Product Benefits-Key Highlights (Senior Citizen)

Product Benefits-Key Highlights




Benefits offered, their sub-limits and deductibles
 
 Product Benefit Table

 

S.No. Benefits   Deductible
  Sum Insured (in USD) 25000, 50000, 100000  
1 Medical Expenses (including medical evacuation) 1# 25000, 50000, 100000 USD 100
2 Sickness Dental Relief 500 USD 100
3 Accidental Death and Dismemberment Benefit (24 hrs) 15,000 Nil
4 Repatriation of Mortal Remains 7,500 Nil
5 Delay of Checked-in Baggage 250 after 6 hours
6 Loss of Checked-in Baggage 2 1000 Nil
7 Loss of Passport Benefit 300 USD 25
8 Personal Liability Benefit 100,000 USD 100
9 Trip Delay Benefit USD50 per 12hrs to max. 500 USD (5 days) after 6 hours
10 Hijacking Benefit USD125 per day (7 Days Max) after 12 hours
11 Emergency cash advance 3                        1,000 Nil
12 Trip Cancellation                        1,000 Nil
13 Missed Connections/Missed Departures                          500 after 6 hours
14 Political risk and Catastrophe evacuation                        7,500 Nil
15 Difference in Airfare due to delayed or early return                          500 Nil
16 Assistance Services Included  

 

 

All benefit limits are in USD unless specified

 

# Following sub limits shall apply in respect of Medical Expenses (including medical evacuation). All other benefits will be applicable as mentioned under Product benefit table above. These sub limits will not be applicable if the Insured is travelling to Schengen countries and Premium will be charged as per the Schengen rates shared.

 
Sub-limits applicable

 

S.No. Benefits Classic
1 Hospital Room and boarding USD1500/day upto 30 days
2 Intensive Care Unit USD2500/day upto 7 days
3 Surgical treatment * Max USD10,000
4 Anaesthetist services Max upto 25% of Surgical Treatment
5 Physician’s visit Max USD75/day upto 10 visits
6 Diagnostic and pre-admission testing Max upto USD500
7 Ambulance services ** Max upto USD400
8 Misc Expenses *** Part of Room Charges

 

*Includes OT charges, Surgeon Fee and implant charges

**Includes cost of transportation to hospital and paramedic services

***Includes but not limited to medicines/pharmacy/drugs/supplies/nursing charges/external medical appliances as prescribed by doctor as necessary and essential as part of the treatment

 

All benefit limits are in USD unless specified

 

  • PED condition is not covered. Coverage for PED is applicable only in case of Life Threatening condition upto a max of USD2000.
  • In case of one bag is 100 % and in case of two or more bags Per Baggage is max 50% and per item in the baggage is max 10% 
  • Includes delivery and service charges

Details of all benefits have been provided below:

 

 

1.     Medical Expenses (including Medical Evacuation)

 

Following conditions are covered on actual expenses incurred subject to the limits specified in the policy schedule under this section:

  1. OPD, Hospitalisation Expenses, Medical Practitioner’s charges, local emergency medical transportation and medical services for any illness or injury sustained while abroad.
  2. Medical Evacuation to another better nearby location or to India subject to obtaining prior approval from our end. The medical evacuation shall be as a result of Accidental Bodily Injury and/or Sickness and/or Disease occurring or having first manifested itself during an Insured Journey. It will not cover rescue operations in case of natural calamities/riots when there is no emergency due to accident/sickness. This benefit is available as cashless benefit and not on reimbursement basis.
  3. Any expenses due to Pre Existing Diseases will not be covered. Only in case of Life Threatening emergency, the expenses incurred abroad will be covered up to a max of USD2000.

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 2.     Sickness Dental Relief

 

The companywill cover actual expenses incurred resulting from sickness sustained to Sound Natural Teeth during a Trip abroad subject to the limits specified in the schedule under this section.Back to top

 

 3.     Accidental Death & Dismemberment (24 hours)

 

In case of death or disability arising out of and consequent (within 12 months) upon an injury sustained during the trip, the policy will pay the limits specified in the schedule under this section as per the benefit table mentioned below.

1. Death

100%

2. Permanent Total Disablement

 

Total and irrevocable loss of

 

(i) Both Hands or both feet

100%

(ii) sight of both eyes

100%

(iii) one entire hand and one entire foot

100%

(iv) Loss of either hand or foot and sight of one eye

100%

(v) Speech and hearing in both ears

100%

(vi) Either hand or foot

50%

(vii) Sight of One eye

50%

(viii) Speech

50%

(ix) Hearing in both ears

50%

(x) Thumb and index finger of the same hand

25%

(xi) Quadriplegia

100%

(xii) Paraplegia

50%

(xiii) Hemiplegia

50%

(xiv) Uniplegia

25%

 

In any case, the maximum liability of the company in the event of a claim shall not exceed 100% of the sum insured provided under this section.Back to top

 

 4.     Repatriation of Mortal Remains

 

In the event of the death of the Insured Person during the Trip due to illness/ injuries, which are insured events in terms of this Policy, the Company shall compensate for the transportation expenses reasonably incurred to return the mortal remains of the Insured Person to the place of residence in the Republic of India or the expenses for local burial or cremation in the country where the death occurred, subject to the limits specified in the schedule under this section.Back to top

 

 5.     Delay of Checked-in Baggage 

 

The Company will reimburse up to the limits specified under this section in the policy schedule for necessary emergency purchase of essential clothes, toiletries and essential medicines in the event that the Insured Person suffers a delay of more than 6 hours from the Scheduled Arrival time at the destination for delivery of Baggage that has been checked by a Common Carrier for an international outbound flight from the Republic of India. This benefit is only payable on outward journey from India and not on return journey to India. Amount payable will be only in excess of any amount paid or payable by the carrier responsible for the delay/loss. This benefit shall be payable only once during the policy period irrespective of the number of intermittent trips undertaken by the insured.Back to top

 

 6.     Loss of Checked-in Baggage

 

The Company will reimburse up to the limits specified in the Schedule of the policy in the event of the Insured Person suffering Total Loss of entire piece of Checked in Baggage which is under the care control and custody of the Common Carrier, while the Insured Person is a ticketed passenger on the Common Carrier during the course of the Insured Period. Any amount payable will be in excess of any amount paid or payable by the Carrier responsible for the loss and/or in excess of all other valid and collectible insurance. The maximum amount reimbursable per bag is 50% of the Sum Insured   and the maximum value per article contained in any bag is 10% the Sum Insured.Back to top

 

 7.     Loss of Passport

 

In the event that the Passport, Visa belonging to the Insured Person is lost, the Company will reimburse up to the limit mentioned in the Schedule to cover only the direct expenses necessarily and reasonably incurred in connection with obtaining emergency travel documents in lieu of passport /visa or duplicate or new passport. Any loss should be reported to local Police within 24 hours.Back to top

 

 8.     Personal Liability

 

In the event of the Insured Person becoming legally liable to a Third Party (under statutory liability provisions or in common law for an incident which results in death, injury of such third party or damage to his/ her properties), the company will compensate the Insured person up to the limit specified, provided the incident occurs during the Period of Insurance and whilst on a Trip abroad and provided that the claim is reported to the Company immediately.Back to top

 

 9.     Trip Delay

 

The Company will pay a lump sum subject to the limits specified in the policy schedule under this section, if the Insured Person’s Common Carrier commencement is delayed for more than 6 continuous hours due to any Covered Occurrence. This section provides coverage both for inbound and outbound journey out of India. This benefit shall be payable only once during the period specified in the policy schedule.

 

Covered occurrence shall mean the following:

      i.        Earthquake.

     ii.        Lighting, Storm,  Tempest, Typhoon, Hurricane, Inundation, Subsidence

    iii.        Landslide and rockslide

    iv.        Avalanche

     v.        Floods resulting from unseasonal rains, storm or cyclone.

    vi.        Terrorism.

   vii.        Tsunami

  viii.        Volcano Eruption

 

provided that, the named perils hereinabove shall take place at and in the vicinity of any port involved in the Trip; and Cancellation or rescheduling of flights done at the instance of the  Common Carrier that causes delay.Back to top

 

 10.  Hijacking Benefit

 

A lump sum amount is payable subject to the limits as specified in schedule for each 24 hours in captivity in the event of any Common Carrier, in which the Insured Person is traveling being hijacked on the trip abroad and held captive for more than 12 continuous hours.Back to top

 

11.  Emergency Cash Advance

 

The company will provide an assistance service when the insured person requires emergency cash following incidents like theft/burglary of luggage/money or hold up whilst on a trip covered under policy. The service provider will coordinate with the insured person’s family members in his country of residence to provide emergency cash advance to the insured person as per his requirement up to the limit specified (including service and delivery charges) in the policy schedule under this section.Back to top

 

 12.  Trip Cancellation

 

The Company will reimburse the unused and non-refundable portion of the pre-paid lodging cost and/or the ticket cancellation charges (up to the maximum amount specified in the schedule) if the Trip is cancelled and the Insured Person is unable to undertake the Trip due to:

 

              i.          death or serious injury or sudden sickness requiring minimum 3 days of hospitalization within 5 days before the date of departure specified in the policy schedule of (a) of the Insured Person or (b) Traveling Companion or (c) immediate Family member of the Insured Person.

             ii.                Covered occurrence (same list as shared under point no9) provided they take place at and in the vicinity of any port involved in the Insured's Trip.

 

                   Amount payable under this section will be only in excess of any amount paid or payable if any by the Hotel/Airlines. The booking should have been made in advance prior to the cancellation.Back to top

 13.  Missed Connections/Missed Departures

 

The Company will reimburse cost of reasonable expenses towards actual boarding and lodging incurred if the insured misses the connecting flight at intermediate port due to a delay beyond 12 hours from the original schedule by the outbound air craft from India in which insured is expected to travel, caused by Inclement weather, Equipment failure of the common carrier, strike or other job action by employees of the airlines. This benefit shall be payable either for a Missed connection or departure and not for both.Back to top

 

 14.  Political risk and Catastrophe evacuation 

 

The Company shall, subject to the sum insured limits specified in the schedule, reimburse the insured:

      i.        the cost of travel expenses to the country of residence or nearest place of safety up to the cost of an economy class air ticket and

     ii.        reasonable accommodation expenses, if incurred, up to a maximum of USD 300 per day for a maximum of 7 days if insured is unable to return to his country of residence, when:

  1. Officials in the country where Insured is visiting, recommend that certain categories of persons which include the Insured should leave the country, or
  2. Insured is expelled from or declared persona non grata in the Country he is in, or
  3. A catastrophe (fire, flood, earthquake, Tsunami, Volcano Eruption, storm, lightning, explosion, hurricane or epidemic due to contagious disease) has occurred in the Country the Insured is in, necessitating his immediate evacuation in order to avoid risk of personal Injury or Illness to himself.

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 15.  Difference in Airfare due to delayed or early return

 

If the insured returns back to India before or after the scheduled date of return, due to illness or accident to self or accompanying travelers who are also travelling with the insured person and insured with us, the Company shall pay the insured person, subject to the limits specified in Policy Schedule, the difference fare for economy class return ticket when the insured’s original return ticket was issued at a reduced rate and with a fixed or limited return date, and such return date cannot be met due to the insured’s illness or accident covered under the policy.Back to top

 

 16.  Assistance Services

 

The Company shall provide assistance services such as Overview of country, Weather, Currency Exchange Rates, Vaccinations etc.Back to top

 

Key Exclusions:

 

The Company shall not be liable to make any payments in respect of:

1. Any claim relating to events occurring before the commencement of the cover or otherwise outside of the Period of Insurance.

2. Any claim in respect of Pre-existing conditions (excepting in case of life threatening situations up to a maximum of USD2000).

3. Any claim arising out of illnesses or Accidents that the Insured Person has caused intentionally or by committing a crime or as a result of drunkenness or addiction (drugs, alcohol).

4. Any claim arising out of mental disorder, suicide or attempted suicide self-inflicted injuries.

5. Any claim arising from the Insured Person engaging in Air Travel unless he/she flies as a fare paying passenger on an aircraft properly licensed to carry passengers. For the purpose of this exclusion Air Travel means being in or on or boarding an aircraft for the purpose of flying therein or alighting there from following a flight.

6. Any claim for any losses in whole or in part and/expenses directly or indirectly in respect of the Insured Person riding on a motor cycle or any other two-wheeled and two-wheeled motorized mode of conveyance as driver unless at the time of the Accident the insured is in possession of a currently valid full international driving licence and while riding a two wheeler is wearing a safety crash helmet and following rules applicable in the country of visit.

7. Illness and Accidents that are results of war and warlike occurrence or invasion, acts of foreign enemies, hostilities, civil war, rebellion, insurrection, civil commotion assuming the proportions of or amounting to an uprising, military or usurped power, seizure, capture, arrest, restraints, detainments of all kings princes and people of whatever nation condition or quality whatsoever.

8. Any claim up to the Excess as shown in the Policy Schedule.

9. Any claim for participation in Hazardous Sports/Hazardous Activities

 10. Any claim arising out of sporting activities in so far as they involve in training or participation in competitions of professional or semi- professional sports persons

 

Please note that this list is not exhaustive. Please refer to the policy terms and conditions for the complete list of exclusions.