PolicySoftCopy_747067404

Date:15 Dec 2024
Policy Number: 10000000155602

Amandeep Kaur
VPO KUKRAN, Hoshiarpur, Punjab, India, 144528
Subject : Niva Bupa Travel Insurance Policy No.10000000155602
Dear Amandeep Kaur
Thank you for choosing Niva Bupa as your preferred travel insurance partner. At Niva Bupa, we
put your health first and are committed to provide you access to the very best of healthcare,
backed by the highest standards of service.
Please find enclosed your Niva Bupa Policy kit which will help you understand your policy in detail
and give you more information on how to access our services easily. Your Policy kit includes the
following:
· Policy Schedule: Confirming your specific policy details like date of commencement, persons
covered and specific conditions related to your plan.
· Premium Receipt: Receipt issued for the premium paid by you.
· Policy Terms and Conditions:For a clear understanding of policy coverage’s and exclusions.
· Proposal Form:This is a copy of the proposal form as per the information provided by you. Do
inform us immediately in case there is any change in the details mentioned therein.
· Annexure of Policyholder Servicing Turnaround Times as prescribed by Insurance
Regulatory and Development Authority (IRDA)
Do visit us online at www.nivabupa.com to view and download claim forms and for other useful
information. You can register with us online using your policy number, date of birth & email id
and access your policy details. In case of any further assistance, call us at 1860-500-8888
(customer helpline number) or email us at nivabupa@europ-assistance.in
We request you to read your policy terms and conditions carefully so that you are fully aware of
your policy benefits. For benefits related to section 80D, please consult your tax advisor.
Assuring you of our best services and wishing you and your loved ones good health always.
Yours Sincerely,
Director - Operations & Customer Service

For and on behalf of Niva Bupa Health Insurance Co. Ltd.
(Formerly known as Max Bupa Health Insurance Co. Ltd.)
Important - Please read this document and keep in a safe place.

Policyholder Servicing Turnaround Times as prescribed by Insurance Regulatory and Development
Authority of India (IRDAI)
Turnaround Time*
(Calendar Days)
Processing Of Proposal And Communication Of Decisions –
7 Days
From The Date Of Receipt Of Proposal Form
Providing Copy Of The Proposal – From The Date Of
15 Days
Acceptance Of Risk
POLICY Post Policy Issue Service Requests – From The Date Of
7 Days
SERVICING Receipt Of Service Request
Proposal Refund In Case Of Cancellation – From The Date
7 Days
Of Decision Of The Proposal
Request For Policy Cancellation With Free-Look Period–
7 Days
From The Date Of Receipt Of Service Request
CLAIM Settlement Of Claims - From The Date Of Submission Of
15 Days
SERVICING Claim
Acknowledge A Grievance – From The Date Of Receipt Of
Immediately
GRIEVANCE Grievance
HANDLING Resolve A Grievance– From The Date Of Receipt Of
14 Days
Grievance
*Turnaround time will start from the date of receipt of complete documents at Niva Bupa Health
Insurance Company Ltd.
TravelAssure- Policy Schedule
Policyholder Details:
Name Amandeep Kaur
VPO KUKRAN, Hoshiarpur, Punjab, India,
Address
144528
Policy Details:
Policy Number 10000000155602
Policy Start Date 16 Dec 2024
Policy End Date 20 Dec 2024
Plan SingleTrip
Policy Tenure 5 Days
Geographical Coverage WorldWide Excl USA-Canada
Renewal Due Date NA
Electronic Insurance Account (eIA) Details:

EIA Number None
Insurance Repository Name None
InsuredDetails:
Date of Birth/ Relationship Base Sum
Name Gender Passport No
Age to Proposer* Insured ($)
Amandeep
19 Sep 99,25 Female Self 50,000 U7627594
Kaur
*Relationship of all insured members is with respect to the first insured member.
Nominee Details:
Name Charanjeet Singh
Relationship Father
Claim Administrator Servicing Branch Details

Niva Bupa Health Insurance Company
Limited.
Contact Details For Registering Claim:
Europ Assistance
24*7 Emergency Contact For +91 22 6787
Logix Infotech Park , Plot No D-5, Sector 59,
2092
Noida, Gautam Budh Nagar, Uttar Pradesh
Email Address : nivabupa@europ-
201301
assistance.in
Niva Bupa Health Insurance
Contact No: 1860-500-8888; Fax No.: 011-
30902010
Email ID: nivabupa@europ-assistance.in
Pursuant to Notification no 13/2020- Central Tax and Notification no 14/2020- Central Tax
both dated 21st March 2020 read with rule 54 (2) of CGST Rules 2017, the provisions of E
Invoicing& QR code are not applicable to an Insurance company, hence E Invoice number and
QR code has not been printed on this document. GST under RCM: NIL
Policy issuing office: D-5, Second Floor, Sector-59, Noida, Gautam Budh Nagar, Uttar Pradesh-
201307.
Consolidated Stamp Duty deposited as per the order of Government of National Capital
Territory of Delhi
Niva Bupa GST No.: SAC Code / Type Of Service : 997136 / Travel Insurance
09AAFCM7916H1Z6 Services
Niva Bupa State Code: 09 Customer State Code / Customer GSTI No.: 3/NIL
Location: Noida Director - Operations & Customer Service
Date: 15 Dec 2024 For and on behalf of Niva Bupa Health Insurance Company
Limited
Intermediary Details
Intermediary Contact
Intermediary Name Intermediary Code
No.
Policybazaar Insurance
WEB0030001 18002088787
Brokers Private Limited
Product Benefit Table

Benefit Deductible/ Time Excess Sum Insured
Repatriation of Mortal
- $50,000
Remains
Trip Cancellation - $1,000
Dental Treatment $100 $300
Hospital Daily Cash 2 Day(s) $20 Per Day
Loss of Checked-in Baggage $50 $500

Medical Evacuation - $50,000
Personal Accident - $15,000
Trip Delay 4 Hour(s) $25 Per 4 Hour
Emergency Ambulance $50 $25,000
Emergency In-patient medical

$100 $50,000
treatment
Hijack Daily Allowance - $100 Per Day
Loss of International Driving

- $100
license
Loss of Laptop, Tablet, Mobile

$50 $100
Phone, Camera
Loss of Passport - $300
Note: In case of life threatening medical condition we will cover pre-existing conditions up to
5% of "emergency in-patient medical treatment" sum insured and maximum up to $2500.
"COVID related hospitalization is covered in the policy"
TravelAssure- Premium Receipt
Amandeep Kaur
VPO KUKRAN, Hoshiarpur, Punjab, India, 144528
We acknowledge the receipt of payment towards the premium of the following Travel
insurance policy:
Policyholder Name Amandeep Kaur Policy No 10000000155602
Policy Start Date 16 Dec 2024 Policy End Date 20 Dec 2024
Product Name TravelAssure SingleTrip Base Sum Insured $ 50,000
Premium Calculation:
(A) Premium (Rs.) - Base Product 350

(B) Premium (Rs.) – Optional Benefits 0
(C) Risk Loading (Rs.) 0
(D) Total Discount (Rs.) 0
(E) Net Premium / Taxable Value (Rs.) 350
(F) Integrated Goods And Service Tax (18.00 %) 63
(G) Central Goods And Service Tax (9.00 %) 0
(H) State/UT Goods And Service Tax (9.00 %) 0
Gross Premium (Rs.) 413
Four Hundred And
Gross Premium (In Words)
Thirteen Rupees Only
Issuance of policy is subject to clearance of premium paid
Details Of Person Insured

Name Age (In Years) Gender Relationship To Proposer*
Amandeep Kaur 25 Female Self
Upon issuance of this receipt, all previously issued temporary receipts, if any, related to this
policy are considered null and void.
For the purpose of deduction under section 80D, the benefit shall be as per the provisions of
the Income Tax Act,1961 and any amendments made thereafter.
For more details kindly consult your tax advisor. In the event of non-realization of premium,
tax benefits cannot be obtained against this premium receipt.
Policy issuing office: Delhi, Consolidated Stamp Duty deposited as per the order of
Government of National Capital Territory of Delhi.
SAC Code / Type Of Service : 997136 / Travel

Niva Bupa GST No.: 09AAFCM7916H1Z6
Insurance Services
Niva Bupa State Code: 09 Customer State Code / Customer GSTI No.: 3/NIL
In the absence of Customer GST number receipt, Niva Bupa Health Insurance Co. Ltd. will
treat all customers as unregistered with GSTN. The customer will not get GST input credit on
GST paid on this policy. Customer GST number cannot be updated after policy issuance.
Location: Noida Director - Operations & Customer Service

For and on behalf of Niva Bupa Health Insurance Company
Date:15 Dec 2024 Limited
CUSTOMER INFORMATION SHEET
POLICY CLAUSE
S. No. TITLE DESCRIPTION
NUMBER
1. Product Name TravelAssure
2. What am I covered Base Coverage:

for: Ÿ Emergency Inpatient medical treatment- Coverage for inpatient hospitalization due to an accident or illness. 3.1
Ÿ Maternity- We will pay the expenses incurred by you on treatment if you were admitted in a hospital in the course of your 3.2
pregnancy. This cover is available only for people who are traveling overseas on student visa for full time college or
school education with policy term equal to or more than 12 months.
Ÿ New born baby cover- Emergency inpatient medical treatment and vaccination expenses of new born baby will be 3.3
covered as per "Emergency inpatient medical treatment" benefit of this policy. This cover is available only for people
who are traveling overseas on student visa for full time college or school education with policy term equal to or more
than 12 months.
Optional Coverage:
Ÿ Emergency Outpatient treatment- Coverage for outpatient treatment due to an accident or illness. 3.4.1
Ÿ Emergency ambulance- Coverage of ambulance cost for transportation of insured. 3.4.2
Ÿ Hospital daily cash- Daily benefit in case of hospitalization of insured. 3.4.3
Ÿ Dental treatment- Coverage of medical expenses for pain relieving dental treatment received by the Insured Person 3.4.4
Ÿ Medical evacuation- Reimbursement of the cost of the transportation of the Insured Person from a Hospital to the 3.4.5
nearest facility which is prepared to admit the Insured Person.
Ÿ Extension to in-patient care- Coverage if insured person is hospitalized during trip due to an accident or illness and 3.4.6
wants to get back to country or residence for continued treatment
Ÿ Personal accident- Coverage for accidental death, permanent total disability or permanent partial disability due to an 3.4.7
accident
Ÿ Accidental Death and Disability (Common Carrier)- Coverage for accidental death, permanent total disability or 3.4.8
permanent partial disability due to an accident while travelling in a common carrier
Ÿ Repatriation of mortal remains- Coverage of cost of either transporting insured person's mortal remains from the 3.4.9
foreign country to permanent place of residence or a cremation or burial ceremony in the foreign country.
Ÿ Total Loss of checked-in baggage- Coverage for loss of accompanying checked in baggage of Insured Person 3.4.10
Ÿ Delay of checked-in baggage- Payment for purchasing essential personal items in case checked-in baggage's delivery 3.4.11
is delayed by a Carrier
Ÿ Trip Delay- We will pay a fixed amount for each block of 4 hour delay up to the limits as specified in the policy schedule, if 3.4.12
your common carrier's actual departure time is delayed for more than 4 hours from the scheduled departure time
Ÿ Trip cancellation- Coverage for financial loss incurred due to cancellation of trip before its onset 3.4.13
Ÿ Trip interruption- Coverage for financial loss incurred due to in between abandonment of trip 3.4.14
Ÿ Loss of passport- Reimbursement of expenses for obtaining duplicate or fresh passport 3.4.15
Ÿ Loss of International Driving license- Reimbursement of expenses for obtaining duplicate or fresh international driving 3.4.16
license
Ÿ Missed connection- reimbursement for travel cost if you missed a pre-booked onward connection as a direct result of 3.4.17
the scheduled common carrier not running on its published timetable
Ÿ Financial emergency Cash- lump sum amount as stated in policy schedule in case travel funds are lost due to theft, 3.4.18
robbery or dacoity
Ÿ Personal liability- payment towards third party death, bodily injury or property damage 3.4.19
Ÿ Hijack daily allowance- fixed daily amount payable if the aircraft is hijacked 3.4.20
Ÿ Loss of Laptop, Tablet, Mobile Phone, Camera- Coverage in the case of robbery, theft or if the items were stolen 3.4.21
Ÿ Bounced Booking- Hotel/ Common Carrier- Reimbursement in case accommodation provider/ common carrier is 3.4.22
unable to honor your confirmed bookings
Ÿ Compassionate Visit- Reimbursement of accommodation (boarding and lodging)/ economy class transportation cost 3.4.23
for an immediate family member in case of hospitalization of insured person for more than 5 consecutive days
Ÿ Escort of minor child- Reimbursement of return economy class airfare and accommodation only for one immediate 3.4.24
family member to travel to insured person location of hospitalization and escort minor child back home in case of
hospitalization of insured person for more than 48 consecutive hours
Ÿ Adventure sports- Coverage for permanent total disablement or death of the Insured Person in an event of an accident 3.4.25
during risk period while engaged in adventure sports in a non-professional capacity
Ÿ Sports equipment hire- We will pay for sports equipment in case your equipment is lost in travel or your equipment is 3.4.26
delayed by 12 hours
Ÿ Rented sports equipment damage or loss- We will cover for the penalty/ fine charged to insured member on account of 3.4.27
damaging or losing the sports equipment rented out on the name of insured member
Ÿ Sports activity coverage- We will pay for the unused portion of the already paid sports activity if insured member fell 3.4.28
sick or hospitalized or had to cut short their trip
Product Name: TravelAssure | Product UIN: NBHTIOP22148V012122

Ÿ Loan protector- We will pay balance principal loan amount in case of death on insured person due to an accident during 3.4.29
policy period
Ÿ Emergency trip extension- We will pay for extended period of stay and economy class return fare in case trip is 3.4.30
extended beyond scheduled dates due to reason mentioned in policy wording
Ÿ Upgradation to business class- We will pay for the cost to upgrade the return ticket of insured member to business class 3.4.31
after insured member's hospitalization of 5 or more continuous days
Ÿ Study interruption- We will reimburse actual expenses on Tuition fee already paid to the educational institution in case 3.4.32
student is not able to continue his/her studies due to hospitalisation for more than 30 consecutive days
Ÿ Sponsor protection- We will pay for unpaid part of Tuition fee in case of death or disablement of the insured's sponsor 3.4.33
Ÿ Cancer screening and mammography examinations- We will reimburse the expenses for cancer screening and 3.4.34
mammography examinations of the Insured Person during the Risk Period
Ÿ Bail bond- we will pay for bail bond costs if insured person is falsely arrested or wrongfully detained by any government 3.4.35
or foreign authority during the Risk Period
Ÿ Waiver of deductible- We will waive off deductibles applicable under each cover of this policy. 3.4.36
Ÿ Optional co-payment- we will apply co-payment to applicable claims if this benefit is chosen by customer 3.4.37
Ÿ Refund of visa- We will pay for re-imbursement of Visa fee if your Visa got rejected for no fault or negligence 3.4.38
Ÿ Home to home cover- We will extend the Coverage for 6 hours before /beyond the Period of Insurance for In-Patient 3.4.39
treatment, Out-Patient and Personal Accident
Ÿ Colleague replacement- If an Insured Person suffers an Illness or Accident during the Risk Period as result of which he is 3.4.40
Hospitalised then We will reimburse the cost of an economy class return air fare to send a substitute person to complete
the business purpose for which the Insured Person was travelling
Ÿ Complete pre-existing disease cover - Pre-existing diseases will be covered up to sum insured of "emergency inpatient 3.4.41
medical treatment" after opting this cover
3. What are the 1. Treatment for any Injury or Illness resulting directly or indirectly from nuclear, radiological emissions, war or war like 4
major exclusions situations (whether war is declared or not), rebellion (act of armed resistance to an established government or leader),
in the policy acts of terrorism
2. Your participation in any naval, military or air force operations whether in the form of military exercises or war games or
actual engagement with the enemy, whether foreign or domestic.
3. Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to
commit a breach of law with criminal intent (Code-Excl10)
4. Obesity or any weight control program.
5. Maternity Expenses (Code-Ecxl18)
a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections
incurred during Hospitalization) except ectopic pregnancy;
b. Expenses towards miscarriage (unless due to an Accident) and lawful medical termination of pregnancy during the
Policy Period.
6. Unproven Treatments (Code-Excl16)- Expenses related to any unproven treatment, services and supplies for or in
connection with any treatment. Unproven treatments are treatments, procedures or supplies that lack significant
medical documentation to support their effectiveness.
7. The provision or fitting of hearing aids, spectacles or contact lenses including optometric therapy, any treatment and
associated expenses for alopecia, baldness, wigs, or toupees, medical supplies including elastic stockings, diabetic test
strips, and similar products.
8. Non-prescription drugs or treatments
9. If the Insured Person is travelling against the advice of a Doctor or is receiving or on a waiting list for specified medical
treatment.
10. Any claim for your death, injury, medical condition or disability resulting from;
a. your suicide or attempted suicide or wilfully self-inflicted injury or illness; or
b. your consumption of alcohol or drugs or substance abuse
c. depression
11. Any claim for an incident that results from your involvement in any unlawful activities or violation of operating/safety
guidelines published by the service provider contracted by you.
12. Any claim originating in a country against whom Indian government has imposed travel restrictions, or any country
which has imposed such restrictions against citizens of India
13. Any claim where trip was specifically planned for the purpose of availing treatment of an existing medical condition
(Medical tourism)
14. Any claim for an incident which happens during the trip that results from taking part in any adventure sports unless
specifically covered
15. Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an
Accident, Burn(s) or Cancer or as part of medically necessary treatment to remove a direct and immediate health risk to
the insured. For this to be considered a medical necessity, it must be certified by the attending Medical Practitioner
(Code- Ecxl08);
16. Investigation & Evaluation- Code- Excl04
a. Expenses related to any admission primarily for diagnostics and evaluation purposes only
b. Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment

4. Waiting period 24 month waiting period for Maternity and new born baby cover 3.2 and 3.3
5. Payment basis Ÿ Cashless treatment or Reimbursement of covered expenses up to specified limits

Ÿ Fixed amount on the occurrence of a covered event 3
Ÿ All payments under this Policy will be in Indian Rupees only
6. Loss Sharing 20% co-payment applicable only if benefit "optional co-payment" is selected by customer. 3.4.37
7. Renewal Ÿ Single trip insurance policy is non-renewable 5.16

Conditions Ÿ Multi-Trip Policy can be renewed subject to below conditions:
i. This Policy will automatically terminate at the end of the Policy Period unless renewed.
ii. We are under no obligation to give notice that it is due for renewal, or to renew it or to renew it on the same terms
whether as to premium or otherwise.
iii. In respect of all applications for renewal received by Us before the end of the Policy Period, we will ordinarily offer
renewal terms unless We believe that You or any Insured Person or anyone acting on Your behalf or on behalf of an
Insured Person has acted in a dishonest or fraudulent manner under or in relation to this Policy or the renewal of the
Policy poses a moral hazard. 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.
iv. All applications for renewal of the Policy must be received by Us at least 30 days before the end of the Policy Period.
8. Renewal Benefits Not Applicable
9. Cancellation Ÿ Cancellation of Policy, at a date earlier than the Policy Period End Date can be done only upon :- 5.8
i. Denial of visa OR
ii. Cancellation of trip OR
iii. Early return of the individual to India
For cancellations due to above reasons, adequate documentary proof including but not limited to written request
from customer & copy of passport/Visa denial letter would need to be provided.
Ÿ The company may also initiate cancellation of the policy in case any untrue or incorrect statements are made or there has
been a misrepresentation, mis-description or non-disclosure of any material particulars or any material information
having been withheld, or if a Claim is fraudulently made or any fraudulent means or devices are used by the Policyholder
or the Insured Person or any one acting on his / their behalf.
Ÿ No refund of premium shall be eligible in case of cancellation of this Policy where a Claim has been incurred under the
Policy.
10. Claims When outside India- In the case of an emergency or the need for medical treatment, please ensure that you or your family 5.21
member contact Europ Assistance
Europ Assistance
24*7 Emergency Contact for +91 22 6787 2092
Email address : nivabupa@europ-assistance.in
Assist America
Toll Free Number-18004252955
Email Id- medservicesindia@assistamerica.in
When in India-
Contact No: 1860-500-8888
Fax No.: 011-30902010
11. Policy Servicing/ Ÿ In case of any grievance the Insured Person may contact the company through: 5.17
Grievances/ Customer Services Department
Complaints 2nd Floor, Plot No D-5,
Sec-59, Noida , Gautam Buddh Nagar,
Uttar Pradesh - 201301
Contact No: 1860-500-8888
Fax No.: 011-30902010
Email us through our service platform https://rules.nivabupa.com/customer-service/"
Senior citizens may write to us at: seniorcitizensupport@nivabupa.com
Ÿ If Insured person is not satisfied with the redressal of grievance through one of the above methods, Insured Person
may contact the grievance officer at:
Grievance Redressal Officer
Niva Bupa Health Insurance Company Limited
2nd Floor, Plot No D-5,

Sec-59, Noida , Gautam Buddh Nagar,
Uttar Pradesh - 201301
Email: priority.services@nivabupa.com or GRO@nivabupa.com
For details of grievance officer, kindly refer the link https://www.nivabupa.com/customer-care/health-
services/grievance-redressal.aspx
Ÿ IRDAI/(IGMS/Call Centre): Email ID: www.igms.irdai.gov.in
Ÿ Ombudsman (Refer Annexure III of policy document for List of Insurance Ombudsmen)
12. Insured's Rights Ÿ Free Look - If you do not agree to the terms and conditions of the Policy, you may cancel the Policy, stating your reasons 5.5
within 15 days of receipt of the Policy document provided no claims have been made under any benefits. The free look
provision is not applicable at the time of Renewal of the Policy. This Clause shall be applicable only for the policies which
are issued for a period of at least 365 days
13. Insured's Ÿ Please disclose all pre-existing disease/s or condition/s before buying a policy. Non-disclosure may result in claim not
Obligations 5.8
being paid.
Legal Disclaimer Note: The information must be read in conjunction with the product brochure and policy document. In case of any conflict between the CIS and the policy
document, the terms and conditions mentioned in the policy document shall prevail.
Disclaimer: Insurance is a subject matter of solicitation. Niva Bupa Health Insurance Company Limited (formerly known as Max Bupa Health Insurance Company
Limited) (IRDAI Registration Number 145). 'Bupa' and 'HEARTBEAT' logo are registered trademarks of their respective owners and are being used by Niva Bupa
Health Insurance Company Limited under license. Registered office:- C-98, First Floor, Lajpat Nagar, Part 1, New Delhi-110024, Customer Helpline: 1860-500-8888.
Website: www.nivabupa.com. CIN: U66000DL2008PLC182918.

TravelAssure
Policy Document
1. Preamble
This 'TravelAssure' policy is a contract of insurance between You and Us which is subject to payment of full premium in
advance and the terms, conditions and exclusions of this Policy. Expense incurred outside the policy period will NOT be
covered. Unutilized Sum Insured will expire at the end of policy year. All applicable benefits, details and limits are
mentioned in your Policy Schedule. We will cover only allopathic treatments in this policy.
2. Defined Terms
The terms listed below in this Section and used elsewhere in the Policy in Initial Capitals shall have the meaning set out
against them in this Section.
Standard Definitions
2.1 Accident or Accidental means sudden, unforeseen and involuntary event caused by external, visible and violent
means.
2.2 Co-payment means a cost sharing requirement under a health insurance policy that provides that the
policyholder/insured will bear a specified percentage of the admissible claims amount. A co-payment does not
reduce the Sum Insured.
2.3 Day care center means any institution established for day care treatment of illness and/or injuries or a medical setup
with a hospital and which has been registered with the local authorities, wherever applicable, and is under
supervision of a registered and qualified medical practitioner AND must comply with all minimum criterion as under
a. has qualified nursing staff under its employment;
b. has qualified medical practitioner/s in charge
c. has fully equipped operation theatre of its own where surgical procedures are carried out
d. maintains daily records of patients and will make these accessible to the insurance company's authorized
personnel.
2.4 Day care treatment means medical treatment and/or surgical procedure which is
a. undertaken under General or Local Anesthesia in a hospital/day care center in less than 24 hrs because of
technological advancement, and
b. which would have otherwise required hospitalization of more than 24 hours. Treatment normally taken on an out-
patient basis is not included in the scope of this definition.
2.5 Deductible means a cost sharing requirement under a health insurance policy that provides that the insurer will not
be liable for a specified rupee amount in case of indemnity policies and for a specified number of days/hours in case
of hospital cash policies which will apply before any benefits are payable by the insurer. A deductible does not reduce
the Sum Insured
2.6 Dental treatment means a treatment related to teeth or structures supporting teeth including examinations, fillings
(where appropriate), crowns, extractions and surgery.
2.7 Emergency Care- 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.
2.8 Grace Period means the specified period of time immediately following the premium due date during which a
payment can be made to renew or continue a policy in force without loss of continuity benefits such as waiting
periods and coverage of preexisting diseases. Coverage is not available for the period for which no premium is
received
2.9 Hospital
For the purpose of domestic insurance
A 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 Clinical Establishments (Registration and
Regulation) Act 2010 or under enactments specified under the Schedule of Section 36(1) and the said act Or complies

with all minimum criteria as under:
a. has qualified nursing staff under its employment round the clock;
b. 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;
c. has qualified medical practitioner(s) in charge round the clock;
d. has a fully equipped operation theatre of its own where surgical procedures are carried out;
e. maintains daily records of patients and makes these accessible to the insurance company's authorized personnel;
2.10 Hospitalisation- Hospitalization 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.
2.11 Illness- Illness means a 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:
i. it needs ongoing or long-term monitoring through consultations, examinations, check-ups, and /or tests
ii. it needs ongoing or long-term control or relief of symptoms
iii. it requires rehabilitation for the patient or for the patient to be specially trained to cope with it
iv. it continues indefinitely
v. it recurs or is likely to recur
2.12 Injury means accidental physical bodily harm excluding illness or disease solely and directly caused by external,
violent, visible and evident means which is verified and certified by a Medical Practitioner
2.13 Inpatient Care- Treatment for which the insured person has to stay in a hospital for more than 24 hours for a covered
event.
2.14 Maternity Expenses means
a) medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections
incurred during hospitalization);
b) expenses towards lawful medical termination of pregnancy during the policy period.
2.15 Medical Advice- Medical Advice means any consultation or advice from a Medical Practitioner including the issuance
of any prescription or follow-up prescription.
2.16 Medical Expenses- 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.
2.17 Medical Practitioner/Doctor- A person who is qualified to practice medicine or is a physician, surgeon or an
anaesthetist and has a valid medical license issued by the appropriate authority. This person should not be the
insured person him/herself or an Immediate Family Member of the Insured or the insured person's employer/business
partner".
2.18 Medically Necessary Treatment- Any treatment, tests, medications, or stays in hospital (or part of a stay in hospital)
which:
a. Is required for the medical management of the illness or injury suffered by the insured.
b. Must not exceed the level of care necessary to provide safe, adequate and appropriate medical care in scope,
duration, or intensity.
c. Must have been prescribed by a medical practitioner.
d. Must conform to the professional standards widely accepted in international medical practice or by the medical
community in India.

2.19 New Born Baby- Newborn baby means baby born during the Policy Period and is aged upto 90 days.
2.20 Notification of claim means the process of intimating a claim to the insurer or TPA through any of the recognized
modes of communication.
2.21 Outpatient Treatment (OPD)- OPD treatment means the one in which the Insured visits a clinic / hospital or
associated facility like a 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.
2.22 Pre-Existing Disease means any condition, ailment or injury or related condition(s) for which there were signs or
symptoms, and / or were diagnosed, and / or for which medical advice / treatment was received within 48 months
prior to the first policy issued by the insurer and renewed continuously thereafter.
2.23 Qualified Nurse : 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.
2.24 Reasonable and Customary Charges: 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.
2.25 Renewal: Renewal means the terms on which the contract of insurance can be renewed on mutual consent with a
provision of grace period for treating the renewal continuous for the purpose of gaining credit for pre-existing
diseases, time-bound exclusions and for all waiting periods.
2.26 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.
2.27 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 and prolongation of
life, performed in a hospital or day care centre by a medical practitioner
2.28 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.
Specific Definitions
2.29 Adventure sports- Any sport or activity, which is potentially dangerous to the Insured Person whether he/ she is
trained, or not. This includes:
a. Sky Sports: Sky Diving, Hang Gliding, Ballooning, Parasailing, Paragliding, Bungee Jumping, Bridge Swinging, Zip
Lining, Zip Trekking
b. Mountain Sports: Skiing, Snowboarding, Rock Climbing, Rock Scrambling, Rappelling, Via Ferrata, Fell Running,
Fell Walking, Gorge Walking, Indoor Rock Climbing, Mountain Biking, Cannoning, Mountaineering
c. Water Sports: Fishing, Deep Sea Fishing, Kite Surfing, Body Boarding, Paddle Boarding, Kayaking, Canoeing,
Scuba Diving, Shark Diving, Swimming with Dolphins, Diving with Whales, Wakeboarding, Surfing, white water
rafting, Snorkeling, Waterskiing, Whale Watching
d. Racing Sports: Auto (car) racing, Motor rallying, Motorcycle racing, Air racing, Kart racing, Boat racing, Hovercraft
racing, Lawn, mower racing, Snowmobile racing, Truck racing, Off Road 4x4
e. Earth Sport: Land Windsurfing, Zorbing, Sand Boarding,
2.30 Age or Aged means completed years as at the commencement date.
2.31 Assistance Service Provider means service provider specified in Policy Schedule appointed by the Company from
time to time.
2.32 Bodily Injury / Injury- 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.
2.33 Checked-In Baggage shall mean the baggage entrusted by the Insured and accepted by a Common Carrier for
transportation for which a baggage receipt/tag is issued to the Insured by the Common Carrier. This shall exclude
items that are carried/ transported under a contract of affreightment.
2.34 Child or Children means Your children Aged between 6 months and 21 years at the commencement of the Policy

Period if they are unmarried, still financially dependent on You and have not established their own independent
households.
2.35 Claim Deductible- means a cost sharing requirement under a health insurance policy that provides that the insurer
will not be liable for a specified rupee amount in case of indemnity policies and for a specified number of days/hours
in case of hospital cash policies which will apply before any benefits are payable by the insurer. A deductible does not
reduce the Sum Insured.
2.36 Common Carrier- Any commercial public airline, railway, motor transport, or water borne vessel (including ocean
going and/or coastal vessels and/or vessels engaged for official or personal purposes), operating under license issued
by the appropriate authority for transportation of passengers and/or cargo.
2.37 Contract of Affreightment is an agreement between a charterer and a common carrier, where the common carrier
agrees to transport specific number of goods for the charterer at a specified period.
2.38 Damages- The sum of money claimed or awarded in compensation for loss/injury. But this does not include fines,
penalties, punitive damages, exemplary damages, any non-pecuniary relief, or any other amount for which an
Insured is not financially liable, or which is without legal recourse.
2.39 Depreciation means the monetary value of an asset decreases over time due to use, wear and tear or obsolescence.
This decrease is measured as depreciation.
2.40 Educational Institution shall mean any school, vocational institute, polytechnic, college, university or institute or
higher learning which is duly licensed to provide educational services by trained or qualified teacher/professor and
where the Insured is registered as a full-time student
2.41 Excursions- Day trips and outings arranged either by you or your travel or accommodation provider.
2.42 Family means legally married Spouse and/or a maximum of 4 Children as named in the Schedule.
2.43 Geographical scope means the countries or geographical boundaries In which the coverage under this policy is valid
as specified in the policy schedule.
2.44 Hijacked means the unlawful seizure or exercise of control of any Carrier by force or violence or threat of force or
violence or an act, including but not limited to the use of force or violence or the threat thereof, committed for any
reason (including political, religious or ideological) by any person or group of persons, whether acting alone or on
behalf of or in connection with any organisation or government.
2.45 Home/Residential Address- Your address in India as mentioned in Policy Schedule
2.46 Hospital
For the purpose of overseas insurance-
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 and complies with all minimum criteria as under:
a. has qualified nursing staff under its employment round the clock;
b. has qualified medical practitioner(s) in charge round the clock;
c. has a fully equipped operation theatre of its own where surgical procedures are carried out;
d. Maintains daily records of patients and makes these accessible to the insurance company's authorized personnel.
2.47 Immediate Family- Spouse, children, mother, father, brother, sister, parent in law, daughter-in-law, son-in-law,
grandparent, grandchild.
2.48 Insured Person means You and the persons named in the Schedule.
2.49 Money- Includes coins, cash (including foreign currency), traveller's cheques and credit cards/ debit cards.
2.50 Policy Period/ Period of Insurance
Single-trip Policies: The below dates are shown on your policy schedule:
a. "Trip Cancellation" cover begin from the date your policy is issued, or the date of booking of your ticket
(whichever is later). It ends when you start utilization of the ticket for its intended purpose.
b. For all other coverage, cover starts when you start the insured trip. It continues until the expiry date and time of
the policy or on the date and time you return whichever is earlier
Multi-trip Policies:

The period as shown on your policy schedule.
Each trip you make during the period of insurance will be treated as a separate insurance, each subject to the policy
terms, conditions and exclusions.
Cover for individual trips apply as follows
a. "Trip Cancellation" cover begin from the date of policy issuance or the date of booking of ticket (whichever is
later) and ends when you start utilization of the ticket for its intended purpose.
b. All other Covers start when you start the insured trip and continues for the duration of each trip.
We will cover trips booked during one period of insurance but not taking place until the next period of insurance if
your multi-trip policy with us is still in force at the time of the incident resulting in a claim.
You may travel as many times as you wish during the period of coverage provided that no one trip exceeds the
maximum number of days as specified and contracted for at the time of application and shown on your policy
schedule.
2.51 Permanent Partial Disability- Continuous loss or impairment of a body part or sensory organ which is certified by a
Medical practitioner
2.52 Permanent Total Disability- The disability resulting in either of:
a. Loss of the sight of both eyes.
b. Physical separation of or the loss of ability to use both hands or both feet.
c. Physical separation of or the loss of ability to use one hand and one foot.
d. Loss of sight of one eye and the physical separation of or the loss of ability to use either one hand or one foot.
2.53 Planned Event- Events/tickets for places like museums/historical sites /attractions, visit passes, guided tours, music
and other entertainment shows, theme park entry tickets, skiing tickets, Scheduled Adventure sport booking ticket.
2.54 Policy- Insurance related documents issued in Your name including without limitations certificate of insurance,
proposal, policy schedule, applicable endorsements, Policy wording containing the terms and conditions of the
insurance contract.
2.55 Schedule means the schedule attached to and forming part of this policy, and if more than one then latest in time.
2.56 Sponsor means any individual responsible for paying the tuition fees of the student of his/her fulltime study in a
registered educational institution outside his/her home country
2.57 Spouse means the Insured Person's legally married spouse as long as she continues to be married to him.
2.58 Sum Insured/ Policy Limits- The amount stated in the Schedule against each relevant Cover, which shall be the
Company's maximum liability under this Policy for any and all Claims under such Cover. Some covers also include
other specific limits, for example, for any one item or limits for valuables in total.
2.59 Terrorism/ Terrorist Incident- Any actual or threatened use of force or violence directed at or causing damage, injury,
harm or disruption. Commission of an act dangerous to human life or property, against any individual, property or
government, with the stated or unstated objective of pursuing economic, ethnic, nationalistic, political, racial or
religious interests, whether such interests are declared or not. Robberies or other criminal acts, primarily committed
for personal gain and acts arising primarily from prior personal relationships between perpetrator(s) and victim(s)
shall not be considered Terrorist activity. Terrorism shall also include any act, which is verified or recognized by the
relevant Government as an act of terrorism.
2.60 Time Excess- Time before/after (as the case may be) when our claim liability doesn't trigger. This refers to specified
time period which needs to elapse/pass before or after (as the case may be) to make us liable for benefit payment
under the policy. Example, a time excess of 60 minutes for Common Carrier Delay cover means that insurer will pay
claim only when the delay is more than 60 minutes. A time excess of 6 hours for "common carrier delay" cover means
that insurer will pay claim only when the insured affects the cancellation before 6 hours of scheduled timing of the
services.
2.61 Theft- As defined in Section 378 of Indian Penal Code, 1860 whoever, intending to take dishonestly any movable
property out of the possession of any person without that person's consent, moves that property in order to carry out
such taking is said to commit theft.

2.62 Travel Agent- An agent, tour operator, or other entity from which the Insured purchases his travel arrangements, and
includes all officers, employees, and affiliates of such agent or tour operator.
2.63 Travelling Companion- An individual or individuals traveling with the Insured during the Period of Insurance,
provided that, the Insured and such individual(s) are traveling to the same destination on the same dates and
provided that such individual(s) is/ are also Insured under the Policy. For the purpose of this definition, any
individual(s) forming part of a group traveling on a tour arranged by a travel agent or a tour leader is not considered
as Traveling Companion, unless the individual(s) is part of the Insured's Immediate Family.
2.64 Trip(s)/ Insured Journey-
For Domestic travel: Refers to the journey performed by you within India commencing during the period of insurance
and limited to sector(s) for which the risk is covered as per the policy.
For International travel: Refers to the journey performed by you commencing from India and returning to India during
the period of insurance and limited to sector(s) for which the risk is covered as per the policy.
2.65 Unattended- Property that is not in your full view or positioned where you are unable to prevent unauthorized taking
of your property, unless it is left in a locked room or safe. Property left in a motor vehicle is considered unattended
unless the vehicle is locked and the items are placed out of view in an enclosed storage compartment, boot or
luggage space.
2.66 We, us, our, ours, Company, insurer- Niva Bupa Health Insurance Limited
2.67 You, your, yours, yourself, policyholder, insured person(s)- The person or people named on your policy schedule we
insure.
3. Base Benefit- It is compulsory to opt for base benefit. Refer to policy schedule for sum insured available under each benefit.
3.1 Emergency In-patient medical treatment (Expenses during emergency hospitalization)

We will pay the expenses incurred by you on treatment (Naturally this excludes expenses not linked to treatment like
food, beverage, toiletries and cosmetics) if you were admitted in a hospital for emergency care for more than 24
hours. Claims will be treated as Day Care treatment for hospitalization of less than 24 hours.
Special conditions
1. The treatment of illness/ accident shall commence during the period of insurance.
2. Refer Annexure 1 for expenses that are not covered or subsumed into room charges / procedure charges / costs of
treatment.
3. People traveling overseas on student visa for full time education will be covered in India as well till the end of
policy period.
Claim deductible- As shown on your policy schedule
What is not covered (in addition to General exclusions- section 5)
1. Out-patient treatment
2. Any claim for:
i. the cost of any non-emergency treatment or surgery including exploratory tests which are not directly related
to the illness/accident that you originally went to hospital for;
ii. any form of treatment that your treating doctor and we/our Medical Emergency Assistance provider think can
reasonably wait until you return home;
iii. routine medication which you were consuming or started, at the time your trip start, and you knew that you
would need while you were away;
iv. Treatments received in heath hydros, nature cure clinics, spas or similar establishments or private beds
registered as a nursing home attached to such establishments or where admission is arranged wholly or partly
for domestic reasons. (Code-Excl13);
3. Costs incurred following your decision not to move hospital or return to India after the date when it was deemed
safe for you to do so by us/our Medical Emergency Assistance provider and your treating doctor.

4. Vitamins and tonics, vaccination (unless related to animal bite), Weight management services and treatments
related to weight reduction programs including treatment of obesity, external Congenital disease, defect or
anomalies.
5. Physiotherapy, rehabilitation of organs.
3.2 Maternity
We will pay the expenses incurred by you on treatment (Naturally this excludes expenses not linked to treatment like
food, beverage, toiletries and cosmetics) if you were admitted in a hospital in the course of your pregnancy. Coverage
includes delivery, lawful medical termination of pregnancy and the cost of a midwife or obstetric nurse.
Special conditions
1. The Insured Person was not pregnant at the commencement of the Policy Period
2. A waiting period of 24 months will apply to all claims under this Benefit
3. Clause 5 of General exclusions stand waived for this benefit
4. This benefit can be used only twice during the insured person's lifetime
5. This cover is available only for people who are traveling overseas on student visa for full time college or school
education with policy term equal to or more than 12 months
3.3 New born baby cover
Emergency inpatient medical treatment and vaccination expenses of new born baby will be covered as per
"Emergency inpatient medical treatment" benefit of this policy.
Special conditions (in addition to special conditions of "maternity")
1. Any claim under this benefit will use sum insured of "maternity" benefit only
2. Coverage for vaccination of the new born is restricted to up to USD 500
3.4 Optional Benefits- Insured can choose from any of the below benefits on payment of additional premium. Refer to
policy schedule for sum insured available under each benefit.
3.4.1 Emergency Outpatient treatment (OPD)

We will reimburse the Medical Expenses incurred on emergency out-patient treatment.
What is not covered (in addition to General exclusions- section 5)?
1. Anything mentioned in "What is not covered" section of "emergency inpatient medical treatment" cover
3.4.2 Emergency Road Ambulance
We will cover the road ambulance cost for transportation of the Insured Person to a Hospital.
Special conditions
1. The ambulance service provider must be registered.
2. This claim will be payable only if claim under "emergency inpatient medical treatment" cover of this Policy is also
payable
3.4.3 Hospital Daily Cash
We will pay a daily cash amount for each day the insured person is hospitalized.
Special conditions
1. Insured person is hospitalized for Minimum 48 consecutive hours to claim under this benefit
2. This cover is available for maximum of 15 days of hospitalization during the policy period
payable
3.4.4 Dental treatment
We will pay the expenses incurred by you on pain relieving dental treatment received under anaesthesia at hospital

following:
1. An Accident or
2. Sudden acute pain to one or more of the Insured Person's natural teeth
3.4.5 Medical evacuation
We will pay the expenses incurred on your transportation from one Hospital to another in case the hospital where you
are admitted cannot provide satisfactorily medical services.
Special conditions
1. Transportation has been prescribed by a Doctor and is medically necessary
2. If transportation is required, then we/Our Medical Emergency Assistance provider will discuss with the Doctor
whether to transport the Insured Person to a more suitable country for medical treatment or to India.
payable.
3.4.6 Extension to in-patient care
If you were hospitalized during trip and are in need of treatment even after coming back to India, then we will cover
expenses for
1. Hospitalization in an Indian hospital if hospitalized within a period of 30 days from the end of the policy period
2. Your return economy class ticket to India
Special conditions
payable
2. Hospitalization in home country is for same illness or injury for which you were hospitalized during trip
3.4.7 Personal Accident
If your Accident during the policy period causes any or combination of the conditions as mentioned in Table 1, then
we will pay in accordance with Table 1.
S. % age of Sum S. % age of Sum

No. Description Description
Insured payable No. Insured payable
1 Death 100% 12 Loss of each other Finger 5%
Complete & Irrecoverable loss of 2 Limbs
(both hands or both feet or one hand Loss of each leg above centre
2 100% 13 70%
and one foot) of the femur
Complete & Irrecoverable loss of a Loss of each leg up to a point

3 Limb and an eye 100% 14 65%
below the femur
Complete and irrecoverable loss of Loss of each leg to a point
4 sight of both eyes 100% 15 50%
below the knee
Complete and irrecoverable loss of
5 speech & hearing of both ears 100% 16 Loss of each foot at the ankle 40%
6 Loss of each arm at the shoulder joint 70% 17 Loss of each big toe 5%
Loss of each arm to a point above
7 elbow joint 65% 18 Loss of each other toe 2%
8 Loss of each arm below elbow joint 50% 19 Loss of each eye 50%
9 Loss of each hand at the wrist 50% 20 Loss of hearing in each ear 30%
10 Loss of each Thumb 20% 21 Loss of sense of smell 10%
11 Loss of each Index Finger 10% 22 Loss of sense of taste 5%

Complete & Irrecoverable loss of limb means physical separation or complete loss of functionality of the limb, within
365 days from the date of the Accident. This will include Paralysis including Paraplegia, Quadriplegia with loss of
functional use of limb.
Special conditions
1. Claim is admissible only if the accident causes death or disability within 365 days from the date of the accident
2. Our payment will not exceed 100% of the Sum Insured if the accident causes a combination of more than one
condition mentioned in Table 1.
3. If a loss is not mentioned in the table 1, then we will assess the degree of disability and determine the amount of
payment to be made. In all such cases our liability will be limited to 50% of the Sum Insured.
4. Any disability claim amount already paid to you will be deducted from future death claim, if any.
What is not covered (in addition to General exclusions- section 5)- Any Claim arising while you are travelling in a
common carrier (including boarding and alighting from that Common Carrier) as a fare paying passenger.
3.4.8 Accidental Death and Disability (Common Carrier)
If your Accident in a common carrier (including boarding and alighting from that Common Carrier) during the policy
period causes any or combination of the conditions as mentioned in Table 2, then we will pay in accordance with
Table 2.
S. % age of Sum S. % age of Sum

No. Description Description
Insured payable No. Insured payable
1 Death 100% 12 Loss of each other Finger 5%
Complete & Irrecoverable loss of 2 Limbs
(both hands or both feet or one hand Loss of each leg above centre
2 100% 13 70%
and one foot) of the femur
Complete & Irrecoverable loss of a Loss of each leg up to a point

3 Limb and an eye 100% 14 65%
below the femur
Complete and irrecoverable loss of Loss of each leg to a point
4 sight of both eyes 100% 15 50%
below the knee
Complete and irrecoverable loss of
5 speech & hearing of both ears 100% 16 Loss of each foot at the ankle 40%
6 Loss of each arm at the shoulder joint 70% 17 Loss of each big toe 5%
Loss of each arm to a point above
7 elbow joint 65% 18 Loss of each other toe 2%
8 Loss of each arm below elbow joint 50% 19 Loss of each eye 50%
9 Loss of each hand at the wrist 50% 20 Loss of hearing in each ear 30%
10 Loss of each Thumb 20% 21 Loss of sense of smell 10%
11 Loss of each Index Finger 10% 22 Loss of sense of taste 5%
Complete & Irrecoverable loss of limb means physical separation or complete loss of functionality of the limb. This will
include Paralysis including Paraplegia, Quadriplegia with loss of functional use of limb.
Special conditions
1. Claim is admissible only if the accident causes death or disability within 365 days from the date of the accident
2. Our payment will not exceed 100% of the Sum Insured if the accident causes a combination of more than one
condition mentioned in Table 2.
3. If a loss is not mentioned in the table 1, then we will assess the degree of disability and determine the amount of
payment to be made. In all such cases our liability will be limited to 50% of the Sum Insured.
4. Any disability claim amount already paid to you will be deducted from future death claim, if any.
5. You will be presumed to be dead if you are not found within 365 days of the disappearance/accident of the
common carrier.

6. Claim is payable only if you are travelling in the common carrier as fare paying passenger
3.4.9 Repatriation of mortal remains
If you die in the Risk Period, then We will reimburse the cost of either transporting your mortal remains to permanent
place of residence or a cremation ceremony in the city/country of death.
Special condition- Claim under this cover is admissible only if hospitalization claim is also payable under "emergency
inpatient medical treatment" OR death claim is payable under "personal accident" or "accidental death or disability
(common carrier)" cover of this policy
3.4.10 Total Loss of checked-in baggage
We will pay the pro-rated amount if common carrier permanently loses your checked-in baggage.
How pro-rata will work?
If you have checked-in 3 baggage's and one was lost by common carrier, then we will pay one-third of the Sum
Insured.
Special conditions
1. Any Claim amount paid already under the "Delay of Checked-in Baggage" cover, will be deducted from the claim
amount payable under this cover.
2. If common carrier has paid any compensation amount for Total Loss of Checked-in Baggage, that amount will be
deducted from the claim amount payable under this cover.
1. Losses arising from any delay, detention, confiscation by customs officials or other public authorities
2. Partial loss- Loss of one or more items from the baggage.
3.4.11 Delay of checked-in baggage
We will pay the sum insured if delivery of your checked-in baggage is by common carrier is delayed by more than 12
hours from the expected time of delivery.
Special conditions- If common carrier has paid any compensation amount for Delay of Checked-in Baggage, that
amount will be deducted from the claim amount payable under this cover.
1. Delay arising from any detention, confiscation by customs officials or other public authorities
2. Any delay of checked-in baggage on the return to origin city/ country of trip
3.4.12 Trip Delay
If departure of your scheduled common carrier is delayed due to any of the following reasons, then we will pay an
amount for every 4 hours of delay:
1. Delay due to bad Weather.
2. Delay due to a sudden Strike or any other action by employees of the Common Carrier.
3. Delay due to equipment failure of the Common Carrier.
4. Delay due to operational problem at the Common Carrier end like crew/staff scheduling issues.
5. Cancellation or rescheduling done by the Common carrier.
1. Any delay due to reasons, which were made public or known to You at least 6 hours prior to the scheduled
departure of the Common Carrier.
3.4.13 Trip cancellation
If you cancel your trip before starting the journey due to any of the reasons listed below, then we will cover for costs
that you have already paid towards the trip and cannot get back or which legally must be paid.
1. Death or minimum 24 hour hospitalization of your immediate family member or traveling companion or You.
2. Your presence is required by judicial authority during the period of insurance.
3. You are unable to start your trip due to any natural disaster declared by the appropriate government authority.
4. Due to unexpected strike, riot or Civil commotion at Your destination or hometown or departure city.
5. Loss of passport.
6. Compulsory quarantine or prevention of travel by Government of India.

Special conditions
1. We will cover only travel ticket and accommodation costs.
2. We will cover only one instance of Trip Cancellation for single trip policies and maximum of three instances for
multi trip policies.
What is not covered (in addition to General exclusions- Section 5)?
1. Any cancellation due to Hospitalization resulting from pre-existing disease, Childbirth, Pregnancy or related
medical complications to You, Your immediate family or traveling companion.
2. Failure to start the journey due to rejection of VISA.
3.4.14 Trip interruption
If you return home without completing the trip due to below mentioned reasons, then we will reimburse
1. additional travel costs (in the same class as original booking) if you cannot use your return ticket;
2. unused accommodation costs that insured person has paid and cannot get back
Reasons for returning home:
1. Death or minimum 24 hour hospitalization of your immediate family member or traveling companion or You
2. You are unable to start your trip due to any natural disaster declared by the appropriate government authority.
3. The common carrier which you boarded as a passenger is hijacked.
4. Compulsory quarantine or prevention of travel by government.
5. Due to unexpected strike, riot or Civil commotion at place of visit other than your hometown.
Special conditions
1. If you need to return home and intend to make a claim under this cover, you must call and inform the Medical
Emergency Assistance provider as soon as reasonably possible.
2. Any refund which you have received against cancellation of travel ticket will be deducted from claim amount
3. We will cover only one instance of Trip Cancellation for single trip policies and maximum of three instances for
multi trip policies.
1. Any claim which was not authorized by our Medical Emergency Assistance provider before you returned home.
2. Any abandonment due to Hospitalization due to a pre-existing disease, Childbirth, Pregnancy or related medical
complications to You, Your immediate family or traveling companion.
3. Any claim for Trip interruption where there is no valid claim for Emergency Treatment.
3.4.15 Loss of Passport
If you lose your passport while on trip, then We will reimburse the actual expenses incurred in obtaining a duplicate
or fresh passport either overseas or within 30 days of his return to India.
1. Loss, delay or confiscation or detention by customs, police or public authorities.
2. Any loss or theft, if you do not report it to the police/embassy within 24 hours of discovery or as soon as
reasonably possible and request a written police report
3.4.16 Loss of International Driving license
If you lose your international driving license while on trip, then We will reimburse the actual expenses incurred in
obtaining a duplicate or fresh international driving license either overseas or within 30 days of his return to India.
2. Any loss or theft of your International Driving license, if you do not report it to the police within 24 hours of
discovery or as soon as reasonably possible and request a written police report
3.4.17 Missed Connection
If common carrier you are travelling in is not running on its published timetable and you missed a pre-booked onward
connection as a direct result of this delay then we will reimburse for extra accommodation and travel costs you incur
to reach the next destination shown on your ticket/itinerary.
Special conditions

1. We will cover only one such instance for single trip policies and maximum of three instances for multi trip policies
2. We will cover extra accommodation and travel costs for the same class as originally planned.
3. There should be minimum of 3 hours gap between scheduled arrival of incoming common carrier and scheduled
departure of connection common carrier
Claim deductible- The claim deductible is as shown on your policy schedule
1. Any claim caused by a strike or industrial action or any other reason for which the dates had been publicly
announced or reported by the media at the time you took out your policy.
2. Any occasion when the carrier has offered a reasonable alternative transport or connection or the Insured Person's
ticket for the connecting flight could have been used for an alternative connection.
3.4.18 Financial emergency Cash
If you are left without any travel funds (including cash, travelers cheque, debit or credit card) due to theft, pilferage or
robbery of your Money whilst on a trip, then we will pay for the financial emergency cash.
Special condition- Any such loss should immediately be reported to the police of the foreign country within 24 hours
and to Us within 48 hours.
1. Any loss of Money that was not in the personal custody of the Insured Person
2. Any loss of Money in respect of which a claim is made only after the Insured Person has already returned to India.
3.4.19 Personal Liability
We will cover costs incurred for:
1. Your actual legal liability for unintentional injury, property damage or death that you cause during your travel.
2. All costs, fees and expenses in the investigation, defence or settlement of any claim.
Special conditions
1. You shall:
a. give Us written notice within 10 days of any claim or demand made against you
b. not admit liability/ settle/ compromise/ make any payment without Our prior written consent.
c. allow Us, in Our sole and absolute discretion, to take over and conduct investigation, defence and/or
settlement of any claim. You shall provide all the cooperation and assistance We may require. Having taken
over the defence of any claim, We may in Our sole and absolute discretion relinquish the same.
2. We will not settle any claim without your consent. But if you refuses settlement recommend by Us and chooses to
contest or continue any legal proceedings, then Our liability will not exceed the amount for which the claim could
have been settled plus the defence costs incurred with Our consent up to the date of such refusal.
3. For us to cover the costs, claim shall be made on you by the third parties during the Period of Insurance or within
60 days from the date of expiry of the insurance.
1. Any fines or exemplary damages aimed at punishing you rather than awarding compensation to third party
2. Liability arising from:
a. Violation of operating/safety guidelines published by the service provider contracted by you.
b. Action of any type by any other person accompanying you.
c. Loss of or damage to property which belongs to you or is under your control or the control of a member of
your household or the control of people who work for you.
d. Your job/profession/professional activities/trade/business/employment or occupation.
e. Any willful, malicious, criminal or unlawful act, error, or omission.
f. Liability assumed by you by an agreement / contract which would not have attached in the absence of such
agreement / contract.
g. Personal injuries including but not limited to libel, slander, false arrest, sexual molestation, corporal
punishment, wrongful eviction, wrongful detention, defamation, any mental injury, anguish, or shock resulting

therefrom.
h. Ownership and / or Occupation of any land and / or building, unless you are occupying any temporary holiday
accommodation, which is not owned by you.
i. Ownership and / or Usage of any of the following:
i. livestock (except domestic animals);
ii. firearms (except sporting guns used for clay-pigeon shooting);
iii. motorized vehicles, aircraft of any description, including unpowered flight
iv. vessels (except manually-propelled watercraft); or
j. Your participation in any leisure activity or activity based holiday or adventure sports where Personal Liability
is specifically excluded.
k. Transmission of illness or disease by the insured
l. Any family member, relative, friend, travel companion or close business associate
3. Any Claim paid or compromised or commitment made without our prior written consent
3.4.20Hijack Daily Allowance
If the aircraft in which an Insured Person is travelling as a fare paying passenger during the Risk Period is Hijacked
and the journey is interrupted for a continuous and completed period of more than 12 hours, then We will pay the
daily allowance specified in the Schedule.
Special conditions
1. Claim will be provided for a maximum duration of 7 days
2. Clause 1 of General exclusions (Section 5) stand waived for this benefit
1. Any claim where the Insured person is considered as accessory or is in anyway involved with the Hijacking.
2. Any claim as a consequence of change in the direction of the route of the aircraft due to security reasons
3.4.21 Loss of Laptop, Tablet, Mobile Phone, Camera
We will indemnify the depreciated value up to sum insured mentioned in policy schedule, only in the case of robbery,
theft or if the belonging was stolen. Depreciation value to be calculated basis below table
Equipment age Up to 1 year Up to 2 years Up to 3 years Up to 4 years Up to 5 years More than 5 years
Applicable
50% 70% 75% 80% 90% 95%
depreciation
Special condition- Coverage under this benefit is limited to laptop, tablet, mobile phone and camera
1. Any loss of item sent in advance or mailed or shipped separately
2. Any item that was in a baggage lost by common carrier
4. Any loss of software or data in laptop/ tablet/camera/mobile and any consequential loss
3.4.22 Bounced Booking- Hotel/ Common Carrier
If Accommodation provider/ Common Carrier is unable to honor your confirmed bookings (pre-paid or contracted to
pay) due to overbooking then we will reimburse difference of cost in original booking and alternate booking.
Special conditions
1. Original booking and alternate booking should be of same class and for the same number of nights or same travel
destination. Upgradation to higher class will be considered in case similar alternate arrangement is not available
2. You must always check-in on time stipulated as 'must check-in by' time on your reservation or fulfil any other
obligation on your part.
3. In case of international flights, you are expected to have web-checked-in prior to your arrival at the airport.

4. The overbooking at the common carrier must happen at check-in.
1. Any booking for which You are unable to furnish proof of booking/payment and bounced booking.
2. Any contractual breach by You including but not limited to non-adherence to the terms and conditions of the
booking service provider.
3. If you had any waitlisted booking irrespective of whether such bookings have been promised to be confirmed
later.
4. Claims where the alternative travel/accommodation arrangements is provided by the service provider.
5. If you volunteer to take a late flight (Voluntary denied booking).
3.4.23 Compassionate Visit
If You are hospitalized and someone from your family/friend is visiting you, then we will reimburse economy class
travel cost for one such person
Special conditions
1. Provided there is no other adult traveling companion with you.
2. Provided that no Adult member of your Immediate Family is present at the location of your hospitalization.
3. Claim under this benefit will be applicable only if we have accepted claim under "emergency inpatient medical
treatment" cover of this policy
4. You should have been hospitalization for a period of minimum 5 consecutive days
3.4.24 Escort of minor child
If You, accompanied only by minor children, are hospitalized and someone from your family is travelling to your
location to escort minor children back to city of residence, then we will reimburse
1. Economy class return travel ticket for one family member along with reasonable costs of accommodation
2. Economy class travel ticket for minor children
Special conditions
1. The cover is available for a maximum of two minor children and We shall indemnify maximum of one such event
during the policy period.
2. Provided there is no other adult traveling companion to take care of children.
3. Provided that no Adult member of your Immediate Family is present at the location of your hospitalization.
4. Claim under this cover will be payable only if claim is also payable under "Personal Accident" or "accidental death
and disability (common carrier" or "emergency inpatient medical treatment" cover of this policy.
5. Hospitalization should have been for a continuous period of more than 48 hours and occurs not within 3 days of
the completion of the trip.
3.4.25 Adventure Sports
By selecting this Cover, participation in adventure sports will be included in your policy.
Special conditions
1. Such extension will not result into any increase in Sum Insured of the respective Coverage.
2. Clause 15 of General exclusion stands waived for this cover
1. Non-adherence to the guidelines / instructions of the organizers of adventure sports
2. Participation in a professional capacity and without supervision of trained professional
3.4.26 Sports Equipment hire
If the sports equipment being carried by You is lost because of the reasons mentioned below, then we will reimburse
cost of renting the same type of equipment
1. Robbery/ theft of the sports equipment
2. Baggage containing the sports equipment is lost or delayed for 12 hours or more by common carrier
Special conditions- If there is a compensation amount paid by the common carrier for Delay/loss, that amount will be
deducted from the claim amount payable under this cover.

2. Any loss or theft, if you do not report it to the police within 24 hours of discovery or as soon as reasonably
possible and request a written police report
3.4.27 Rented sports equipment damage or loss
If You damages or loses sports equipment which was rented out to You for Your personal use, then We shall
reimburse the penalty/ fine charged by the sports equipment owner.
Special conditions
1. You shall ensure the safety of sports equipment at all times during the rental period.
2. You shall not pass on hired equipment to third parties.
3. The complete payment of Rental equipment has been made by the You before the equipment is rented out You.
4. The hired equipment is NOT insured and insurance is not included in the normal rental tariffs.
5. You shall make sure that the sports equipment rented out to You are in good condition and without any damage.
What is not covered (in addition to General exclusions- Section 5)- In the case of theft, if you do not report it to the
police within 24 hours of discovery or as soon as reasonably possible and request a written police report
3.4.28 Sports Activity Coverage
We will reimburse for the unused portion of the sports activity which you had already paid for or had contracted to
pay (minus refunds) in case
1. You fall ill and medical practitioner has advised you to refrain from taking part in the sports activities
2. You are hospitalized
3. You have to cut short your trip and return to origin city
Special conditions
1. Reason for Hospitalization is admissible under "emergency inpatient medical treatment" cover of this Policy
2. Reason for cutting short your trip is admissible under "trip interruption" cover of this policy
3.4.29 Loan Protector
If your Accident during the policy period causes your death, then We will pay the balance outstanding principal loan
amount as on the date of death.
Special conditions
1. We will not pay for any arrears or penalties levied by the bank or financial institution.
2. Claim under this cover will be payable only if claim under "personal accident" or "accidental death or disability
(common carrier)" cover of this policy is also payable
3.4.30 Emergency Trip Extension
If duration of your international trip is extended beyond the scheduled dates because of reasons mentioned below
then we will extend period of insurance once for a period of up to 7 days
1. Death of the Travelling Companion.
2. You or your travelling companion is hospitalized
3. Any natural disaster (declared by appropriate government authority) at your current location or at destination
that forces you to extend the trip.
4. Cancellation or Re-scheduling of the common carrier due to unexpected strike, riot or Civil commotion at the port
where the Trip got extended.
Special conditions
1. Reason for Hospitalization is admissible under "emergency inpatient medical treatment" cover of this Policy
2. Any refundable amount pertaining to the original scheduled return ticket will be deducted from the admissible
claim amount
1. Any extension due to Childbirth, Pregnancy or related medical complications occurring to you or your immediate
family member or traveling companion.

3.4.31 Upgradation to Business Class
If insured person is hospitalized for a period of 5 or more continuous days, then we will cover the extra cost incurred
in upgrading the insured person's return ticket to business class by the most direct route from the place of
hospitalization.
Special conditions
1. Claim under this benefit is payable only if claim under " emergency inpatient medical treatment" cover of this
Policy is also payable
2. Your return air travel to city of residence shall commence not later than 20 consecutive days from the date of
discharge
3. If your economy class air ticket cannot be up-graded, then the Company's maximum liability under this Benefit
shall be limited to the difference between the cost of the new business class ticket and the refund amount received
on the economy class ticket cancelled
4. The Company shall not be liable to make any payment under this Benefit if you were originally booked to return to
the Country of Residence on a business class air ticket.
3.4.32 Study interruption
In case you have to discontinue your planned studies for remainder part of ongoing semester, then we will reimburse
you for
1. The actual semester fees paid which cannot be refunded by the Educational Institution.
2. Booked Air tickets from the city of residence of the student to the country where Educational Institution is,
provided interruption happens when the insured is at his own city of residence.
3. Return Air-ticket back to insured's city of residence, in case, interruption happens at the city of educational
institution
This benefits can be availed subject to the following:
1. You are Hospitalized for more than 30 consecutive days
2. In case of death or Permanent Total Disability of any one of Your Immediate Family Member or the Sponsor during
the policy period.
Special conditions
1. Any actual/possible refund amount from the Educational Institution will be deducted from the admissible claim
amount.
2. Any actual/possible refundable amount pertaining to the original scheduled ongoing/return ticket will be
deducted from the admissible claim amount.
3. In the event of a claim, only the figures shown on official invoice(s) from the educational institution and
voucher(s) of payment of the said Tuition fees, shall be used for calculating any reimbursement paid by us.
4. Simultaneous claims under "Study Interruption" cover and "Sponsor Protection" is not permitted.
education
What is not covered (in addition to General exclusions- Section 5)- Any exclusion mentioned in the "What is not
covered?" Section of the "Personal Accident" or "emergency inpatient medical treatment" cover applicable to You,
Your Immediate Family, your Sponsor.
3.4.33 Sponsor protection
In case of death or permanent total disability of your sponsor, as named in policy schedule, due to an accident during
planned studies, we will pay a lump sum amount up to the limits shown in your policy schedule for the below
expenses
1. The unpaid tuition fees of remaining part of your enrolled full-time study in a registered educational institution
2. One time return economy class air-ticket between the city of residence of the student and the city of Educational
Institution.
Special conditions
1. Death/Permanent Total Disablement of Sponsor should occur during the covered period and the journey is also

undertaken during the period of insurance.
2. Any actual/possible refundable amount pertaining to the original scheduled return ticket will be deducted from
the admissible claim amount, if any.
3. In the event of a claim, only the figures shown on official invoice(s) from the educational institution and
voucher(s) of payment of the said Tuition fees, shall be used for calculating any reimbursement paid by Us.
4. Simultaneous claims under "Study Interruption" cover and "Sponsor protection" is not permitted.
education
6. if the Insured Person is eligible to receive or receives any scholarship for the tuition fees, then We will pay the
difference between the amount due or paid under the scholarship and the amount payable in respect of the claim
under this benefit
What is not covered (in addition to General exclusions- Section 5)- Any exclusion mentioned in the "What is not
covered?" Section of the "Personal Accident" cover applicable to Your Sponsor
3.4.34 Cancer Screening and Mammography Examinations
We will reimburse the expenses incurred on your cancer screening and mammography examinations during the Risk
Period.
Special conditions
1. Screening or examination has been prescribed by a medical practitioner
education
3.4.35 Bail bond
If the you are falsely arrested or wrongfully detained by any government or foreign authority during the Risk Period,
then We will pay the bail bond amount in case you are acquitted by competent court and furnishing of relevant court
documents.
1. Insured Person has been charged with breaking the law with any criminal intent.
2. Insured Person has been charged with driving a vehicle at over the speed limit.
3.4.36 Waiver of deductible
By selecting this cover, deductibles applicable under each cover of this policy will be waived off.
3.4.37 Optional co-payment
By selecting this cover, co-payment of 20% will be applicable to all the payable/admissible claims under this policy.
3.4.38 Refund of Visa (if rejected)
We will pay for re-imbursement of Visa fee if your Visa got rejected for no fault or negligence on your part provided
that you had submitted all the valid documents in order as directed by the Embassy of the respective Country for
which the Visa is being applied and Visa application should be filed with the respective Embassy well in advance and
as per the prescribed processing time, if any.
Special conditions- This cover is not available for multi-trip policies
3.4.39 Home to home cover
We will extend the Coverage before /beyond the Period of Insurance for In-Patient treatment, Out-Patient and
Personal Accident up to the sum Insured for the following:
1. Starting of the Journey from Home (or any intermediate place) at the Country of Residence to the Airport for
duration of 6 hours before the Scheduled departure time of the Common Carrier
2. Return journey from the Airport to Home (or any intermediate place) after de-boarding the Common Carrier at
the Country of Residence for duration of 6 hours after the Actual arrival time
You should inform the Company immediately if you suffer an illness or injury and which occurs within the duration
specified in this Benefit
What is not covered (in addition to General exclusions- Section 5)- Any exclusion mentioned in "what is not covered?"
section of "emergency inpatient medical treatment", "emergency outpatient treatment" and "personal accident"

cover of this policy
3.4.40Colleague Replacement
If an Insured Person is Hospitalized then We will reimburse the cost of an economy class return air fare to send a
substitute person to complete the business purpose for which the Insured Person was travelling provided that
1. Insured Person's Hospitalization lasts for a period of at least 7 consecutive days
2. Insured Person's travel was for a pre-arranged specific and specified business purpose
3. The substitute employee commences his journey within 30 days from the date of Hospitalization of the Insured
Person
4. Substitute employee is in fact an employee and a proper substitute for the Hospitalized Insured Person
Special conditions- This cover is not available for people who are traveling overseas on student visa for full time
college or school education
3.4.41 Complete pre-existing disease cover
Pre-existing diseases will be covered up to sum insured of "emergency inpatient medical treatment" after opting this
cover.
Special conditions- This cover is available only for people who are traveling overseas on student visa for full time
college or school education
4. General Exclusions
Specific Exclusions
We will not make any payment for any claim directly or indirectly for, caused by, or in any way attributable to any of the
following unless expressly stated to the contrary in this Policy:
1. Treatment for any Injury or Illness resulting directly or indirectly from nuclear, radiological emissions, war or war like
situations (whether war is declared or not), rebellion (act of armed resistance to an established government or leader),
acts of terrorism
2. Your participation in any naval, military or air force operations whether in the form of military exercises or war games or
actual engagement with the enemy, whether foreign or domestic.
3. Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to
commit a breach of law with criminal intent (Code-Excl10)
4. Obesity or any weight control program.
5. Maternity Expenses (Code-Ecxl18)
a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred
during Hospitalization) except ectopic pregnancy;
b. Expenses towards miscarriage (unless due to an Accident) and lawful medical termination of pregnancy during the
Policy Period.
6. Unproven Treatments (Code-Excl16)- Expenses related to any unproven treatment, services and supplies for or in
connection with any treatment. Unproven treatments are treatments, procedures or supplies that lack significant medical
documentation to support their effectiveness.
7. The provision or fitting of hearing aids, spectacles or contact lenses including optometric therapy, any treatment and
associated expenses for alopecia, baldness, wigs, or toupees, medical supplies including elastic stockings, diabetic test
strips, and similar products.
8. Non-prescription drugs or treatments
9. If the Insured Person is travelling against the advice of a Doctor or is receiving or on a waiting list for specified medical
treatment.
10. Any claim for your death, injury, medical condition or disability resulting from;
a. your suicide or attempted suicide or wilfully self-inflicted injury or illness; or
b. your consumption of alcohol or drugs or substance abuse
c. depression
11. Any claim for an incident that results from your involvement in any unlawful activities or violation of operating/safety

guidelines published by the service provider contracted by you.
12. Any claim originating in a country against whom Indian government has imposed travel restrictions, or any country
which has imposed such restrictions against citizens of India
13. Any claim where trip was specifically planned for the purpose of availing treatment of an existing medical condition
(Medical tourism)
14. Any claim for an incident which happens during the trip that results from taking part in any adventure sports unless
specifically covered
15. Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an
Accident, Burn(s) or Cancer or as part of medically necessary treatment to remove a direct and immediate health risk to
the insured. For this to be considered a medical necessity, it must be certified by the attending Medical Practitioner
(Code- Ecxl08);
16. Investigation & Evaluation- Code- Excl04
a. Expenses related to any admission primarily for diagnostics and evaluation purposes only
b. Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment
5. General Terms and Clauses

5.1 Condition Precedent to Admission of Liability
The terms and conditions of the policy must be fulfilled by the insured person for the Company to make any payment
for claim(s) arising under the policy.
5.2 Insured person
Only those persons named as Insured Persons in the Schedule/Certificate of Insurance shall be covered under this
Policy.
If an Insured Person dies, he/she will cease to be an Insured Person upon Us/Administrator receiving all relevant
particulars in this regard. We will return a rateable part of the premium received for such person IF AND ONLY IF
there are no claims in respect of that Insured Person under the Policy.
5.3 Reasonable Care
Insured persons shall take all reasonable steps to safeguard the interests against any illness or injury that may give
rise to a claim.
5.4 Material change
It is a condition precedent to the Company's liability under the Policy that the Policyholder shall immediately notify
the Company in writing of any material change in the risk on account of change in nature of occupation or business at
his own expense. The Company may, in its discretion, adjust the scope of cover and/or the premium paid or payable,
accordingly.
5.5 Free look period
This Clause shall be applicable only for the policies which are issued for a period of at least 365 days. This clause is
not applicable on policy renewal.
a. The Policyholder may, within 15 days from the receipt of the Policy document, return the Policy stating reasons, if
the terms and conditions are not acceptable to the Policyholder.
b. If no Claim has been made under the Policy, the Company will refund the premium received after deducting
proportionate risk premium for the period on cover and stamp duty charges. If only part of the risk has
commenced, such proportionate risk premium shall be calculated as commensurate with the risk covered during
such period.
5.6 Discount
Below mentioned discounts are available in the policy.
S.no Discounting Parameters % discount
1 Existing MBHI Customers 10%
2 Loyalty Discount to Repeat Customers 10%
3 Discount basis number of members travelling 10% for each member
4 MBHI Employee Discount 15%

5.7 Extension of the policy period
a. Extension of the Policy Period for a Single Trip Policy-
On the Policyholder's written request, the Company may at its sole discretion extend the Policy Period provided
that the total Policy Period shall not exceed 365 days. If any Claim has been made under the Policy in respect of
the original Policy Period then the Insured shall be entitled to all benefits payable on fixed basis for which any
claim has not been made with the company earlier under the same policy. For other benefits where the payment
is on indemnity basis, balance sum insured shall be available during the extended policy period.
b. Extension of the Geographical Scope of the Policy
i. On the Policyholder's written request, the Company may at its sole discretion extend Geographical Scope of
the Policy specified in the Policy Certificate provided that the additional premium specified by the Company is
received in advance of commencement of coverage and provided that the Insured Person has not already
entered any part of the proposed extended Geographical Scope of the Policy or made any medical related
Claim under the Policy.
c. All requests for extensions must be made at least 1 day before the expiry of the original Policy Period and
accompanied by all the following information and documents:
i. Duly completed application for extension;
ii. Details of complete particulars of all Claims;
iii. A good health declaration.
d. However, if the request to extend the Policy is received within 3 days of the Policy Period End Date then coverage
shall be reinstated, at Company's sole discretion subject to underwriting, with effect from Policy Period End Date
on the date of receipt of premium by the Company. In such case Company shall not be liable for any Claim arising
during the Policy Period End Date and date of receipt of premium.
e. This product may be withdrawn by the Company after due approval from the IRDA. In case this product is
withdrawn by the Company. This Policy can be extended under the then prevailing product or its nearest
substitute approved by IRDA. The Company shall duly intimate the Policyholder regarding withdrawal of this
product and the options available to the Policyholder at the time of extension of this policy.
5.8 Termination/ cancellation
a. Cancellation of Policy, at a date earlier than the Policy Period End Date can be done only upon :-
i. Denial of visa OR
ii. Cancellation of trip OR
iii. Early return of the individual to India
For cancellations due to above reasons, adequate documentary proof including but not limited to written request
from customer & copy of passport/Visa denial letter would need to be provided.
b. The policyholder may request for cancellation of the policy. The company shall cancel the policy and premium will
be refunded if difference between the date of request of cancellation and end date of policy is at least 15 days or
more.
Refund amount = Amount of premium paid for the original policy period less the premium applicable by taking
the request date as the new policy period end date.
Example - Mr. X has purchased a single trip policy with trip duration as 90 days for a premium of Rs. 9,000. He
curtails the trip after 30 days. The premium for 30 day single trip is Rs. 4,200, hence refund 9,000 less (4,200) =
Rs. 4,800.
c. Policies with term equal to or more than 1 year, premium will be refunded on short scale basis as under:

Refund Premium (%)
Policy in-force up to
Less than 1 year 1 year 2 years 3 years
Up to 30 days 75% 87.5% 90%
31 to 90 days 50% 75% 87.5%
91 to 180 days 25% 62.5% 75%
181 to 365 days 0% 0% 50% 60%
366 to 455 days 25% 50%
456 to 545 days 12% 25%
545 to 720 days 0% 12%
Exceeding 720 days 0%
The above grid shall be applicable for 'Yearly / Annual' premium payment frequency. For Half Yearly or Quarterly
premium payment frequencies, the Company shall refund premium as per below grid:
No. of completed months at the Refund %

time of cancellation Half-Yearly Quarterly
0 62.5% 50%
1 33.3% 16.7%
2 25% 0%
3 8.3% 50%
4 4.2% 16.7%
5 0% 0%
6 62.5% 50%
7 33.3% 16.7%
8 25% 0%
9 8.3% 50%
10 4.2% 16.7%
11 0% 0%
For monthly premium payment frequency, no refund shall be applicable for cancellation of the Policy.
d. The company may also initiate cancellation of the policy in case any untrue or incorrect statements are made or
there has been a misrepresentation, mis-description or non-disclosure of any material particulars or any material
information having been withheld, or if a Claim is fraudulently made or any fraudulent means or devices are used
by the Policyholder or the Insured Person or any one acting on his / their behalf.
e. No refund of premium shall be eligible in case of cancellation of this Policy where a Claim has been incurred under
the Policy.
5.9 Limitation of liability
Any Claim under this Policy for which the notification or intimation of Claim is received 12 calendar months after the
event or occurrence giving rise to the Claim shall not be admissible, unless the Policyholder proves to the Company's
satisfaction that the delay in reporting of the Claim was for reasons beyond his control.
5.10 Other insurance
If at the time when any claim is made under this Policy, Insured Person has two or more policies from one or more
Insurers to indemnify treatment cost, which also covers any claim (in part or in whole) being made under this Policy,
then the Insured Person shall have the right to require a settlement of his/her claim in terms of any of his/her
policies. The insurer so chosen by the Insured Person shall settle the claim, as long as the claim is within the limits of
and according to terms of the chosen Policy.
Also where the Insured Person has two or more policies from one or more Insurers, then the Insured Person shall have
the right to claim from other policy/ policies for the amounts which is disallowed under earlier chosen policy/ policies

even if sum insured is not exhausted. The insurer so chosen by the Insured Person shall settle the claim, as long as the
claim is within the limits of and according to terms of the chosen Policy.
Provided further that, If the amount to be claimed under the Policy chosen by the Insured Person, exceeds the Sum
Insured under a single Policy after considering the deductibles or co-pay (if applicable), the Insured Person shall have
the right to choose the insurers by whom claim is to be settled. In such cases, the respective insurers may then settle
the balance of the claimed amount as per the limits and according to terms of the respective Policy. This clause shall
only apply to indemnity sections of the Policy
5.11 Subrogation
You and/or any Insured Persons shall at Your own expense do or concur in doing or permit to be done all such acts
and things that may be necessary or reasonably required by Us for the purpose of enforcing and/or securing any civil
or criminal rights and remedies or obtaining relief or indemnity from any other party to which We are or would
become entitled upon Us making reimbursement under this Policy, whether such acts or things shall be or become
necessary or required before or after Our payment. Neither You nor any Insured Person shall prejudice these
subrogation rights in any manner and shall at Your own expense provide Us with whatever assistance or cooperation
is required to enforce such rights. Any recovery We make pursuant to this clause shall first be applied to the amounts
paid or payable by Us under this Policy and Our costs and expenses of effecting a recovery, whereafter We shall pay
any balance remaining to You. However, this clause shall not be applicable for benefit 18 which indemnifies the
insured person for treatment cost incurred due to diseases contracted during the period of travel.
5.12 Alterations 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 Us, and any change We make will be evidenced by a written
endorsement signed and stamped by Us.
5.13 Notices
Any notice, direction or instruction under this Policy shall be in writing and if it is to:
a. Any Insured Person, it would be sent to You at the address specified in Schedule/endorsement/Certificate of
Insurance.
b. Us, shall be delivered to Our address specified in the Schedule/Certificate of Insurance.
c. No insurance agents, brokers, other person/ entity unless authorised by Us is authorised to receive any notice on
Our behalf.
5.14 Dispute Resolution Clause
Any and all disputes or differences under or in relation to this Policy shall be determined by the Indian Courts and
subject to Indian law.
5.15 Cause of action
No claim shall be payable under this policy unless the event or occurrence giving rise to the claim occurs in the
geographical scope specified in the policy schedule.
5.16 Renewal
a. Single trip insurance policy is non-renewable
b. Multi-Trip Policy can be renewed subject to below conditions:
i. This Policy will automatically terminate at the end of the Policy Period unless renewed.
ii. We are under no obligation to give notice that it is due for renewal, or to renew it or to renew it on the same
terms whether as to premium or otherwise.
iii. In respect of all applications for renewal received by Us before the end of the Policy Period, we will ordinarily
offer renewal terms unless We believe that You or any Insured Person or anyone acting on Your behalf or on
behalf of an Insured Person has acted in a dishonest or fraudulent manner under or in relation to this Policy or
the renewal of the Policy poses a moral hazard. 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.

iv. All applications for renewal of the Policy must be received by Us at least 30 days before the end of the Policy
Period.
v. Grace period- delay in payment up to 30 days from the premium due date is allowed where you can still pay your
premium and continue your policy. Coverage would not be available for the period for which no premium has been
received. Post 30 days from premium due date,
5.17 Redressal of Grievance:
ln case of any grievance the Insured Person may contact the company through:
Website: www.nivabupa.com, Toll free: 1860-500-8888
E-mail: Email us through our service platform https://rules.nivabupa.com/customer-service/ (Senior citizens may
write to us at: seniorcitizensupport@nivabupa.com)
Fax: 011-4174-3397
Courier: Customer Services Department
D-5, 2nd Floor, Logix Infotech Park, opp. Metro Station, Sector 59, Noida, Uttar Pradesh, 201301
lnsured person may also approach the grievance cell at any of the company's branches with the details of grievance.
If lnsured person is not satisfied with the redressal of grievance through one of the above methods, Insured Person
may contact the grievance officer at:
Head – Customer Services
D-5, 2nd Floor, Logix Infotech Park, opp. Metro Station, Sector 59, Noida,Uttar Pradesh, 201301
Contact No: 1860-500-8888, Fax No: 011-4174-3397
Email ID: Email our Grievance officer through our Grievance Redressal platform https://transactions.nivabupa.com/
pages/grievance-redressal.aspx
For updated details of grievance officer, kindly refer the link https://www.nivabupa.com/customer-care/health-
services/grievance-redressal.aspx
If the Insured Person is not satisfied with the above, they can escalate to our Grievance Redressal officer through our
platform https://transactions.nivabupa.com/pages/grievance-redressal.aspx.
lf lnsured person is not satisfied with the redressal of grievance through above methods, the Insured Person may also
approach the office of lnsurance Ombudsman of the respective area/region for redressal of grievance as per
lnsurance Ombudsman Rules 2017 (Refer below Annexure).
Grievance may also be lodged at IRDAI lntegrated Grievance Management System –www.bimabharosa.irdai.gov.in
5.18 Premium Payment in Installments
Premium payment in installments is applicable only for policies with term equal to or more than 1 year.
lf the insured person has opted for Payment of Premium on an instalment basis i.e. Half Yearly, Quarterly or Monthly,
as mentioned in the policy Schedule/Certificate of insurance, the following Conditions shall apply (notwithstanding
any terms contrary elsewhere in the policy)
i. Grace Period of 30 days in case of single premium policies, and a period of 15 days in case of other than single
premium policies, would be given to pay the instalment premium due for the policy.
ii. During such grace period, coverage will not be available from the due date of instalment premium till the date of
receipt of premium by Company.
iii. The insured person will get the accrued continuity benefit in respect of the "Waiting Periods", "Specific Waiting
Periods" in the event of payment of premium within the stipulated grace Period.
iv. No interest will be charged lf the instalment premium is not paid on due date
v. ln case of instalment premium due not received within the grace period, the policy will get cancelled.
vi. ln the event of a claim, all subsequent premium instalments shall immediately become due and payable.
vii. The company has the right to recover and deduct all the pending installments from the claim amount due under
the policy.
5.19 Assignment
The Policy can be assigned subject to applicable laws.

5.20 Pre-existing conditions
International single and multi-trip- We will not cover any type of Pre-existing Condition whether declared or not
declared. However, in case of life threatening medical condition we will cover pre-existing conditions up to 5% of
"emergency in-patient medical treatment" sum insured and maximum up to $2500.
Domestic single and multi-trip- We will not cover any type of Pre-existing Condition whether declared or not
declared.
International Student Travel- We will not cover any type of Pre-existing Condition whether declared or not declared.
However, in case of life threatening medical condition we will cover pre-existing conditions up to 5% of "emergency
in-patient medical treatment" sum insured and maximum up to $2500. However, if customer opts for optional benefit
"Complete pre-existing disease cover" then pre-existing conditions will be covered up to the sum insured of
"emergency inpatient medical treatment" cover.
5.21 Claims Process & Requirements
When outside India- In the case of an emergency or the need for medical treatment, please ensure that you or your
family member contact
Europ Assistance
24*7 Emergency Contact for +91 22 6787 2092
Email address : nivabupa@europ-assistance.in
Assist America
Toll Free Number-18004252955
Email Id- medservicesindia@assistamerica.in
When in India-
Contact No: 1860-500-8888
Fax No.: +91 11 41743397
5.21.1 Notification of Claim
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.
5.21.2 Supporting Documentation required
a. Dully filled and signed claims form and KYC Documents.
b. Death Certificate
c. Copy of Post-mortem report (wherever applicable)
d. Disability Certificate, issued by a Medical Board duly constituted by the Central and/or the State
Government.
e. Original Final Hospital bill with detailed break-up and payment receipt (including pharmacy bills).
f. Medical Records, Case histories, investigation reports
g. A precise diagnosis of the treatment for which a claim is made.
h. Original Discharge summary with first and subsequent consultation/treatment papers.
i. Laboratory investigation reports with supporting prescriptions.
j. Copy of settlement letter from other insurance company or TPA
k. MLC/First Information Report (FIR) (in accident cases)
l. Legal heir certificate (not required if valid nomination exists)
IMPORTANT:
a. All documents MUST be submitted within 30 days from discharge.
b. For any delay in submission, You MUST provide the reasons in writing. We will condone such delay on
merits (i.e. reasons beyond your control).
c. We reserve the right to ask for additional documents/reports from case to case basis.
d. We reserve the right to check and investigate the hospital / medical records from any doctor, Hospital,

clinic, individual or institution.
5.21.3 Claims payment
a. We shall be under no obligation to make any payment under this Policy unless We have received all
premium payments in full in time and all payments have been realised and We have been provided with
the documentation and information We or Our TPA has requested to establish the circumstances of the
claim, its quantum or Our liability for it, and unless the Insured Person has complied with his obligations
under this Policy.
b. We will only make payment to Insured Person under this Policy. Receipt of payment by Insured Person shall
be considered as a complete discharge of Our liability against the respective claim under this Policy. In the
event of Insured Person's death, We will make payment to the Nominee (as named in the
Schedule/Certificate of Insurance), payments under this Policy shall only be made in Indian Rupees within
India.
c. We are not obliged to make payment for any claim or that part of any claim that could have been avoided
or reduced if the Insured Person had taken reasonable care, or that is brought about or contributed to by
the Insured Person failing to follow the directions, advice or guidance provided by a Medical Practitioner.
d. We shall reject the claim by sending claim rejection letter to Insured Person or settle a claim by making the
payment of claim that has been admitted as payable by Us under the Policy terms and conditions within 30
days of receipt of last necessary document(s) / information and any other additional information required
for the settlement of the claim. All claims will be settled in accordance with the applicable regulatory
guidelines, including IRDAI (Protection of Policyholders Regulation), 2017. In case of delay in payment of
any claim that has been admitted as payable by Us under the Policy terms and condition, beyond the time
period as prescribed under IRDAI (Protection of Policyholders Regulation), 2017, we shall pay interest at a
rate which is 2% above the bank rate from the date of receipt of last necessary document(s) to the date of
payment of claim. For the purpose of this clause, 'bank rate' shall mean the bank rate fixed by the Reserve
Bank of India (RBI) at the beginning of the financial year in which claim has fallen due.
e. Where the circumstances of a claim warrant an investigation in our Opinion, We shall initiate and complete
such investigation at the earliest, in any case not later than 30 days from the date of receipt of last
necessary document. In such cases, We shall settle the claim within 45 days from the date of receipt of last
necessary document. In case of delay beyond stipulated 45 days , We shall be liable to pay interest at a rate
2% above the bank rate from the date of receipt of last necessary document to the date of payment of
claim.
f. All payments made shall be subject to an applicable Deductible (if any) for such payment for each and
every claim made, and to the Accumulation Limit.
g. All payments under this Policy will be in Indian Rupees only.
5.21.4 Fraud/ Dishonest or Fraudulent Claims
If any claim is in any manner dishonest or fraudulent, or is supported by any dishonest or fraudulent means or
devices, whether by You or the Insured Person or anyone acting on behalf of You or an Insured Person, then
this Policy shall be:
a. cancelled ab-initio from the inception date or the renewal date (as the case may be), upon a 30 day notice
by sending an endorsement to Your address shown in the Schedule/Certificate of Insurance or the Policy
may be modified by Us with the consent of the Proposer and
b. all benefits payable, if any, under such Policy shall be forfeited with respect to such claim
5.22 Possibility of Revision of Terms of the Policy Including the Premium Rates
The Company, with prior approval of IRDAI, may revise or modify the terms of the Policy including the premium rates.
The Insured Person shall be notified three months before the changes are effected.
5.23 Withdrawal of Product

a. In the likelihood of this product being withdrawn in future with due approval of IRDAI, the Company will intimate
the Insured Person about the same 90 days prior to expiry of the Policy.
b. Insured Person will have the option to migrate to similar health insurance product available with the Company at
the time of renewal with all the accrued continuity benefits such as cumulative bonus, waiver of waiting period
etc. provided the Policy has been maintained without a break as per extant regulatory framework.
5.24 Disclosure of Information
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 by the policyholder.
(Explanation: "Material facts" for the purpose of this policy shall mean all relevant information sought by the
company in the proposal form and other connected documents to enable it to take informed decision in the context
of underwriting the risk)
Disclaimer: Insurance is a subject matter of solicitation. Niva Bupa Health Insurance Company Limited (formerly known as Max Bupa Health Insurance Company
Limited) (IRDAI Registration Number 145). 'Bupa' and 'HEARTBEAT' logo are registered trademarks of their respective owners and are being used by Niva Bupa
Health Insurance Company Limited under license. Registered office:- C-98, First Floor, Lajpat Nagar, Part 1, New Delhi-110024, Customer Helpline: 1860-500-8888.
Website: www.nivabupa.com. CIN: U66000DL2008PLC182918.

Annexure - I
The expenses that are not covered or subsumed into room charges / procedure charges / costs of treatment
List I - Expenses not covered
Sl. No. Item Sl. No. Item Sl. No. Item
1. BABY FOOD 24. ATTENDANT CHARGES 47. LUMBO SACRAL BELT
2. BABY UTILITIES CHARGES 25. EXTRA DIET OF PATIENT (OTHER THAN THAT 48. NIMBUS BED OR WATER OR AIR BED CHARGES
WHICH FORMS PART OF BED CHARGE)
3. BEAUTY SERVICES 26. BIRTH CERTIFICATE 49. AMBULANCE COLLAR
4. BELTS/ BRACES 27. CERTIFICATE CHARGES 50. AMBULANCE EQUIPMENT
5. BUDS 28. COURIER CHARGES 51. ABDOMINAL BINDER
6. COLD PACK/HOT PACK 29. CONVEYANCE CHARGES 52. PRIVATE NURSES CHARGES- SPECIAL
NURSING CHARGES
7. CARRY BAGS 30. MEDICAL CERTIFICATE 53. SUGAR FREE Tablets
CREAMS POWDERS LOTIONS
8. EMAIL / INTERNET CHARGES 31. MEDICAL RECORDS 54. (Toiletries are not payable, only prescribed
medical pharmaceuticals payable)
FOOD CHARGES (OTHER THAN PATIENT's
9. 32. PHOTOCOPIES CHARGES 55. ECG ELECTRODES
DIET PROVIDED BY HOSPITAL)
10. LEGGINGS 33. MORTUARY CHARGES 56. GLOVES
11. LAUNDRY CHARGES 34. WALKING AIDS CHARGES 57. NEBULISATION KIT
OXYGEN CYLINDER ANY KIT WITH NO DETAILS MENTIONED
12. MINERAL WATER 35. 58.
(FOR USAGE OUTSIDE THE HOSPITAL) [DELIVERY KIT, ORTHOKIT, RECOVERY KIT, ETC]
13. SANITARY PAD 36. SPACER 59. KIDNEY TRAY
14. TELEPHONE CHARGES 37. SPIROMETRE 60. MASK
15. GUEST SERVICES 38. NEBULIZER KIT 61. OUNCE GLASS
16. CREPE BANDAGE 39. STEAM INHALER 62. OXYGEN MASK
17. DIAPER OF ANY TYPE 40. ARMSLING 63. PELVIC TRACTION BELT
18. EYELET COLLAR 41. THERMOMETER 64. PAN CAN
19. SLINGS 42. CERVICAL COLLAR 65. TROLLY COVER
20. BLOOD GROUPING AND 43. SPLINT 66. UROMETER, URINE JUG
CROSS MATCHING OF DONORS SAMPLES
21. SERVICE CHARGES WHERE NURSING 44. DIABETIC FOOT WEAR 67. AMBULANCE
CHARGE ALSO CHARGED
22. TELEVISION CHARGES 45. KNEE BRACES (LONG/ SHORT/ HINGED) 68. VASOFIX SAFETY
23. SURCHARGES 46. KNEE IMMOBILIZER/SHOULDER IMMOBILIZER
List II - Items that are to be subsumed into Room Charges

1. BABY CHARGES (UNLESS SPECIFIED/INDICATED) 14. BED PAN 27. ADMISSION KIT
2. HAND WASH 15. FACE MASK 28. DIABETIC CHART CHARGES
DOCUMENTATION
3. SHOE COVER 16. FLEXI MASK 29.
CHARGES /ADMINISTRATIVE EXPENSES
4. CAPS 17. HAND HOLDER 30. DISCHARGE PROCEDURE CHARGES
5. CRADLE CHARGES 18. SPUTUM CUP 31. DAILY CHART CHARGES
6. COMB 19. DISINFECTANT LOTIONS 32. ENTRANCE PASS / VISITORS PASS CHARGES
7. EAU-DE-COLOGNE / ROOM FRESHNERS 20. LUXURY TAX 33. EXPENSES RELATED TO PRESCRIPTION
ON DISCHARGE
8. FOOT COVER 21. HVAC 34. FILE OPENING CHARGES
INCIDENTAL EXPENSES / MISC. CHARGES
9. GOWN 22. HOUSE KEEPING CHARGES 35.
(NOT EXPLAINED)
10. SLIPPERS 23. AIR CONDITIONER CHARGES 36. PATIENT IDENTIFICATION BAND / NAME TAG
11. TISSUE PAPER 24. IM IV INJECTION CHARGES 37. PULSEOXYMETER CHARGES
12. TOOTH PASTE 25. CLEAN SHEET
13. TOOTH BRUSH 26. BLANKET/WARMER BLANKET

List III - Items that are to be subsumed into Procedure Charges
1. HAIR REMOVAL CREAM 9. WARD AND THEATRE BOOKING CHARGES 17. BOYLES APPARATUS CHARGES
DISPOSABLES RAZORS CHARGES
2. 10. ARTHROSCOPY AND ENDOSCOPY INSTRUMENTS 18. COTTON
(for site preparations)
3. EYE PAD 11. MICROSCOPE COVER 19. COTTON BANDAGE
4. EYE SHEILD 12. SURGICAL BLADES, HARMONICSCALPEL,SHAVER 20. SURGICAL TAPE
5. CAMERA COVER 13. SURGICAL DRILL 21. APRON
6. DVD, CD CHARGES 14. EYE KIT 22. TORNIQUET
7. GAUSE SOFT 15. EYE DRAPE 23. ORTHOBUNDLE, GYNAEC BUNDLE
8. GAUZE 16. X-RAY FILM
List IV - Items that are to be subsumed into costs of treatment

1. ADMISSION/REGISTRATION CHARGES 7. INFUSION PUMP- COST 13. MOUTH PAINT
2. HOSPITALISATION FOR EVALUATION/ 8. HYDROGEN PEROXIDE\SPIRIT\ 14. VACCINATION CHARGES

DIAGNOSTIC PURPOSE DISINFECTANTS ETC
3. URINE CONTAINER 9. NUTRITION PLANNING CHARGES - 15. ALCOHOL SWABES

DIETICIAN CHARGES- DIET CHARGES
4. BLOOD RESERVATION CHARGES AND 10. HIV KIT 16. SCRUB SOLUTION/STERILLIUM
ANTE NATAL BOOKING CHARGES
5. BIPAP MACHINE 11. ANTISEPTIC MOUTHWASH 17. GLUCOMETER & STRIPS
6. CPAP/ CAPD EQUIPMENTS 12. LOZENGES 18. URINE BAG

ANNEXURE - II
List of Insurance Ombudsmen
Office Details Jurisdiction of Office Union Territory, District
AHMEDABAD - Shri Kuldip Singh
Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor,
Tilak Marg, Relief Road, Ahmedabad - 380 001. Gujarat, UT of Dadra & Nagar Haveli, Daman and Diu.
Tel.: 079 - 25501201/02/05/06
Email: bimalokpal.ahmedabad@cioins.co.in
BENGALURU - Smt. Neerja Shah

Office of the Insurance Ombudsman,
Jeevan Soudha Building, PID No. 57-27-N-19, Ground Floor, Karnataka.
19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru - 560 078.
Tel.: 080 - 26652048 / 26652049
Email: bimalokpal.bengaluru@cioins.co.in
BHOPAL - Shri Guru Saran Shrivastava

Janak Vihar Complex, 2nd Floor, 6, Malviya Nagar, Madhya Pradesh, Chhattisgarh.
Opp. Airtel Office, Near New Market, Bhopal - 462 003.
Tel.: 0755 - 2769201 / 2769202
Fax: 0755 - 2769203
Email: bimalokpal.bhopal@cioins.co.in
BHUBANESHWAR - Shri Suresh Chandra Panda

62, Forest park, Bhubneshwar - 751 009.
Orissa.
Tel.: 0674 - 2596461 /2596455
Fax: 0674 - 2596429
Email: bimalokpal.bhubaneswar@cioins.co.in
CHANDIGARH - Dr. Dinesh Kumar Verma

S.C.O. No. 101, 102 & 103, 2nd Floor, Batra Building, Punjab, Haryana (excluding Gurugram, Faridabad,
Sector 17 - D, Chandigarh - 160 017. Sonepat and Bahadurgarh), Himachal Pradesh,
Tel.: 0172 - 2706196 / 2706468 UT of Jammu & Kashmir, Ladakh and Chandigarh.
Fax: 0172 - 2708274
Email: bimalokpal.chandigarh@cioins.co.in
CHENNAI - Shri M. Vasantha Krishna

Fatima Akhtar Court, 4th Floor, 453, Anna Salai,
Tamil Nadu, UT-Pondicherry Town and Karaikal
Teynampet, CHENNAI - 600 018.
(which are part of UT of Pondicherry).
Tel.: 044 - 24333668 / 24335284
Fax: 044 - 24333664
Email: bimalokpal.chennai@cioins.co.in
DELHI - Shri Sudhir Krishna

2/2 A, Universal Insurance Building, Delhi & Following Districts of
Asaf Ali Road, New Delhi - 110 002. Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh
Tel.: 011 - 23232481/23213504
Email: bimalokpal.delhi@cioins.co.in
GUWAHATI - Shri Kiriti .B. Saha

Jeevan Nivesh, 5th Floor, Nr. Panbazar over bridge, Assam, Meghalaya, Manipur, Mizoram,
S.S. Road, Guwahati - 781001(ASSAM). Arunachal Pradesh, Nagaland and Tripura.
Tel.: 0361 - 2632204 / 2602205
Email: bimalokpal.guwahati@cioins.co.in
HYDERABAD - Shri I. Suresh Babu

6-2-46, 1st floor, "Moin Court", Lane Opp. Saleem Function Palace,
Andhra Pradesh, Telangana, UT of Yanam
A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004.
and part of UT of Pondicherry.
Tel.: 040 - 23312122
Fax: 040 - 23376599
Email: bimalokpal.hyderabad@cioins.co.in

JAIPUR - Smt. Sandhya Baliga
Jeevan Nidhi - II Bldg., Gr. Floor, Rajasthan.
Bhawani Singh Marg, Jaipur - 302 005.
Tel.: 0141 - 2740363
Email: bimalokpal.jaipur@cioins.co.in
ERNAKULAM - Ms. Poonam Bodra

2nd Floor, Pulinat Bldg., Opp. Cochin Shipyard,
M. G. Road, Ernakulam - 682 015. Kerala, UT of Lakshadweep, Mahe-a part of UT of Pondicherry.
Tel.: 0484 - 2358759 / 2359338
Fax: 0484 - 2359336
Email: bimalokpal.ernakulam@cioins.co.in
KOLKATA - Shri P. K. Rath

Hindustan Bldg. Annexe, 4th Floor,
4, C.R. Avenue, KOLKATA - 700 072. West Bengal, Sikkim, UT of Andaman
Tel.: 033 - 22124339 / 22124340 & Nicobar Islands.
Fax : 033 - 22124341
Email: bimalokpal.kolkata@cioins.co.in
LUCKNOW -Shri Justice Anil Kumar Srivastava Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda,
Office of the Insurance Ombudsman, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh,
6th Floor, Jeevan Bhawan, Phase-II, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur,
Nawal Kishore Road, Hazratganj, Lucknow - 226 001. Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad,
Tel.: 0522 - 2231330 / 2231331 Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur,
Fax: 0522 - 2231310 Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria,
Email: bimalokpal.lucknow@cioins.co.in Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar.
MUMBAI - Shri Milind A. Kharat

3rd Floor, Jeevan Seva Annexe, Goa,
S. V. Road, Santacruz (W), Mumbai - 400054. Mumbai Metropolitan Region
Tel.: 022 - 26106552 / 26106960 excluding Navi Mumbai & Thane.
Fax: 022 - 26106052
Email: bimalokpal.mumbai@cioins.co.in
NOIDA - Shri Chandra Shekhar Prasad

State of Uttaranchal and the following Districts of Uttar Pradesh:
Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah,
Bhagwan Sahai Palace
Kanooj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar,
4th Floor, Main Road, Naya Bans, Sector 15,
Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautambodhanagar,
Distt: Gautam Buddh Nagar, U.P-201301.
Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj,
Tel.: 0120-2514252 / 2514253
Email: bimalokpal.noida@cioins.co.in Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur.
PATNA - Shri N. K. Singh

1st Floor,Kalpana Arcade Building,
Bihar, Jharkhand.
Bazar Samiti Road, Bahadurpur, Patna - 800006.
Tel.: 0612-2680952
Email: bimalokpal.patna@cioins.co.in
PUNE - Shri Vinay Sah
Office of the Insurance Ombudsman, Maharashtra,
Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, Area of Navi Mumbai and Thane
N.C. Kelkar Road, Narayan Peth, Pune - 411030.
excluding Mumbai Metropolitan Region.
Tel.: 020-41312555
Email: bimalokpal.pune@cioins.co.in
EXECUTIVE COUNCIL OF INSURERS, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054.
Tel.: 022 - 69038801/03/04/05/06/07/08/09 | Email: inscoun@cioins.co.in
Shri B. C. Patnaik, Secretary General | Smt. Poornima Gaitonde, Secretary

Application for Insurance:
TravelAssure
310000186581
URN: 21
Insurance contract is a legal contract too and it's based on TRUST and We TRUST You.
We understand you may not know how relevant is the information on your health and
it's impact on your policy. Hence it's very important that you disclose all health
information and we would decide how relevant it is (we call it 'material fact'). We
would cancel your policy, will not pay any claim, will notrefund any premium paid and
have right to take all possible legal action against you including for recovery of
benefits paid earlier, if correct and complete information is not provided about all
members proposed to be insured.
Regulations mandate that the coverage can start only after we have received the full
premium and have explicitly accepted the risk.
1-PROPOSER DETAILS:
Proposer (Mr./Mrs./Ms.) Amandeep Kaur

Gender Male Female Other Date of Birth: 19 Sep 1999
Address VPO KUKRAN
LandMark City Hoshiarpur
District Hoshiarpur State Punjab
PinCode 144528 Email-id

VGMFINANS@GMAIL.COM
PhoneNumber 9768887859
PAN No LBCPK7171A Nationality 1
Occupation : Salaried Self-Employed Student HouseWife Other please

specify
Annual income (Rs.)

Rural and Social Sector Category (if applicable): ASHA Worker MGNREGA
Worker
CKYC number (optional): /
I will do my bit to preserve the planet for children. I will go green. Send me soft
copy only. Strictly no paper please
I wish to have this Policy credited to an eIA.
Existing E-Insurance Account No. Insurance Repository

Name (you have opened your account with)
1.M/s NSDL Database Management Limited 2.M/s Central Insurance
Repository Limited
3. M/s Karvy Insurance Repository Limited 4.M/s Central Insurance
Repository Limited
If you wish us to help open an eIA account for you, please fill details in sec 9,
NEFT & Bank details Or
I do not have an eIA and do not wish to open one
I authorize Niva Bupa Health Insurance or any of its Agents and/or third
party(ies) / affiliates to contact me via SMS / Email / Phone / WhatsApp / Facebook
or any other modes on my registered phone number over-riding my 'DND'
registration to make welcome calls / SMS, service calls / SMS, policy related
information or any other commercial communication.
Are you or any of the proposed applicants a politically exposed person (PEP)
Yes No
#PEP is someonewho are or have been entrusted with prominent public functions
i.e. Heads / ministers of central or state government, senior politicians, senior
government, judicial or military officials, senior executives of government
companies, important party officials. (If you have ticked against PEP, kindly fill the
separate PEP questionnaire)
2-DETAILS OF APPLICANTS & PLAN SELECTION:
Plan: International Single trip International Multi trip International Student

Maximum trip duration (for multi trip plan): 30 Days 45 Days 60 Days 90
Days
International geographic coverage: AsiaPacific Worldwide excluding
USA/Canada Worldwide Africa Ecxl South Africa & Mauritius Whole Africa
South and Southeast Asia excl Malaysia and Singapore West Asia (Middle East)
East and Central Asia Excl Japan Whole Asia & Oceania East Europe (Excl
Schengen) Whole Europe America's excl USA/Canada Worldwide Excluding
US/Canada
Gender Height
Date Sum
Applicant (Male (Feet Weight Relationship
Name Of Mobile No. Insured
No. /Female/ & (Kg) To Proposer
Birth Individual
Other Inches
19
Amandeep
1 Female Sep 9768887859 Self $ 50,000
Kaur
1999
5
6
Additional information to be completed by the student traveling overseas on student

visa for full time college or school education
Student Name:
Date of birth:
Name and address of school/ university:
Course opted for:
Course duration:
Sponsor name:
Sponsor relationship with student:
Address of sponsor:
Other Details
Details of existing policy from Niva Bupa Health Insurance- /

Details of past travel insurance policy from Niva Bupa Health Insurance-
/
3- COVERAGE SELECTION:
Base Coverage:
Policy Type: Individual
Adults 1
Number Of Lives To Be Covered:
Children 0
5 Days/ Years (Whichever Is Applicable)

Policy Term:
Trip Start Date: 16 Dec 2024
Trip End Date: 20 Dec 2024
Inpatient Medical Treatment (Base Sum

$ 50000
Insured)
Maternity No
New Born Baby Cover No
Optional Coverage:
Outpatient Treatment No
Emergency Ambulance Yes
Hospital Daily Cash Yes
Dental Treatment Yes
Medical Evacuation
Yes
Extension To In-Patient Care No
Personal Accident Yes
Accidental Death And Disability (Common

No
Carrier)
Repatriation Of Mortal Remains Yes
Total Loss Of Checked-In Baggage Yes
Delay Of Checked-In Baggage No
Trip Delay Yes
Trip Cancellation Yes
Trip Interruption No
Loss Of Passport Yes
Loss Of International Driving License Yes
Missed Connection No
Financial Emergency Cash No
Personal Liability No
Hijack Daily Allowance Yes
Loss Of Laptop, Tablet, Mobile Phone, Camera Yes
Bounced Booking- Hotel/ Common Carrier No
Compassionate Visit No
Escort Of Minor Child No
Adventure Sports No
Sports Equipment Hire No
Rented Sports Equipment Damage Or Loss No
Sports Activity Coverage No
Loan Protector No
Emergency Trip Extension No
Up-Gradation To Business Class No
Study Interruption No
Sponsor Protection No
Cancer Screening And Mammography

No
Examinations
Bail Bond No
Waiver Of Deductible No
Optional Co-Payment No
Refund Of Visa No
Home To Home Cover No

Colleague Replacement No
Complete Pre-Existing Disease Cover No
4- NOMINATION:
In the event of the death of the Proposer, claim shall be paid to the Nominee. For
other insured persons, Proposer is the nominee. Payment to the nominee constitutes
discharge of the Company's full liability.
Appointee
Relationship Name
Nominee Date Of Address And Contact Details Of
With The (If Nominee Is
Name Birth Nominee
Proposer Less Than 18
Years Of Age)
Charanjeet
Father
Singh
5-MEDICAL, HABITS AND PAST PROPOSAL INFORMATION:

}
In Respect Of Any Of The
Member Member Member Member Member
S.No. Persons Proposed To Be Member 6
1 2 3 4 5
Insured:
Is Any Of The Member

Proposed To Be Insured
1
Suffering From Any Of The
Following Diseases
Heart Disease Like Heart

Attack, Heart Failure, YES YES YES YES YES YES
1a Ischemic Heart Disease Or
Coronary Heart Disease, NO No No No No No
Angina Etc.
Tumor, Cancer Of Any YES YES YES YES YES YES

1b Organ, Leukemia,
Lymphoma, Sarcoma NO No No No No No
Major Organ Failure (Kidney, YES YES YES YES YES YES
1c
Liver, Heart, Lungs Etc)
NO No No No No No
Stroke,Encephalopathy,Brain YES YES YES YES YES YES

1d Abscess,Or
AnyNeurologicalDisease NO No No No No No
Pulmonary Fibrosis, Collapse YES YES YES YES YES YES

1e Of Lungs Or Interstital Lung
Disease (ILD) NO No No No No No
Hepatitis B Or C, Chronic YES YES YES YES YES YES

1f Liver Disease, Crohn's
Disease, Ulcerative Colitis NO No No No No No
Any Anaemia Other Than YES YES YES YES YES YES
1g
Iron Deficiency Anaemia
NO No No No No No
Other details/ declarations:

6. DECLARATION (Please read carefully and put a check mark against each
before signing the proposal form)
I hereby declare, on my behalf and on behalf of all persons proposed to be insured,

that the above statements, answers and/or particulars given by me are true and
complete in all respects to the best of my knowledge and that I am authorized to
propose on behalf of these other persons.
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 insurer
and that the Policy will come into force only after full payment of the premium
chargeable.
I further declare that I 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.
I declare that I consent to the company seeking medical information from any
doctor or hospital who/which at any time has attended on the person to be
insured/proposer or from any past or present employer concerning anything which
affects the physical or mental health of the person to be insured/proposer and
seeking information from any insurer to whom an application for insurance on the
person to be insured /proposer has been made for the purpose of underwriting the
proposal and/or claim settlement.
I authorize the company to share information pertaining to my proposal including
the medical records of the insured/proposer for the sole purpose of underwriting the
proposal and/or claims settlement and with any Governmental and/or Regulatory
authority.
if the Proposer has signed in vernacular: The content of this form have been
explained by me,
in ,in presence of to the Proposer

who has understood and confirmed the same. Witness must be someone other than
agent/ employee of the Company.
15 Dec 2024 Place Signature of the Proposer
Signature of the certifying person: Signature of the Witness:
SMobile number of the certifying person: Mobile number of

the Witness:
7- DECLARATION IF FORM IS NOT FILLED BY THE PROPOSER & ADVISOR

DECLARATION:
Declaration if for any reason, the proposal and other connected papers are not filled
by the Proposer. The contents of the proposal form have been fully explained to me
and I have fully understood all aspects and implications. The Proposal Form is filled by
Mobile number of the Witness:under
my instruction and I found all information to be correct & complete.
Signature of the Proposer:
Advisor declaration: Ias an Insurance Advisor / Specified Person of the Corporate

Agent / Authorised employee of the Broker / Relationship Officer, do hereby declare
that I have explained all the contents of this product / proposal to the Proposer
Signature of the Insurance Advisor: Intermediary code
8- PREMIUM DETAILS (FOR OFFICE USE ONLY):
Premium payment option Cheque Demand Draft Credit card Net Banking
Cash Other
Premium amount Premium paid by
Relationship with proposer Online payment transaction ID:
Bank name/branch 15 Dec 2024
Niva Bupa branch location Code No.
Business sourced by: Advisor/DST/Corporate Agency/other channels Code No.
Name
Proposal received on: Customer ID:
Is Proposer or the applicant a staff? Yes No
9- NEFT & BANK DETAILS:
All payments (refund of premium, claims etc) would be made electronically ONLY to
your account. Please provide following details
Bank Name
Branch Account number
City Account type: Savings Current
IFSC Code
10-RENEWAL*:
Renewal payment sign-up:

Payment of renewal premium of your travel insurance Policy can be made every year
through continuing your existing Automated Clearing House (ACH) / Standing
Instructions (SI) with the Company. Under this option, your Policy can be renewed
promptly, but subject to you completing all additional requirements of information
and documentation as may be required by the Company.
I want to opt for the ACH/SI renewal option and thereby avail a discount of 2.5% on
the premium till the time policy is renewed using the same.
Dated Place Signature of the

Proposer
*Renewal is not applicable for single trip policies.
11-ADDITIONAL DETAILS FOR BANCASSURANCE CHANNEL ONLY (FOR OFFICE

USE ONLY):
Branch Code SP Code RM/LG code
Customer account number
12-STATUTORY WARNING:
Prohibition of Rebates (Under Section 41 of the Insurance Act 1938)
1. 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.
2. 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.
13-ACKNOWLEDGMENT BY THE COMPANY:
Application No. 310000186581 15 Dec 2024
We acknowledge with thanks the receipt of your proposal and amount by Cheque
/Demand Draft/ Others of amount of Rs. 413 dated 15 Dec 2024 drawn on
Neither the submission to us of a completed proposal for Insurance nor any payment
made towards issuance of a Policy obliges us to agree to issue a Policy, which
decision is and always shall be in our sole and absolute discretion. If we accept a
proposal for Insurance, it shall be subject to the Policy's terms and conditions and we
shall have no liability whatsoever if premium is not received by us in full and in time
or is not realized. If we do not accept the proposal, we will inform you and refund the
payment after deducting cost of medical tests, if any, received from you without
interest.
Name and Signature of the receiver and office seal
Disclaimer: Insurance is a subject matter of solicitation. Niva Bupa Health Insurance Company Limited (formerly
known as Max Bupa Health Insurance Company Limited) (IRDAI Registration Number 145). 'Bupa' and 'HEARTBEAT'
logo are registered trademarks of their respective owners and are being used by Niva Bupa Health Insurance
Company Limited under license. Product Name: TravelAssure | Product UIN: NBHTIOP22148V012122. Registered
office:- C-98, First Floor, Lajpat Nagar, Part 1, New Delhi-110024, Customer Helpline: 1860-500-8888. Website:
www.nivabupa.com. CIN: U66000DL2008PLC182918.
14. POS Details
POS Code No. :

POS Name :
POS PAN :
COVID – 19 Certificate
We wish to bring it to the notice of our Customers, Intermediaries, Embassies and Consulates that this policy provides coverage
towards Medical expenses related to COVID – 19 hospitalization, subject to policy terms and conditions.
In case of any further assistance, call us at 1860-500-8888 (customer helpline number) or email us at Email us through our service
platform https://rules.nivabupa.com/customer-service/ (Senior citizens may write to us at: seniorcitizensupport@nivabupa.com)"
Assuring you of our best services and wishing you and your loved ones good health always.
Yours Sincerely,
Director - Operations & Customer Service

For and on behalf of Niva Bupa Health Insurance Co. Ltd.

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Date:15 Dec 2024

Policy Number: 10000000155602

Subject : Niva Bupa Travel Insurance Policy No.10000000155602

Dear Amandeep Kaur

Director - Operations & Customer Service

Important - Please read this document and keep in a safe place.

Policy Start Date 16 Dec 2024

Policy End Date 20 Dec 2024

Geographical Coverage WorldWide Excl USA-Canada

Renewal Due Date NA

Electronic Insurance Account (eIA) Details:

Claim Administrator Servicing Branch Details

Location: Noida Director - Operations & Customer Service

Product Benefit Table

Trip Cancellation - $1,000

Benefit Deductible/ Time Excess Sum Insured

Dental Treatment $100 $300

Hospital Daily Cash 2 Day(s) $20 Per Day

Loss of Checked-in Baggage $50 $500

Medical Evacuation - $50,000

Personal Accident - $15,000

Trip Delay 4 Hour(s) $25 Per 4 Hour

Emergency Ambulance $50 $25,000

Emergency In-patient medical

Hijack Daily Allowance - $100 Per Day

Loss of International Driving

Loss of Laptop, Tablet, Mobile

Loss of Passport - $300

VPO KUKRAN, Hoshiarpur, Punjab, India, 144528

Policyholder Name Amandeep Kaur Policy No 10000000155602

Product Name TravelAssure SingleTrip Base Sum Insured $ 50,000

(A) Premium (Rs.) - Base Product 350

Issuance of policy is subject to clearance of premium paid

Details Of Person Insured

SAC Code / Type Of Service : 997136 / Travel

Location: Noida Director - Operations & Customer Service

1. Product Name TravelAssure

2. What am I covered Base Coverage:

Product Name: TravelAssure | Product UIN: NBHTIOP22148V012122

Product Name: TravelAssure | Product UIN: NBHTIOP22148V012122

5. Payment basis Ÿ Cashless treatment or Reimbursement of covered expenses up to specified limits

7. Renewal Ÿ Single trip insurance policy is non-renewable 5.16

8. Renewal Benefits Not Applicable

Product Name: TravelAssure | Product UIN: NBHTIOP22148V012122

Product Name: TravelAssure | Product UIN: NBHTIOP22148V012122

Product Name: TravelAssure | Product UIN: NBHTIOP22148V012122

Product Name: TravelAssure | Product UIN: NBHTIOP22148V012122

Product Name: TravelAssure | Product UIN: NBHTIOP22148V012122

Product Name: TravelAssure | Product UIN: NBHTIOP22148V012122

Product Name: TravelAssure | Product UIN: NBHTIOP22148V012122

3.1 Emergency In-patient medical treatment (Expenses during emergency hospitalization)

Product Name: TravelAssure | Product UIN: NBHTIOP22148V012122

3.4.1 Emergency Outpatient treatment (OPD)

Product Name: TravelAssure | Product UIN: NBHTIOP22148V012122

S. % age of Sum S. % age of Sum

Complete & Irrecoverable loss of a Loss of each leg up to a point

Product Name: TravelAssure | Product UIN: NBHTIOP22148V012122

S. % age of Sum S. % age of Sum

Complete & Irrecoverable loss of a Loss of each leg up to a point

Product Name: TravelAssure | Product UIN: NBHTIOP22148V012122