Polacy

Digitally signed by Reliance
General Insurance
Company Limited
Date: 2024.05.12 20:47:11
Trejhara IST
RELIANCE TRAVEL CARE POLICY - FOR SCHENGEN

POLICY SCHEDULE
Reliance General Insurance
Policy Issuing Office : Policy Servicing Office Code 9202
RELIANCE GENERAL INSURANCE COMPANY LIMITED 6TH FLOOR, OBEROI 6TH FLOOR, OBEROI COMMERZ, OBEROI GARDEN CITY, OFF. WESTERN
COMMERZ, INTERNATIONAL BUSINESS PARK, OBEROI GARDEN CITY, OFF EXPRESS HIGHWAY, GOREGAON (EAST)MAHARASHTRA INDIA
WESTERN EXPRESS HIGHWAY, GOREGAON (EAST), MUMBAI – 400 063
Policy No : 920222428330013274 Intermediary Code : Direct
Tax Invoice No. & Date : R12052422545 & 12/05/2024
Proposer Details :
Communication Address & Place of Policy Issue
Name of the Proposer Date of Birth Occupation Contact No.
Supply Date and Time
Mr. DHAWAL INDERSINGH 30/12/1997 Others 1066 2 RANZUNZAR CHOWK 2024-05-12T00:
RAJPUROHIT GAONBHAG SANGLI 8793949099 00:00
MIRAJMAHARASHTRA,,SANGLI
MAHARASHTRA 416416
GSTIN / UIN of the Proposer :
Details of the Insured Person :
Insured Pre-Existing
Date of
Name of the Insured Person Relationship with Passport No illness/ injury/ Suffering Since Under Medication
Birth
the proposer condition if any
Mr. DHAWAL INDERSINGH 30-Dec-1997 Self U1789039 No NA No
RAJPUROHIT
Nominee Details
Nominee Name Date of Birth Nominee Relationship with Insured
ranjana Mother
Address of the Insured : 1066 2 RANZUNZAR CHOWK GAONBHAG SANGLI MIRAJ MAHARASHTRA .,,SANGLI MAHARASHTRA
416416
Email-ID : dhawalpurohit30@gmail.com Telephone No : Mobile No : 8793949099
Group corp ID :
Name of Countries to b
visited : Denmark, Germany
Policy Period : From 00:00 Hrs on 01-Jun-2024 To 30-Jun-2024 midnight or Date of return of Insured whichever is earlier
Name of the Plan Opted : Standard
Trip Type: Single
Coverage Sum Insured (In EUROS) Deductible (In EUROS)
Medical Expenses Including Transportation Evacuation 50000 50
And Repatriation Of Mortal Remains
Dental Treatment 500 50
Loss of Passport 300 25
Total Loss of Checked in baggage 500 NA
Delay of Checked In Baggage 100 12 Hours
Personal Accident 15000 NA
Accidental Death Common Carrier 2500 NA
Personal Liability 50000 NA
Compassionate visit Return Fare for any one accompanying NA
person - spouse / child / family doctor
Reliance General Insurance Company Limited. IRDAI Registration No. 103 An ISO 9001:2015 Certified Company
Registered & Corporate Office: Reliance General Insurance Company Limited 6th Floor, Oberoi Commerz, International Business Park, Oberoi Garden City, Off Western
Express Highway, Goregaon (East), Mumbai – 400 063
Corporate Identity No. U66603MH2000PLC128300. UIN: RELTIOP08002V010708. Trade logo displayed above belongs to Anil Dhirubhai Ambani Ventures Private Limited and
used by Reliance General Insurance Company Limited under. License RGI/MCOM/CO/Trave/PS/VER.1.0/010218
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Warranties/Conditions:
1 Warranted that insured is a citizen of India and has a permanent place of residence in India and is not a NRI or OCI
or foreign national and was within the territory of India at the time of issuance of the policy and before the
commencement of the trip
2 All pre existing illness/injury/Condition and its complications are excluded Under the Policy and shall not be covered
under any circumstances under this Policy.
3 Warranted that the trip is for the purpose of leisure or personal business not for any other purpose including
employment.
4 Warranted that any claim arising out of sporting activities in so far as they involve the training or participation in
competitions of professional or semiprofessional sports persons is excluded
5 Warranted that maximum amount payable per checked-in baggage in case more than one bag has been checked in,
is 50% (100% for only one checked-in baggage) of applicable Sum Insured and per item in baggage max 10%.
6 Medical/Hospitalization expenses due to COVID 19 Infection is covered if contracted during the travel as per policy
terms and conditions.
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Net Premium (` 924.00

CGST (@ 9.00% ) (` 83.16
SGST (@ 9.00% ) (` 83.16
Total Premium : (` 1,090.00
GSTIN : 27AABCR6747B1ZG , HSN :997142
As per the GST regulations, the amount of GST will not be refunded if the policy / endorsement is cancelled after 30th September of the next financial year.
Description of Services : Freight insurance services & Travel insurance services
Category-General Insurance Business Service 00440005
Note : In the event of dishonor of the cheque, this policy document automatically stands cancelled from inception, irrespective of whether a separate communication is sent
or not.
In witness whereof this policy has been signed at Mumbai on policy tax invoice date in lieu of Proposal No. as mentioned in the policy.
This document shall be treated as a Tax Invoice as per Rule 46 of the Central Goods and Services TaxRules 2017.
The policy wording with detailed terms, conditions and exclusions are available on our website www.reliancegeneral.com
Policy wordings link : https://www.reliancegeneral.co.in/Insurance/About-Us/Downloads.aspx)

You can also write to us at rgicl.services@relianceada.com or call us on 1800 3009 (toll free)/ 022 4890 3009 (Paid) to avail the policy wording.
In case of a renewal, the benefits provided under the policy and/or terms and conditions of the policy including premium rate may be subject to change
Grievance Clause : For resolution of any query or grievance, Insured may contact the respective branch office of the Company or may call at 02248903009 or may
write an email at rgicl.services@relianceada.com. In case the insured is not satisfied with the response of the office, insured may contact the
Nodal Grievance Officer of the Company at rgicl.grievances@relianceada.com. In the event of unsatisfactory response from the Nodal Grievance
Officer, insured may email to Head Grievance Officer at rgicl.headgrievances@relianceada.com. In the event of unsatisfactory response from the
Head Grievance Officer, he/she may, subject to vested jurisdiction, approach the Insurance Ombudsman for the redressal of grievance. Details of
the offices of the Insurance Ombudsman are available at IRDAI website www.irda.gov.in or on company website www.reliancegeneral.co.in or on
www.gbic.co.in. The insured may also contact the following office of the Insurance Ombudsman within whose territorial jurisdiction the branch or
office of the Company is located.
Office of the Insurance Ombudsman,3rd Floor,Jeevan Seva Annexe,S. V. Road,Santacruz (W), Mumbai - 400 054. Tel.: 022 - 26106552 / 26106960
Fax: 022 - 26106052 Email: bimalokpal.mumbai@cioins.co.in
For and on behalf of Reliance General Insurance Company Limited
Authorised Signatory
The policy has been issued based on the information provided by you / your representative and the policy is not valid if any of the information provided is incorrect or
incomplete.
Subject otherwise to the terms, conditions and exclusions of the Reliance Travel Care Policy
Medical Assistance & Emergency Services are implemented by our Service Providers-
EUROP ASSISTANCE INDIA PVT LTD.
7th Floor, Star Hub, Bldg No. 2,
Near ITC Maratha Hotel, Sahar,
Andheri East, Mumbai – 400 059, INDIA.
Are at your disposal for 24 hours during 365 days/year
In case of any requirement for emergency assistance whilst abroad, please contact the International Toll Free helpline numbers given below:
USA – 18337426673,Greece – 86002038017,Australia – 0011-80099441111,Canada -011-80099441111,Singapore and Thailand – 001-80099441111,
Japan – 001-010-80099441111 and 010-80099441111,Hong Kong – 001-80099441111 and 006-80099441111,
Israel – 00-80099441111 and 014-80099441111,Argentina, Austria, Belgium, China, Czech Republic, Denmark, France, Germany, Hungary, Italy, Malaysia,
Netherlands,
New Zealand, Norway, Philippines, Poland, Portugal, South Africa, Spain, Sweden, Switzerland, Taiwan & United Kingdom – 00-80099441111
Dedicated National Toll Free Help Line : 1800 209 5522 Land Line Numbers: +91 22 67347843 & +91 22 67347844
E-mail: reliance@europ-assistance.in Fax Number: +91 22 67347888
Website: www.europ-assistance.com
Consolidated Stamp duty Paid vide Letter of Authorisation “NO LOA/ENF-1/CSD/62/2024/(Validity Period Dt.01/03/2024 to Dt.01/12/2025)/1501 Date 28-02- 2024” at General
Stamp Office, Mumbai. ** Not Applicable for the State of Jammu & Kashmir
PLEASE NOTE:
·Attached with this Policy Schedule are the Policy Terms and Conditions, and Annexures. Please ensure that the Policyholder has received, read and understood all these
documents. If the Policyholder has not received any of these, pleaseemail/write to the Company at Rgicl.services@relianceada.com or contact us on 022 4890 3009 (Paid))
.The Benefits which are mentioned in this Schedule shall only be available under the Policy.
Intermediary Name & Code Direct Direct

Intermediary Contact No.:
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Reliance Travel Care Policy - Online Proposal Form with Proposal No R12052422545
Please find attached herewith Policy No. 920222428330013274 which has been issued based on the details furnished to us by Proposer / Insured Person:- Mr. DHAWAL
INDERSINGH RAJPUROHIT
Proposer Details :
Communication Address & Place of Policy Issue
Name of the Proposer Date of Birth Occupation Contact No.
Supply Date and Time
Mr. DHAWAL INDERSINGH 30/12/1997 Others 1066 2 RANZUNZAR CHOWK 2024-05-12T00:
RAJPUROHIT GAONBHAG SANGLI 8793949099 00:00
MIRAJMAHARASHTRA,,SANGLI
MAHARASHTRA 416416
GSTIN / UIN of the Proposer :
Nature Of Employment (Income Sources) : Salaried Self-Employed
Details of the Insured Person :
Pre-Existing
Date of
Relationship with Passport Suffering Under Professional
Name illness/ injury/
Birth
proposer No Since Medication Sports person
condition if any
Mr. DHAWAL INDERSINGH 30-Dec-1997 Self U1789039 No NA No No
RAJPUROHIT
Nominee Details
Nominee Name Date of Birth Nominee Relationship with Insured
ranjana Mother
Whether Resident of India : Yes

OCI No. Country of Permanent residence : India
Mailing Address : 1066 2 RANZUNZAR CHOWK GAONBHAG SANGLI MIRAJMAHARASHTRA,,SANGLI
MAHARASHTRA INDIA 416416
Address of residential property : 1066 2 RANZUNZAR CHOWK GAONBHAG SANGLI MIRAJMAHARASHTRA,,SANGLI
Insured MAHARASHTRA INDIA 416416
Telephone No. : Mobile No. : 8793949099
E-mail id : dhawalpurohit30@gmail.com
Visa Type : NA
Policy Period : From: 01-Jun-2024 To: 30-Jun-2024
Plan : Standard
Trip Type : Single
Purpose of Visit : Leisure or business
Please go through the details as furnished above and also as provided in the Policy Schedule and confirm that they are in order. Should you feel that there are any
discrepancies / variations, you are requested to write back to us immediately at Rgicl.services@relianceada.com for necessary changes / rectification. In the absence of
any written communication from you within 7 days or commencement of Policy Period whichever is earlier , it is hereby agreed and understood that the above statements,
answers and particulars are complete, correct and true in all respects and are the basis on which this Policy is being granted and that if, after insurance is effected, it is
found that the above statements, answers or particulars are incorrect or untrue in any respect, the policy will be considered Null and Void-ab-initio and the Company shall
have no liability under the policy
Declaration & Warranty on Behalf of All Persons Proposed to be Insured
I Policy has been issued basis Insured Person(s)
1) Is / are not travelling against advice of Medical Practitioner
2) Is / are not on Waiting list for any Medical treatment
3) Is / are not travelling for the purpose of obtaining Medical treatment
4) Have not received a terminal prognosis for a medical condition before Journey
5) Being in India before taking cover and commencement of Trip
6) Warranted that Declaration of any Pre existing Condition, using words / terms which mean any disease/illness which are same or similar to - Cancer / Leukemia /
Malignant Tumor, Cardiac ailments, COPD, HIV /AIDS, Insulin Dependent Diabetes, Kidney Ailment, Liver Disease, Neurological Disorder / Stroke / Paralysis, Thalasemia
will render this policy null and Void-ab-initio and the Company shall have no liability under the policy.
7) Being Indian Citizen
8) Purpose of visit either Leisure or Business
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II.I have read and understood the brochure, prospectus, sales literature & Policy wordings and confirm to abide by the same.
III.I understand that the information provided by me will form the basis of the insurance policy, is subject to the Board approved underwriting policy of the insurance
company and that the policy will come into force only after full receipt of the premium chargeable.
IV. I/We further declare that I/We will notify in writing any change occurring in the occupation or general health of the life to be insured / proposer after the proposal has
been submitted but before communication of the risk acceptance by the Company.
V.I/We declare and consent to the Company seeking medical information from any Doctor or from a hospital who at anytime has attended on the life to be insured /
proposer or from any past or present employer concerning anything which affects the physical or mental health of the life to be assured / proposer and seeking information
from any insurance company to which an application for insurance on the life to be assured / proposer has been made for the purpose of underwriting the proposal and / or
claim settlement.
VI. I/We authorize the company to share information pertaining to my proposal including the medical records for the sole purpose of proposal underwriting and/or claims
settlement and with any Governmental and / or Regulatory Authority.
VII. Receipt of the Proposal form by the Company shall not be construed as acceptance of proposal. I hereby agree that the insurance coverage shall commence only on
realization of full premium and on receipt of complete medical reports (wherever applicable) and subject to individual underwriting by the Company. The Company at its sole
discretion reserves the right to accept or reject or load any proposal without assigning any reason thereof.
VIII.I understand that the Policy shall become void at the Company's option, in the event of any untrue or incorrect statement, misrepresentation, non-description or
nondisclosure of any material fact in the Proposal form/personal statement, declaration and connected documents or any material information having been withheld by me or
anyone acting on my behalf.
IX.I hereby declare that the person(s) proposed to be insured would submit to medical examinations, before the nominated doctors of the Company, or undergo diagnostic
or other medical tests, as suggested by the Company for its underwriting.
X. I consent to provide a valid age proof and identity proof at the time of claims or any other time when required by the Company.
XI. I/We consent to receive information from the Company through physical, electronic or telecommunication means from time to time.
XII.I hereby declare on my behalf & on behalf of all persons proposed to be insured that the above statements, answers and/or particulars given by me in this proposal form
are true and complete in all respects to the best of my knowledge and that I/We am/are authorized to propose on behalf of these other persons.
XIII.I further declare that the premium is being paid from my credit/debit card/internet bank account.
AML GUIDELINES
1.I/we hereby confirm that all premiums have been/will be paid from bonafide sources and no premiums have been/will be paid out of proceeds of crime related to any of
the offence listed in Prevention of Money Laundering Act, 2002
2.I understand that the Company has the right to call for documents to establish sources of funds.
3.The insurance company has right to cancel the insurance contract in case I am/ have been found guilty by any competent court of law under any of the statutes, directly
or indirectly governing the prevention of money laundering in India.
Online Transaction Facility - Terms and Conditions:
I have read and understood the terms and conditions governing the Online Transaction Facility of Reliance General Insurance Company Ltd. I have also read and
understood the salient features, terms and conditions of the policy as stated in the Brochure.
IMPORTANT:
The information that you give to Reliance General Insurance Company Ltd in this online form will be treated as the proposal form and details in any supplemental
information form or documentation supplied by you or on behalf will influence our decision to offer insurance and the terms upon which to offer it. Further, any policy we
issue will be based on what you have told us. It is there for important that your answers are complete and accurate in all respects.
•The questions in this online form are indicative rather than exhaustive. You must provide us with all information relative to the risk to be insured, even if it is not the subject
of a question in this online form. If you are in any doubt as to what information should be given, please email us Rgicl.services@relianceada.com Any failure to provide us
with full and accurate material information may mean that your policy can be declared as void.
•No insurance cover will be in force until we have approved it and the premium has been paid.
Statutory Warning - PROHIBITION OF REBATES - Section 41 of the Inusurance Act,1938 as ammended by Insurance Laws(Ammendment) Act,2015.
•No person shall allow or offer to allow either directly or indirectly as an inducement to any person to take out or renew or continue an insurance in respect of any kind of
risk relating to lives or property, in India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy, nor shall any person
taking out or renewing or continuing a policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectuses or tables of the
insurer
•Any person making default in complying with the provisions of this section shall be liable for a penalty which may extend to ten lakh rupees.
PEP Declaration
Are you a Politically Exposed Person (PEP)? Yes No

If yes, please mention the position held
Is any of your close relation or family member a PEP? Yes No

If yes, please mention the name and relation and the position held by such close
relative/family member.
I hereby declare that in future if me, any of my close relatives or any of my family member attains a position of PEP then I shall confirm the same to Reliance General
Insurance Co. Ltd as a mandate. I understand that this is a crucial information under the PMLA Rules and AML/CFT Guidelines and shall confirm that the answers given by me
is true. In case the company comes to know that this is a misrepresentation and concealment of information then the policy shall be put on hold for scrutiny by the company
and I shall be solely responsible for the same.
Note :
“Politically Exposed Persons” (PEPs) are individuals who are or have been entrusted with prominent public functions in a foreign country, e.g., Heads of States/Governments,
senior politicians, senior government/judicial/military officers, senior executives of stateowned corporations, important political party officials, etc (As per sub clause (xii) of 3(b)
of Chapter I of Master Direction – Know Your Customer (KYC) Direction, 2016 issued by Reserve Bank of India (RBI).
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General Declaration
I understand that as per the new AML/CFT Guidelines issued Reliance General Insurance Co. Ltd will be verifying my details pertaining to KYC and PAN provided at the time of
proposal.
I further, do hereby agree and consent that in the case of the event of a mismatch of information provided by me in the proposal form, identification proof, and address proof at
the time of issuance of the policy. I request Reliance General Insurance Company Limited to issue the policy with the details appearing as per my proposal form. I will be solely
responsible for any consequences arising out of the difference in detail given by me during the verification of supporting documents provided by me at the time of issuance of
policy or otherwise.
I/We hereby declare, on my behalf and on behalf of all individuals proposed to be insured, that the aggregate premium for this insurance proposal, including all existing policies
issued by Reliance General Insurance Company Limited, has not exceeded Rs. 10,000/- per annum.
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CUSTOMER INFORMATION SHEET/KNOW YOUR POLICY
THIS DOCUMENT PROVIDES KEY INFORMATION ABOUT YOUR POLICY. YOU ARE ALSO ADVISED TO
GO THROUGH YOUR POLICY DOCUMENT.
POLICY
SI DESCRIPTION (PLEASE REFER TO APPLICABLE
TITLE CLAUSE
NO POLICY CLAUSE NUMBER IN NEXT COLUMN)
NUMBER
1 Name of Insurance
Travel Care-Schengen Plan
Product/Policy
2 Policy number 920222428330013274
3 Type of Insurance Indemnity (Where insured losses are covered upto
Product/Policy the Sum Insured under the policy)
4 Sum Insured (Basis) Cover type - Individual Sum Insured - EUROS
(Along with amount) 50000 (Where each member has a separate sum
insured under the policy)
5 Policy Coverage Medical Expenses Including Transportation Benefits 1
Evacuation And Repatriation Of Mortal Remains -
It covers, Reasonable And Customary Charges for
medical emergency inpatient and outpatient
treatment, diagnostic services, the extra costs of
Medically Necessary Treatment and evacuation to
India or the nearest Hospital, Transporting the
mortal remains back to the Republic of India or, up
to an equivalent amount, for a local burial or
cremation in the Destination Country where the
death occurred.
Dental Treatment - Covers expenses incurred on Benefits 2
acute anaesthetic treatment of a Healthy Natural
Tooth or Teeth during Policy Period and whilst
being overseas.
Loss of Passport - In the event that the passport Benefits 3
lost during the Trip, the actual expenses
necessarily and reasonably incurred in connection
with obtaining a duplicate or fresh passport will be
reimbursed.
Total Loss of Checked in baggage* - It covers Benefits 4
Insured Person for the total loss of checked-in
baggage on an Insured Trip.
Registered & Corporate Office: Reliance General Insurance Company Limited 6th Floor, Oberoi Commerz, International Business Park, Oberoi
Garden City, Off Western Express Highway, Goregaon (East), Mumbai – 400 063.
Corporate Identity No. U66603MH2000PLC128300.. UIN No.RELTIOP08002V010708. Trade Logo displayed above belongs to Anil Dhirubhai
Ambani Ventures Private Limited and used by Reliance General Insurance Company Limited under License.
RGI/MCOM/CO/Trave/PS/VER.1.0/010218.
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Delay Of Checked In Baggage - It covers the Benefits 5
expense of Necessary Personal Effects incurred
during the Insured Trip if the Insured's Checked-in
Baggage is delayed or misdirected by a Common
Carrier more than 12 hours from the actual arrival
time of the common carrier at the destination.
Personal Accident - This covers the Insured Benefits 6
Person or their legal heir, for any injury solely and
directly caused by accident whilst on the Insured
Trip, resulting in permanent disablement or death
within 365 continuous days of occurrence of such
injury.
Accidental Death Common Carrier - This Benefits 7
compensates the Insured / Insured Person or their
legal heir, for an accident occurring during the
Insured Trip and resulting in death while riding in or
on, boarding or alighting from any common carrier
as a fare-paying passenger within 365 continuous
days from the date of the accident, where the
accident was caused
Personal Liability - This indemnifies the Insured Benefits 8
Person in the event the Insured Person becomes
legally liable to a third party under the law
applicable in the jurisdiction / destination
mentioned as the Insured Trip for an incident which
results in death, injury or damage to the health of
such third party or damage to his/her properties.
Compassionate visit - If Insured Person is Benefits 9

hospitalized for more than seven (7) consecutive
days, the Company, after obtaining confirmation of
need for assistance of a companion from the
attending doctor and the Emergency Assistance
Service Provider, will provide A round trip economy
class air ticket and Expenses towards
accommodation.
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6 Exclusions (What the Policy Exclusions - Without prejudice to anything
policy does not cover) 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 disease or complications
thereof.
3. Treatment abroad if that is the sole reason or
one of the reasons for the Insured / Insured
Person`s temporary stay abroad.
4. Any claim if the Insured / Insured Person
a. is travelling against the advice of a physician;
b. s receiving, or is on a waiting list to receive,
specified medical treatment declared in the
physician`s report or certificate;
c. has received terminal prognosis for a medical
condition;
d. is taking part in a naval, military or air force
operation.
5. Deductibles as specified in the Schedule.
6. Any claim arising out of 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).
7. Any claim arising out of mental disorder, anxiety,
stress, depression, venereal disease or any loss,
directly or indirectly, attributable to HIV (Human
Immuno Deficiency Virus) and/or any HIV related
illness including AIDS (Acquired Immuno
Deficiency Syndrome) and / or any mutant derivative
or variations thereof howsoever caused.
8. Illness / injury that are results of war and war like
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..
9. Any act of terrorism which means an act,
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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 put the public, or any section of the public,
in fear.
10 Any claim arising from damage to any property
or any loss or expense whatsoever 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.
11. Any claim arising out of sporting activities in so
far as they involve the training or participation in
competitions of professional or semiprofessional
sports persons, unless declared beforehand and
necessary additional premium paid.
Specific Exclusions - As per policy wording and

prospectus
7 Waiting period Initial waiting Period - Delay of Checked In
Benefit-5
Baggage - 12 Hours
Specific Waiting periods (Not applicable for claims
arising due to an accident) - As per policy wording
and prospectus
Pre-existing diseases - Not Applicable
8 Financial limits of
Sub-limit - Not Applicable
coverage
Co-payment - Not Applicable
Deductible - a. Medical Expenses Including Benefit - 1

transportation, Evacuation and Repatriation of
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Mortal Remains - 50 Euros
Benefit - 2
- b. Dental Treatment - 50 Euros
Benefit - 3
- c. Loss of Passport - 25 Euros
Any other limit (as applicable) - As per policy

wording and prospectus
9 Claims/Claims
Details of procedure to be followed for cashless
Procedure
service as well as for reimbursement of claim
including pre and post hospitalization.
Turn Around Time (TAT) for claims settlements

i. TAT for preauthorization of cashless facility – 6
hours from receipt of complete documents.
ii. TAT for cashless final bill authorization – 4 hours
from receipt of complete documents.
iii. TAT for Reimbursement Claims – 7 to 10
workings days.
Provide the details / web link for following:
i. Network Hospital details- Not Applicable for
Overseas Travel Insurance.
a. In case of an emergency the customer in
overseas can visit the nearest hospital and avail
medical facility.
ii. Helpline number- National Toll-Free Number
(1800 209 5522) Paid Support Numbers
(91-22-67347843, 91-22-67347844)
iii. Hospitals which are blacklisted or from where no
claims will be accepted by insurer- Not Applicable
for Overseas Travel Insurance.
iv. Downloading/getting claim form- Reliance

General Insurance Website
10 Policy Servicing Any issues related with respect to policy, kindly
E-mail us at rgicl.services@relianceada.com and
for correspondence contact us Reliance General
Insurance Company Limited Correspondence
Address – Reliance General Insurance., Winway
Building 2nd & 3rd Floor, 11/12 Block No-4, Old
no-67, South Tukoganj, Indore (M.P) - 452001
Contact No.- 022- 41112600
Page 11 of 12
11 Grievances/Complaints a. Details of Grievance redressal officer refer the Grievance
link Clause
https://www.reliancegeneral.co.in/Insurance/About-
us/Grievance-Redressal.aspx
b.IRDAI Integrated Grievance Management System-
https://igms.irda.gov.in/
c. Insurance Ombudsman - The contact details of
the Insurance Ombudsman offices have been
provided under the link
https://www.reliancegeneral.co.in/Insurance/About-
us/Grievance-Redressal.aspx
12 Things to remember Free Look Cancellation: Not Applicable
Policy Renewal: Not Applicable
Migration and Portability: Not Applicable
Migration: Not Applicable
Change in Sum Insured: Not Applicable
Moratorium Period: Not Applicable
13 Your Obligations Please disclose all pre-existing disease/s or
condition/s before buying a policy. Non-disclosure
may affect the claim settlement. Disclosure of other
material information during the policy period.)
Insurer to specify the material information
The enclosed Customer Information Sheet bearing reference number CIS 920222428330013274
is essential part of your policy schedule, Kindly review it carefully.
Declaration by the Policy Holder:
I have read the above and confirm having noted the details.
Place:MIRAJ,MAHARASHTRA
Date :12-05-2024 (Signature of the Policyholder)
Note:
In case of any conflict, the terms and conditions mentioned in the policy document shall prevail.
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Digitally signed by Reliance

RELIANCE TRAVEL CARE POLICY - FOR SCHENGEN

Net Premium (` 924.00

Policy wordings link : https://www.reliancegeneral.co.in/Insurance/About-Us/Downloads.aspx)

For and on behalf of Reliance General Insurance Company Limited

Intermediary Name & Code Direct Direct

Whether Resident of India : Yes

Are you a Politically Exposed Person (PEP)? Yes No

Is any of your close relation or family member a PEP? Yes No

CUSTOMER INFORMATION SHEET/KNOW YOUR POLICY

Compassionate visit - If Insured Person is Benefits 9

Specific Exclusions - As per policy wording and

Co-payment - Not Applicable

Deductible - a. Medical Expenses Including Benefit - 1

Any other limit (as applicable) - As per policy

Turn Around Time (TAT) for claims settlements

iv. Downloading/getting claim form- Reliance

b.IRDAI Integrated Grievance Management System-

Declaration by the Policy Holder:

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