Travel Insurance Claims

Claim can be registered by calling the TPA on Toll Free No, mentioned on the Certificate of Insurance (COI), by anyone who is accompanying the insured person who is being hospitalised or needs any other assistance.

Yes, it is preferable to contact the Assistance Provider abroad (TPA) while seeking admission to any hospital for treatment…the network of hospitals managed by the TPA will provide standard medical treatment at affordable costs to the insured. However in the case of a medical emergency, the insured can get admitted to any hospital closest to them for immediate attention.

All the Inpatient (IPD) medical claims, subject to admissibility, will be considered under Cashless category, subject to the insured’s hospitalisation for a minimum 24 hours. All other claims like Outpatient (OPD) treatment, and non-medical claims like Passport Loss, Baggage Loss or Delay, Trip Cancellation / Interruption etc will be considered under Reimbursement category.

Yes, any admissible claim in accordance with the policy terms & conditions, will be eligible for reimbursement after the insured traveller has submitted the requisite supporting documents to the insurance provide/ assistance company while abroad or on their return to India. The insured should remember to retain all the hospital bills and receipts and submit them to the company, along with the claim form to get a reimbursement.

The Assistance Provider (TPA) or the Insurance company will settle the approved and admissible claim amount directly to with the hospital after deducting any deductible / Co-Pay / Sublimit against the policy. This deductible, co-pay etc will need to be settled by the insured traveller to the hospital at the time of discharge.

Once the insured member requires treatment, then the Assistance company needs to be informed immediately. All the insured/insured’s family member needs to do is to reach out to the Assistance Company, on the Toll Free/Toll number, which is printed on the COI while quoting the Policy/Certificate of Insurance (COI) number. The Assistance Provider / Insurance Company will provide a Claims Reference number for future correspondence.

Claim forms are easily available on request from the Overseas Assistance Service Providers, on the website of Insurance Company, or by reaching out to the InstantCover/EIndia customer support team on 0091 80 41101026.

Yes, All the claims are approved after receiving complete set of required documents and as per the terms and conditions of the policy. Submission of partial documents may result in part settlement or non-settlement of the claim.

The Insurance company or its Assistance Provider shall process the request for Cashless treatment after having obtained the complete information in respect of the claim from the hospital. The Insurance company or its Assistance Provider (TPA) shall provide a Guarantee of Payment (GOP)) to the hospital if the claim is admissible and approved. Hence the insured will become aware of the approval of the claim. If the claim is to be rejected because it is not admissible, then the rejection will be confirmed to the insured member accordingly.

There are no restrictions on the hospital where treatment should be taken whilst abroad in the case of a medical emergency…however in the case of a planned hospitalisation, it is preferable to approach the Assistance Provider (TPA), who will direct the insured to a network hospital.

Yes, you can often claim reimbursement under a travel insurance policy after returning to India. These are referred to as Reimbursement Claims.

There are however some specific conditions to keep in mind:
Important Considerations for Reimbursement Claims
1.Policy Terms: Check and confirm that your travel insurance policy allows for reimbursement of claims under the scope of the policy. Most policies do permit claims for expenses incurred while traveling, even if you return home and submit the claim.
2.Documentation: Ensure you have all necessary documentation, such as:

• Original bills and receipts for medical expenses, other routine expenses linked to the benefit. It is important to note that almost all travel insurers in India offer Non Medical Benefits as an Indemnity, which means that they will reimburse expenses actually incurred, upto the Sum Insured for the respective benefit/coverage in the policy. If no expenses are incurred, there will no reimbursement from the insurance company.
• A copy of your travel itinerary and proof of travel.
• Any relevant medical reports or police reports, if applicable.

3.Claim Notification: Many insurers require you to notify them of any incidents that may lead to a claim as soon as possible, within 7-15 days from the date of loss/incident. Delaying notification may affect your claim's validity.
4.Claim Process: Follow the claims process outlined by your insurer, which usually involves filling out an online claim form and submitting all required documents in scanned format. For Outpatient Medical Expenses, which are high, the insurer may request for originals to be submitted.
5.Exclusions and Limitations: Be aware of any exclusions in your policy. Claims related to certain activities or pre-existing conditions may not be reimbursable.
6.Timeliness: Submit your claim within the timeframe specified by your insurance provider, as there may be deadlines for filing claims after your trip.
By understanding your policy and following the necessary steps, you can effectively claim reimbursement under your travel insurance after returning to India, subject to the T&Cs of the policy.