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Group Domestic Traveller Insurance Policy

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0% found this document useful (0 votes)

44 views62 pages

Group Domestic Traveller Insurance Policy

Uploaded by

Ankita Mittal

We take content rights seriously. If you suspect this is your content, claim it here.

Available Formats

Download as PDF, TXT or read online on Scribd

Group Domestic Traveller Insurance Policy

Policy wordings

Policy Wordings: Group Domestic Traveller Insurance Policy

WHEREAS the Insured designated in the Policy Schedule having by a proposal and declaration
together with any statement, report or other document which shall be the basis of this contract
and shall be deemed to be incorporated herein, has applied to ICICI Lombard General Insurance
Company Limited (hereinafter called “the Company”) for the insurance hereinafter set forth and
paid appropriate premium for the period as specified in the Schedule.

Operative Clause:
Now this Policy witnesseth that subject to the definitions, terms, conditions and exclusions
contained, endorsed or otherwise expressed herein, the Company shall compensate, indemnify, pay
and/or reimburse the Insured/Insured Person or his/her nominee or legal representatives, as the
case may be, in respect of insured events occurring during the period of insurance stated in the
Schedule, in the manner and to the extent set forth in this Policy.

I. Definitions:
Any word or expression to which a specific meaning has been assigned in any part of this Policy or
the Schedule shall bear the same meaning wherever it appears. For purpose of this Policy, the
terms specified below shall have the meaning set forth:

“Accident” means a sudden, unforeseen and involuntary event caused by external, visible and
violent means.

“Injury” means accidental physical bodily harm excluding illness or disease solely and directly caused
by external, violent and visible and evident means which is verified and certified by a Medical
Practitioner.

"Cashless facility” means a facility extended by the insurer to the insured where the payments, of
the costs of treatment undergone by the insured in accordance with the policy terms and conditions,
are directly made to the network provider by the insurer to the extent pre-authorization approved.

“Condition Precedent” means a policy term or condition upon which the Insurer's liability under
the policy is conditional upon.

“Congenital Anomaly” means a condition which is present since birth, and which is abnormal with
reference to form, structure or position.

a. “Internal Congenital Anomaly “ refers to the Congenital anomaly which is not in the visible
and accessible parts of the body;

b. “External Congenital Anomaly” refers to the Congenital anomaly which is in the visible and
accessible parts of the body.

Policy Wordings: Group Domestic Traveller Insurance Policy

“Disclosure to information norm” means the Policy shall be void and all premium paid thereon
shall be forfeited to the Company, in the event of misrepresentation, mis-description or non-disclosure
of any material fact.

“Emergency Care” means management for an illness or injury which results in symptoms which
occur suddenly and unexpectedly, and requires immediate care by a medical practitioner to prevent
death or serious long term impairment of the insured person's health.

“Hospital” means any institution established for in- patient care and day care treatment of illness
and/or injuries and which has been registered as a hospital with the local authorities under the
Clinical Establishments (Registration and Regulation) Act, 2010 or under the enactments specified
under the schedule of Section 56(1) of the said Act Or complies with all minimum criteria as under;
� has qualified nursing staff under its employment round the clock;
� has at least 10 in-patient beds in towns having a population of less than 10,00,000 and at
least 15 in-patient beds in all other places;
� has qualified medical practitioner(s) in charge round the clock;
� has a fully equipped operation theatre of its own where surgical procedures are carried out;
� maintains daily records of patients and makes these accessible to the Insurance
company’s authorized personnel.

“Hospitalisation” means admission in a Hospital for a minimum period of 24 consecutive “In-

patient Care” hours except for specified procedures/ treatments, where such admission could be for
a period of less than 24 consecutive hours.

"Illness" means sickness or a disease or pathological condition leading to the impairment of

normal physiological function and requires medical treatment.

a) “Acute condition” - Acute condition is a disease, illness or injury that is likely to respond
quickly to treatment which aims to return the person to his or her state of health immediately
before suffering the disease/illness/injury which leads to full recovery.

b) “Chronic condition” - A chronic condition is defined as a disease, illness, or injury that has
one or more of the following characteristics:—

• it needs ongoing or long-term monitoring through consultations, examinations, check-ups, and /

or tests;

• it needs ongoing or long-term control or relief of symptoms;

• it requires rehabilitation for the patient or for the patient to be specially trained to cope with it;

• it continues indefinitely;

• it recurs or is likely to recur.

Policy Wordings: Group Domestic Traveller Insurance Policy

b) expenses towards lawful medical termination of pregnancy during the policy period.

“Medical Advice” means any consultation or advice from a Medical Practitioner including the
issuance of any prescription or follow-up prescriptions.

“Emergency Medical expenses” means those expenses that an Insured Person has
necessarily and actually incurred for medical treatment on account of Illness or Accident on the
advice of a Medical Practitioner, as long as these are no more than would have been payable if the
Insured Person had not been insured and no more than other hospitals or doctors in the same
locality would have charged for the same medical treatment.

“Medical Practitioner” means a person who holds a valid registration from the Medical Council
of any state or Medical Council of India or Council for Indian Medicine or for Homeopathy set up by
the Government of India or a State Government and is thereby entitled to practice medicine within
its jurisdiction; and is acting within the scope and jurisdiction of license.

“Medically Necessary Treatment” means any treatment, tests, medication, or stay in hospital or
part of a stay in hospital which,

• is required for the medical management of the illness or injury suffered by the insured;
• must not exceed the level of care necessary to provide safe, adequate and appropriate
medical care in scope, duration, or intensity;

• must have been prescribed by a medical practitioner;

• must conform to the professional standards widely accepted in international medical practice
or by the medical community in India.

"Network Provider” means hospitals or health care providers enlisted by an insurer, or by a

TPA or jointly by an Insurer and TPA to provide medical services to an insured by a cashless
facility.

“Non- Network Provider” means any hospital, day care centre or other provider that is not part
of the network.

“Notification of Claim ” means the process of intimating a claim to the insurer or TPA through any
of the recognized modes of communication.

“OPD treatment” means is the one in which the Insured visits a clinic / hospital or associated
facility like consultation room for diagnosis and treatment based on the advice of a Medical
Practitioner. The insured is not admitted as a day care or in-patient.

“Qualified Nurse” means a person who holds a valid registration from the Nursing Council of
India or the Nursing Council of any state in India.

“Reasonable and Customary Charges” means the charges for services or supplies, which
are the standard charges for the specific provider and consistent with the prevailing charges in the
geographical area for identical or similar services, taking into account the nature of the illness / injury
involved.

Policy Wordings: Group Domestic Traveller Insurance Policy

“Subrogation” means the right of the insurer to assume the rights of the insured person to recover
expenses paid out under the policy that may be recovered from any other source.

“Surgery or Surgical Procedure” means manual and / or operative procedure (s) required for
treatment of an illness or injury, correction of deformities and defects, diagnosis and cure of diseases,
relief from suffering or prolongation of life, performed in a hospital or day care centre by a medical
practitioner.

“Unproven/ Experimental treatment” means the treatment including drug experimental therapy
which is not based on established medical practice in India, is treatment experimental or unproven.

“Air Travel” means travel by an airline/aircraft for the purpose of flying therein as a Fare Paying
passenger.

“Alternative Treatments” means forms of treatments other than treatment "Allopathy" or "
modem medicine " and includes Ayurveda, Unani, Sidha and Homeopathy in
the Indian context.

“Appliances” shall mean and include electrical, mechanical and electronic appliances such as
refrigerator, television, , washing machine, microwave oven, Audio and Video system, personal
computer, laptops and air-conditioner contained or fixed in the Insured's home for domestic use.

Adventure Sports” skydiving/parachuting, parasailing, hang gliding, paragliding, balooning

bungee jumping, scuba diving, mountaineering or rock climbing (where ropes or guides are
customarily used), Speed contest or racing of any kind, caving or pot-holing, absoiling, hunting or
equestrian activities, deep sea diving, skin diving or other underwater activity, polo, snow and ice
sports, rafting or canoeing involving white water rapids, yachting or boating, , Base Jumping, Ski
Jumping, Trekking, Adventure racing on land and water, Snorkeling, Kayaking, Surfing,any bodily
contact sport or any other hazardous
or potentially dangerous sport

“Aggregate Limit” - Company’s maximum liability per event under the Accidental Death and
Dismemberment or Permanent Total/Partial Disability benefits of this Policy in respect of all claims
by or on behalf of all Insured Persons , If at any time the total value of unpaid claims would, if paid,
result in this aggregate limit being exceeded, the individual benefits attributable to those
outstanding claims shall be reduced pro rata as necessary to ensure that this maximum aggregate
limit is not exceeded.

“Baggage” shall mean articles and / or personal effects of the Insured (other than property of the
Business) in packing or in containers suitable and standard to the mode of Travel that is
accompanied by the Insured or whilst such Baggage is lodged either in a locked private room of a
hotel or guest house or any other accommodation occupied by the Insured during the Insured's stay
at that location or in a public locker facility availed by the Insured during the course of or at any
intermediate stage of the Travel.

“Burglary” means an act involving the unauthorized or forcible entry to or exit from the Insured's
home in India or any attempt threat, with intent to commit crime.
“Checked-in Baggage” means baggage handed over by the Insured/Insured Person and accepted
by a common carrier for transportation in the same carrier in which the Insured/Insured Person is or
would be travelling and for which the common carrier has issued a baggage receipt to the
Insured/Insured Person.

Policy Wordings: Group Domestic Traveller Insurance Policy

“Common Carrier” - means any civilian land, rail or Scheduled Airline in each case operated
under a valid license for the transportation of passengers for hire.

“Contents” mean and include electrical and electronic equipment, household appliances, furniture,
fixture, fittings, linen, clothing, interior decorations, kitchen items, cutlery /crockery contained in the
Insured's home belonging to the Insured or his/her family members permanently residing with the
Insured including items for which the Insured is responsible, and used for domestic use. However,
this does not include deeds, bonds, bills of exchange, promissory notes, cheques, traveller's
cheques, and securities
for money, documents of any kind, cash, and currency notes.

“Corporate” means any organization, firm, society or body corporate on whose name the Policy
is issued.

“Dependent Child” refers to a child (natural or legally adopted), below the age of 23 years, who is
financially dependent on the primary insured or proposer and does not have his / her independent
sources of income.

"Disease” means an alteration in the state of the body or of some of its organs interrupting or
disrupting the performance of the functions, and causing or threatening pain and weakness or
physical or mental disorder and certified by a Medical Practitioner.

“Emergency Assistance Service Provider” means Third Party Administrator or any organization
or institution appointed by the Company for providing services to the Insured/Insured Person for an
insurable event.

“Family” means the Insured, his/her lawful spouse and maximum of any two dependent children
up to the age of 23 years.

“Felonious Assault” means an act of violence against the Insured/Insured Person or a travelling
companion requiring medical treatment.

“Financial Emergency” means a situation wherein the Insured/Insured Person loses all or a
substantial amount of his/her travel funds due to theft, robbery, mugging or dacoity, which has
detrimental effects on his/her travel plans.

“Foreign Enemy” means any group of individuals, entity or country, who intends to cause injury, or
commissions an act dangerous to human life or property in the location where the Insured/Insured
Person is travelling to, by the use of hostile force or violence.

“Hijack” means any unlawful seizure or exercise of control, by force or violence or threat of force or
violence and with wrongful intent, of the common carrier in which the Insured/Insured Person is
travelling.

“Housebreaking” means an act involving physical break-in and unauthorized and forcible entry
into Insured Person's home in India, or any threat, with intent to commit crime.

“Immediate family member” shall mean any member of the Insured Person's immediate family
i.e the Insured Person's spouse, child, parent or sibling.

“Inclement Weather” means any severe catastrophic weather conditions which delay the
scheduled arrival or departure of a common carrier but not including normal, seasonal/climatic
weather changes.

Policy Wordings: Group Domestic Traveller Insurance Policy

“Insured Person” means the person named in the Policy Schedule, who has a permanent
place of residence in India and for whom the insurance is proposed and appropriate premium paid.

“Insurable Event” means an event, loss or damage for which the Insured/Insured Person is
entitled to benefit/s under the Policy.

“Loss” means loss or damage.

“Land/Sea Arrangements” - means pre-paid travel arrangements for a scheduled tour, trip or
cruise included within the description of covered Trips on the Proposal / Enrollment and Declaration
Form and arranged by a tour operator, travel agent, or other organization.

“Life threatening condition / situation” refers to a medical condition suffered by the Insured which
has the following characteristics:
i. Markedly unstable vital parameters (blood pressure, pulse, temperature and respiratory rate).
ii. Acute impairment of one or more vital organ systems (involving brain, heart, lungs, Liver,
Kidneys and pancreas).
iii. Critical care being provided, which involves high complexity decision making to assess,
manipulate and support vital system function(s) to treat single or multiple vital organ failure(s)
and requires interpretation of multiple physiological parameters and application of advanced
technology.
iv. Critical care being provided in critical care area such as coronary care unit, intensive
care unit, respiratory care unit, or the emergency department.

“Man days” is a 24 hours period starting from midnight for an individual whilst travelling within the
territorial boundaries of India.

“Multi trip” means two or more trips to destinations of Republic of India during the Policy period.

“Natural Teeth” - means natural teeth that is unaltered or is fully restored to their normal function
and is Disease-free, have no decay and are not more susceptible to Injury than unaltered natural
teeth.

“Period of Insurance” in respect of Single Trip Policy means the period from the
commencement of the insurance cover to the end of the insurance cover as specified
in the Policy Schedule.

“Period of Insurance” in respect of the Multi Trip/ Annual policy shall mean the period from
Commencement of Insurance cover to the end of the insurance cover or full utilization of the
maximum number of travel days per trip as mentioned in Policy Schedule, or expiry of the Policy or
cancellation of the insurance, whichever is earlier whichever is earlier.

“Physician” - means a licensed medical practitioner acting within the scope of his license and who
holds a degree of a recognized institution and is registered by the Medical Council of India. The
term Physician would include specialist and surgeon. Family members are excluded from the
Definition of Physician.

“Policy” means proposal, the Schedule, the Policy documents and any endorsements attaching
to or forming part hereof either on the commencement date or during the Policy Period..

“Policy Schedule” means the document giving mentioning the name of the Insured / Insured
persons, Policy Period, scope of cover, limits to which benefits are subject to and other relevant
terms and conditions

“Permanent Partial Disablement” means a bodily injury caused by accidental, external, violent

Policy Wordings: Group Domestic Traveller Insurance Policy

“Permanent Total Disablement” means a bodily injury caused by accidental, external, violent
and visible means, which as a direct consequence thereof totally disables and prevents the
insured from attending to any business or occupation of any and every kind or if he/she has no
business or occupation, from attending to his/her usual and normal duties that last for a
continuous period of twelve calendar months from the date of the accident, with no hopes of
improvement at the end of that period.

“Pre-existing Disability” means an existing disability and consequence of such disability

existing or known to exist at the commencement of the policy period.

“Pre-existing Disease” - means any condition, ailment or injury or related condition(s) for which
the Insured / Insured Person had signs or symptoms, and /or were diagnosed, and /or received
medical advice/ treatment, within 48 months prior to the this policy

“Professional Sportsperson” means those sports persons who are in to full time sports and
maintain their livelihood through earnings from their involvement in sports.

“Reasonable Additional Expenses” means any expenses for meals and lodging necessarily
incurred by the Insured/Insured Person as a result of a trip delay but does not include meals and
lodging provided by the common carrier or any other party free of charge.

“Return Destination” means the place to which the Insured/Insured Person is scheduled to return
from his/her trip.

“Scheduled Airline” means any civilian aircraft operated by a civilian scheduled air carrier
holding a certificate, license or similar authorization for civilian scheduled air carrier transport issued
by the country of the aircraft’s registry, and which in accordance therewith flies, maintains and
publishes tariffs for regular passenger service between named cities at regular and specified times,
on regular or chartered flights operated by such carrier.

“Schedule Railways” means any Railways operated by Indian Railways, which in accordance
there with operates, maintains and publishes tariffs for regular passenger service between named
cities at regular and specified times, on regular journey operated by such carrier.

“Schedule Roadways” means a roadways carrier which is operated between named cities under a
valid license issued by the appropriate Indian governmental authority for the transportation of
passengers within India for a fee, and which maintains and publishes regular tariffs for regular
passenger services which it operates between named cities at regular and specified times

“Semiprofessional sports person” shall mean those sports persons who participate in sports on
frequent basis (at least once in a month) while being separately employed elsewhere or self-
employed and whose primary source of income is not from sports.

“Strike” means stoppage of work (a) announced, organized and sanctioned by a labour union and
(b) which interferes with the normal departure and arrival of a common carrier inclusive of work
slowdowns, lockouts and sickouts.

“Sum Insured” means the maximum amount of coverage, as specified in the Policy Schedule, that
the Insured/Insured Person is entitled to in respect of each benefit and as applicable under the
Policy.

“Terrorism/Terrorist Incident” means any actual or threatened use of force or violence directed
at or causing damage, injury, harm or disruption, or the commission of an act dangerous to human
life or property, against any individual, property or government, with the stated or unstated objective

Policy Wordings: Group Domestic Traveller Insurance Policy

“Travel Agent” means the Travel Agent, tour operator or other entity from which the Insured
purchases his/her insurance Policy or travel arrangements, and includes all officers, employees and
affiliates of the Travel Agent, tour operator or other entity.

“Travelling Companion” means an individual or individuals travelling with the Insured/Insured

Person, provided that, the Insured and such individual(s) are travelling to the same destination and on
the same date and such individual(s) is/are also insured under this Policy. For the purpose of this
definition, any individual(s) forming part of a group travelling on a tour arranged by a Travel Agent
or a tour operator shall not be considered as Travelling Companion, unless the individual(s) is/are
part of the family of the Insured/Insured Person.

“Territory”: This Policy applies to incidents anywhere in India while travelling.

“Trip” means a journey out of usual place of residence in India and back, the details of which
are specified in the Policy Schedule.
� Includes Business and Leisure trips both unless specified otherwise
� Coverage for a Trip involving travel by <<Air/Rail/Road>> will be as specified in the policy
schedule
� which commences when the passenger boards the Common Carrier, including Private
Vehicle for onward journey and terminates when he disembarks on return to Your usual
Town of residence or the contracted date whichever earlier
� The insured journey also includes and covers Sojourn and/or Personal Deviation.

Unattended ” A Vehicle, premises or personal belongings are unattended if there is no one able to
observe or to prevent interference with it.

“Valuables” mean photographic, audio, video, computer and any other electronic equipment,
telecommunications and electrical equipment, telescopes, binoculars, antiques, watches, perfumes,
jewellery, furs and articles made of precious stones and metals.

“War’’ means war, whether declared or not, or any warlike activities, including use of military force by
any sovereign nation to achieve economic, geographic, nationalistic, political, racial, religious or other
ends.

II. Scope of Cover:

The Company hereby agrees subject to the terms, conditions and exclusions herein contained or
otherwise expressed, to compensate, indemnify, pay and/or reimburse in manner provided in this
policy, benefits to the insured for loss or damage described hereunder as per the coverage and up
to the limit of Sum Insured specified in the Policy Schedule.

Section- I: Emergency Medical Expenses

If the Insured/Insured Person contracts any disease/illness sustains any injury due to an Accident
during the Policy period requiring life-saving unforeseen emergency measures for such injury and
requires treatment as an In-Patient at a Hospital, provided such injury or illness is not due to a pre-
existing condition, the Company will pay or reimburse the following medical expenses incurred for
Hospitalisation to the Insured/Insured Person The treatment for these emergency measures would
be paid till the Insured/Insured Person becomes medically stable, as ascertained by the Medical
Practitioner of the Emergency Assistance Service Provider. All further medical costs to maintain
medically stable state would have to be borne by the Insured/Insured Person;

1. In-patient treatment in a local hospital at the place where the Insured is staying at the time

Policy Wordings: Group Domestic Traveller Insurance Policy

Section II - Emergency Medical Evacuation:

The Company shall pay or reimburse reasonable cost of transportation charges of the Insured
Person during the policy period due to an emergency accident or illness arising out of other
than pre-exiting diseases and if such transportation has been prescribed by the Medical Practitioner

(a) From a Hospital where the insured was treated to another nearest hospital, provided
1. such transportation is medically necessary
2. such medical services provided at a Hospital where the Insured Person is situated
are not satisfactory
3. Our Assistance Company has agreed to the reimbursement of the cost of
transportation in advance of the transportation, and has arranged the same.
(b) From a Hospital where the insured was last treated to the Insured Person’s usual place of
residence.

Section III – Repatriation of Mortal Remains:

In the event of accidental death of the Insured/ Insured Person due to an accident, the Company
shall pay or reimburse the costs of transporting the mortal remains of the deceased
Insured/Insured Person back to his/her usual place of residence within India or the cost of local
burial or cremation anywhere in INDIA where the accidental death occurred.

The deductible in respect of this benefit will be applicable for each and every claim separately and
shall be of an amount as specified in the Policy Schedule.

Specific Exclusions (Section I to III)

The Company shall not be liable to make any payment under this benefit in connection with or in respect of
any expenses whatsoever incurred by the Insured/ Insured Person for:

1. Any pre-existing condition and /or any complications arising from it,

2. Treatment which could be reasonably delayed until Insured/Insured Person's return to his /her place of
permanent residence. The question of what can or what cannot be reasonably delayed will be decided
jointly by the treating Medical Practitioner and the Company and shall be in accordance with accepted
standards of medical care.

3. Charges in excess of reasonable and customary charges incurred for emergency treatment on account of an
insured event.

4. Treatment relating to the removal of physical flaws or anomalies (cosmetic treatment or plastic surgery in
any form or manner unless medically required as part of treatment for accidents and burns).

5. Expenses incurred in connection with rest or recuperation at a spa, health resort, sanatorium,
convalescence home, rehabilitation measures, private duty nursing, respite care, domiciliary care, long-
term nursing care, custodial care and treatment related alcoholism and drug dependency

6. Any cost relating to the insured person’s pregnancy, childbirth or the consequences of eithert completed.

Policy Wordings: Group Domestic Traveller Insurance Policy

8. Any health check-ups or examinations or measures primarily carried out for diagnostic or investigative
reasons for any purpose other than treatment related to an Accident

9. Any cost in any way related to psychiatric disorders.

10. Any exclusion mentioned in the 'General Exclusions' section of this Policy.

Section- IV: Personal Accident (Death+PTD+PPD)

Coverage:
The Company shall compensate the Insured/Insured Person or his/her nominee or legal
representatives, as the case may be, for accidental bodily injury (whilst on a trip covered by this
Policy) solely and directly caused by accidental, violent, external and visible means resulting in
accidental death or Permanent Total Disablement or Permanent Partial Disablement within twelve
(12) calendar months of occurrence of such injury.

In case of the unfortunate accidental death of the Insured/Insured Person, the compensation shall
be paid to the nominee or legal representatives. The Sum Insured shall be the maximum liability of
the Company under this benefit.

Subject to the above; the Company shall pay to the Insured/Insured Person, his/her nominee or
legal representatives, as the case may be, the sum or the sums as set forth in the Table of Benefits
below:

Table of Benefits Percentage

of Sum
Insure
d payable
as
compensation
1. Accident Death 100%
2. P T D – T otal and irrecoverable loss of
i) Sight of both eyes or of the actual loss by physical separation of two entire hands or two 100%
entire feet or one entire hand and one entire foot or of such loss of sight of one eye
and such loss of one entire hand or one entire foot.
ii) Use of two hands or of two feet or of one hand and one foot or of such loss of 100%
sight of one eye and such loss of use of one hand or one foot.
iii) T otal P aralysis 100%
iv) Loss of all fingers and both thumbs OR loss of arm – at shoulder; between 100%
shoulder and elbow; at and below elbow OR loss of leg – at hip; between knee and hip;
below knee
For the purpose of items 2 i) and 2 ii) above, physical separation of one entire hand shall mean
separation at or above wrist and/or of the foot at or above ankle respectively.
3. Permanent total and absolute disablement disabling the Insured/Insured Person 100%
from engaging in any employment or occupation of any description whatsoever which
he or she was capable of doing earlier
4. PPD - Total and irrecoverable loss of various parts as given below: Percentage of
Sum Insured
The sight of one eye or the actual loss by physical separation of one entire hand or 50%
one entire foot.
Use of a hand or a foot without physical separation 50%
Loss of speech 50%

Policy Wordings: Group Domestic Traveller Insurance Policy

Loss of middle finger or ring finger or little finger – two phalanges 7%

Loss of middle finger or ring finger or little finger - one phalanx 3%
Loss of metacarpals – first or second (additional) or third, fourth or fifth (additional) 3%
Any other permanent partial disablement Percentage as
assessed by an
IndependentPhysi
cian and / or
doctor
� The disablement occurs within one year of accident
� The disablement must be confirmed and claimed for prior to the expiry of a period of 3
months since occurrence of the disablement

Notwithstanding anything contained in the Policy, the Company shall not be liable for compensation
under more than one of the points (1) to (4) in the Table of Benefits hereinabove, in the same
period of disablement of the Insured/Insured Person.

Special Exclusions
The Company shall not be liable to make any payment under this benefit in respect of the following:

1. Any existing physical disability.

2. “Accidents due to disturbances of consciousness which may be due to sleep

disorders, hypnosis, tolerance and / or withdrawal symptoms due to intake of psychoactive drugs,
stimulants, sedatives, narcotics, hallucinogens.

3. Damage to health caused by curative measures, radiation, Infection, poisoning except where these
arise from an accident.

4. Any payment under this benefit whereby the Company's liability would exceed the sum payable in the
event of accidental death.

5. Any other claim after a claim for accidental death has been admitted by the Company and becomes
payable.

6. Any claim which arises out of an accident connected with the operation of an aircraft (Including Cabin
Crew) or which occurs during parachuting except when the Insured/Insured Person is flying as a Fare
Paying passenger in a multi-engine, scheduled commercial aircraft or Air Charter company.

Policy Wordings: Group Domestic Traveller Insurance Policy

a. intentional self-injury, suicide, or attempted suicide.

b. whilst under the influence of intoxication, liquor or drugs.

c. arising or resulting from the insured/insured person committing any breach of law with criminal intent or
participating in an actual or attempted felony, riot, crime, misdemeanour or civil commotion.

d. whilst engaging in speed contest or racing of any kind, hunting, bungee jumping, parasailing, ballooning,
skydiving, paragliding, hand gliding, mountaineering or rock climbing, potholing, abseiling, deep sea
diving, polo, snow and ice sports, etc. unless specifically covered and duly mentioned in the Policy
Schedule.

8. Any consequential loss or damage cost or expense of whatsoever nature.

9. Accidental Death or disablement resulting, directly or indirectly, caused by, contributed to or aggravated or
prolonged by childbirth, maternity or pregnancy or in consequence thereof, venereal disease or infirmity.

10. Payment of compensation in respect of accidental death, injury or disablement of the Insured/Insured
Person, due to or arising out of or directly or indirectly connected with or traceable to act of terrorism or
terrorist activities.

11. Any exclusion mentioned in the 'General Exclusions” section of this Policy.

Special Conditions:
1. In the event of partial loss or impairment of the function of one of the above parts of the body
or senses, the appropriate proportion of the percentage as stated in the “Table of Benefits”
will be considered for payment.

2. If the accident impairs a number of physical or mental functions, the degree of disablement
given in the Table of Benefits will be added together, but the amount payable shall not
exceed 100% of the Sum Insured as specified in the Policy Schedule.

3. If the accident affects parts of the body or senses whose loss or inability to function is not
dealt with above, the governing factor in determining the benefit amount in such a case
will be the degree to which the normal physical or mental capabilities are impaired, solely
from a medical point of view, as ascertained by a Medical Practitioner or a panel of
doctor of the company or Emergency Assistance Service Provider.

4. In the event of permanent disablement, the Insured/Insured Person will be under obligation:

a. To have himself/herself examined by the Medical Practitioners appointed by the

Company/Emergency Assistance Service Provider and the Company will pay the costs
thereof

b. To authorize Medical Practitioner providing treatment or giving expert opinion and any
other authority to supply the Company any information that may be required on the
condition of the Insured/Insured Person.

5. If the above obligations are not met with due to whatsoever reason, the Company shall be
relieved of its liability to compensate under this benefit.

6. The benefit applicable under this Section shall be in addition to the benefits applicable
under Section V - Accidental Death and Permanent Total Disability- Common carrier.

Policy Wordings: Group Domestic Traveller Insurance Policy

Special Exclusions:
All the exclusions and Special Conditions applicable to Personal Accident Section shall be
applicable to this Section also.

The benefit applicable under this Section shall be in addition to the benefits applicable under
Personal Accident Section.

Section VI - Personal Liability

Coverage
The Company shall indemnify the Insured/ Insured Person towards legal liability of the Insured/
Insured Person to a third party for an incident which results in accidental death, injury or damage to
the health or property of such third party whilst on a trip during the period of insurance covered by
this Policy, up to the limits specified in the Policy Schedule. The incident leading to the legal
liability of the Insured/ Insured Person should have occurred during the period of insurance and
whilst on a trip covered by this Policy.

The deductible in respect of this benefit will be applicable for each and every claim separately, and
shall be of an amount as specified in the Policy Schedule.

Special Exclusions
The Company shall not be liable to make any payment under this Section in respect of the following:
1 Any claim arising from Insured’s/ Insured Person’s personal contractual liability or through
promises made by the Insured/ Insured Person.
2 Any claim of personal liability of the Insured/ Insured Person towards his/her family,
relations and travelling companions, whether personal or official.
3 Any claim resulting from transmission of an illness or disease by the Insured/ Insured Person.
4 Any claim for damage resulting from professional activities/ sports involving the Insured/
Insured Person.
5 Any claim for liability, arising directly or indirectly, from or due to:
a) possession of animals, birds, reptiles, insects etc. and their by-products like skin,
hair, feathers, horns, fur, ivory, bones, eggs, etc.
b) ownership or possession of vehicles, aircrafts, water crafts, or activities of the
insured/insured person involving parachuting, hand-gliding, hot air ballooning or use of
fire arms.
c) Any wilful, negligent, malicious or unlawful act.
d) Insanity, the use of any alcohol/drugs (except as medically prescribed) or drug addiction.
e) Any supply of goods or services on the part of the Insured/Insured Person.
f) Any ownership or occupation of land or buildings other than the occupation of any
temporary residence.
6 Any exclusion mentioned in the ‘General Exclusions’ section of this Policy.

Special Conditions

Policy Wordings: Group Domestic Traveller Insurance Policy

2 If there is a legal action in process against the Insured/Insured Person over a personal
liability issue, the Company may conduct the legal action, including appointment of legal
counsel, at the Company’s expense in the name of the Insured/Insured Person at the
Company’s sole discretion.

3 The Company will have the right, but in no case the obligation, to take over and conduct in
the name of the Insured/Insured Person the defense of any claim and will have full
discretion in the conduct of any proceedings and in the settlement of any claim and having
taken over the defence of any claim, the Company may relinquish the same.

4 In the event the Company, in its sole discretion, chooses to exercise its right in pursuance
of this condition, no action taken by the Company in the exercise of such right will serve
to modify or expand in any manner, what the Company’s liability or obligations under this
Policy would have otherwise been had it not exercised its rights under these Special
Conditions.

Section- VII: Accidental Dental Treatment

Coverage:
The Company shall reimburse the Insured/ Insured Person reasonable dental expenses incurred
in respect of acute anaesthetic treatment of a natural tooth or teeth during a trip due to an
emergency accident or illness arising out of other than pre-exiting diseases, but not exceeding the
Sum Insured as specified in the Policy Schedule
Special Exclusions:
The Company shall not be liable to make any payment under this benefit in connection with or in
respect of any expenses whatsoever incurred by the Insured/ Insured Person for:

1 Any pre-existing condition and /or any complications arising from it

2 Treatment which could be reasonably delayed until the Insured/Insured Person's return to
his /her place of permanent residence. The question of what can or what cannot be
reasonably delayed will be decided jointly by the treating Medical Practitioner and the
Emergency Assistance Service Provider and shall be in accordance with accepted standard
of medical care.
3 Charges in excess of reasonable and customary charges incurred on account of an
insured event as per the determination of the Emergency Assistance Service Provider.
4 Treatment relating to the removal of physical flaws or anomalies (cosmetic treatment or
plastic surgery in any form or manner unless medically required).
5 Treatment of orthopedic, degenerative or oncological disease
6 Beauty and/or cosmetic treatment and/or reconstructive plastic surgery in any form or manner
7 Expenses incurred in connection with rest or recuperation at a spa, or health resort,
Sanatorium, convalescence home, rehabilitation measures, private duty nursing, respite
care, domiciliary care, long- term nursing care, custodial care and treatment related
alcoholism and drug dependency
8 Any exclusion mentioned in the 'General Exclusions' section of this Policy.

Section- VIII: - Daily Allowance in case of hospitalization

Coverage:
The Company will pay a fixed daily allowance, in the event of hospitalization of the Insured/Insured
Person due to an emergency accident or illness arising out of other than pre-exiting diseases
beyond a specified number of days as mentioned in the Policy Schedule as deductible, for which
a valid claim is admissible under the Policy whilst on a trip.

Policy Wordings: Group Domestic Traveller Insurance Policy

Section-IX: - Total Loss of Checked-in Baggage

Coverage:
The Company shall pay the compensation to the Insured/Insured Person for the total and
complete loss of checked-in baggage caused by a Common Carrier (Air) on a trip covered under
this Policy, up to the limits specified in the Policy Schedule. The cover is limited to the travel
destinations specified in the main travel ticket from his/her usual place of residence.

In the event of such a total and complete loss of checked-in baggage whilst in the custody of an
airline, a Property Irregularity Report (PIR) must be obtained from the airline immediately upon
discovery of the loss which must be submitted along with the claim.

The deductible in respect of this benefit will be applicable for each and every claim separately and
shall be of an amount as specified in the Policy Schedule.

Special Exclusions:
The Company shall not be liable to make any payment under this Section in respect of the following:

1. Valuables and money, all kinds of securities and tickets/passes or any other item(s) not
declared to, and agreed to by the Company.
2. Loss of property unless a Property Irregularity Report or other report usually issued by
common carriers in the event of loss of checked-in baggage has been procured and submitted to
the Company.
3. Any partial loss of the items contained within the checked-in baggage.
4. Items contained within the checked-in baggage, which are valued in excess of INR.5000 without
appropriate proof of ownership.
5. Losses arising from any delay, detention, confiscation by the customs officials or other public
authorities.
6. Any exclusion mentioned in the “General Exclusions” section of this Policy.

Special Conditions:
1 The Company will compensate the Insured/Insured Person for the market value of the
checked-in baggage in the event of total and complete loss of such checked-in baggage
caused by a common carrier up to the limits specified in the Policy Schedule provided that:

a. Maximum amount payable per checked-in baggage, in case more than one bag has
been checked-in, is 50% of the applicable Sum Insured. In case of only one bag
being checked-in, the amount payable is 100% of the applicable Sum Insured.

b. Insured has provided all the documents, reports and other details concerning the loss.

2 For the purpose of this benefit, “market value” refers to the sum required to purchase new
items of the same kind and quality (which are lost) less an amount representing wear and
tear, usage etc., at the time of loss.

3 If the Company makes any payment under this benefit, it is a condition that any recovery
from any common carrier by the Insured/Insured Person, under the terms of the
Convention for the Unification of Certain Rules Relating to International Carriage by Air,
1929 (“Warsaw Convention”) shall become the property of the Company.

Policy Wordings: Group Domestic Traveller Insurance Policy

5 No partial loss or damage shall become payable. However, total loss of individual unit(s) of
baggage shall not be construed as falling within this Special Condition.

6 In the event that claims are submitted for total loss of checked-in baggage as well as
temporary delay of checked-in baggage, the higher of the claims shall be payable by the
Company in respect of the same item(s) of checked-in baggage during any one period of
insurance.

Section- X -: - Delay of Checked-in Baggage

Coverage:
The benefit under this section is aimed at paying or reimbursing the costs of necessary emergency
purchases of toiletries, medication and clothing in the event of the Insured/Insured Person suffering
delay in scheduled arrival of his/her checked-in baggage caused by a common carrier while being
transported during the insured trip upto the limits & mode(s) specified in the Policy Schedule,
provided that:

a. The delay of checked-in baggage is more than certain number of hours specified in the Policy
Schedule as deductible which is calculated from the actual arrival time of the common carrier
at the destination and relates to delivery of baggage that has been checked-in by the common
carrier.

b. Insured/ Insured Person provide the Company with a written proof of delay from the common
carrier.

c. Insured/Insured Person provides the Company with the receipts for the necessary emergency
purchase of toiletries, medication and clothing that he/she needed to [Link] the event that
claims are submitted for total loss of checked-in baggage as well as temporary delay of
checked-in baggage, the higher of the claims shall be payable by the Company in respect of
the same item(s) of checked-in baggage during any one period of insurance.

The cover is limited to the travel destinations specified in the main travel ticket from his/her usual
place of residence and return trip back to usual place of residence along with all halts and via
destinations included in the main travel ticket.

Special Exclusions:
The Company shall not be liable to make any payment under this benefit in connection with or in
respect of any expenses whatsoever incurred by the Insured/Insured Person for:

1 Valuables and money, all kinds of securities and tickets/passes or any other item not
declared to, and agreed to by the Company.
2 Loss of property unless a Property Irregularity Report or other report usually issued by
common carriers in the event of loss of checked-in baggage has been procured and
submitted to the Company.
3 Any partial loss of the items contained within the checked-in baggage.
4 Items contained within the checked-in baggage, which are valued in excess of INR5000
without appropriate proof of ownership.
5 Losses arising from any delay, detention, confiscation by the customs officials or other
public authorities.
6 Loss due to complete/partial damage of the checked-in baggage.

Policy Wordings: Group Domestic Traveller Insurance Policy

Special Conditions:
1. The benefit under this section is aimed at paying or reimbursing the costs of necessary
emergency purchases of toiletries, medication and clothing in the event of the
Insured/Insured Person suffering delay of his/her checked-in baggage while being
transported during the trip, provided that:

a. The delay of checked-in baggage is more than certain number of hours specified in the
Policy Schedule as deductible which is calculated from the actual arrival time of the
common carrier at the destination and relates to delivery of baggage that has been
checked-in by the common carrier.

b. Insured/ Insured Person provide the Company with a written proof of delay from the
common carrier.

c. Insured/Insured Person provides the Company with the receipts for the necessary
emergency purchase of toiletries, medication and clothing that he/she needed to
[Link] the event that claims are submitted for total loss of checked-in baggage as well as
temporary delay of checked-in baggage, the higher of the claims shall be payable by the
Company in respect of the same item(s) of checked-in baggage during any one period of
insurance.

2. If the Company makes any payment under this benefit, it is a condition that any recovery
from any common carrier by the Insured/Insured Person, under the terms of the
Convention for the Unification of Certain Rules Relating to International Carriage by Air,
1929 (“Warsaw Convention”) shall become the property of the Company.

Section- XI: Compassionate Visit

Coverage:
In the event the Insured / Insured Person is hospitalized for more than five (5) consecutive days due
to an emergency accident or illness arising out of other than pre-exiting diseases for which a
valid claim is admissible under Medical Expenses Section of this Policy and his/her medical
condition forbids repatriation and no adult member of his/her immediate family is present, the
Company / Emergency Assistance Service Provider, after obtaining confirmation of need for a
companion from the attending Medical Practitioner will provide:

a) a return trip economy class air ticket, or first class railway ticket, to allow one immediate family
member, to be at his/ her bedside for the duration of stay in the Hospital; and

b) expenses towards stay of the immediate family member during such compassionate visit.

The company will also reimburse the cost of return fare for the insured to visit his/her native
place in India, in the unfortunate event of the immediate family member (spouse, dependent
children, parents) being hospitalized for more than five (5 consecutive days in India or in the event
of death of the immediate family member (spouse, dependent children or parents).

The Company’s liability for round trip ticket and the expenses relating to this benefit shall be as
per the coverage and the limits of Sum Insured specified in the Policy Schedule.

Special Exclusions:

Policy Wordings: Group Domestic Traveller Insurance Policy

Section XII -Trip Cancellation and / or Interruption -

Coverage
In the event of cancellation / interruption of trip due to necessary and unavoidable reasons as
stated below, the Company will indemnify the insured subject to limits shown in the schedule, for
loss of personal accommodation, visa charges, any sightseeing booked in advance, cruise ticket
and travel charges paid or contracted to be paid by the insured, which are not recoverable from any
other source,
1. Cancellation before the trip because of
a) Death of Insured, Insured’s spouse, children, parent or parent in-law’s.
b) Death of Brother or Sister of the insured 15 days prior to the departure date as stated
in the policy.
c) Serious injury, sudden sickness of Insured, insured’s spouse or parent or parent in-law
or child requiring hospitalization for more than 24 hrs.
d) Compulsory quarantine or prevention of travel by Government of India

2. Interruption (the cutting short by early return to India) of the trip because of:
a) Death, serious injury or sudden major sickness of insured, insured’s spouse, child, parents
or parent in laws residing in India at the time of incident.
b) The hijack of an aircraft in which Insured Person is traveling as a fare paying passenger.
c) Death of Brother or Sister of the insured in India.

Section XIII Travel Inconvenience Cover:

In the event of Trip cancellation or Interruption of a covered trip due to necessary and unavoidable
reasons as stated below, the Company will indemnify the insured subject to the limits shown in the
policy schedule, for loss of personal accommodation, any sightseeing booked in advance, cruise
ticket and travel charges paid or contracted to be paid by the insured, which are not recoverable
from any other source.

1. When Insured’s Principal residence and/or his intended place of stay at destination is
rendered uninhabitable due to Fire, flood, vandalism or natural disaster and also his place
of business is rendered inoperative due to operation of said perils.
2. Termination of employment or layoff affecting the insured provided that the insured have
been employed with the same employer for at least five continuous years without any break.
3. The Insured and/or his immediate family member have become victim of Felonious
Assault 10 days prior to the departure date provided he/they are not principal or an
accessory in such felonious assault.
4. Inclement weather / climatic condition in the city or primary place of departure and / or at
intended destination.
5. Civil Unrest, Riot and Strike in the home city and/or at departing station and/or intended
destination (as defined in the policy) of the Insured making the trip impossible, provided that
� The Govt. of India issues a travel advisory.
� Airport is shut down forcing the Airline to delay the flight for more than 24 hours
or to cancel the flight.
� Curfew is imposed by the City Administration.

6. Terrorist Attack in the home city and/or at departing station and/or destination listed on the
insured’s itinerary 3 days prior to the Insured’s departure date and resulting that the
Insured is unable to move out consequent upon such terrorist attack.

Policy Wordings: Group Domestic Traveller Insurance Policy

2. TRIP INTERRUPTION BENEFIT: The Company will pay this benefit up to the Maximum Limit
as specified in the Policy Schedule for the Trips that have been interrupted or delayed
due to operation of Insured Peril as mentioned hereinabove. The company will
reimburse for the forfeited, non-refundable unused prepaid expenses made prior to
Insured’s departure date and additional reasonable and necessary transportation
expenses incurred by him / her plus accommodation expenses maximum up to INR.
3,000 per night for
Return to City of Residence in India
Rejoining the remaining trip after its interruption during the period of trip. Due to
operation of any of the insured peril.

However the benefits payable under this clause shall not exceed the cost of economy
airfare by the most direct route less any refunds paid or payable.

SPECIFIC EXCLUSION
a. Travel arrangements being cancelled or changed by any airline, cruise line or the tour
operator beyond insured peril
b. Voluntary changes in travel plans by the Insured giving rise to a claim under this section.
c. Any business or contractual obligations of the Insured and/or any family member except
for termination or lay off of employment as defined above provided insured is not the
Owner, proprietor, Majority Shareholder and Director of the said company.
d. Termination of employment due to any unlawful act of the insured.
e. Default / insolvency by and of the person, agency or tour operator from whom the
Insured had bought his Travel arrangements.
f. Any governmental regulations or prohibition imposed by any Administrative Authority at
the time or before booking of insured’s travel arrangement.
g. Booking of the trip is undertaken ignoring the adverse situation as published by the
Mass Media, Union Government, State Government and/or any Administrative
Authority for travel to particular country or part of the country which may give rise to a
claim.
h. Loss of visa charges shall not be paid under this section.

SPECIFIC CONDITIONS
a) It is a condition precedent to liability hereunder that in the event of any occurrence likely to
give rise to a claim under this Insurance, that the Insured Person must notify insurer
immediately. While notifying the occurrence, the insured person must quote as much as
information concerning the occurrence as is available including policy number and its date of
issue.

Policy Wordings: Group Domestic Traveller Insurance Policy

Section XIV - Home Fire Insurance (Contents)

Coverage
This Section provides for indemnity, against any loss, destruction or damage to the contents of
the Insured’s home in India caused by any of the fire and related perils specified hereunder whilst
the Insured is on a trip covered by the Policy.

I. Fire
Excluding destruction or damage caused to the property insured by;
(a) (i) Its own fermentation, natural heating or spontaneous combustion;
(ii) Its undergoing any heating or drying process.
(b) Burning of property insured by order of any Public Authority.

II. Lightning

[Link]/ Implosion
Excluding destruction or damage caused to the boilers (other than domestic boilers), economisers
or other vessels in which steam is generated, machinery or apparatus subject to centrifugal force by
its own explosion/implosion.

IV. Aircraft Damage

Destruction or damage caused by Aircraft, other aerial or space devices and articles dropped there
from excluding those caused by pressure waves.

V. Riot, Strike, Malicious Damage

Loss of or visible physical damage or destruction by external violent means directly caused to the
property insured but excluding those caused by:
(a) Total or partial cessation of work or the retarding or interruption or cessation of any process or
operations or omissions of any kind;

Policy Wordings: Group Domestic Traveller Insurance Policy

Terrorism Damage Exclusion Warranty:

Notwithstanding any provision to the contrary within this insurance it is agreed that this insurance
excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by,
resulting from or in connection with any act of terrorism regardless of any other cause or event
contributing concurrently or in any other sequence to the loss.

For the purpose of this endorsement an act of terrorism means an act, including but not limited to the
use of force, violence and/or threat thereof, of any person or group(s) of persons whether acting
alone or on behalf of or in connection with any organization(s) or government(s), committed for
political, religious, ideological or similar purpose including the intention to influence any government
and/or to put the public, or any section of the public in fear.

The warranty also excludes loss, damage, cost or expense of whatsoever nature directly or
indirectly caused by, resulting from or in connection with any action taken in controlling, preventing,
suppressing or in any way relating to action taken in respect of any act of terrorism.
If the Company alleges that by reason of this exclusion, any loss, damage, cost or expenses is
not covered by this insurance the burden of proving the contrary shall be upon the Insured.

In the event any portion of this endorsement is found to be invalid or unenforceable, the remainder
shall remain in full force and effect.

VI. Storm, Cyclone, Typhoon, Tempest, Hurricane, Tornado, Flood and Inundation (STFI)

[Link] Damage
Impact by any Rail/Road vehicle or animal by direct contact not belonging to or owned by;
(a) The Insured or any occupier of the premises; or
(b) Their employees while acting in the course of their employment.

VIII. Subsidence and Landslide including Rock Slide

Destruction or damage caused by Subsidence of part of the site on which the property stands or
Land slide/Rock slide excluding:
(a) The normal cracking, settlement or bedding down of new structures;
(b) The settlement or movement of made up ground;
(c) Coastal or river erosion;
(d) Defective design or workmanship or use of defective materials;
(e) Demolition, construction, structural alterations or repair of any property or ground works or
excavations.

IX. Bursting and/or overflowing of Water Tanks, Apparatus and Pipes

X. Missile Testing operations

Policy Wordings: Group Domestic Traveller Insurance Policy

Excluding destruction or damage caused by;

(a) Repairs or alterations to the buildings or premises;
(b) Repairs, Removal or Extension of the Sprinkler Installation;
(c) Defects in construction known to the Insured.

[Link] Fire
Excluding destruction or damage caused by Forest Fire.

PROVIDED that the liability of the Company shall in no case exceed in respect of each item the
sum expressed in the Schedule to be insured thereon or in the whole the total Sum Insured
hereby or such other sum or sums as may be substituted therefore by memorandum hereon or
attached hereto signed by or on behalf of the Company.

Special Exclusions
This Section of the Policy does not cover:
1 Loss, destruction or damage caused by war, invasion, act of foreign enemy hostilities or war
like operations (whether war be declared or not), civil war, mutiny, civil commotion assuming
the proportions of or amounting to a popular rising, military rising, rebellion, revolution,
insurrection or military or usurped power.
2 Loss, destruction or damage directly or indirectly caused to the property insured by;
(a) ionising radiations or contamination by radioactivity from any nuclear fuel or from
any nuclear waste from the combustion of nuclear fuel;
(b) the radioactive toxic, explosives or other hazardous properties of any explosive
nuclear assembly or nuclear component thereof.
3 Loss, destruction or damage caused to the insured property by pollution or contamination
excluding
(a) pollution or contamination which itself results from a peril hereby insured against
(b) any peril hereby insured against which itself results from pollution or contamination.

4 Loss, destruction or damage to bullion or unset precious stones, any curios or works of art
for an amount exceeding Rs.10000/-, manuscripts, plans, drawings, securities,
obligations or documents of any kind, stamps, coins or paper money, cheques, books
of accounts or other business books, computer systems records, explosives unless
otherwise expressly stated in the Policy.

5 Loss, destruction or damage to the stocks in Cold Storage premises caused by change of
temperature.

6 Loss, destruction or damage to any electrical and/or electronic machine, apparatus, fixture
or fitting (excluding fans and electrical wiring in dwellings) arising from or occasioned by
over- running, excessive pressure, short circuiting, arcing, self-heating, or leakage of
electricity, from whatever cause (lightning included).

7 Expenses necessarily incurred on

(a) Architects, Surveyors and Consulting Engineer’s Fees and
(b) Debris Removal by the Insured
8 following a loss, destruction or damage to the property insured by an insured peril in
excess of 3% and 1% of the claim amount respectively.

Policy Wordings: Group Domestic Traveller Insurance Policy

10 Loss or damage by spoilage resulting from the retardation or interruption or cessation

of any process or operation caused by operation of any of the perils covered.

11 Loss by theft during or after the occurrence of any insured peril except as provided
under Riot, Strike and Malicious Damage cover.

12 Any Loss or damage occasioned by or through or in consequence directly or indirectly

due to earthquake, Volcanic eruption or other convulsions of nature.

13 Loss or damage to property insured if removed to any building or place other than in which it
is herein stated to be insured, except machinery and equipment temporarily removed for
repairs, cleaning, renovation or other similar purposes for a period not exceeding 60 days

14 Any exclusion mentioned in the ‘General Exclusions’ section of this Policy.

Special Conditions
1. This benefit does not cover any loss or damage to property which, at the time of the happening
of such loss or damage, is insured by or would, but for the existence of this Policy, be insured by
any marine policy or policies except in respect of any excess beyond the amount which would
have been payable under the marine policy or policies had this insurance not been effected.
2. All insurances under this Policy shall cease on expiry of seven days from the date of fall or
displacement of any building or part thereof or of the whole or any part of any range of buildings
or of any structure of which such building forms part

Provided such a fall or displacement is not caused by insured perils, loss or damage by which
is covered by this Policy or would be covered if such building, range of buildings or structure
were insured under this Policy.

Notwithstanding the above, the Company subject to an express notice being given as soon as
possible but not later than seven days of any such fall or displacement may agree to continue the
insurance subject to revised rates, terms and conditions as may be decided by it and confirmed
in writing to this effect.
3. If the interest in the property passes from the Insured otherwise than by will or operation of law,
the insurance shall cease to attach as regards the property affected unless the Insured shall
have before the occurrence of any loss or damage, obtained the sanction of the Company
signified by endorsement upon the Policy by or on behalf of the Company.
4.(i) On the happening of any loss or damage the Insured shall forthwith give notice thereof to the
Company and shall within 15 days after the loss or damage, or such further time as the
Company may in writing allow in that behalf, deliver to the Company

(a) A claim in writing for the loss or damage containing as particular an account as may be
reasonably practicable of all the several articles or items or property damaged or destroyed, and
of the amount of the loss or damage thereto respectively, having regard to their value at the time
of the loss or damage not including profit of any kind.

(b) Particulars of all other insurance, if any.

Policy Wordings: Group Domestic Traveller Insurance Policy

No claim under this Policy shall be payable unless the terms of this condition have been complied with.

(ii) In no case whatsoever shall the Company be liable for any loss or damage after the expiry
of 12 months from the happening of the loss or damage unless the claim is the subject of
pending action or arbitration; it being expressly agreed and declared that if the Company shall
disclaim liability for any claim hereunder and such claim shall not with 12 calendar months from
the date of the disclaimer have been made the subject matter of a suit in a court of law then
the claim shall for all purposes be deemed to have been abandoned and shall not thereafter be
recoverable hereunder.

5. On the happening of loss or damage to any of the property insured by this Policy, the Company may;
(a) Enter and take and keep possession of the building or premises where the loss or
damage has happened;
(b) Take possession of or require to be delivered to it any property of the Insured in the building
or on the premises at the time of the loss or damage;
(c) Keep possession of any such property and examine, sort, arrange, remove or otherwise
deal with the same;
(d) Sell any such property or dispose of the same for account of whom it may concern.

The powers conferred by this condition shall be exercisable by the Company at any time until
notice in writing is given by the Insured that he makes no claim under the Policy, or if any claim is
made, until such claim is finally determined or withdrawn, and the Company shall not by any act
done in the exercise or purported exercise of its powers hereunder, incur any liability to the
Insured or diminish its rights to rely upon any of the conditions of this Policy in answer to any
claim.

If the Insured or any person on his behalf shall not comply with the requirements of the Company
or shall hinder or obstruct the Company, in the exercise of its powers hereunder, all benefits
under this Policy shall be forfeited.

The Insured shall not in any case be entitled to abandon any property to the Company whether
taken possession of by the Company or not.

6. If the Company at its option, reinstates or replaces the property damaged or destroyed, or any
part thereof, instead of paying the amount of the loss or damage, or join with any other company
or insurer(s) in so doing, the Company shall not be bound to reinstate exactly or completely but
only as circumstances permit and in reasonably sufficient manner, and in no case shall the
Company be bound to expend more in reinstatement than it would have cost to reinstate such
property as it was at the time of the occurrence of such loss or damage nor more than the Sum
Insured by the Company thereon. If the Company so elects to reinstate or replace any property
the Insured shall at his own expense furnish the Company with such plans, specifications,
measurements, quantities and such other particulars as the Company may require, and no acts
done, or caused to be done, by the Company with a view to reinstatement or replacement shall
be deemed an election by the Company to reinstate or replace.

Policy Wordings: Group Domestic Traveller Insurance Policy

7. If the property hereby insured shall at the breaking out of any fire or at the commencement of any
destruction of or damage to the property by any other peril hereby insured against be
collectively of greater value than the Sum Insured thereon, then the Insured shall be
considered as being his own insurer for the difference and shall bear a ratable proportion of
the loss accordingly. Every item, if more than one, of the Policy shall be separately subject to
this condition.

8. If at the time of any loss or damage happening to any property hereby insured there be any
other subsisting insurance or insurances, whether effected by the Insured or by any other person
or persons covering the same property, this Company shall not be liable to pay or contribute
more than its ratable proportion of such loss or damage.

9. The Insured shall at the expense of the Company do and concur in doing, and permit to be
done, all such acts and things as may be necessary or reasonably required by the Company for
the purpose of enforcing any rights and remedies or of obtaining relief or indemnity from other
parties to which the Company shall be or would become entitled or subrogated, upon its paying
for or making good any loss or damage under this Policy, whether such acts and things shall be
or become necessary or required before or after his indemnification by the Company.

10. At all times during the period of insurance of this Policy the insurance cover will be maintained to
the full extent of the respective sum insured in consideration of which upon the settlement of
any loss under this Policy, pro-rata premium for the unexpired period from the date of such loss
to the expiry of period of insurance for the amount of such loss shall be payable by the Insured to
the Company.

The additional premium referred above shall be deducted from the net claim amount payable
under the Policy. This continuous cover to the full extent will be available notwithstanding any
previous loss for which the Company may have paid hereunder and irrespective of the fact
whether the additional premium as mentioned above has been actually paid or not following such
loss.

Notwithstanding what is stated above, the Sum Insured shall stand reduced by the amount of
loss in case the Insured immediately on occurrence of the loss exercises his option not to
reinstate the Sum Insured as above.

Section XV – Home Burglary Insurance (Contents)

Coverage
This Section provides for indemnity, against any loss, destruction or damage to the contents of the
Insured’s home in India caused by burglary and/or housebreaking specified hereunder whilst the
Insured is on a trip covered by the Policy.

The maximum amount payable under this Section as indemnity is limited to the Sum Insured as
specified in the Policy Schedule in any one period of insurance irrespective of the number of such
incidents or occurrences arising out of such incidents.

Jewellery kept in safe will be covered under this benefit as part of contents up to 20% of the Sum
Insured as specified in the Policy Schedule or actuals whichever is less.

Policy Wordings: Group Domestic Traveller Insurance Policy

Terrorism Damage Exclusion Warranty:

For the purpose of this endorsement an act of terrorism means an act, including but not limited to the
use of force of violence and/or the threat thereof, of any person or group(s) of persons whether
acting alone or on behalf of or in connection with any organisation(s) or government(s), committed
for political, religious, ideological or similar purpose including the intention to influence any
government and/or to put the public, or any section of the public in fear.

In the event any portion of this endorsement is found to be invalid or unenforceable, the remainder
shall remain in full force and effect.

9. Any exclusion mentioned in the ‘General Exclusions’ section of this Policy.

Policy Wordings: Group Domestic Traveller Insurance Policy

A) Coverage

This Section provides that in the event of necessary and unavoidable cancellation of Hotel and
Airline booking arrangement due to the following listed reasons, , the Company will compensate
the Insured/ Insured Person against the loss of irrevocable deposits or charges paid in advance or
contracted to be paid towards Hotel and transportation expenses

� Inclement Weather
� Accident of Vehicle resulting in hospitalization of Insured or an admissible claim in the motor
insurance policy along with the FIR proving that the insured was involved in an Accident with a
third party,
� Strike, Curfew, Failure of public transport, death of insured person, felonious assault fire & flood

The Company shall be liable to reimburse the forfeited, non-refundable prepaid payments if the
Insured event occurs on the trip start date or within 8 hours prior to the trip start date.

The Company will reimburse for the forfeited, non-refundable prepaid payments, made prior to the
Insured/ Insured Person's departure date after adjusting the proceeds of cancelling or preponing
of the arrangement, if any.
1. Unforeseen disease, illness, injury, or death of the Insured/ Insured Person’s family
member. Disease, injury or illness must be so disabling as to reasonably cause a trip to be
cancelled or interrupted as supported by medical records and opinion acceptable to the
Company;
2. Strike of the airline, rail or state road transport where the insured person had booked
conveyance in advance
3. Termination of employment or layoff affecting the Insured/ Insured Person or the travelling
companion of the Insured, provided that the Insured/ Insured Person or the travelling
companion, as the case may be, have been employed with the employer for at least three
continuous years;
4. Inclement weather conditions causing cancellation or interruption of the trip with due
authentication by a letter from the common carrier;
5. The place intended to be occupied by the Insured/ Insured Person for purposes of his or her
stay during the trip or the destination being made uninhabitable by fire, flood, vandalism,
burglary, or such natural disaster;

Cover will also be available, if indicated on the certificate of insurance for Bounced Hotel Booking

B) In addition to this, the event of hotel booking at destination point(s) being bounced i.e. Insured
Person(s) could not obtain hotel accommodation services already booked for him on confirmed
basis with the suppliers / agents within India due to non-supply of services, the Insurance Company
shall reimburse to the extent of 80% of following expenses:
a. Reasonable cost of Transportation expenses to the alternative hotel in the same location.
b. The difference of cost in up gradation to a superior class of accommodation, wherever alternate
accommodation is not available on the cost of pre-booked hotel. For this benefit the Insured
shall be required to furnish proof that the alternate accommodation on the cost of pre-booked hotel is
not available in the same location in the form of a certificate issued by the Alternate Accommodation
Service Provider

Special Exclusions
The Company shall not be liable to make any payment under this Policy for:

Policy Wordings: Group Domestic Traveller Insurance Policy

Section- XVII: - Trip Delay

Coverage:
The Company shall reimburse the reasonable additional expenses incurred by the Insured, if his or
her trip, covered by this Policy, is delayed beyond a specified number of hours, as mentioned in the
Policy Schedule, from the scheduled time only on account of the following unforeseen reasons:

1. Strike of the airline, where the insured person had booked conveyance in advance
2. Inclement weather conditions causing cancellation or interruption of the trip with due
authentication by a letter from the common carrier;
3. The place intended to be occupied by the Insured/ Insured Person for purposes of his or her
stay during the trip or the destination being made uninhabitable by fire, flood, vandalism,
burglary, or such natural disaster;

The deductible in respect of this benefit will be applicable for each separate claim. It is the
responsibility of the Insured to produce necessary proof establishing the reason for Trip Delay along
with the receipts.
Special Exclusions:
This benefit does not cover loss other than those mentioned above under the head coverage,
directly or indirectly, in whole or in part, including loss caused by or resulting from any exclusion
mentioned in the 'General Exclusions' section of this Policy.

Section XVIII – Emergency Accommodation due to Trip Delay

Coverage
This Section provides for payment of compensation for the additional cost of emergency
accommodation upto a maximum of two (2) nights if the Insured/Insured Person could not stay in the
accommodation originally booked due to,

1. Inclement weather conditions causing cancellation or interruption of the trip with due
authentication by a letter from the common carrier;

2. The place intended to be occupied by the Insured/ Insured Person for purposes of his or her
stay during the trip or the destination being made uninhabitable by fire, flood,
earthquake, storm, hurricane, explosion, outbreak of major infectious diseases, vandalism,

Policy Wordings: Group Domestic Traveller Insurance Policy

The cost of the emergency accommodation shall be less than or equal to the category of
accommodation originally booked by the Insures/Insured person

Special Exclusions
This benefit does not cover any loss other than those mentioned above under the head “coverage”,
directly or indirectly, in whole or in part, including loss caused by or resulting from any exclusion
mentioned in the 'General Exclusions' section of this Policy.

Section XIX – Bail Bond

Coverage
The Company shall provide the payment of bail amount to the appropriate authority/court on behalf of
the Insured/ Insured Person if the Insured/ Insured Person is arrested or detained by Police or
Judicial authorities, for any bailable offence whilst on a trip covered by this Policy upto the limits
specified in the Policy Schedule.

The deductible in respect of this benefit will be applicable for each and every claim separately, and
shall be of an amount as specified in the Policy Schedule.

Special Exclusions
The Company shall not be liable to make any payment under this benefit in connection with or in
respect of any expenses whatsoever incurred by the Insured/ Insured Person for:
1. All non-bailable offences as per the local law of the Republic of India where the incident has
taken place whilst the Insured is on a trip;
2. Any exclusion mentioned in the “General Exclusions” section of this Policy.

Special Conditions
The Company will pay or arrange to pay through Emergency Assistance Service Provider to the
Judicial Authority / Court directly on behalf of the Insured, the bail amount. This benefit would be
for bailable offences only. The Insured shall appear in the Court on the date specified by the Court
for trial and judgment. If the bail bond is forfeited due to the misconduct or negligence or any
wrongful act of the Insured/insured person or otherwise for breach of the terms of such bail bond,
then the amount of the bail bond and all costs reasonably incurred by the Company in such behalf
will require to be repaid by the Insured to the Company within 1 month after the bail bond is
forfeited.
In case of death of the Insured, at the first instance, the immediate family member, and in case,
where there is no immediate family member, the Sponsor, if any, will be liable to produce the death
certificate or the necessary documents, as per the local law, in the Court within 1 month (of death)
for the release of the bail amount to Emergency Assistance Service Provider. In case they fail to do
so, it is hereby agreed that the Company would have full right and authority to recover the bail
amount from the estate of the Insured, or the parents/guardians of the Insured, and if applicable, the
Sponsor.

The amount will be refunded to the Company or Emergency Assistance Service Provider by the
Court with which it was deposited as soon as the Court releases the bail amount with which the
deposit was made. In no case the amount will be paid out to the Insured/ Insured Person.

In the event the Court releases the bail amount to the Company/Emergency Assistance Service
Provider and the bail amount has already been recovered from the estate of the Insured, it shall be
paid back to the Insured’s legal heir.

The judgment shall have no bearing on the refund of the deposit to the Company or Emergency
Assistance Service Provider. If the Court imposes any penalty or fine on the Insured at the time of

Policy Wordings: Group Domestic Traveller Insurance Policy

Section XX – Missed Connection

Coverage
If the confirmed onward connecting flight is missed at the transfer point due to the late arrival of
the incoming confirmed connecting scheduled flight and no onward transportation is made available
within 3 hours of actual arrival time of the incoming flight, the Company will provide for payment of
allowance as specified in the Policy Schedule, towards transportation costs to join the trip (must be of the
same class of original tickets purchased) together with

1. expenses incurred in respect of reasonable hotel accommodation, restaurant meals or

refreshments, if not provided by the carrier or other third party, subject to production of bills/
receipts;
2. non-refundable, unused portion of the pre-paid expenses as long as these expenses are
supported by a proof of purchase and is not reimbursable by another source.

Such delay must be authenticated by the airline in writing.

Special Exclusions
This benefit does not cover any other loss other than those mentioned above under the head
coverage, directly or indirectly, in whole or in part, including loss caused by or resulting from any
exclusion mentioned in the 'General Exclusions' section of this Policy.

Section XXI - Hijack Distress Allowance

Coverage
This Section provides for payment of an allowance in the event of hijack of a common carrier in
which the Insured/ Insured Person is traveling on a trip covered under this Policy as specified in
the Policy Schedule.

The deductible in respect of this benefit will be applicable for each and every claim separately and
shall be of the number of hours the common carrier has been under hijack, as specified in the Policy
Schedule.

Special Exclusions
The Company shall not be liable to make any payment under this benefit in respect of the following:

1. Any incident where the Insured/Insured Person is suspected to be either principal or an

accessory in the hijacking.
2. Any claim as a consequence of a change in the regular routes of travel/journey of the
common carrier due to traffic, weather, fuel shortage, and technical snag or security reasons.
3. Any exclusion mentioned in the ‘General Exclusion’ section of this Policy.

Section- XXII: - Loss of Baggage & Personal Effects

Coverage:

Policy Wordings: Group Domestic Traveller Insurance Policy

Specific Conditions
1. Any valid claim involving a motor vehicle, and at all-time subject to Specific Exclusion (5), will be
limited to a maximum of fifty percent (50%) of the Sum Insured stated in the Schedule.

2. All claims will be subject to the Company at its own discretion assessing the value of the claim
based on the age and estimated wear and tear of the article that forms the basis of the claim.

3. If applicable and if payment has been made under the Baggage Delay Section, any
amounts paid would be deducted from payment of a claim under this Section of the Policy.

4. If a Policyholder or Insured Person has other insurance against a loss covered by this Section,
then the Company shall not be liable for a greater proportion of the loss than the applicable
benefit under this Section bears to the total applicable benefit under all such insurance.

Specific Definitions

“Personal Documents” means an Insured Person's identity card (if applicable), ration card, voter
identity card, passport, driving licence.

“Personal Effects” means an Insured Person's mobile, laptop or tablet, , .

Specific Claims Provisions:

In the event of a claim the Insured Person must:

1. give immediate written notice:

a. to the relevant Common Carrier in the event of loss or damage in transit;

b. to the relevant police authority in the event of loss or theft;

2. submit a copy of the relevant Common Carrier or police report when a claim is made;

3. obtain a Common Carrier or police report where the loss occurred;

4. in the event of loss by a Common Carrier, retain original tickets and baggage slips and submit
them when a claim is made;

5. submit original purchase receipts in the event of claims regarding goods purchased during the
Insured Journey; and

6. for claims involving jewellery, submit original or certified copies of valuation certificates issued
prior to the commencement of the Period of Insurance, when a claim is made

For purposes of any claim hereunder:

1. a pair of skis, ski boots and accessories shall be regarded as one item;

Policy Wordings: Group Domestic Traveller Insurance Policy

3. the equipment and accessories of any sport that an Insured Person takes on a trip shall be
regarded as one item.

Special Exclusions:
The Company shall not be liable to pay any benefit in respect of any Insured Person for:

1. loss of cash, bank or currency notes, cheques, debit or credit cards or unauthorised use
thereof, postal orders, travellers cheques, travel, tickets, securities of any kind and petrol or
other coupons.

2. mechanical or electrical breakdown or derangement or breakage of fragile or brittle articles, or

damage caused by such breakage unless caused by fire or by Accident to the conveying vehicle.

3. destruction or damage due to wear and tear, moth or vermin.

4. baggage, clothing and personal effects dispatched as unaccompanied baggage.

5. theft from a motor vehicle unless the property is securely locked in the boot and entry to such
vehicle is gained by visible, violent and forcible means.

6. loss or damage to sports equipment whilst in use, contact lenses, samples, tools.

7. for loss, destruction, or damage due to delay, confiscation or detention by order of any
government or Public Authority.

8. for loss, destruction or damage directly occasioned by pressure waves, caused by aircraft
or other aerial devices travelling at sonic or supersonic speeds.
9. for loss, destruction or damage caused by any process of cleaning, dyeing, repairing or restoring.

10. for loss, destruction, or damage caused by atmospheric or climatic conditions or any other
gradually deteriorating cause.

11. a claim involving animals.

12. loss, including but not limited to loss by theft, or damage to vehicles or other accessories.

13. for any loss that is not reported either to the appropriate police authority or transport carrier
within twenty four (24) hours of discovery or if the carrier is an airline if a property irregularity
report is not obtained.

14. baggage and/or personal effects sent under an airway-bill or bill of lading.

15. contact lenses, glasses, hearing aids or bridges or dentures for a tooth or teeth.

Section XXIII- Financial Emergency Assistance

Coverage
In the event you require financial emergency Assistance following incidents ie., burglary/ theft of
luggage/ money or hold up. The Service provider shall co-ordinate with your relatives within India
to provide emergency cash assistance to You as per Your requirement, up to the limit specified in
the Policy Schedule.

Section XXIV – Overbooked Flight

Coverage

Policy Wordings: Group Domestic Traveller Insurance Policy

Special Exclusions
This benefit does not cover any other loss other than those mentioned above under the head
“coverage”, directly or indirectly, in whole or in part, including loss caused by or resulting from any
exclusion mentioned in the 'General Exclusions' section of this Policy.

Section XXV –Legal Expenses

Coverage
The Company shall pay the legal costs and expenses incurred by the Insured/ Insured Person, as
the case may be, towards claims for from third parties for compensation for accidental death or
disablement arising due to an injury, whilst on a trip, up to the limits specified in the Policy Schedule.

The benefit under the Section is limited to the Sum Insured as specified in the Schedule to the Policy.

Special Exclusions
1. All the exclusions applicable to the Personal Accident Section and the Accidental Death and
Permanent Total Disablement - Common Carrier will also be applicable to this Section in so far
as the accidental death or disablement is concerned.
2. All exclusions mentioned in the ‘General Exclusions’ section of this Policy shall also apply to
this Section.

Section XXVI– Pet Care

Coverage
This Section provides for payment of medical expenses including fees for the Veterinary Medical
Practitioner’s fees towards the medical care and treatment of the pet animal (limited to cat or dog)
of the Insured / Insured Person arising due to an injury sustained whilst under the care of a friend,
relative, house servant, other family members of the house or a Professional Carrier in India
during the Insured/ Insured Person’s trip, covered under this Policy.

The benefit under the Section is limited to the Sum Insured as specified in the Schedule to the Policy.
Special Exclusions
This benefit does not cover any loss other than those mentioned above under the head “coverage”,
directly or indirectly, in whole or in part, including loss caused by or resulting from any exclusion
mentioned in the 'General Exclusions' section of this Policy.

Section- XXVII: - Missed departure

Coverage

If the Insured / Insured person cannot reach the original departure point of Insured/Insured persons
booked journey or the onward or return journey due to below mentioned, the company shall pay an
cost for alternative travel arrangement (Common Carrier- Air/ Rail)

The company shall pay such cost after adjusting the reimbursed made by the airline.

� inclement weather conditions;

� failure of public transport services ;
� accident of the vehicle in which you are travelling, on the way to catch the return flight/ train journey;

Policy Wordings: Group Domestic Traveller Insurance Policy

Section XXVIII - Alternate Employee Expenses

Coverage
This Section provides for reimbursement of cost of economy return fare incurred by the Insured
towards sending an alternate employee for an uncompleted assignment, in case the original
employee of the Insured who has been sent on an assignment and covered under this Policy, has to
be transported back/repatriated to his/her usual place of residence in India, due to\
1. Accident/Injury
2. Illness
3. Accidental death arising due to an injury whilst on trip.
Special Exclusion
All the exclusions and Special Conditions applicable to the Personal Accident section shall be
applicable to this Section also as far as the accidental death due to injury of the original
employee is concerned who is covered under the Policy as the Insured Person.

Section XXIX - Business Equipment

Coverage
This Section provides indemnifies the cost of repair or replacement to the Insured/Insured Person
for the physical loss or damage to Laptop, carried under personal baggage on a trip, due to any
cause other than those excluded.

Special Exclusions
a) The Excess stated in the Schedule to be borne by the Insured in any one occurrence. If,
however, more than one property is lost or damaged in any one occurrence then the Insured
shall not be called upon to bear more than the highest single deductible applicable to such
properties.
b) Loss or damage caused by any defects existing at the time of commencement of the present
insurance within the knowledge of the Insured/Insured Person, whether such defects were
known to the Company or not.
c) Loss or damage as a direct consequence of wear and tear or of gradual deterioration due to
atmospheric conditions.
d) Any costs incurred in connection with the elimination of functional failures unless such failures
were caused by an indemnifiable loss of or damage to the insured properties.

Policy Wordings: Group Domestic Traveller Insurance Policy

In respect of the parts mentioned under (i) above, the Company shall be liable to provide
compensation in the event such parts are affected by an indemnifiable loss of or damage to the
insured properties.

k) Wilful misconduct/ negligence on the part of the Insured/Insured Person.

l) Theft from car except from car of fully enclosed saloon type having all the doors, windows and
other openings securely locked.
m) Loss/damage while kept in a secure hotel room unless forcible entry was used to gain access to it.
n) Loss/damage not reported to Police within 24 hours of the discovery of loss and a report obtained.
o) Loss/damage due to confiscation or detention by Customs or any other public authority.
p) Loss/damage while left unattended at a public place or in a public conveyance.
q) Loss/damage while sent under contract of afreightment.
r) Loss or damage to equipment due to felonious assault, burglary

GENERAL EXCLUSIONS (APPLICABLE TO ALL BENEFITS UNDER THE POLICY):

In addition to the exclusions that are applicable for the specific sections of the Policy as mentioned
above in this Policy, the following exclusions apply to benefits under all Sections of the Policy.

Without prejudice to anything contained in this Policy, the Company shall not be liable to make any
payment 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 Pre-existing Condition and / or any complication arising from it

a) This policy is not designed to provide an indemnity with respect to medical services, the
need for which arises out of a pre-existing condition as defined below in General Exclusion
2(b) in normal course of treatment. However in any of the threatening situation this exclusion
shall not be applied and also that the cover will up to the limit shown under Life threatening
condition / situation as defined in this policy

b) Any condition, ailment or injury or related condition(s) for which insured/insured person had
signs or symptoms, and / or were diagnosed, and / or received medical advice/ treatment, prior
to your first policy with us.

3. Treatment if that is the sole reason or one of the reasons for the Insured/Insured Person’s
temporary stay.
4. Any claim if the Insured/Insured Person: –
a. is travelling against the advice of a Medical Practitioner;
b. is receiving, or is on a waiting list to receive, specified medical treatment declared in the
Medical Practitioner's report or certificate;
c. has received terminal prognosis for a medical condition;

Policy Wordings: Group Domestic Traveller Insurance Policy

5. Deductibles as specified in the Policy Schedule.

6. Any claim arising out of anxiety, depression, venereal disease
7. Diseases, 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, active participation in
riots, confiscation or nationalisation or requisition of or destruction of or damage to property by
or under the order of any government or local authority.
8. Congenital external diseases, defects or anomalies.
9. Any claim resulting or arising from or any consequential loss, directly or indirectly, caused by
or contributed to or arising from:
a. Ionizing radiation or contamination by radioactivity from any nuclear fuel or from any nuclear
waste from the combustion of nuclear fuel; or
b. The radioactive, toxic, explosive or other hazardous properties of any explosive nuclear
assembly or nuclear component thereof.

10. Any claim arising out of sporting activities in so far as they involve the training or
participation in competitions of professional or semi-professional sports persons, Adventure Sports
unless declared beforehand and necessary additional premium paid

11. No claim will be paid which arises from the insured Person engaging in Travel unless he
or she travels as a passenger on a carrier properly licensed to carry passengers. For the purpose
of this exclusion, Traveller means being in or on, or boarding a carrier for the purpose of
travelling therein or alighting there from .

12. Any claim arising out of diseases, illnesses or accidents that the Insured/Insured Person has
caused intentionally or by committing a crime or as a result of drunkenness or addiction (drugs,
alcohol). However, treatment of mental and nervous disorders, including alcohol and drug
dependency, will be covered subject to the limits specified in the Policy Schedule, if specifically
agreed for and mentioned in the Policy Schedule. The payment for such medical expenses shall be
limited to inpatient hospitalization in a Hospital/Nursing Home for a period more than 24 hours

13. Medical Expenses in respect of Experimental, investigational or unproven treatments or

treatments which are not consistent with or incidental to the diagnosis and treatment of the
positive existence or presence of any Illness for which confinement is required at a Hospital. Any
Illness or treatment which is a result or a consequence of undergoing such experimental or unproven
treatment

14. Naturopathy treatment

15. No claims will be paid for losses arising directly or indirectly from manual work or hazardous
occupation, self exposure to peril or if engaging in any criminal or illegal act.

16. Any claim arising out of any act of terrorism which means an act, including but not limited to the
use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether
acting alone or on behalf of or in connection with any organization(s) or government(s), committed
for political, religious, ideological, or ethnic purposes or reasons including the intention to influence
any government and/or to

Policy Wordings: Group Domestic Traveller Insurance Policy

LIST OF EXCLUDED EXPENSES IN HOSPITALIZATION:

Notwithstanding anything contained in the Policy, the Company shall not be liable to pay the
expenses incurred under “excluded” or “non-medical” expenses as mentioned in the table below;

SNO List of Expenses Generally Excluded ("Non - SUGGESTIONS

Medical") in Hospital Indemnity Policy
TOILETRIES/ COSMETICS/ PERSONAL COMFORT OR CONVENIENCE ITEMS
1 Hair removal cream Not P ayable
2 Baby charges (unless specified/indicated) t Payable
N
o
3 Baby food Not P ayable
4 Baby utilities charges Not P ayable
5 Baby set Not P ayable
6 Baby bottles Not P ayable
7 Brush Not P ayable
8 C osy towel Not P ayable
9 Hand wash Not P ayable
10 Moisuriser paste brush Not P ayable
11 P owder Not P ayable
12 R azor P ayable
13 S hoe cover Not P ayable
14 Beauty services Not P ayable
15 Belts/ braces P ayable in respect of surgery related to
thoracic or lumbar spine
16 Buds Not P ayable
17 Barber charges Not P ayable
18 C aps Not P ayable
19 C old pack/hot pack Not P ayable
20 C arry bags Not P ayable
21 C radle charges Not P ayable
22 C omb Not P ayable
23 Disposables razors charges (for site preparations) able
Pa
y
24 E au-de-cologne / room fresheners Not P ayable
25 E ye pad Not P ayable
26 E ye sheild Not P ayable
27 E mail / internet charges Not P ayable
28 Food charges (other than patient's diet provided by Not Payable
hospital)
29 F oot cover Not P ayable
30 G own Not P ayable
31 Leggings P ayable in respect of bariatric and varicose
vein surgery
32 Laundry charges Not P ayable
33 Mineral water Not P ayable

Policy Wordings: Group Domestic Traveller Insurance Policy

37 T elephone charges Not P ayable

38 T issue paper Not P ayable
39 T ooth paste Not P ayable
40 T ooth brush Not P ayable
41 G uest services Not P ayable
42 Bed pan Not P ayable
43 Bed under pad charges Not P ayable
44 C amera cover Not P ayable
45 C liniplas t Not P ayable
46 C repe bandage Not P ayable
47 C urapore Not P ayable
48 Diaper of any type Not P ayable
49 DVD, C D charges Not P ayable (However if C D is
specifically sought by
Insurer/TPA/Emergency
Assistance Service Provider then payable)
50 E yelet collar Not P ayable
51 F ace mask Not P ayable
52 F lexi mask Not P ayable
53 G ause soft Not P ayable
54 G auze Not P ayable
55 Hand holder Not P ayable
56 Hansaplast /adhesive bandages Not P ayable
57 Infant food Not P ayable
58 S lings R easonable costs for one s ling in case of
upper arm fractures is payable
59 Weight control programs/ supplies/ services cluded
E
x
ITEMS SPECIFICALLY EXCLUDED IN THE POLICIES
60 Cost of spectacles/ contact lenses/ hearing aids etc. luded
Ex
c
61 Dental treatment expenses that do not Excluded
require hospitalization
62 Hormone replacement therapy E xcluded
63 Home visit charges E xcluded
64 Infertility/ sub fertility/ assisted conception procedure xcluded

E
65 Obesity (including morbid obesity) treatment if Excluded
excluded in policy
66 Psychiatric & psychosomatic disorders cluded
E
x
67 Corrective surgery for refractive error cluded
E
x
68 Treatment of sexually transmitted diseases luded
Ex
c

Policy Wordings: Group Domestic Traveller Insurance Policy

N
ITEMS WHICH FORM PART OF HOSPITAL SERVICES WHERE SEPARATE CONSUMABLES ARE NOT
PAYABLE BUT THE SERVICE IS

75 Ward and theatre booking charges ayable under OT Charges, not payable
separately
P
76 Arthroscopy & endoscopy instruments ental charged by the hospital payable.
Purchase of Instruments not payable.
R
77 Microscope cover P ayable under OT C harges, Not payable as
separate head
78 Surgical blades, harmonic scalpel, shaver yable under OT Charges, Not payable as
P separate head
a
79 S urgical drill P ayable under OT C harges, Not payable as
separate head
80 E ye kit P ayable under OT C harges, Not payable as
separate head
81 E ye drape P ayable under OT C harges, Not payable as
separate head
82 X-ray film P ayable under R adiology C harges, Not
payable as separate head
83 S putum cup P ayable under Investigation C harges, Not
payable as separate head
84 Boyles apparatus charges P ayable under OT C harges, Not payable as
separate head
85 Blood grouping and cross matching of donors Payable under Cost of Blood Charges, Not
samples payable as separate head
86 Antiseptic or disinfectant lotions P ayable under Dressing C harges, Not
payable as separate head
87 Band aids, bandages, sterile injections, needles, Payable under Dressing Charges, Not
syringes payable as separate head
88 C otton P ayable under Dressing C harges, Not
payable as separate head
89 C otton bandage P ayable under Dressing C harges, Not
payable as separate head
90 Micropore/ surgical tape P ayable under Dressing C harges, Not
payable as separate head
91 B lade Not P ayable
92 Apron P ayable under OT / IC U C harges, Not
payable as separate head

Policy Wordings: Group Domestic Traveller Insurance Policy

101 S urcharges P ayable under R oom C harges, Not payable as

separate head
102 Attendant charges P ayable under R oom C harges, Not payable as
separate head
103 IM IV injection charges P ayable under Nursing C harges, Not
payable as separate head
104 C lean sheet P ayable under
Laundry/Housekeeping Charges,
Not payable as separate head
105 Extra diet of patient(other than that which forms Payable
part of bed charge)
106 B lanket/warmer blanket P ayable under R oom C harges, Not payable as
separate head
ADMINISTRATIVE OR NON -MEDICAL CHARGES
107 Admission kit Not P ayable
108 B irth certificate Not P ayable
109 Blood reservation charges and ante natal Not Payable
booking charges
110 C ertificate charges Not P ayable
111 C ourier charges Not P ayable
112 C onvenyance charges Not P ayable
113 Diabetic chart charges Not P ayable
114 Documentation charges / administrative expenses t Payable
N
o
115 Discharge procedure charges Not P ayable
116 Daily chart charges Not P ayable
117 Entrance pass / visitors pass charges t Payable
N
o
118 Expenses related to prescription on discharge be claimed by patient under Post
T Hosp where admissible
o
119 F ile opening charges Not P ayable
120 Incidental expenses / misc. Charges (not explained) Payable
Not

Policy Wordings: Group Domestic Traveller Insurance Policy

N
127 W ashing charges Not P ayable
128 Medicine box Not P ayable
129 Mortuary charges P ayable upto 24 hrs, shifting charges
not payable
130 Medico legal case charges (MLC charges) Not Payable
EXTERNAL DURABLE DEVICES
131 W alking aids charges Not P ayable
132 B IP AP machine Not P ayable
133 C ommode Not P ayable
134 C P AP / C AP D equipments Device not payable
135 Infusion pump – cost Device not payable
136 Oxygen cylinder (for usage outside the hospital) t Payable
N
o
137 P ulseoxymeter charges Device not payable
138 S pacer Not P ayable

139 S pirometre Device not payable

140 S p 02 probe Not P ayable
141 Nebulizer kit Not P ayable
142 S team inhaler Not P ayable
143 Armsling Not P ayable
144 T hermometer Not P ayable (paid by patient)
145 C ervical collar Not P ayable
146 S plint Not P ayable
147 Diabetic foot wear Not P ayable
148 Knee braces ( long/ short/ hinged) ot Payable

N
149 Knee immobilizer/shoulder immobilizer ot Payable

N
150 Lumbosacral belt P ayable in respect of surgery related to lumbar
spine
151 Nimbus bed or water or air bed charges yable in respect of patients requiring more
P than 3 days in ICU and patients with paraplegia
a / quadriplegia for any reason and subject
to limit of approximately USD 5/ day
152 Ambulance collar Not P ayable
153 Ambulance equipment Not P ayable
154 Microsheild Not P ayable
155 Abdominal binder P ayable in respect of major abdominal surgery
including TAH, LSCS, incisional hernia repair,
exploratory laparotomy for intestinal
obstruction, liver transplant etc.
ITEMS PAYABLE IF SUPPORTED BY A PRESCRIPTION

Policy Wordings: Group Domestic Traveller Insurance Policy

P
157 Private nurses charges- special nursing charges Not Payable
158 Nutrition planning charges - dietician charges Payable
diet charges
159 S ugar free tablets P ayable
160 Creams, Powders, Lotions (Toileteries are not Payable if prescribed by Medical Practitioner
payable, only prescribed medical
pharmaceuticals payable)
161 Digestion gels P ayable if prescribed by Medical P ractitioner
162 E C G electrodes Upto 5 electrodes are required for every case
visiting OT o r ICU. For longer stay in ICU, may
require a change and at least one set every
second day must be payable.
163 G loves S terilized G loves payable / unsterilized
gloves not payable
164 HIV kit P ayable - payable P re operative screening
165 Listerine/ antiseptic mouthwash P ayable if prescribed by Medical P ractitioner
166 Lozenges P ayable if prescribed by Medical P ractitioner
167 Mouth paint P ayable if prescribed by Medical P ractitioner
168 Nebulisation kit P ayable
169 Novarapid P ayable if prescribed by Medical P ractitioner
170 Volini gel/ analgesic gel P ayable if prescribed by Medical P ractitioner
171 Zytee gel P ayable if prescribed by Medical P ractitioner
172 Vaccination charges R outine Vaccination not P ayable / P ost B ite
Vaccination Payable

PART OF HOSPITAL'S OWN COSTS AND NOT PAYABLE

173 AHD P ayable under Hospital's internal C harges, Not
payable as separate head
174 Alcohol swabs P ayable under Hospital's internal C harges,
Not payable as separate head
175 S crub solution/sterillium P ayable under Hospital's internal C harges,
Not payable as separate head
OTHERS
176 Vaccine charges for baby Not P ayable
177 Aesthetic treatment / surgery Not P ayable
178 T P A charges Not P ayable
179 Visco belt charges Not P ayable
180 Any kit with no details mentioned [delivery kit, Not Payable
orthokit, recovery kit, etc]
181 E xamination gloves Not P ayable
182 K idney tray Not P ayable
183 Mask Not P ayable
184 Ounce glass Not P ayable
185 Outstation consultant's/ surgeon's fees t payable, except for telemedicine
N consultations where covered by
o policy
186 Oxygen mask Not P ayable
187 P aper gloves Not P ayable
188 P elvic traction belt P ayable in respect of P IVD
189 R eferral doctor's fees Not P ayable

Policy Wordings: Group Domestic Traveller Insurance Policy

D
191 P an can Not P ayable
192 S ofnet Not P ayable
193 T rolly cover Not P ayable
194 Urometer, urine jug Not P ayable
195 Ambulance P ayable
196 T egaderm / vasofix safety P ayable subject to limit of 3 in 48 hrs and
then 1 in 24 hrs
197 Urine bag P ayable subject to limit of 1 per 24 hrs
198 S oftovac Not P ayable
199 S tockings P ayable in respect of C AB G

GENERAL CONDITIONS (APPLICABLE TO ALL BENEFITS UNDER THIS POLICY)

1. Policies covering single trips can be issued upto single trip not exceeding 365 days.
2. Of the covers indicated in this policy wording coverage available to the insured will be indicated
in the Certificate of Insurance along with Sum Insured and Deductibles
3. Policies covering annual multi trips can be issued for annual period of one year covering multiple
single trips within the annual period of insurance with each and every single trip not
exceeding a specified number of days as mentioned in the Policy Schedule.
4. The Policy start date shall be on or before the trip start date.
5. Extension of the Period of Insurance of the Policy during the duration of the trip can be done
only at the sole discretion of the Company depending upon the risk factors.
6. If the Insured/Insured Person does not declare the full current facts or declare wrong facts
while requesting for extension of the Policy, any extension of such a Policy if granted shall be
deemed to be invalid. No refund of premium will be given in case of extensions so
invalidated. The Company will also not be liable to pay any claim filed under the
extended Policy.
7. Termination of the Policy at a date earlier than the end date can be done only if the Insured/
Insured Person returns back to his/her usual place of residence in India earlier than the end
date of the Period of Insurance of the Policy. Refund of premium for the days between the
return date to his/her usual place of residence in India and the end date of the Period of
Insurance as mentioned in the Policy Schedule will only be given if the same are a minimum of
10 days. Premium refunded will be equal to
the amount of premium to be paid for the original Policy duration minus the premium to be
paid by taking the return date as the new end date of Period of Insurance. No refunds will be
given on policies with claims.
8. The premium payable for the extension of the Policy during the trip duration shall be the
premium payable for the overall trip duration (including the extension) less the initial premium
already paid.
9. Policy is applicable for one-way travel also, with a condition for maximum duration of coverage
limited to specified number of days as mentioned in the Policy Schedule.
10. The Insured/ Insured Person shall provide the Company with the details of the trip and other
information as may be required by the Company from time to time.
11. Deductible will be charged for each separate incident reported for claims payment, even
though the claim may be registered under the same benefit more than once.
12. Claim Procedure – The procedure to be followed by the Insured/ Insured person in case of any
event that may give rise to a claim under this Policy, the claim documentation required to be
submitted by the Insured/ Insured Person at the time lodging claims as well as the claim
settlement process are enumerated in the enclosed Claim Procedure attached to this Policy.
Any failure on the part of the Insured/ Insured Person in complying with the procedure or
submission of required documents in support of his/her claim may prejudice the claim of the
Insured/ Insured Person.
13. Obligations of the Insured/ Insured Person:

Policy Wordings: Group Domestic Traveller Insurance Policy

UIN of Product: B H A T G D P 1 8 0 0 9 V 0 1 1 7 1 8
Registered and corporate offce address: ICICI Lombard General Insurance Company Ltd., ICICI Lombard House,
414, Veer Savarkar Marg, Prabhadevi, Mumbai – 400025, IRDAI Registration No: 115, CIN: L67200MH2000PLC129408, Telephone: 18001032292, Website:
[Link], Email: customersupportba@[Link]
a) Insured/ Insured Person shall provide to the Company or the Emergency Assistance Service
Provider appointed by the Company, on demand any information that is required to
determine the occurrence of the insurable event or the Company's liability to pay the benefits.
b) If requested to do so by the Company or the Emergency Assistance Service Provider
appointed by the Company, the Insured/ Insured Person is obliged to undergo a medical
examination by a Medical Practitioner designated by the Emergency Assistance Service
Provider. For the purpose of settlement of claims only. The cost towards the medical
examination shall be borne by the Company.
c) The Company or the Emergency Assistance Service Provider appointed by the Company is
authorized to take all measures which includes the Insured/ Insured Person's transportation
back to his/her usual place of residence in India. The transportation of the Insured/ Insured
person back to his/her usual place of residence in India shall be done only on agreement and
confirmation from the attending medical practitioner that the Insured/ Insured Person is
capable of being transported to his/her usual place of residence in India with consent from
Insured/Insured Persons.
d) The Company shall be released from any obligation to pay benefits under this Policy, if any,
of the aforementioned obligations are breached by the Insured/ Insured Person.
15. Transfer and Set-off of Claims:
a) If the Insured/ Insured Person have any outstanding claims against third parties, such claims
shall be transferred in writing to the Company up to the amount for which the reimbursement
of costs is made by the Company in accordance with the terms hereunder.
b) In so far as an Insured/ Insured Person receives compensation for costs he/she has
incurred either from third parties liable for damages or as a result of other legal
circumstances, the Company shall be entitled to set off this compensation against the
insurance benefits payable.
c) Claims to the insurance benefits may be neither pledged nor transferred by the Insured/
Insured Person. Transfer and Set-off of Claims shall not be applicable to any of
the medical sections under Emergency Medical Expenses, Emergency Medical
Evacuation, Repatriation of Mortal Remains, Personal Accident, Accidental Death
and Permanent Total Disablement – Common carrier, Accidental Dental
Treatment, Daily Allowance in case of hospitalization
16. The premium charged shall be based on the number of man days insured in each category
at the commencement of the Policy Period, as declared by the Insured Person. Depending on the
actual number of man days covered in the Policy Period in each category as at the last day of
such Policy period, if the premium calculated on the actual number of man days shall differ from the
premium charged at the commencement of the Policy, then such difference shall be paid to the
Company or refunded by the Company as the case may be

17. All Claims will be settled in India and in Indian Rupees only.
17. Multiple Claims: In the event a claim is payable in multiple sections under this policy the
Company’s liability will be restricted to the highest amount payable per section. This will not apply
to the following sections: Accidental Death; Permanent Total Disability (PTD); Permanent Partial
Disablement (PPD)

18. In case a covered insured event, as described in the Benefit Section, occurs before date of purchase
of this policy or advance warning is issued by the relevant authorities of the likelihood of such an
event happening before date of purchase of this policy the Company shall not be liable to pay a claim.

GRIEVANCES REDRESSAL PROCEDURE

The Company is committed to extend the best possible services to its customers. However, If
Policyholder/Insured Person have a grievance that he/she wish us to redress, he/she may
contact the Company with the details of their grievance via:
•Website: [Link]
•Email: customersupportba@[Link]
•Phone: 18001032292
•Courier: Any of the Company’s Branch office or corporate office

Policy Wordings: Group Domestic Traveller Insurance Policy

Escalation Level 1
In case the Policyholder/Insured/Insured Person has not got his/her grievances redressed through
one of the above methods (After 5 days of intimating of your complaint), Policyholder/ Insured/
Insured Person may contact the National Grievance Redressal Officer at :
Write to: ICICI Lombard General Insurance Company Ltd., ICICI Lombard House, 414, Veer Savarkar
Marg, Prabhadevi, Mumbai – 400025,
Telephone: 18001032292
Email: [Link]
In case the Policyholder/ Insured/Insured Person has not got his/her grievances redressed through
any of the above methods (After 5 days of approaching National Grievance Redressal Officer),
Policyholder/ Insured/ Insured Person may contact the Chief Grievance Redressal Officer at:
Email : [Link]
Escalation Level 3
In case the Policyholder/ Insured/Insured Person has not got his/her grievances redressed by the
Company within 14 days, or, If Policyholder/ Insured/Insured Person is not satisfied with Company’s
redressal of the grievance through one of the above methods, Policyholder/ Insured/ Insured
Person may approach the nearest Insurance Ombudsman for resolution of their grievance. The
contact details of Ombudsman offices are mentioned below. Policy holder may also obtain copy of
IRDAI circular Ref No. F. No. IRDAI/Reg/8/145/2017, notification on Insurance Regulatory and
Development Authority (Protection of Policy holders’ interests) Regulations, 2017 from any of our
offices.
Grievance of Senior Citizens:
In respect of Senior Citizens, the Company has established a separate channel to address the
grievances. Any concerns may be directly addressed to the Senior Citizen’s channel of the
Company for faster attention or speedy disposal of grievance, if any.
•Website: [Link]
•Email: [Link]@[Link]
•Phone: 18001032292
•Courier: Any of the Company’s Branch office or corporate office
Insured/ Insured Person may also approach the grievance cell at any of the Company’s branches
with the details of the grievance during working hours from Monday to Friday.
Grievance Redressal Cell of the Consumer Affairs Department of IRDAI
The insurance company should resolve the complaint within a reasonable time. In case if it is not
resolved within 15 days or if the Insured/Insured Person is unhappy with their resolution you can
approach the Grievance Redressal Cell of the Consumer Affairs Department of IRDAI.
•Website: [Link]
•Email: complaints@[Link]
•Toll Free Number 155255 (or) 1800 4254 732

Policy Wordings: Group Domestic Traveller Insurance Policy

NAMES OF OMBUDSMAN AND ADDRESSES OF OMBUDSMAN

CENTRES
Jurisdiction of O ce, Union Territory,
Location O ce Details
District

Shri Kuldip Singh

Office of the Insurance
Ombudsman, Jeevan Prakash Gujarat,
Ahmedabad Building, 6th floor, Tilak Marg, Dadra & Nagar
Relief Road, Haveli, Daman and
Ahmedabad – 380 001. Diu
Tel.: 079 - 25501201/02/05/06
Email:
[Link]@[Link]

Smt. Neerja Shah

Office of the Insurance Ombudsman,
Jeevan Soudha Building,PID No. 57-27-
N-19 Ground Floor, 19/19, 24th Main
Bengaluru Karnataka
Road,
JP Nagar, Ist
Phase, Bengaluru
– 560 078.
Tel.: 080 - 26652048 / 26652049
Email: [Link]@[Link]

Shri Guru Saran Shrivastava

Office of the Insurance
Ombudsman,
Janak Vihar Complex, 2nd
Madhya
Bhopal Floor, 6, Malviya Nagar, Opp.
Pradesh
Airtel Office,
Chattisgarh
Near New
Market, Bhopal –
462 003.
Tel.: 0755 - 2769201 / 2769202
Fax: 0755 - 2769203
Email: [Link]@[Link]

Policy Wordings: Group Domestic Traveller Insurance Policy

Office of the Insurance Ombudsman,

Punjab,
S.C.O. No. 101, 102 & 103, 2nd
Haryana(excluding Gurugram,
Floor, Batra Building, Sector
Faridabad,
Chandigarh 17 – D,
Sonepat and Bahadurgarh)
Chandigarh – 160 017.
Himachal Pradesh, Union
Tel.: 0172 - 2706196 / 2706468
Territories of
Fax: 0172 - 2708274
Jammu & Kashmir,
Email:
Ladakh &
[Link]@[Link]
Chandigarh.

Office of the Insurance

Ombudsman, Fatima Akhtar Court,
Tamil Nadu,
4th Floor, 453, Anna Salai,
Chennai Pondicherry Town
Teynampet,
and
CHENNAI – 600 018.
Karaikal (which are part of Pondicherry)
Tel.: 044 - 24333668 / 24335284
Fax: 044 - 24333664
Email: [Link]@[Link]

Shri Sudhir Krishna

Office of the Insurance
Ombudsman, 2/2 A, Universal Delhi &
Delhi Insurance Building, Asaf Ali Road, Following Districts of Haryana -
New Delhi – 110 002. Gurugram, Faridabad, Sonepat &
Tel.: 011 - 23232481/23213504 Bahadurgarh
Email:
[Link]@[Link]

Assam,
Office of the Insurance
Meghalaya
Ombudsman, Jeevan Nivesh, 5th
, Manipur,
Guwahati Floor,
Mizoram,
Nr. Panbazar over bridge, S.S.
Arunachal Pradesh,
Road, Guwahati – 781001(ASSAM).
Nagaland and
Tel.: 0361 - 2632204 / 2602205
Tripura
Email: [Link]@[Link]

Policy Wordings: Group Domestic Traveller Insurance Policy

Office of the Insurance

Ombudsman, Jeevan Nidhi – II
Bldg., Gr. Floor, Bhawani Singh
Jaipur Rajasthan
Marg,
Jaipur - 302 005.
Tel.: 0141 – 2740363
Email:
[Link]@[Link]

Ms Poonam Bodra
Office of the Insurance
Ombudsman, 2nd Floor, Pulinat Kerala,
Bldg., Lakshadwee
Ernakulam
Opp. Cochin Shipyard, M. G. Road, p,
Ernakulam - 682 015. Mahe-a part of Union Territory of
Tel.: 0484 - 2358759 / 2359338 Puducherry.
Fax: 0484 - 2359336
Email: [Link]@[Link]

Shri P.K. Rath

Office of the Insurance
Ombudsman, Hindustan Bldg.
West
Annexe, 4th Floor, 4, C.R.
Kolkata Bengal,
Avenue,
Sikkim,
KOLKATA - 700 072.
Andaman & Nicobar Islands
Tel.: 033 - 22124339 / 22124340
Fax : 033 - 22124341
Email: [Link]@[Link]

Policy Wordings: Group Domestic Traveller Insurance Policy

Office of the Insurance

Ombudsman, 3rd Floor, Jeevan
Seva Annexe, Goa,
Mumbai S. V. Road, Santacruz Mumbai Metropolitan Region
(W), Mumbai - 400 excluding Navi Mumbai &
054. Thane
Tel.:
69038821/23/24/25/26/27/28/2
8/29/30/31 Fax: 022 -
26106052
Email: [Link]@[Link]

State of Uttaranchal and the following

Shri Chandra Shekhar Prasad Districts of Uttar Pradesh:
Office of the Insurance Agra, Aligarh, Bagpat, Bareilly, Bijnor,
Ombudsman, Budaun, Bulandshehar, Etah, Kanooj,
Bhagwan Sahai Mainpuri, Mathura, Meerut,
Noida Palace 4th Floor, Moradabad, Muzaffarnagar, Oraiyya,
Main Road, Naya Pilibhit, Etawah, Farrukhabad,
Bans, Sector 15, Firozbad, Gautambodhanagar,
Distt: Gautam Buddh Ghaziabad, Hardoi, Shahjahanpur,
Nagar, U.P-201301. Hapur, Shamli, Rampur, Kashganj,
Tel.: 0120- 2514252 / 2514253 Sambhal, Amroha, Hathras,
Email: Kanshiramnagar, Saharanpur
[Link]@[Link]

Policy Wordings: Group Domestic Traveller Insurance Policy

Shri Vinay Sah

Office of the Insurance
Ombudsman, Jeevan Darshan
Maharashtra,
Bldg., 3rd Floor,
Pune Area of Navi Mumbai and Thane
C.T.S. No.s. 195 to 198,
excluding Mumbai Metropolitan
N.C. Kelkar Road, Narayan
Region
Peth, Pune – 411 030.
Tel.: 020-41312555
Email:
[Link]@[Link]

GENERAL TERMS AND CONDITIONS (APPLICABLE TO ALL SECTIONS OF THIS POLICY)

1. Duty of Disclosure or Disclosure to information norm:

The Policy shall be void and all premium paid hereon shall be forfeited and no benefit shall be
payable in the event of misrepresentation, mis-description or non-disclosure of any material fact
in the proposal form, personal statement, declaration and connected documents, or any
material information having been withheld, or a claim being fraudulent or any fraudulent` means
or device being used by the Insured/Insured Person or any one acting on his/their behalf to obtain
a benefit under this Policy.

2. Observance of terms and conditions:

The due observance and fulfillment of the terms, conditions and endorsement of this Policy in so
far as they relate to anything to be done or complied with by the Insured / Insured Person, shall
be a condition precedent to any liability of the Company to make any payment under this Policy.

3. Insured Person:
Only those persons named as an Insured Person in the Schedule shall be covered under this
Policy. Any person may be added as an Insured Person during the Policy Period after his
application has been accepted by the Company, additional premium to be paid and the
Company has issued an endorsement confirming the addition of such person as an Insured
Person

4. Alterations and Endorsements to the Policy:

This Policy constitutes the complete contract of insurance. This Policy cannot be changed or
varied by anyone (including an insurance agent or broker) except the Company, and any
change made by the Company will be evidenced by a written endorsement signed and stamped
by the Company.

The following endorsement requests can be accepted by the Company:

Policy Wordings: Group Domestic Traveller Insurance Policy
UIN of Product: B H A T G D P 1 8 0 0 9 V 0 1 1 7 1 8
Registered and corporate offce address: ICICI Lombard General Insurance Company Ltd., ICICI Lombard House,
414, Veer Savarkar Marg, Prabhadevi, Mumbai – 400025, IRDAI Registration No: 115, CIN: L67200MH2000PLC129408, Telephone: 18001032292, Website:
[Link], Email: customersupportba@[Link]
S no S cenarios Before P olicy S tart Date After P olicy S tart

Date
1 Name C hange Allowed Allowed
2 Address C hange Allowed Allowed
3 DOB C hange Allowed Allowed
4 C hange of E mail Allowed Allowed
5 C hange of C ontact number Allowed Allowed
6 Change of Risk Start and/or Allowed Not Allowed
End Date
7 T rip E xtension Not Allowed Allowed
8 C hange of Nominee Allowed Allowed
9 C hange of P assport Details Allowed Not Allowed
10 Policy Cancellation Allowed, only if request is Not Allowed
received before 24 hours
11 P lan C hange Allowed Not Allowed
12 G eography C hange Allowed Not Allowed

5. Loadings and / or exclusion

On change of your Occupation and / or risk profile, the coverage may cease, unless
specifically agreed by the Company. However in such case, the Company may charge an
additional loading or apply exclusion or both depending upon the risk profile.

The final decision regarding the same shall be at the Company’s sole discretion. The
Company will inform Insured Person/Policy Holder about the applicable risk loading through a
counter offer letter. You need to revert to the Company with consent and additional premium (if
any), within 15 days of the issuance of such counter offer letter. In case, Insured Person/ Policy
Holder neither accept the counter offer nor revert to the Company within 15 days, the Company
shall cancel the Insured Person’s/ Policy Holder’s application and refund the premium paid within
next 7 days.

6. Material change
The Insured/ Insured Person shall immediately notify the Company in writing of any material
change in the risk such as the trip duration, country and location of travel, correction in age,
nature of job and cause at his own expense such additional precautions to be taken as
circumstances may require to ensure safety and containing the circumstances that may give rise
to the claim, and the Company may adjust the scope of cover and / or premium if necessary,
accordingly. The liability of Insurance Company shall continue only if there is a written
acceptance on the part of the Insurance Company through endorsement.

7. Fraudulent Claims
If any claim is in any respect fraudulent, or if any false statement, or declaration is made or
used in support thereof, or if any fraudulent means or devices are used by the Insured/Insured
Person or anyone acting on his/her behalf to obtain any benefit under this Policy all benefits
and premium paid under this Policy shall be forfeited

The Company will have the right to reclaim all benefits paid in respect of a claim which is
fraudulent as mentioned above under this Condition as well as under Condition No 1 of this Policy

8. No constructive Notice

Policy Wordings: Group Domestic Traveller Insurance Policy

9. Notice of charge
The Company shall not be bound to take notice or be affected by any notice of any trust, charge,
lien, assignment or other dealing with or relating to this Policy, but the payment by the
Company to the Insured /Insured Person or his/her nominee or legal representative, as the case
may be, of any compensation or benefit under the Policy shall in all cases be an effectual
discharge to the Company. In the cases of delay in the payment, the Company shall be liable
to pay interest in line with the Protection of Policyholders’ Interests) Regulations, 2017. The
said act is available for reference in the website of the Insurance Development Regulatory
Authority of India (IRDAI).

10. Electronic Transaction

The Insured /Insured Person agrees to adhere to and comply with all such terms and conditions as
the Company may prescribe from time to time and hereby agrees and confirms that all
transactions effected by or through facilities for conducting remote transactions including the
internet, world wide web, Electronic data interchange, call centres, teleservice operations (whether
voice, video, data or combination thereof) or by means of electronic, computer, automated
machines network or through other means of telecommunication established by or on behalf of
the Company for and in respect of the Policy or its terms or the Company’s other products and
services, shall constitute legally binding and valid transactions when done in adherence to and
in compliance with the Company’s terms and conditions for such facilities, as may be prescribed
from time to time. However, the terms of this condition shall not override provisions of any law(s)
or statutory regulations including provisions of IRDAI regulations for protection of policyholder’s
interests. All conditions of section 41 prescribed for the proposal form, all necessary disclosures
on terms, conditions and major exclusions shall be made known to the Insured/Insured Person;
Any voice transaction shall be duly recorded, with the consent of the Insured/Insured Person and
the recordings shall be maintained by or on behalf of the Company and shall be made available
to the Insured/Insured Person for subsequent validation/confirmation of the Insured/Insured
Person, if so required.

11. Duties of the Insured/ Insured Person on occurrence of loss

On the occurrence of any loss, within the scope of this Policy the Insured/ Insured Person shall:
a. Forthwith inform the Company and file/submit a Claim Form in accordance with 'Claim
Procedure'.
b. Allow the Medical Practitioner or the Surveyor or any agent of the Company to inspect the
lost/damaged properties premises/goods as well as examine the Insured/ Insured Person.
c. Assist and not hinder or prevent the Company or any of its agents in pursuance of their duties.
d. Not to abandon the insured property/items in the premises, nor take any steps to
rectify/remedy the damage before the same has been approved by the Company or any of its
agents or the Surveyor.

If the Insured/Insured Person does not comply with this provision of this Clause, all benefits under
this Policy shall be forfeited, at the option of the Company.

12. Right to inspect

If required by the Company, an agent/representative of the Company including a loss assessor
or a Surveyor appointed in that behalf shall in case of any loss or any circumstances that have
given rise to
a claim to the Insured/Insured Person be permitted at all reasonable times to examine into the
circumstances of such loss. The Insured /Insured Person shall on being required so to do
by the Company produce all relevant documents relating to or containing reference relating to
the loss or such circumstance in his possession including presenting himself for examination and
furnish copies of or extracts from such of them as may be required by the Company so far as
they relate to such claims or will in any way assist the Company to ascertain the correctness
Policy Wordings: Group Domestic Traveller Insurance Policy
UIN of Product: B H A T G D P 1 8 0 0 9 V 0 1 1 7 1 8
Registered and corporate offce address: ICICI Lombard General Insurance Company Ltd., ICICI Lombard House,
414, Veer Savarkar Marg, Prabhadevi, Mumbai – 400025, IRDAI Registration No: 115, CIN: L67200MH2000PLC129408, Telephone: 18001032292, Website:
[Link], Email: customersupportba@[Link]
thereof or the liability of the Company under this Policy.

13. Position after a claim

The Insured/ Insured Person shall not be entitled to abandon any insured property whether the
Company has taken possession of the same or not. As from the day of receipt of the claim
amount by the Insured/ Insured Person, the Sum Insured for the remainder of the period of
insurance shall stand reduced by the amount of the compensation.

In case of claims under Home Fire Insurance (Contents) and Home Burglary Insurance
(Contents) Sections, the Sum Insured can be reinstated by payment of pro-rata premium for the
unexpired period from the date of such loss to the expiry of period of insurance for the amount of
such loss.

14. Condition of Average (applicable to Sections Home Fire Insurance (Contents) and
Home Burglary Insurance Content)
If the property hereby insured shall at the time of loss or at the commencement of any destruction
of or damage to the property by any other peril hereby insured against be collectively of greater
value than the Sum Insured thereon, then the Insured shall be considered as being his own
insurer for the difference and shall bear a rateable proportion of the loss accordingly. Every item,
if more than one, of the Policy shall be separately subject to this condition

15. Indemnity
The Company may at its option, if applicable reinstate, replace or repair the property or
premises lost or damaged or any part thereof instead of paying the amount of loss or damage
or may join with any other insurer in so doing. The Company shall not be bound to reinstate
exactly or completely but only as circumstances permit and in reasonably sufficient manner. In
no case shall the Company be bound to expend more in reinstatement than it would have cost
to reinstate such property as it was at the time of the occurrence of such loss or damage
and in any event not more than the Sum Insured thereon.

If in any case the Company shall be unable to reinstate or repair the insured property/item,
because of any law or other regulations in force affecting insured property or otherwise, the
Company shall, in every such case, only be liable to pay such sum as would be requisite under
this Policy. However, this condition shall not be applicable to Personal Accident, Accidental
Death and Permanent Total Disablement – Common Carrier Sections

16. Subrogation
In the event of payment under this Policy, the Company shall be subrogated to all the Insured
/Insured Person's rights or recovery thereof against any person or Organisation, and the
Insured/Insured Person shall execute and deliver instruments and papers necessary to secure
such rights. The Insured/Insured Person and any claimant under this Policy shall at the
expense of the Company do and concur in doing and permit to be done, all such acts and
things as may be necessary or required by the Company, before or after Insured /Insured
Person's indemnification, in enforcing or endorsing any rights or remedies, or of obtaining relief
or indemnity, to which the Company shall be or would become entitled or subrogated.
However, this condition shall not be applicable to any heath sections ie., Emergency Medical
Expenses,Emergency Medical Evacuation, Repatriation of Mortal Remain. Personal Accident,
Accidental Death and Permanent Total Disablement – Common Carrier -, Accidental Dental
Treatment & Daily Allowance in case of hospitalization

17. Contribution
If at the time of the happening of any loss or damage covered by this Policy, there shall be existing
any other insurance of any nature whatsoever covering the same, whether effected by the Insured
/Insured Person or not, then the Company shall not be liable to pay or contribute more than its
rateable proportion of any loss or damage. However, this condition shall not be applicable to any
heath sections ie., Emergency Medical Expenses, Emergency Medical Evacuation, Repatriation
of Mortal
Remains Personal Accident, Accidental Death and Permanent Total Disablement -,
Policy Wordings: Group Domestic Traveller Insurance Policy
UIN of Product: B H A T G D P 1 8 0 0 9 V 0 1 1 7 1 8
Registered and corporate offce address: ICICI Lombard General Insurance Company Ltd., ICICI Lombard House,
414, Veer Savarkar Marg, Prabhadevi, Mumbai – 400025, IRDAI Registration No: 115, CIN: L67200MH2000PLC129408, Telephone: 18001032292, Website:
[Link], Email: customersupportba@[Link]
Accidenta
l Dental Treatment & Daily Allowance in case of hospitalization

18. Forfeiture of claims

If any claim is made and rejected and no court action or suit commenced within 12 months after
such rejection or, in case of arbitration taking place as provided herein, within 12 calendar
months after the Arbitrator or Arbitrators have made their award, all benefits under this Policy
shall be forfeited.

19. Termination / Cancellation

The company shall exercise its right to cancel the Policy only in case of mis-representation, non-
disclosure of material facts, in which case policy shall be void and all premium paid thereon
shall be forfeited to the Company as per the disclosure to information norm. In case of Annual
Policies, the Company may at any time, cancel this Policy, by giving 30 days notice in writing by
Registered Post Acknowledgment Due to the Insured/ Insured Person at his last known address.
The Company shall exercise its right to cancel the policy on grounds of non-cooperation of the Insured
/ Insured Person in implementing the terms and conditions of this Policy. In such cases, Insurer
shall be liable to repay premium as specified in the below mentioned table subject to no claims

The Insured/Insured Person may also give 30 days notice in writing, to the Company, for the
cancellation of this Policy, in which case, the Company shall from the date of receipt of notice
cancel the Policy and retain the premium for the period this Policy has been in force at the
Company's short period scales, provided that, no refund of premium shall be made if any claim
has been made under this Policy by or on behalf of the Insured/ Insured Person.

Policy Period Rate Of Premium to be

retained
Up to 15% of Policy Period 25% of premium paid
Up to 25% of Policy Period 50% of premium paid
Upto 50% of Policy Period 75% of premium paid
Exceeding 50% of Policy 100% of premium paid
Period

In case of Single Trip policies, termination of the Policy at a date earlier than the end date can be
done only if the Insured / Insured Person returns back to his/her usual place of residence in India
earlier than the end date of the Period of Insurance of the Policy. Refund of premium for the days
between the return date to his/her usual place of residence in India and the end date of the Period of
Insurance as mentioned in the Policy Schedule will only be given if the same are a minimum of 10
days. Premium refunded will be
equal to the amount of premium to be paid for the original Policy duration minus the premium to be
paid by taking the return date as the new end date of Period of Insurance, provided that, no refund of
premium shall be made if any claim has been made under this Policy by or on behalf of the
Insured/Insured Person.

20. Cause of Action

No claim shall be payable under this Policy where the cause of action arises outside the
territorial limits of India, unless otherwise specifically provided in the Policy Schedule.

21. Policy Disputes

The parties to this Policy expressly agree that the laws of the Republic of India shall govern the
validity, construction, interpretation and effect of this Policy. Any dispute concerning the
interpretation of the terms and conditions, limitations and/or exclusions contained herein is
understood and agreed to by both the insured and the Company to be subject to Indian law and
in Indian Court.

22. Arbitration
If any dispute or difference shall arise as to the quantum to be paid under this Policy (liability
Policy Wordings: Group Domestic Traveller Insurance Policy
UIN of Product: B H A T G D P 1 8 0 0 9 V 0 1 1 7 1 8
Registered and corporate offce address: ICICI Lombard General Insurance Company Ltd., ICICI Lombard House,
414, Veer Savarkar Marg, Prabhadevi, Mumbai – 400025, IRDAI Registration No: 115, CIN: L67200MH2000PLC129408, Telephone: 18001032292, Website:
[Link], Email: customersupportba@[Link]
being otherwise admitted) such difference shall independently of all other questions be referred
to the decision of a sole arbitrator to be appointed in writing by the parties thereto or if they
cannot agree upon a single arbitrator within 30 days of any party invoking arbitration, the same
shall be referred to a panel of three arbitrators, comprising of two arbitrators, one to be
appointed by each of the parties
to the dispute/difference and the third arbitrator to be appointed by such two arbitrators and
arbitration shall be conducted under and in accordance with the provisions of the Arbitration
and Conciliation Act, 1996.
It is clearly agreed and understood that no dispute or difference shall be referable to arbitration,
as hereinbefore provided, if the Company has disputed or not accepted liability under or in
respect of this Policy.

It is hereby expressly stipulated and declared that it shall be a condition precedent to any right
of action or suit upon this Policy that the award by such arbitrator/arbitrators of the amount of the
loss or damage shall be first obtained.

23. Renewability
The Company under no obligation shall give notice for renewal of the Annual Multi-trip policies
and accept renewal premium in all cases except in case of fraud, misrepresentation or non-
cooperation of the Insured/ Insured Person in implementing the terms and conditions of this
Policy or if the renewal of Policy poses a moral hazard. Every renewal premium (which shall be
paid and accepted in respect
of this Policy) shall be so paid and accepted upon the distinct understanding that no alteration
has taken place in the facts contained in the proposal or declaration herein before mentioned
and that nothing is known to the Insured / Insured Person that may result to enhance the risk of
the Company. No renewal receipt shall be valid unless it is on the printed form of the
Company and signed by an authorized official of the Company.

Renewal premium are subject to change with prior approval of IRDAI.

The Company may vary the renewal premium and/or benefits payable subject to approval from
IRDAI and inform the same to the Insured at least 3 months prior to the date of revision and/ or
modification.

In the likelihood of this policy being withdrawn in future, the Company will inform the same to the
Insured at least 3 months prior to expiry of the policy.

Insured will have the option to migrate to other plan under similar travel insurance policy at the
time of renewal, provided the policy has been maintained without a break. The Sum Insured
can be enhanced up to the next available sum insured slab at the time of renewal, subject to no
claim in the previous policy and Good Health Declaration.

24. Extension
The Company may in its sole and absolute discretion extend the Policy once during the Risk
Period, provided that:
1) We receive the request for extension of the Policy and the applicable premium before the
expiry date of the Policy Period.
2) We have received a good health and no claim declaration during the Risk Period.
3) The insured persons has not made a claim just before we receive the request for extension
of the policy

The Company is under no obligation to extend the Policy or to extend the Policy on the same
terms and conditions whether as to premium or otherwise.

25. Notices
Any notice, direction or instruction given under this Policy shall be in writing and delivered by
hand, post, or facsimile to -
a) In case of the Insured/Insured Person, at the address specified in the Policy Schedule.
b) In case of the Company, to the Policy issuing office of the Company.
Policy Wordings: Group Domestic Traveller Insurance Policy
UIN of Product: B H A T G D P 1 8 0 0 9 V 0 1 1 7 1 8
Registered and corporate offce address: ICICI Lombard General Insurance Company Ltd., ICICI Lombard House,
414, Veer Savarkar Marg, Prabhadevi, Mumbai – 400025, IRDAI Registration No: 115, CIN: L67200MH2000PLC129408, Telephone: 18001032292, Website:
[Link], Email: customersupportba@[Link]
26. Customer Service (Claims Notification- Claims Multi Media Model)

It is the endeavour of Company to give multiple options to the Insured Person/Insured Person’s
representative to intimate the claim to the Company. The intimation can be given in following
ways:
• Toll Free call Centre of the Insurance Company(24x7) - 1800-103-2292
• Login to the website of the Insurance Company and intimate the claim – [Link]
[Link]/contact-us
• Send an email to the Company- customersupportba@[Link]
• Post/courier to TPA/Company - ICICI Lombard Healthcare, ICICI Bank Tower, Plot No.
12, Financial District, Nanakram Guda, Gachibowli, Hyderabad-500032.
• Directly contact our Company office but in writing. - ICICI Lombard House, 414, Veer
Savarkar Marg, Prabhadevi, Mumbai – 400025
In all the above, the intimations are directed to a central team for prompt and immediate action.

Claims Procedure

1 In respect of claims payable under this policy, the Company may settle claims either in the
form of cashless treatment or by reimbursement of the claim amount to the Insured, at its
sole discretion. Cashless treatment facility cannot be demanded by the Insured as a
matter of right. The cashless facility will be provided only in respect of network providers.

2 In the event of an accident or sudden illness which is likely to give rise to a claim
under this Policy, the Insured Person or his/her representative shall immediately contact
the Emergency Assistance Service Provider giving details of the Policy issued to Insured
Person/ Policy Holder. The details of phone numbers and Help Line are given in the
Schedule attached to this Policy.

3 The first call will have to be made by the Insured Person or his/her representative giving his/
her contact number and subsequent calls will be made by the Service Provider at the
contact number given by the Insured Person.

4 The Insured Person or his representative shall provide to the Emergency Assistance Service
Provider maximum information about the illness, accident or occurrence as is available, as
well as other information such as the Policy number etc. Emergency Assistance Service
Provider shall assist the Insured Person in getting admitted in to a hospital / getting
treatment from a Medical Practitioner as an outpatient.

5 Where it is not possible to make an emergency call before consulting a Medical

Practitioner or going into hospital, the Insured Person shall contact the Emergency
Assistance Service Provider as soon as possible. In either case, when being admitted as a
patient, the Insured Person shall inform the Medical Practitioner or personnel at the
hospital, the details of his/her policy coverage

Policy Wordings: Group Domestic Traveller Insurance Policy

6 All necessary claimed documents should be furnished to the Company/ Emergency

Assistance Service Provider by the policy holder/insured to make a claim. However, claims
filed even beyond such period should be considered if there are valid reasons of any delay..

7 If proper intimation is given, the Emergency Assistance Service Provider shall give a benefit
guarantee (cash less in-patient hospitalisation as well as outpatient treatment) to the
hospital / other providers for the costs of hospitalization, transportation by emergency
services, emergency evacuation, transportation home, repatriation or transportation of mortal
remains and burial listed under Scope of Coverage under the Policy. These costs will be
settled directly by the Emergency Assistance Service Provider on behalf of and for the
account of the Company. The Insured Person shall release Medical Practitioners/hospital
contacted by Emergency Assistance Service Provider from their duty not to disclose
information about his/her case.

8 In such cases, the Insured Person before his discharge from the Hospital, shall fill up and
sign the claim form and hand over the same to the Hospital authorities to be handed over
to Emergency Assistance Service Provider. Please send the duly signed claim form along
with all the documents to designated TPA within 14 days of the occurrence of the Incident.
However, claims filed even beyond such period should be considered if there are valid
reasons of any delay.

9 Where no information is given to Emergency Assistance Service Provider and the

payment for hospital treatment / outpatient treatment has been made by the Insured Person,
the reasons therefore shall have to be given by the Insured / Insured Person along with the
claim form giving details of treatment and bills for expenditure to the Company OR
Emergency Assistance Service Provider. After examining the facts and establishing the
liability, in consultation and with the approval of the Company Emergency Assistance
Service Provider will reimburse to the Insured Person the costs incurred within the Scope
of Coverage of the Policy on behalf of and for the account of the Company.

10 With respect to Emergency evacuation or repatriation, the following services shall be

arranged by the Company through the Emergency Assistance Service Provider:

In the event of death of the Insured/Insured Person due to an insured event in terms of this
policy, arrangements for bringing transporting the mortal remains of the deceased back to
his/her usual place of residence in India or reimbursement of cost of local burial or
cremation in any part of India where the death occurred. An official death certificate and a
physician's statement giving the cause of death needs to be submitted.

11 Quick turnaround time shall be ensured in case the Emergency Assistance Service Provider
arranges the emergency evacuation. The Company shall review and monitor the
promptness and quality of the service, turnaround time and accessibility provided by the
Emergency Assistance Service Provider in the interest of the policyholder and shall take
due course of action based on the results of the review.

12 Claims, if any, for Total Loss of Checked Baggage, Personal Accident and Loss of
Passport will be settled in Indian Rupees in consultation and with approval of the
Company. In such cases, the claim form with details is to be submitted to the Company
OR Emergency Assistance Service Provider.

Policy Wordings: Group Domestic Traveller Insurance Policy

14 The total loss of checked baggage caused by a carrier (airlines) must be reported to the
Carriers (airlines) and a Property Irregularity Report (P.I.R) shall be obtained from them.
Original report together with the ticket(s), baggage tag(s) and the claim form are to be
submitted in support of a claim by the Insured Person to the Company OR Emergency
Assistance Service Provider.

15 A loss of passport must be reported to the police authorities within 24 hours of discovery of
such loss and an official report obtained from the Police authorities. The original official
report of the Police authorities should also be submitted along with the claim form to the
Company OR Emergency Assistance Service Provider

16 Failure to comply with the claims procedure stated above in respect of Total Loss of
Checked Baggage and Loss of Passport, may prejudice the claim of the Insured Person.

17 Claims for reimbursement shall be submitted to the Company OR Emergency Assistance

Service Provider within one month after completion of the treatment or transportation home.
In the event of accidental death, the same shall be submitted within one month after
transportation of mortal remains/burial.

18 The Insured and the Insured Person shall provide Emergency Assistance Service Provider /
the Company on demand with any information that is required to determine the
occurrence of the insured event or the scope of the Company's liability. In particular, at the
request of Emergency Assistance Service Provider / the Company proof shall be furnished
of the actual commencement of the trip.

19 If requested to do so by Emergency Assistance Service Provider / the Company, the

Insured Person and/or the Insured shall authorise Emergency Assistance Service Provider /
the Company to obtain all the information considered necessary from third parties (Medical
Practitioners, dentists, alternative practitioners, medical institutions of any kind, insurance
carriers, health or pension offices) and release these parties from their obligation not to
disclose information.

20 If requested to do so by Emergency Assistance Service Provider / the Company, the

Insured Person is obliged to undergo a medical examination by a Medical Practitioner
designated by Emergency Assistance Service Provider / the Company for the purpose of
settlement of claims only The costs towards any such medical examination shall be borne
by the Company.

21 In case of any claim under Personal Liability, Legal Expenses or Bail Bond proof of judicial
decision rendered by a Court of Law may be required.

22 In case of any accident giving rise to a claim under the Personal Accident section of the
Policy, the Insured/ Insured Person, his/her nominee or legal representatives, as the case
may be, shall provide complete information and details about the Insured Person in the claim
form along with the following documents to the Company or Emergency Assistance Service
Provider. Such a claim will be settled only in Indian rupees.

23 Upon receipt of all required documents, the offer of settlement will be made within 30 days.
Settlement (payment) of claim will be made within 7 days of receipt of acceptance in
response to offer of settlement, failing which penal interest (in compliance with applicable
regulations) at a

Policy Wordings: Group Domestic Traveller Insurance Policy

List of documents required for Claims processing:

i) In case of a disability claim
(1) Certificate from the Hospital and attending Medical Practitioner
(2) Discharge summary from the hospital explaining the disability
(3) Police report on the accident if any
(4) Hospital bills
ii) In case of a death claim
(1) Police report on the accident, if any
(2) Death Certificate
(3) Post Mortem report (if conducted)
iii) Certificate from Institution, in case of a burglary claim
(1) Duly completed claim form
(2) Copy of first information report/policy report.
(3) Copy of final investigator report/non-detectable certificate issued by the police authorities/magisterial
order.
(4) Letter of undertaking/subrogation form obtained from the insured.
iv) In case of baggage loss claim
(1) Duly completed claim form
(2) Copy of the complaint filed with airline authorities
(3) Property Irregularity Report/ Certificate from airline authorities that baggage has been lost
v) In case of baggage delay claim
(1) Duly completed claim form
(2) Copy of the complaint filed with airline authorities
(3) Property Irregularity Report/Certificate from airline authorities that baggage has been delayed from
more than the specified hours
(4) Vouchers/Bills for toiletries, medication and clothing
vi) Emergency Medical Emergency
(1) Claim form duly signed along with attending Medical Practitioner statement
(2) Discharge summary
(3) Hospital final bill
(4) Attending Surgeon’s/ Medical Practitioner’s Prescription advising hospitalization
(5) Surgery/consultation bills and receipts
(6) Operation theatre
(7) Medicines bill with prescriptions of Medical Practitioners
(8) Others if any
vii) Accidental Dental Treatment
(1) claim form duly signed along with attending Medical Practitioner statement
(2) Original documents of Medical Practitioner’s medical report, admission and discharge
cards, and prescriptions
(3) Original bills, vouchers, reports and payment receipts stating the details of the tooth treated
and the treatment performed
(4) Copy of X-ray, pathological and investigative reports
viii) Trip cancellation and interruption
[Link] reports and doctors statement if trip is cancelled or interrupted due to medical reasons.
2. Termination letter from the company if trip is cancelled due to employments.
3. If due to other events, police report confirming the incident shall be submitted.

Policy Wordings: Group Domestic Traveller Insurance Policy

The original ticket / boarding pass indicating the travel dates must be submitted with every claim,
along with the completed claim form.

Policy Wordings: Group Domestic Traveller Insurance Policy

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