Easy Domestic Travel Insurance: Quick Reference Guide To Benefits Offered
Easy Domestic Travel Insurance: Quick Reference Guide To Benefits Offered
Easy Domestic Travel Insurance: Quick Reference Guide To Benefits Offered
10th Floor, Building No. 10, Tower B, DLF City Phase II, DLF Cyber City, Gurgaon-122002
Benefit
Coverage
Accident: Medical
Treatment, Assistance &
Evacuation
Reimbursement upto Rs 100,000 for Medical Treatment of any illness even if caused by Accident, unless necessitated to
maintain life and relieve pain.
expenses incurred for Hospitalization or outpatient treatment by an Insured Person due to Treatment which is not medically necessary
an accident during the risk period.
Dental treatment unless necessitate by an Accident
Reimbursement upto Rs. 7,500 for expenses Valuables, money, any kind of securities
incurred to purchase new similar quality items Any partial loss or not amounting to total loss
in an event of total loss of checked-in baggage Any claim not supported by a written confirmation from the competent airline
while travelling by a Carrier.
authority confirming baggage lost was checked in.
Maximum reimbursement for any one item
within one piece of baggage will be 10% of
the Sum Insured. If the Insured Person has
checked in more than one item of baggage,
then maximum reimbursement for all items
within one piece of baggage will be 50% of the
Sum Insured.
Delay of Checked-in
Baggage
Personal Liability
Indemnification upto Rs. 100,000 against Legal liability other than third party civil claim
actual legal liability (including defence costs) Transmission of an illness
to pay damages for negligence which results Deliberate, willful, malicious or unlawful act or omission
from a third party civil claim made for third
party death, bodily injury or property damage.
Lumpsum benefit upto Rs 500,000 hedging Bacterial infection other than (pyogenic infection which occurs due to
Accident )
against risk of permanent total disablement or
death of the Insured Person in an event of an Medical or surgical treatment except as an result of Accident
accident during risk period.
Flight delay
Reimbursement upto Rs.1,000 for expenses Any delay which is of less than continuous and completed 6 hours
incurred by the Insured Person for meals Any claim not supported by a written confirmation from the competent airline
and accommodation due to delay in flight for
authority confirming reason and duration of said delay.
a continuous and completed 6 hour period Voluntary suspension of services by Carrier
beyond its scheduled departure or scheduled
arrival time, provided that the delay is due to
severe weather conditions, strike or industrial
action of the airline employees and due to
unforeseen breakdown of Carriers equipment
Trip Cancellation
Reimbursement upto Rs. 15,000 for travel and Any charges that could have been avoided but were incurred because of any
delay in cancelling travel or accommodation.
accommodation expenses that the Insured
Person has paid and cannot recover, if Facts or matters of which was aware or ought to be aware which may result
outward journey is cancelled due to death or
in a cancellation while booking the ticket
Hospitalisation of Insured Person or Insured
Persons immediate family member
Trip Curtailment
Reimbursement upto Rs. 15,000 000 for travel Any charges that could have been avoided but were incurred because of any
delay in cancelling travel or accommodation.
and accommodation expenses that the Insured
Person has paid and cannot recover, if the trip Facts or matters of which was aware or ought to be aware which may result
is unavoidably curtailed during the Risk period
in a cancellation while booking the ticket
due to death or Hospitalisation of insured
Person or Insured Persons immediate family
member.
10th Floor, Building No. 10, Tower B, DLF City Phase II, DLF Cyber City, Gurgaon-122002
Benefit
Coverage
Emergency Travel
Reimbursement of return economy class airfare Hospitalisation less than 7 consecutive days
upto Rs. 10,000 for one immediate family Immediate family member does not reside in India
member in case of accidental hospitalization
of insured person for more than 7 consecutive
days
Emergency Hotel
Reimbursement upto Rs. 10,000 of costs Hospitalisation less than 7 consecutive days
for accommodation (boarding and lodging) Immediate family member does not reside in India
for an immediate family member in case of
accidental hospitalization of insured person for
more than 7 consecutive days.
Trip delay
Reimbursement upto Rs.500 for expenses Any delay which is of less than continuous and completed 6 hours
incurred by the Insured Person for meals Any claim not supported by a written confirmation from the competent airline
and accommodation due to delay in flight for
authority confirming reason and duration of said delay.
a continuous and completed 6 hour period Voluntary suspension of services by Carrier
beyond, provided that the delay is due to
severe weather conditions, strike or industrial
action of the airline employees and due to
unforeseen breakdown of Carriers equipment
This is a summary of benefits and exclusions, pl refer to policy terms and conditions for full description.
E-mail : customerservice@apollomunichinsurance.com
10th Floor, Building No. 10, Tower B, DLF City Phase II, DLF Cyber City, Gurgaon-122002
10th Floor, Building No. 10, Tower B, DLF City Phase II, DLF Cyber City, Gurgaon-122002
% of Sum Insured
Accidental death
100%
100%
50%
10th Floor, Building No. 10, Tower B, DLF City Phase II, DLF Cyber City, Gurgaon-122002
a) Facts or matters of which the Insured Person was aware or should have been
aware might result in a delay at the time the Insured Person booked his ticket.
b) Any delay arising from the order or action of any government, civil authority
or official government body.
c) Voluntary suspension of services by the Carrier.
Section 11. Trip Delay
If an Insured Persons journey on a Carrier or Scheduled Railway as a fare paying
passenger is delayed for a continuous and completed 6 hour period beyond its
scheduled departure or scheduled arrival time during the Risk Period because of
any of the reasons below, then We will reimburse up to the Trip Delay Sum Insured
for those expenses incurred by the Insured Person for meals and accommodation
provided that neither meals nor accommodation were offered by the Carrier or
Scheduled Railway or any other person without charge:
a) Delay of the Carrier due to any severe weather conditions.
b) Delay caused by strike or industrial action by the employees of the Carrier.
c) Delay caused by any sudden or unforeseen breakdown of the Carriers
equipment.
Special Condition to Section 11
a) The Insured Person must provide Us with written confirmation from the
Carrier or Scheduled Railway of the length and exact nature of the delay.
Special Exclusions to Section 11
We will not make any payment for any claim in respect of any Insured Person
directly or indirectly for, caused by, arising from or in any way attributable to:
a) Facts or matters of which the Insured Person was aware or should have
been aware might result in a delay at the time the Insured Person booked
his ticket.
b) Any delay arising from the order or action of any government, civil authority
or official government body.
c) Voluntary suspension of services by the Carrier.
GENERAL EXCLUSIONS:
We will not make any payment for any claim in respect of any Insured Person
directly or indirectly for, caused by, arising from or in any way attributable to any of
the following unless expressly stated to the contrary in this Policy:
a) War or any act of war, invasion, act of foreign enemy, war like operations
(whether war be declared or not or caused during service in the armed
forces of any country), civil war, public defence, rebellion, revolution,
insurrection, military or usurped acts, nuclear weapons/materials, chemical
or biological weapons, radiation of any kind.
b) Any Insured Persons participation or involvement in naval, military or
air force operation or professional or semi-professional sporting, racing,
diving, aviation, scuba diving, parachuting, hang-gliding, rock or mountain
climbing.
c) Arising or resulting from the insured person(s) committing any breach of law
with criminal intent, or intentional self injury , suicide or attempted suicide
while sane or insane.
d) The abuse or the consequences of the abuse of intoxicants or hallucinogenic
substances such as drugs and alcohol, including smoking cessation
programs and the treatment of nicotine addiction or any other substance
abuse treatment or services, or supplies.
e) The loss or destruction or damage to any property whatsoever or any loss
or expenses whatsoever resulting or arising therefrom or any consequential
loss directly or indirectly caused by or contributed to by or arising from:
i) Ionising radiation or contamination by radioactivity from any nuclear
waste from combustion of nuclear fuel; or
ii) The radioactive, toxic, explosive or other hazardous properties of any
explosion nuclear assembly or nuclear component, thereof
iii) Asbestosis or other related sickness or disease resulting from the
existence, production, handling, processing, manufacture, sale,
distribution of asbestos or other products thereof.
f) Obesity or morbid obesity or any weight control program, where obesity
means a condition in which the Body Mass Index (BMI) is above 29 & morbid
obesity means a condition where BMI is above 37.
g) Pregnancy (including voluntary termination), miscarriage (except as a result
of an Accident or Illness), maternity or birth (including caesarean section)
except in the case of ectopic pregnancy.
Then We will reimburse up to the Trip Curtailment Sum Insured, for those travel
and accommodation expenses that the Insured Person has paid and cannot
recover or for which no value can be derived or he is liable to pay.
Special Exclusions to Section 7
We will not make any payment for any claim in respect of any Insured Person
directly or indirectly for, caused by, arising from or in any way attributable to:
a) Childbirth, pregnancy or related medical complications.
b) Any charges that could have been avoided but were incurred because of any
delay in cancelling travel or accommodation.
c) Facts or matters of which the Insured Person was aware or should have been
aware might result in the curtailment of the trip.
d) The Hospitalisation of the Insured Person or the travelling Insured Persons
parent, spouse or child for due to depression or anxiety, mental, nervous or
emotional disorders, alcohol or drug abuse, addiction or overdose, elective,
cosmetic, or plastic surgery
e) Travel and accommodation expenses that the Insured Person has paid and
cannot recover or for which no value can be derived or he is liable to pay if
he paid or committed to such expenses when he knew or should have known
of the possibility of curtailment.
Section 8. E mergency Travel
If We have accepted a claim under Section 1-1) and the Accident suffered by the
Insured Person necessitates his Hospitalisation for more than 7 consecutive days,
We will reimburse the actual cost of an economy return airfare for one Immediate
Family Member to travel to the Insured Persons place of Hospitalisation subject to
the Emergency Travel Sum Insured, provided that:
a) The Immediate Family Member resides in India, and
b) The Insured Person was travelling alone.
Section 9. E mergency Hotel
If We have accepted a claim under Section 1-1) and the Accident suffered by the
Insured Person necessitates his Hospitalisation for more than 7 consecutive days,
We will reimburse the reasonable costs of accommodation (boarding and lodging),
of the Immediate Family Member subject to the Emergency Hotel Sum Insured,
provided that
a) The Immediate Family Member resides in India, and
b) The Insured Person was travelling alone.
Section 10. F light Delay
If an Insured Persons journey on a Carrier as a fare paying passenger is delayed
for a continuous and completed 6 hour period beyond its scheduled departure or
scheduled arrival time during the Risk Period because of any of the reasons below,
then We will reimburse up to the Flight Delay Sum Insured for those expenses incurred
by the Insured Person for meals and accommodation provided that neither meals nor
accommodation were offered by the Carrier or any other person without charge:
a) Delay of the Carrier due to any severe weather conditions.
b) Delay caused by strike or industrial action by the employees of the Carrier.
c) Delay caused by any sudden or unforeseen breakdown of the Carriers
equipment.
Special Condition to Section 10
a) The Insured Person must provide Us with written confirmation from the
Carrier of the length and exact nature of the delay.
Special Exclusions to Section 10
We will not make any payment for any claim in respect of any Insured Person
directly or indirectly for, caused by, arising from or in any way attributable to:
10th Floor, Building No. 10, Tower B, DLF City Phase II, DLF Cyber City, Gurgaon-122002
GENERAL CONDITIONS:
a) Conditions Precedent
The fulfilment of the terms and conditions of this Policy (including the
payment of premium by the due dates mentioned in the Schedule) insofar
as they relate to anything to be done or complied with by You or any Insured
Person shall be conditions precedent to Our liability.
b) Insured Person
Only those persons to whom a Certificate of Insurance has been issued shall
be covered under this Policy. Any person may be accepted as an Insured
Person during the Policy Period only after his application has been accepted
by Us, additional premium has been paid and We have issued a Certificate
of Insurance to such person.
c) Notification of Claim
1) If any treatment, consultation or procedure for which a claim may be made
is required in an emergency, then We or Our Assistance Company must be
informed within 7 days of the beginning of such treatment, consultation or
procedure.
2) In all other cases, We or Our Assistance Company must be informed of any
event or occurrence that may give rise to a claim under this Policy within 7
days of the occurrence of the event giving rise to the claim.
10th Floor, Building No. 10, Tower B, DLF City Phase II, DLF Cyber City, Gurgaon-122002
Refund of premium
Upto 1 Month
75.00%
Upto 3 Months
50.00%
Upto 6 Months
25.00%
Exceeding 6 Months
0%
2) We are under no obligation to give notice that the Policy is due for renewal,
or to renew it or to renew it on the same terms whether as to premium or
otherwise. We shall be entitled to call for and receive any information or
documentation before agreeing to renew the Policy, and in renewing We are
not bound to renew for all Insured Persons.
3) The Certificate of Insurance will terminate no later than the expiry date
mentioned therein or the end of the Risk Period (whichever is earlier). No
renewal or extension of the Certificate of Insurance will be permitted. After
the commencement of the Risk Period, the amount paid for the Certificate of
Insurance will be non-refundable.
DEFINITIONS
The terms defined below have the meanings ascribed to them wherever they
appear in this Policy and, where appropriate, references to the singular include
references to the plural; references to the male include the female and references
to any statutory enactment include subsequent changes to the same.
a) Accident or Accidental means a sudden, unforeseen and unexpected
event caused by external, violent and visible means (but does not include
any Illness) which results in physical bodily injury during the Risk Period.
b) Accumulation Limit means the amount stated in the Schedule which
represents Our maximum liability for all claims under any and all benefits
from all Insured Persons arising from the same Accident, event or occurrence
or series of related Accidents, events or occurrences, and if at any time
the total value of unpaid claims would, if paid, result in the Accumulation
Limit being exceeded (even if the Sum Insured is not) the individual benefits
attributable to those outstanding claims shall be reduced pro rata as
necessary to ensure that the Accumulation Limit is not exceeded.
c) Age or Aged means completed years as at the commencement date.
d) Carrier means a civilian air carrier :
1) which is operating under a valid licence issued by the appropriate
Indian governmental authority for the transportation of passengers
within India by air for a fee, and
2) which maintains and publishes tariffs for regular passenger air services
which it operates between named cities at regular and specified times.
e) Certificate of Insurance means the certificate We issue to an Insured
Person. The Certificate of Insurance can only be issued prior to the
commencement of the Risk Period.
f) Deductible means, in respect of each and every claim, the amount stated
in the Schedule which will first be paid by each Insured Person or apply for
the period of time stated in the Schedule.
g) Medical Practitioner means a person who holds a qualification in
medicine from a recognised institution and is registered and licensed
by a state council, governed by the Medical Council of India, in which he
operates and is practicing within the scope of such license and will include
(but is not limited to) physicians, specialists and surgeons who satisfy the
aforementioned criteria.
h) Hospitalisation or Hospitalised means the Insured Persons admission
into a Hospital for medically necessary treatment as an inpatient for a
continuous period of at least 24 hours following an Accident occurring
during the Risk Period.
i) Hospital means any institution in India (including nursing homes)
established for medical treatment which:
Either:
has been registered and licensed as a hospital with the appropriate local or
other authorities competent to register hospitals in the relevant area and is
under the constant supervision of a Medical Practitioner and is not, except
incidentally, a clinic, rest home, or convalescent home for the addicted,
detoxification centre, sanatorium, home for the aged, mentally disturbed,
remodelling clinic or similar institution.
Or:
(i) is under the constant supervision of a Medical Practitioner, and
(ii) has fully qualified nursing staff (that hold a certificate issued by
a recognised nursing council) under its employment in constant
attendance , and
(iii) maintains daily records of each of its patients, and
2) We may terminate this Policy without assigning any reason upon 30 days
notice by sending an endorsement to Your address shown in the Schedule,
and We shall refund a rateable proportion of the premium as long as no
claim has been made under the Policy. If the Policy is cancelled, then each
Certificate of Insurance which is already in force under the Policy will
continue in force until the end of the Risk Period.
3) The amount paid for any Certificate of Insurance will be non-refundable.
n) Renewal
1) This Policy will terminate no later than the expiry date of the Policy Period
unless we have agreed in writing to an extension of the Policy Period and
Our conditions for agreeing to the extension, including as to the payment of
additional premium, have been met.
10th Floor, Building No. 10, Tower B, DLF City Phase II, DLF Cyber City, Gurgaon-122002
liability for each Insured Person for any and all claims made during the
Policy Period under that Section.
w) Surgical Procedure means an operative procedure for the correction
of deformities and defects, repair of injuries, cure of diseases, relief of
suffering and prolongation of life.
x) Assistance Company means the service provider that We appoint from
time to time as specified in the Schedule.
y) Valuables means photographic, audio, video, computer (including personal
data assistants or handheld computers), telecommunications, electronic
and electrical equipment, cellular phones, data recorded on tapes, cards,
discs or otherwise, business goods or samples, securities such as credit
cards, debit cards, membership cards, tickets or documents, musical
instruments, telescopes, binoculars, spectacles, contact or corneal lenses,
artificial teeth, bridges or prosthetic limbs, hearing aids, sunglasses, snow
skis, motor vehicles (including accessories), motorcycles, boats, motors,
any conveyance (except bicycles while checked as baggage with a Carrier),
household effects, antiques, watches, art, jewellery, furs and any articles
made of precious stones and metals.
z) We/Our/Us means the Apollo Munich Health Insurance Company Limited.
aa) You/Your or Policyholder means the person named in the Schedule who
has concluded this Policy with Us.
Schedule of Benefits
Benefits
Sum Insured
Deductible
Rs. 100,000
Nil
Rs. 100,000
Nil
Nil
Rs. 7,500
Nil
Rs. 1,000
12 Hrs.
Rs. 100,000
Nil
Rs. 500,000
Nil
Rs. 15,000
Nil
Rs. 15,000
Nil
Rs. 10,000
Nil
Rs. 10,000
10%
Rs. 1,000
Nil
Rs. 500
Nil
10th Floor, Building No. 10, Tower B, DLF City Phase II, DLF Cyber City, Gurgaon-122002
Jurisdiction
Office Address
Gujarat, UT of
Dadra & Nagar
Haveli, Daman and
Diu
Insurance Ombudsman,
Office of the Insurance Ombudsman, Janak Vihar
Complex, 2nd Floor, 6, Malviya Nagar, Opp. Airtel, Near
New Market, BHOPAL(M.P.)-462 023.
Tel.:- 0755-2569201 Fax : 0755-2769203
Email: bimalokpalbhopal@airtelmail.in
Orissa
Punjab, Haryana,
Himachal Pradesh,
Jammu & Kashmir,
UT of Chandigarh
Insurance Ombudsman,
Office of the Insurance Ombudsman,
Fathima Akhtar Court, 4th Floor, 453 (old 312), Anna
Salai, Teynampet, CHENNAI-600 018.
Tel.:- 044-24333668 /5284 Fax : 044-24333664
Email: chennaiinsuranceombudsman@gmail.com
Assam, Meghalaya,
Manipur, Mizoram,
Arunachal Pradesh,
Nagaland and
Tripura
E-mail : customerservice@apollomunichinsurance.com
Jurisdiction
Office Address
Andhra Pradesh,
Karnataka and
UT of Yanam - a
part of the UT of
Pondicherry
Kerala, UT of (a)
Lakshadweep, (b)
Mahe - a part of UT
of Pondicherry
Maharashtra , Goa
Insurance Ombudsman,
Office of the Insurance Ombudsman, S.V. Road,
Santacruz(W), MUMBAI-400 054.
Tel : 022-26106928 Fax : 022-26106052
Email: ombudsmanmumbai@gmail.com
AMHI/PR/H/0012/0008C/102010/P
You may also approach the grievance cell at any of Our branches with the details
of Your grievance during Our working hours from Monday to Friday.
If You are not satisfied with Our redressal of Your grievance through one of
the above methods, You may contact Our Head of Customer Service at The
Grievance Cell, Apollo Munich Health Insurance Company Ltd., Tenth Floor,
Building No. 10, Tower - B, DLF Cyber City, DLF City Phase II, Gurgaon,
Haryana - 122002
If You are not satisfied with Our redressal of Your grievance through one of
the above methods, You may approach the nearest Insurance Ombudsman for
resolution of Your grievance. The contact details of Ombudsman offices are
mentioned below.
Ombudsman Offices
10th Floor, Building No. 10, Tower B, DLF City Phase II, DLF Cyber City, Gurgaon-122002
Benefit
Accident: Medical
Treatment, Assistance &
Evacuation
Apollo Munich Health Insurance Company Limited will provide the insurance cover detailed in the master Policy
Signed claim form
Medical reports and discharge summary issued by the Hospital or prescriptions and medical report from the Medical
Practitioner furnishing the name of the Insured, period of treatment and details of treatment rendered.
Bills / receipts for
a. Charges paid towards Hospital accommodation, nursing facilities and other medical services rendered;
b. Fees paid to the medical practitioner, special nursing charges, etc.
c. Charges incurred towards any and all test and / or examinations rendered in connection with the treatment.
d. Charges incurred towards medicines or drugs purchased from a registered pharmacy other than the Hospital duly
supported by the prescriptions of the Medical Practitioner attending to the Insured.
Address proof
Delay of Checked-in
Baggage
Personal Liability
Flight delay
Trip Cancellation
10th Floor, Building No. 10, Tower B, DLF City Phase II, DLF Cyber City, Gurgaon-122002
Benefit
Trip Curtailment
Emergency Travel
Address proof
Attested copy of Discharge Summary
Original Invoice, Receipts and Boarding pass along with copy of Air tickets
Signed claim form
Emergency Hotel
Trip delay
This is a summary of benefits and exclusions, pl refer to policy terms and conditions for full description.
E-mail : customerservice@apollomunichinsurance.com