HDFC ERGO General Insurance Company Limited

Transcription

1 INTRODUCTION HDFC ERGO General Insurance Company Limited takes pleasure in offering a comprehensive Package Insurance product which offers protection to all e Indian Residents travelling abroad for Leisure, Business or Study. The salient features of e product and price are briefly ated hereunder. For furer details on definitions, coverage, exclusions and conditions, please refer to e Travel Insurance Policy wording. PRODUCT INFORMATION ELIGIBILITY CRITERIA The Retail Travel policy provides worldwide coverage for Indian Residents for: Business & Official Purpose Holiday Employment Study Accompanying spouse & children of e person are covered and will be treated as going under holiday travel. Foreign nationals working in India wi Indian employers of multinational companies, getting salary in INR can be considered for coverage. Foreign nationals domiciled in India could be covered subject to verification of ration card and IT return. AGE LIMIT: Single Trips and Asia : 6 mons to 70 yrs Annual Multi Trip : 18 yrs to 70 yrs Family Floater: 3 mons to 60 yrs Self up to e age of 60 yrs Spouse up to e age of 60 yrs Child Max - 2 up to e age of 21 years SALIENT PRODUCT FEATURES Composite Coverage in a single Policy. No medicals / heal check up required. The Policy provides worldwide cover Sections can be independently ructured or packaged as whole. WHAT IS COVERED? Emergency Medical Benefits: This covers medical cos incurred due to illness or accident including medically necessary and prescribed emergency evacuation. It covers defined outpatient, in-patient, medical aid, erapies and diagnoic tes. Emergency and of Remains to home country is covered up to e medical sum insured chosen. : Covers non aesetic treatment of natural tee. : Pays a daily allowance for hospitalization due to accident or sickness Loss of Baggage and Personal Documents: Pays actual co of replacing lo documents and belongings : Pays for expenses incurred in moving an Insured Person to e neare Hospital where appropriate treatment can be received : Pays for expenses incurred in moving an Insured Person to his/her country of residence following an emergency. : Pays for e permanent loss of checked-in baggage : Pays for reasonable expenses incurred for e purchase of toiletries, cloing and medication due to delay of checked-in baggage for more an 12 hours. Accidental Dea: Compensation paid in case of accidental dea Permanent Disablement (Table B): Compensation paid in case of permanent total disability due to an accident Accidental Dea & Disability (AD&D) - Common Carrier: Pays e sum insured in addition to e Accidental Dea & Permanent Disablement sum insured, if e insured suains Accidental Bodily Injury during e course of e journey while travelling in a common carrier such as rail, bus, tram, or aircraft : Compensation for damages to be paid to a ird party, resulting from dea, injury or damage to heal or property caused involuntarily by e insured. Financial Emergency Assiance: Cash Assiance provided wherein e Insured loses all or a subantial amount of his/ her travel funds due to eft, robbery, mugging or dacoity. : Compensation paid due to delay of flight for purchase of meals, refreshments etc. Hijack Diress Allowance: Compensation payable on Hijack of Common Carrier on which e Insured travelled. : Pays for hotel accommodation for e insured if bodily injury or sickness results in a missed flight. Benefits Offered wi Sum Insured Single Trip (Including USA/Canada & Excluding USA/Canada) Emergency Medical Expenses () Accidental Dea - Common Carrier Permanent Disablement - Common Carrier Accidental Dea Financial Emergency Assiance Hijack Diress Allowance Single Trip Asia (Excluding Japan) Emergency Medical Expenses () Titanium $,000, per day/ 15 per day/ 15 per day/ 15 per day/ 15 per day/ Max Max Max Max Max 1 Day 3 Days 1 Day ,000 1, 75 per Day/ Max Day $10 per Hour/Max Platinum $,000,000 Silver $,000, per day/max ,000 20,000,000 2, per 75 per 75 per 75 per Day/ Day/ Day/ Day/ Max 525 Max 450 Max 450 Max 450 $10 per $10 per $10 per $10 per Hour/Max Hour/Max Hour/Max Hour/Max Gold $,000, , Silver $,000 Bronze $,000,000 Bronze $ per day/max care@hdfcergo.com CIN : U66010MH2PLC IRDA Reg No

2 Accidental Dea Financial Emergency Assiance Hijack Diress Allowance Annual Multi Trip Plan (Worldwide) Emergency Medical Expenses () Accidental Dea - Common Carrier Permanent Disablement-Common Carrier Accidental Dea Financial Emergency Assiance Hijack Diress Allowance 10% Per 10% Per 20, per Day/Max per Day/Max 450 $10 per Hour/Max 120 $10 per Hour/Max ,000 2,000 Platinum $,000,000 Gold $ per day/max 15 per day/max % 10% Per Per ,000,000 1, 1, 75 per Day/Max per Day/Max 525 $10 per Hour/Max 120 $10 per Hour/Max Single Trip Family Floater Plan (Excluding USA/Canada) Emergency Medical Expenses () $ 15 per day/max Accidental Dea Hijack Diress Allowance GENERAL EXCLUSIONS APPLICABLE ON THE POLICY The Company shall not be liable to pay any benefit in respect of any Insured Person: 1. for Bodily Injury or Sickness occasioned by Civil War or Foreign War. 2. for Bodily Injury or Sickness caused or provoked intentionally by e Insured Person. 3. for Bodily Injury or Sickness due to wilful or deliberate exposure to danger, (except in an attempt to save human life), intentional self-inflicted injury, suicide or attempt ereat, or arising out of non-adherence to medical advice. 4. for Bodily Injury or Sickness suained or suffered whil e Insured Person is or as a result of e Insured Person being under e influence of alcohol or drugs or narcotics unless professionally adminiered by a Physician or unless professionally prescribed by and taken in accordance wi e directions of a Physician. 5. for Bodily Injury due to a gradually operating cause. 6. for Bodily Injury suained whil or as a result of participating in any sport as a professional player. 7. for Bodily Injury suained whil or as a result of participating in any competition involving e utilisation of a motorised land, water or air vehicle. 8. for Bodily Injury suained whil or as a result of riding or driving a motorcycle or motor scooter over one hundred fifty () cc. 9. for Bodily Injury whil e Insured Person is travelling by air oer an as a fare paying passenger on an aircraft regiered to an airline company for e transport of paying passengers on regular and published scheduled routes. 10. for Bodily Injury suained whil or as a result of participating in any criminal act. 11. for Bodily Injury or Sickness resulting from pregnancy wiin twenty-six (26) weeks of e expected date of bir. 12. for Bodily Injury or Sickness caused by or arising from e conditions commonly known as Acquired Immunodeficiency Syndrome (AIDS) or Human Immunodeficiency Virus (HIV) and/or any related illness or condition including derivatives or variations ereof howsoever acquired or caused. The onus shall always be upon e Insured Person to show at Bodily Injury or Sickness was not caused by or did not arise rough AIDS or HIV. 13. for Bodily Injury or Sickness caused by or arising from or due to venereal or venereal related disease. 14. for Bodily Injury suained whil or as a result of engaging in, practising for or taking part in training peculiar to any kind of violent labour diurbance, riot or civil commotion or public disorder. 15. for Bodily Injury suained whil on service or on duty wi or undergoing training wi any military or police force, or militia or paramilitary organisation, notwianding at e Bodily Injury occurred whil e Insured Person was on leave or not in uniform. 16. for treatments for nervous or mental problems, whatever eir classification, psychiatric or psychotic conditions, depression of any kind, or mental insanity. 17. any paological fracture per Day/Max Day care@hdfcergo.com CIN : U66010MH2PLC IRDA Reg No

3 18. for cures of any kind and all ays in long term care initutions (retirement homes, convalescence centres, centres of detoxification etc.). 19. for inveigations, operations or treatment of a purely cosmetic nature; or for obesity; or undertaken to facilitate pregnancy or to cure impotence or to improve potency. 20. for Bodily Injury suained whil or as a result of active participation in any hazardous sport such as parachuting, hangliding, parasailing, off-pie skiing or bungee jumping. 21. Any Medical Expenses incurred, e need of which arises out of a Pre exiing Condition. 22. for Bodily Injury suained as e result of Terrorism. General Conditions: For any insured, if ere is any adverse hiory, as per e proposal form, en heal reports required for irrespective of age & travel duration. No refund is allowed for curtailment of risk and after Journey commencement. Special Exclusions: All exclusions including expenses incurred for pre exiing diseases & condition as per e andard policy. Diseases mentioned in e heal report shall be excluded from e policy. COVERAGE PERIOD Total policy period, including e extension not to exceed 360 days. Operative Time: A trip outside e territorial limits of e country of residence. The insurance arts from e time an Insured person leaves e territorial limits of e country of residence, and ends when an Insured person returns to e territorial limits of e country of residence. PREMIUM As per e premium rating table filed. Depends upon e Sum Insured (SI), Age of e Insured, No. of days of travel & countries visited. The premium rate is shown below in e range which will be used taking into account e various risk factors associated wi e Insured Persons and e coverage offered. Premium mentioned below are excluding service tax PREMIUM Annual Gross Rate Per Unit (Rupees) Varies by Diribution Meod Benefit From To Accidental Dea Permanent Total Disablement Table A Table B Table C Table D Emergency Medical Expenses - Accident Only Rs.,001-2,400, Emergency Medical Expenses - Accident & Sickness Avg. Trip Leng Up To Days Coverage Unit (Rupees) Emergency Medical Expenses - Accident & Sickness Avg. Trip Leng Up To 60 Days Emergency Medical Expenses - Accident & Sickness Avg. Trip Leng Up To 90 Days Emergency Medical Expenses - Accident & Sickness Avg. Trip Leng Up To 120 Days Emergency Medical Expenses - Accident & Sickness Avg. Trip Leng Up To 180 Days Emergency Medical Expenses - Accident & Sickness Avg. Trip Leng Up To 365 Days Emergency Travel Benefits Medical Transportation & Rs ,000 Rs. 960,001-1,920,000 Rs. 1,920,001-2,880,000 Amounts in excess of Rs. 2,880,000 of Mortal Remains Emergency Travel Expenses of Family Member Emergency Travel Expenses of Insured Person's Children Emergency Travel Expenses for Replacement Business Colleague Reimbursement of Coffin Expenses Legal Assiance Following an Automobile Accident care@hdfcergo.com CIN : U66010MH2PLC IRDA Reg No

4 Emergency Hotel Accommodation Emergency Hotel Extension Accidental Dea - Common Carrier Permanent Total Disablement - Common Carrier Table A Table B Table C Table D - Accident Only - Rate Per Rs. 10 of Daily Benefit Attained Age Less Than 18 Attained Age 18 to 40 Attained Age 41 to 50 Attained Age 51 to 60 Attained Age 61 to 65 Attained Age 66 to 80 Baggage Loss Checked Baggage Loss Baggage Delay Trip Cancellation Trip Interruption Broken Bones Hijacking Loss of Cash Hoage Release Fees Mobility Extension Ambulance Cos Concussion Extension Animal Attack Spouse or Dependent Consolation Insured Person's Counselling Benefit - Family Family Counselling Frequent Flyer Cancellation Frequent Flyer Interruption Frequent Flyer Interruption - Emergency Travel Common Accident/Double Indemnity Evacuation Medical Insurance Premium Indemnity Dependent Children Education Comatose Benefit - Accident Only Comatose Benefit - Accident & Sickness Home Tuition - Rate Per Rs. 10 of Daily Benefit Rehabilitation Reconructive Surgery Accident & Sickness - Rate Per Rs. 10 of Daily Benefit Service tax will be applicable The Annual Gross Rate can be adjued for e following risk considerations: 1. Underwriting Risk Adjuments: or Franchise Discounts: i. Leng of Time: Maximum Discount 0% to 50% ii. Percent of Sum Insured: Maximum Discount 0% to 40% iii. Fixed Amount in Rupees: Maximum Discount 0% to 15% Reduced Benefit Period Discounts: Maximum Discount 0% to 15% Operative Time Discounts: Maximum Discount 0% to 75% Occupational Class Loads: Maximum Load 0% to % Loads for Deletion of General Policy Exclusions: Maximum Load 10% to 15% 2. Anti-Selection Load: Maximum Load 0% to % 3. Discretionary Underwriting Discounts: Maximum Discount 0% to 60% Adjus for improved spread of risk, credibility, expense savings, and market competition issues. GENERAL CLAIMS PROVISIONS 1. Written notice of any occurrence which may give rise to a claim under is Policy mu be given to e Company as soon as practicable and in any case wiin irty () Days after such occurrence. Written Notice of Claim mu be given to e Company immediately in e case of dea, or wiin irty () Days after e Date of Loss in all oer cases. 2. All certificates, information and evidence required by e Company shall be furnished at no expense to e Company and shall be in such form and of such nature as e Company may prescribe. When required by e Company, at its own expense, e Insured Person shall submit to medical examination in respect of any alleged claim at may give rise to a benefit being paid. 3. Complete, written proof of loss mu be given to e Company wiin sixty (60) Days after e Date of Loss, or as soon as reasonably possible. Such proof of loss mu contain: I. e Policy Number, and II. e preliminary medical report describing e nature and extent of all injuries or Sicknesses, and providing a precise diagnosis, and III. all invoices, bills, prescriptions, Hospital certificates which will permit e Company to accurately determine e total amount of Medical Expenses (if applicable) incurred by e Insured Person, and IV. in e case where anoer party was involved (e.g. a car collision), e names, contact details and if possible insurance details of e oer party, and V. in e case of dea, an official dea certificate, succession certificate pursuant to e Indian Succession Act 1925, as amended, and any oer legal documents eablishing e identity of any and all beneficiaries, and VI. proof of age, where applicable, and VII. such oer information as e Company may require to handle e claim. a. If an Accident: I. detailed circumances of e Accident and e names of any witnesses, and II. any police reports concerning e Accident, and III. e date a Physician was seen due to e Bodily Injury, and IV. e Physician's contact details, or Discount Table #1 Number of Insured Number of Insured Discount < % < % < % < % < 12.00% < % < 18.00% < % < 0.00% < % > % b. If a Sickness: I. e date symptoms of e Sickness began, and II. e date a Physician was seen due to e Sickness, and III. e Physician's contact details. The Company shall base its assessment of e claim on e complete, written proof of loss. 4. The Company at its own expense shall have e right and opportunity to examine e Insured Person whose Bodily Injury or Sickness is e basis of a claim and as often as it may be reasonably required during e pendancy of e claim and to make an autopsy in case of dea, where it is not forbidden by law. 5. In respect of any disablement claim, no benefit shall be payable before any disablement is recognised as definitive and permanent by a Physician appointed by e Company. 6. Medical advice of a Physician shall be sought and followed promptly on e occurrence of any Bodily Injury or Sickness and e Company shall not be liable for any part of any claim which in e opinion of a Physician appointed by e Company arises from e unreasonable or willful neglect or failure of an Insured Person to seek and remain under e care of a Physician. care@hdfcergo.com CIN : U66010MH2PLC IRDA Reg No

5 7. No claim may be brought under is Policy, nor may any legal action be brought again e Company to recover under such claim: a. in cases of Accidental dea, more an ree (3) years after e date of dea or e date e claim is denied in whole or in part, whichever is later; or b. in all oer cases, more an ree (3) years after e Date of Loss or date e claim is denied in whole or in part, whichever is later. No such legal action may be brought again e Company unless ere has been full compliance wi all e terms and conditions of is Policy. In e event of any failure to timely submit any claim or commence legal action wi respect to any claim, all benefits under is Policy in respect of such claim shall be forfeited. 8. If any difference shall arise as to e amount to be paid under is Policy (liability being oerwise admitted) such difference shall be referred to arbitration in accordance wi e Indian Arbitration and Conciliation Act 1996, as amended, and e making of an award shall be a condition precedent to any liability for e Company to make any payment under is Policy. 9. The Company will effect payment of covered claims subject to: i) e Company having received complete, written proof of loss and such oer information as e Company may require to handle e claim; and ii) e premium for e Policy having been paid. In such cases, e Company shall effect payment wiin 7days. 10. No benefit shall be payable in respect of an Insured Person under more an one of e following insurances: Accidental dea or Accidental disablement. 11. No sum payable under is Policy shall carry intere. 12. Where amounts recoverable from e Company are delayed pending finalisation of any claim, payments on account may be made to e Insured Person at e Company's discretion, on receipt by e Company of certification by a Physician appointed by e Company. 13. An Insured Person has e right to designate a beneficiary. All beneficiary designations shall be in writing, filed wi e Policyholder, and provided to e Company at e time of claim and such oer time as e Company may require. The Insured Person, and no one else, unless ere is an irrevocable assignment, has e right to change e beneficiary. The Insured Person does not need e consent of anyone to do so. Changes mu be in writing, filed wi e Policyholder and provided to e Company at e time of claim and such oer time as e Company may require. The Company does not assume any responsibility for e validity of ese changes. The Insured Person's rights under is Policy may be assigned by giving e Company prior written notice. The assignment may be made irrevocable. However, e Company will only recognise an assignment if e Insured Person has given e Company prior written notice and has e Company's written acknowledgement of e assignment. The Company does not assume any responsibility for e validity of an assignment. Benefit shall be payable only to e Insured Person, his or her Beneficiary, or e Insured Person's legal personal representatives or assignee if applicable, whose receipt shall effectively discharge e Company. 14. In e event of a claim under is Policy, e Policyholder, e Insured Person and e Beneficiary, if applicable, mu fully cooperate wi e Company in its handling of e claim including, but not limited to, e timely submission of all medical and oer reports, and full Cupertino wi all physical examinations and autopsies at e Company may require. 15. The Company shall not be bound or be affected by any notice of any tru, charge, lien, or oer dealing wi or in relation to is Policy. Our 24 hour helpline centre is ju a call away. For travel, medical advice and assiance during your trip, call us on e 24-hour helpline centre: travelclaims@hdfcergo.com International Toll Free No.: Landline (Chargeable) : Fax No.: Insurance is e subject matter of solicitation. For more details on risk factors, terms & conditions, please read e sales brochure before concluding a sale. care@hdfcergo.com CIN : U66010MH2PLC IRDA Reg No