India and the insured travel to visit them.

If an Insured Person needs to travel to the City residence of an Immediate Relative due to death or emergency Hospitalisation of such Immediate Relative, during the Coverage Period, Insurance company will pay the amount incurred for direct route return (two way) economy class tickets or a fixed amount, as specified in the Policy Schedule / Certificate of Insurance towards the travel expenses.

Insurance company will pay the costs incurred up to the Sum Insured or a fixed amount, as specified in the Policy Schedule or Certificate of Insurance for the air or surface transportation of the Insured Person during the Travel Period, including costs incurred for medical care during such transportation caused due to a lack of proper hospitalisation facilities or specialised treatment at the existing location/country.

Insurance company will pay the expenses incurred up to the Sum Insured or a fixed amount, as specified in the Policy Schedule / Certificate of Insurance for transportation of mortal remains from the place of death of the Insured Person during the Travel Period to the residence of the Insured Person in the City of Residence, in case of death due to Injury or Illness suffered or contracted during the Travel Period.

Insurance company will pay the expenses incurred upto the fixed amount (Sum Insured), as specified in the Policy Schedule / Certificate of Insurance, if an Insured Person’s journey is unavoidably cancelled (whether wholly or in part) prior to the inception of the journey, due to one of the circumstances:

• Unforeseen Death, Disablement or Illness or Hospitalization for minimum period of 24 hours of the Insured Person or
• Unforeseen Death, Disablement or Illness or Hospitalization for minimum period of 24 hours of his/her immediate family member or
• In the event of Mass Bandh, Strike or Terrorism

Insurance company will pay the expenses incurred upto the fixed amount (Sum Insured), as specified in the Policy Schedule / Certificate of Insurance, if an Insured Person’s journey is unavoidably cancelled (whether wholly or in part), after the trip has commenced due to one of the circumstances:

• Unforeseen Death, Disablement or Illness or Hospitalization for minimum period of 24 hours of the Insured Person or
• Unforeseen Death, Disablement or Illness or Hospitalization for minimum period of 24 hours of his/her immediate family member or
• In the event of Mass Bandh, Strike or Terrorism

Insurance company will pay the amount specified in the Policy Schedule / Certificate of Insurance, if the Insured Person meets with an Accident during the Travel Period and that Injury is solely and directly resulting in the Insured Person’s death within a defined period from the date of the Accident.

Insurance company will pay the amount specified in the Policy Schedule / Certificate of Insurance to the Insured Person who suffers an Injury due to an Accident that occurs during the Travel Period while the Insured Person is travelling as a passenger on a Common Carrier and that Injury solely and directly results in the Insured Person’s death within a defined period from the date of the Accident.

Insurance company will pay for an Injury due to an Accident that occurs during the Travel Period and that Injury solely and directly results in the Permanent Total Disability of the Insured Person which is of the nature specified in the table mentioned in the policy terms & conditions, within a defined period from the date of the Accident.

Insurance company will pay for an Injury due to an Accident that occurs during the Travel Period and that Injury solely and directly results in the Permanent Partial Disability of the Insured Person which is of the nature specified in the table.

Pre-Existing disease/condition declared at the time of purchase of policy will be considered for claim, subject to this condition resulting in the insured member facing a life-threatening situation. The limit is defined under the policy terms and conditions and is available till the member has been medically stabilised.

If an Insured Person requires Hospitalization due to Injury or Illness, as specified in the Policy Schedule / Certificate of Insurance, suffered or contracted during the Travel Period, then the insurance company will pay the daily allowance amount specified in the Policy Schedule / Certificate of Insurance, for each continuous and completed period of 24 hours of Hospitalisation.

Insurance company will pay the insured person, nominee or the legal heir for the losses incurred due to Kidnapping or Hijack during the Travel Period which continues in excess of the number of hours (deductible) specified in the Policy Schedule / Certificate of Insurance.

Insurance company will pay the amount specified in the Policy Schedule / Certificate of Insurance, if an Insured Person’s journey on a Common Carrier is delayed beyond the number of hours specified in the Policy Schedule / Certificate of Insurance of its scheduled departure or scheduled arrival time, during the Travel Period.

Insurance company will pay the cost of additional travel and accommodation expenses incurred upto the fixed amount, as specified in the Policy schedule/Certificate of Insurance due to the Insured Person’s failure to reach the original departure point of the booked and confirmed journey owing to a delay beyond the number of hours specified in the Policy Schedule / Certificate of Insurance in the arrival of the Common Carrier which was connecting to the booked journey onwards.

Insurance company will reimburse any actual Legal Liability, including Defence Costs, incurred by the Insured Person in his/her private capacity to pay damages to a third party arising out of the third party’s death, Injury or property being damaged during the Travel Period.

Insurance company will pay the cost of alternative accommodation required by the Insured Person upto the fixed amount, as specified in the Policy Schedule or Certificate of Insurance due to any cancellation of the Insured Person’s booked and confirmed accommodation by a hotel or any other similar provider of accommodation.

Insurance company will reimburse any actual loss incurred due to any theft or burglary of personal possessions or property stored within the Insured Person’s usual place of residence in India that was left vacant for the duration of the Travel Period.