| PREAMBLE |
| Royal Sundaram Alliance Insurance Company Limited (hereinafter
called .the Company.), having received a Proposal and the Premium
from the Proposer and the said Proposal, Declaration and Annexure
thereto together with any statement, report or other document leading to
the issue of this Policy, which form the basis of this contract, do, by this
Policy agree, subject to the terms and conditions contained herein, that
on proof to the satisfaction of the Company, of the compensation having
become payable, as set out in the Schedule, upon the happening of an
event, to pay the Sum Insured/ appropriate Benefit.
|
| DEFINITIONS OF WORDS AND EXPRESSIONS |
| In this Policy, the following words and expressions, wherever appears, shall
have the following meanings, as set forth, unless the context otherwise requires: |
1. Accident / Accidental means a sudden unforeseen uncontrollable unexpected physical event to the Insured Person caused by an external violent and visible means
2. Acquired Immune Deficiency Syndrome (AIDS) means the meaning assigned to it by the World Health Organization and shall include Human
Immune deficiency Virus (HIV), Encephalopathy (dementia) HIV Wasting Syndrome and ARC (AIDS Related Condition).
3. Acts of God means Lightning, Storm, Tempest, Typoon, Huricane, Flood and Inundation, Earthquake, Tsunami, Subsidence, Landslide and Rockslide, Avalanche.
4. Age means the age of the Insured Person on his/her most recent birthday as per the English Calendar regardless of the actual time of birth, at the time of
commencement of Period of Insurance.
5. Air Travel means the act of boarding an aircraft for the purpose of flying therein or alighting there from following a flight.
6. House breaking means an act involving the unauthorized entry to or exit from Your Home or attempted threat by unexpected, forcible, visible and violent
means, with the intent to commit an act of Theft.
7. Checked-In Baggage means the baggage handed over by the Insured Person and accepted by the Common Carrier, (airline/coach operator/ferry
company) for transportation in the same carrier in which the Insured Person is going to travel and for which the carrier has issued a baggage receipt to the
Insured Person(excluding goods carried under contract of affreightment)
8. Company means the Royal Sundaram Alliance Insurance Company Limited.
9. Contracted Departure Date means the date on which the Insured Person originally scheduled to leave on the Trip as specified in the Travel Documents
10. Contracted Return Date means the date on which the Insured Person originally scheduled to return from the Trip as specified in the Travel
documents.
11. Common Carrier means any civilian water conveyance or aircraft, in each case operated under a valid license for transportation of passengers for hire.
12. Covered Medical Expenses means reasonable charges which are usual and Customary, incurred for services and supplies for any sickness/illness or
covered Accident to the Insured Person
13. Covered Occurrence means delay of a Common Carrier a)caused by inclement weather or b) due to strike or job action by employees of a
Common Carrier scheduled to be used during the Insured Trip or c) due to industrial action or d) caused by Equipment failure of a Common Carrier.
14. Disease means an illness which a Medical Practitioner or Surgeon will certify
that the Insured Person is suffering from.
15. Emergency Medical Evacuation: means (a) the medical condition of the Insured Person warranting immediate transportation from the place of
Accident/sickness to the nearest hospital where appropriate medical treatment can be obtained (b) after being treated at the local hospital the
medical condition of the Insured Person warrant transportation to the country from where the Trip commenced to obtain further medical treatment to
recover or both (a) and (b) above.
16. Family means Insured Person, his spouse, his children, his parents who continue to be normally resident with the Insured Person.
17. Fire And Allied Perils means Fire, Lightning , Explosion /Implosion , Aircraft Damage , Riot Strike & Malicious Damage , Earthquake, Storm, Cyclone,
Typhoon, Tempest, Hurricane, Tornado, Flood and Inundation (excluding volcanic Eruptions and other Convulsions of Nature) Impact Damage by Rail / Road vehicles (other than Insured Person's Vehicles) & Animals, Subsidence Landslide & Rockslide , Bursting and/or overflowing of water tanks, Apparatus and Pipelines, Missile Testing Operations, Leakage from Automatic Sprinkler installation and Bush Fire.
18. Hazardous Sport / Hazardous Activities means any sport or activity, which is potentially dangerous to the Insured Person whether he/she is trained, or
not. Such Sport/Activity includes but not limited to Winter sports, Skydiving, Parachuting, Scuba Diving, Bungee Jumping, Mountain Climbing, Riding or
Driving in Races or Rallies, caving or pot holing, hunting or equestrian activities, diving or under-water activity, rafting or canoeing involving rapid
waters, yachting or boating outside coastal waters, participation in any Professional Sports and activities of similar nature.
19. Hijack means unlawful seizure or exercise of control by force or violence or threat of force or violence and with wrongful intent of a Common Carrier.
20. Hospital means (1) a medically recognized institution having a valid license (if required by the law of the foreign country) and (2) an establishment which provides 24 hour nursing service for the sick and injured and (3) an institution that has diagnostic and surgical facilities at its disposal and has at least one
qualified and registered medical professional on duty at all times and (4) is not a mental institution, place of rest or a place for the aged drug addicts
alcoholics or any similar institution (5) and restricts the treatment it provides to methods scientifically recognized and clinically tested in that country
21. Home means any building used for permanent occupation by the Insured Person as a place of living or residence for himself and his family members.
22. Injury means Accidental bodily injury solely and directly caused by external, violent and visible means and does not include sickness disease or any
naturally occurring condition or degenerative process.
23. Insured/Insured Person means the individual whose name specifically appears in the Schedule to this Policy.
24. In-Patient means a person who is confined in a hospital as a registered bed patient and for whom at least one day's room and board is charged by the
hospital.
25. Intensive Care means a specially designed facility of the Hospital that provide the highest level of medical care and which is restricted to those patients who
are critically ill or injured.
26. Kutcha construction means buildings having walls and/or roofs of wooden planks thatched leaves and/or bamboo, plastic cloth asphalt canvas tarpaulin
or the like.
27. Paramount means Paramount Health Services Pvt. Ltd. 2 floor, Elite Auto House, 54-A, M. Vasanji Road, Off Kurla-Andheri Road, Andheri-East, and Mumbai - 400093, India. Paramount is delivering assistance services in conjunction with Euro Alarm, Frederikberg Allé 3, Copenhagen V, Denmark.
28. Physician means a person legally qualified to practice in medicine or perform surgery duly licensed by his/her respective jurisdiction, provided that this
person is not a member of the Insured Person's Family.
29. Policy means the insurance contract, the Policy Schedule and any other endorsements riders and any other attached enrollment forms.
30. Pre-Existing Condition shall mean any disease, illness, medical condition, injury for treatment of which claim is made under the policy, which existed
prior to the Commencement Date of the Policy, or is found by the Insurer, to be of such nature that ought to have existed or begun to set in, prior to the
Commencement Date of the Policy, whether or not the Insured Person was aware of such disease, illness, medical condition or injury.
31. Reasonable and Customary Charges means a charge for medical care which shall be considered reasonable and customary to the extent that it does
not exceed the general level of charges being made by others of similar standing in the locality where the charge is incurred when furnishing like or comparable treatment, services or supplies to individuals of the same sex and of comparable age, for a similar Disease or injury.
32. Relative(s) shall mean the Insured Person's legal spouse, parent, children, brother, sister, who live in India.
33. Sound Natural Teeth means natural teeth that are either unaltered or are fully restored to their normal function and are Disease-free, have no decay and are
not more susceptible to injury than unaltered natural teeth.
34.Sum Insured means the maximum amount of coverage per benefit, as specified in the Schedule of this Policy, that the Insured Person is entitled to in
respect of each Benefit.
35. Travel Companion means up to 2 named persons who is/are booked to accompany the Insured Person on the Trip.
36. Trip means booked and planned travel out of, and back to, the Republic of India.
37. Act of Terrorism means any actual or threatened use of force or violence directed at or causing damage, injury, harm or disruption or 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 perpetrators and victims shall not be considered Terrorists Acts. Terrorism also shall include any act, which is verified or recognized by the relevant Government as an act of Terrorism.
38. Valuables means but not limited to photographic, audio, video, computer and any other electronic equipment( including software and data recorded on
tapes and accessories) telecommunications and electrical equipment, musical instruments telescopes, binoculars, spectacles(contact lenses), Sunglasses, antiques, watches, jewellery, furs and articles made of precious stones and metals, money securities ,credit and debit cards, cheques and Travelers cheques,travel tickets, currency notes, curios, paintings and business samples.
39. Market Value means the value at which property insured could be replaced with one of the same kind, type, age and condition.
40. Applicable for Single Trip Policy: a. Single Trip shall mean one Trip, the details of which are specified in the Schedule to this Policy.
b. Period of Insurance: means the period from commencement of Insurance cover to the end of Insurance Cover:
|
| (i) |
Commencement of the Insurance Cover: The Insurance Cover commences on the day specified in the Policy Schedule, but not before conclusion of Insurance contract or the Insured Person boards the conveyance to leave for onward overseas journey or the Contracted Departure Date as per the policy. |
| (ii) |
End of the Insurance Cover: It means that Insurance Cover shall terminate
(i) with the end of Insurance Period i.e. the period for which the premium has been paid or
(ii) with the end of period abroad, whichever is earlier. The period abroad shall be deemed to end when the Insured Person first disembarks on return to India. However, in case of transportation home on the advices of Medical Assistance teams of Paramount and it's assistance cooperation partners, the coverage for treatment will be then as provided under Benefit 1(c) III. |
|
|
41. Applicable for Annual Multi Trip Policy: means the value at which property insured could be replaced with one of the same kind, type, age and condition.
|
| (a) |
Annual Multi Trip shall mean multiple trips, where the maximum duration of cover for all those Trips cumulated is limited to 180 days in the entire policy
period subject to a per trip limitation as specified in Per Trip Duration of the Schedule. |
| (b) |
Expiry Date means
(i) the date of expiry as shown in the Policy Schedule OR
(ii) termination of the Policy OR
(iii) completion of Insured Journey OR
(iv) Insured's journey exceeds Per Trip Duration Limit as specified in the Schedule from the Trip Commencement date OR
(v) when the number of Trip Days exceed the limit specified under Maximum Number of Days of the Schedule as applicable
|
|
|
| SCOPE OF COVER |
| The Company hereby agrees, subject to the terms, conditions and exclusions herein contained or otherwise expressed herein, to pay to the Insured Person a sum as compensation for any loss or damage occurring or expenses incurred during the Period of Insurance as described under different Benefits hereunder, and as specified in the Schedule of the Policy, but not exceeding the Sum Insured |
| SECTION II - LIABILITY TO THIRD PARTIES |
| The Company shall compensate the Insured Person for expenses incurred for availing immediate medical assistance required as a consequence of such Insured Person falling ill or sustaining an Accident whilst on a Trip abroad, but not exceeding the Sum Insured. The coverage is not a general health insurance policy
and is only for the use of the Insured Person in the event of a sudden and unexpected sickness or Accident arising when the terms aforementioned are fulfilled.
The deductible excess in respect of this benefit, if any, shall be an amount as specified in the Schedule of this Policy. |
| Terms and Conditions |
| If the Insured Person falls ill or contracts any Disease or sustains an Accident whilst on a Trip abroad during the Period of Insurance, then the Company will pay or arrange to pay for the following costs: |
| 1. Reasonable and Customary Charges, subject to the deductible excess shown in the Policy Schedule, for Covered Medical Expenses incurred overseas by
the Insured Person which are not due to a Pre-Existing Condition up to the Sum insured for the treatment of an injury or sickness sustained by the Insured Person while the Policy is in effect. Any medical services or series of services with a cost greater than USD 100 shall not be covered by the Policy unless the Insured Person consult with Paramount and the cost for such services are authorized in advance by Paramount and it's assistance cooperation partners. Costs would be those incurred for medically necessary treatment undertaken during a Trip abroad less the Excess stated in the Schedule. For the purpose of this Benefit, 'Treatment' shall be deemed to include only the following: |
| a) |
Out patient treatment (except where stated otherwise) provided the same cannot be deferred till the Insured Person's return to the Republic of India |
| b) |
In patient treatment in a local hospital at the place the Insured is staying at the time of occurrence of an insurable event or at the nearest suitable hospital. |
| c) |
Medical aid that is prescribed by a physician as necessary part of the treatment for broken limbs or injuries (e.g. plaster casts, bandages and
walking aids). |
| d) |
Radiotherapy, Heat therapy or Phototherapy and other such treatment prescribed by a physician. |
| e) |
X-Ray, diagnostic test, provided these pertain to the diagnosed diseases due to which hospitalization was deemed necessary |
| f) |
Cost of transportation, including necessary medical care en-route, by recognized emergency service providers for medical attention at the
nearest hospital or at the nearest available Physician. |
| g) |
Cost of being transferred to a special clinic if this is medically necessary and prescribed as such by a Physician. |
|
In no event will benefits continue to be provided by the Company for any Covered Medical Expenses incurred outside the Period of Insurance of the
Policy or Insured Person's return to India whichever is earlier.
However if the Insured Person is still confined in a hospital overseas after the expiry of the policy and Emergency Medical Evacuation is not appropriate or recommended by Paramount and it's assistance cooperation partners and continued treatment as an in-patient in a hospital overseas as advised by the attending physician and accepted by Paramount and it's Assistance cooperation partners, then this policy will continue to provide benefits for
Covered Medical Expenses, incurred up to the discharge of the Insured Person from the hospital or 60 days after the Expiry Date of the policy whichever is earlier. No benefits are payable for out-patient Covered Medical Expenses incurred after the expiry date of the policy. |
| BENEFIT 1 (b) EMERGENCY DENTAL TREATMENT |
The Company shall compensate the Insured Person for expenses resulting from Injury sustained to Sound Natural Teeth during a Trip abroad but not exceeding the Sum Insured.
Only Dental services for the immediate relief of Dental pain are covered
The Excess in respect of this benefit, if any, shall be of an amount as specified in the Schedule of this Policy |
| BENEFIT 1 (c) EMERGENCY EVACUATION |
The Company shall not be liable for each and every claim under Section - I (Lossof or Damage to the Private Car insured) of this Policy in respect of the deductiblestated in the Schedule.
This medical benefit would include the following:
I. Any extra costs of medically necessary and prescribed transportation from the foreign country to the Republic of India or to the nearest hospital in the event that it is not possible to guarantee medical treatment within a
reasonable distance of Insured Person's current location provided that
| - | extra costs in the event of transportation are the additional costs arising as a consequence of the insured event for the return journey home. |
| - | in the event that the Insured Person is capable of being transported from a medical point of view, it is the decision of Paramount and it's assistance
cooperation partner whether the Insured Person is repatriated to India or
not. |
II. Additional extra costs of an accompanying person, if it is medically necessary or officially required that the Insured Person be accompanied to the Republic of India.
III.Balance Period of Policy + 30
| - | If Paramount advises that the continued treatment in the Republic of India is appropriate, then the Company will pay the Reasonable and Customary Charges, subject to the deductible excess shown in the Policy Schedule, for medical expenses incurred in India for the same illness/ bodily injury contracted abroad following the transportation home, for a maximum period of 30 days from date of return, provided the disease/ injury/ illness is contracted within the Period of Insurance during the Trip abroad. |
|
| BENEFIT 1(d) REPATRIATION OF MORTAL REMAINS |
In the event of the death of the Insured Person during the Trip due to illness/ injuries, which are insured events in terms of this Policy, the Company shall compensate for the transportation expenses reasonably incurred to return the mortal remains of the Insured Person to the place of residence in the Republic of
India or the expenses for local burial or cremation in the country where the death occurred, subject to the Sum Insured.
The Excess in respect of this benefit, if any, shall be of an amount as specified in the Schedule of this Policy |
| BENEFIT 1(e) HOSPITAL DAILY ALLOWANCE |
In case the Insured Person is hospitalized for a period of more than 72 hours and where the Company has accepted liability under Overseas Health Cover aforementioned, then the Company will pay a lump sum benefit for each consecutive 24 hours of hospitalization exceeding the first 72 hours subject to Sum Insured.
The daily limit and the maximum limit are mentioned in the Schedule heret |
| Exclusions Applicable to BENEFIT 1 ( a-e ): |
| The Company shall not be liable to make any payment under this Benefit in connection |
| (a) |
Medical treatment abroad if that is the sole reason or one of the reasons for temporary stay abroad. |
| (b) |
Medical expenses / services, the need for which arises out of a Pre-Existing Condition. |
| (c) |
Treatment that could reasonably be delayed until the Insured Person's return to the Republic of India. The question of what can or what cannot
be reasonably delayed will be decided jointly by the treating physicians and qualified personnel from Paramount and its assistance cooperation partners as the case may be. |
| (d) |
Service, supplies or treatment including the period of hospitalisation confinement determined as excess of Reasonable and Customary
charges by Paramount and its assistance cooperation partners. |
| (e) |
Treatments relating to the removal of physical flaws or anomalies (cosmetic treatment or 'plastic' surgery in any form or manner) unless
necessitated by an Accident. |
| (f) |
Any costs incurred in connection with rest cures or recuperation at a spa or health resort, sanatorium, convalescence home or similar institution whether forming part of treatment or not. |
| (g) |
Any costs related to mental or psychiatric disorders. |
| (h) |
Routine physicals or examinations where there are no objective indications or impairment in normal health. |
| (i) |
Pregnancy of the Insured Person and its complications including child birth mis-carriage abortion or complication of any of these including
diagnosis and treatment of infertility or other problems related to inability to conceive a child, birth control including surgical procedures and devices. |
| (j) |
Medical treatment of typical symptoms suffered during pregnancy and their consequences, including changes in other chronic conditions as a
result of pregnancy. |
| (k) |
Any medical check-ups during pregnancy or treatment of the pregnancy. |
| (l) |
Expenses incurred in connection with weak strained or flat feet corns calluses or toe nails. |
| (m) |
Diagnosis and treatment of acne. |
| (n) |
Organ transplants which are considered experimental in nature. |
| (o) |
Well child care including exams and immunizations. |
| (p) |
Expenses which are not exclusively medical in nature. |
| (q) |
Congenital (external or internal) anomalies or any complications or conditions arising therefrom. |
| (r) |
Any expenses incurred in India unless authorized and approved by Paramount and it's assistance cooperation partners in advance. |
| (s) |
Rehabilitation and/or physiotherapy or the costs of prostheses/ prosthetics (artificial limbs, eye glasses, contact lenses, hearing aids) etc. |
| (t) |
Medical expenses covered under Workman's Compensation or similar policy. |
| (u) |
Medical expenses incurred as a result of alcohol and/or drug abuse, addiction or overdose. |
| (v) |
Treatment by Relatives. |
| (w) |
Dental crowns and bridges. |
| (x) |
Expenses recoverable from any medical or hospital benefit fund. |
| (y) |
Any exclusion mentioned in the General Exclusions section of this Policy. |
|
| BENEFIT 2 - ACCIDENTAL DEATH & DISMEMBERMENT |
| BENEFIT 2 (a)- ACCIDENTAL DEATH & DISMEMBERMENT (24 HOURS) |
If at any time during the Trip the Insured Person shall sustain any bodily injury resulting solely and directly from Accident caused by external violent and visible means, then the insured person or his/her legal representative (s), as the case may be, will be paid the Sum Insured mentioned in the Schedule of this policy, against Accident Death and Dismemberment, if such injury shall within 12 Calendar months of occurrence be the sole and direct cause of Death/Disablement as given
in the table of benefits below
Provided always that the policy will not pay under more than one of the following benefits in respect of the same Accident |
| Table of Benefits |
| Benefits |
Percentage of Sum Insured |
| 1. Death |
100% |
| 2. Permanent Total Disablement |
|
| Total and irrevocable loss* of |
|
| (i) Both Hands or both feet |
100% |
| (ii) sight of both eyes |
100% |
| (iii) one entire hand and one entire foot |
100% |
| (iv) Loss of either hand or foot and sight of one eye |
100% |
| (v) Speech and hearing in both ears |
100% |
| (vi) Either hand or foot |
50% |
| (vii) Sight of One eye |
50% |
| (viii) Speech |
50% |
| (ix) Hearing in both ears |
50% |
| (x) Thumb and index finger of the same hand |
25% |
| (xi) Quadriplegia |
100% |
| (xii) Paraplegia |
50% |
| (xiii) Hemiplegia |
50% |
| (xiv) Uniplegia |
25% |
|
Loss of feet/hand means total severance through or above the ankle/wrist joints respectively.
Eye means entire and irrevocable loss of sight.
Thumb and index finger means actual severance through or above the joint that meets the hand at the palm.
Speech or hearing means entire and irrecoverable loss of speech or hearing of both ears.
Quadraplegia means the complete and irreversible paralysis of both upper and both lower limbs.
Paraplegia means the complete and irreversible paralysis of both lower limbs.
Hemiplegia means the complete and irreversible paralysis of upper and lower limbs of the same side of the body.
Uniplegia means the complete and irreversible paralysis of one Limb. Limb means entire arm or leg.
|
| BENEFIT 2(b) - ACCIDENTAL DEATH AND DISMEMBERMENT (COMMON CARRIER) |
The Company will pay as hereinafter mentioned:
If at any time during the Trip the Insured Person shall sustain any bodily injury while travelling as a passenger in or whilst boarding or alighting from a Common Carrier
resulting solely and directly from Accident caused by external violent and visible means, then the insured person or his/her legal representative (s), as the case may
be, will be paid the Sum Insured mentioned in the Schedule of this policy, against Accidental Death and Dismemberment (Common Carrier), if such injury shall within 12 Calendar months of occurrence be the sole and direct cause of Death/Disablement as given in the table of benefits below
Provided always that the policy will not pay under more than one of the following benefits in respect of the same Accident |
| Table of Benefits |
| Benefits |
Percentage of Sum Insured |
| 1. Death |
100% |
| 2. Permanent Total Disablement |
|
| Total and irrevocable loss* of |
|
| (i) Both Hands or both feet |
100% |
| (ii) sight of both eyes |
100% |
| (iii) one entire hand and one entire foot |
100% |
| (iv) Loss of either hand or foot and sight of one eye |
100% |
| (v) Speech and hearing in both ears |
100% |
| (vi) Either hand or foot |
50% |
| (vii) Sight of One eye |
50% |
| (viii) Speech |
50% |
| (ix) Hearing in both ears |
50% |
| (x) Thumb and index finger of the same hand |
25% |
| (xi) Quadriplegia |
100% |
| (xii) Paraplegia |
50% |
| (xiii) Hemiplegia |
50% |
| (xiv) Uniplegia |
25% |
|
Loss of feet/hand means total severance through or above the ankle/wrist joints respectively.
Eye means entire and irrevocable loss of sight.
Thumb and index finger means actual severance through or above the joint that meets the hand at the palm.
Speech or hearing means entire and irrecoverable loss of speech or hearing of both ears.
Quadraplegia means the complete and irreversible paralysis of both upper and both lower limbs.
Paraplegia means the complete and irreversible paralysis of both lower limbs.
Hemiplegia means the complete and irreversible paralysis of upper and lower limbs of the same side of the body.
Uniplegia means the complete and irreversible paralysis of one Limb. Limb means entire arm or leg.
|
| Terms & Conditions applicable for Benefit 2(a) & 2(b): |
| If the Insured Person meets with an Accident, which leads to death or subsequent disablement, then the Company will provide compensation to the Insured in the following manner:
|
| (1) |
Death of Insured Person: If following an Accident that causes death of the Insured Person within 12 Calendar months from the date of Accident, the Company will pay to the person nominated by the Insured Person, an amount as compensation subject to the Sum Insured |
| (2) |
Permanent disablement of the Insured Person: If following an Accident which caused permanent impairment of the Insured Person's physical
capabilities, the Company will pay the benefits as provided in the Table of Benefits below depending upon the degree of disablement provided that:
a)The disablement occurs within 12 Calendar months from the date of the Accident. b)The disablement must be confirmed and claimed for prior to the
expiry of a period of 3 months since occurrence of the disable |
|
| Special Conditions applicable for Benefit 2(a) & 2(b): |
| (1) |
If the Accident affects any physical function, which was already impaired beforehand, a deduction will be made equal in amount for this prior disable |
| (2) |
If the accident impairs a number of physical functions, the degree of disablement given in the Table of Benefits will be added together, but not
exceeding 100% of the Sum Insured. |
| (3) |
In the event of Accidental death of the Insured Person aged 17 years or below at the time of accident, the Company's liability shall be restricted to a maximum of 10% of the Sum Insured. |
| (4) |
In the event of permanent disablement, the Insured Person will be under obligation.
a) To have himself/herself examined by doctors appointed by Paramount or it's assistance cooperation partners and the Company will pay the costs involved thereof.
b) To authorize doctors providing treatments or giving expert opinion and any other authority to supply the Company any information that may be required. |
|
| If the obligations are not met with due to whatsoever reason, the Company may be relieved of its liability to pay. |
| Special condition applicable to Benefit 2(b) |
| The Company will pay for loss of Life, if while on a Trip, the Insured Person's body cannot be located within 365 days after forced landing, stranding, sinking or wrecking of a conveyance, in which the Insured Person was a passenger or as a result of any Acts of God, in which case, it shall be deemed
subject to all other terms and conditions of the policy that the Insured Person has suffered loss of life within the meaning of the policy. |
| Exclusions applicable for Benefits 2 (a) & 2 (b) |
| The Company shall not be liable to make any payment under this Benefit in connection with: |
| (a) |
Accidents due to mental disorders or disturbances of consciousness, strokes, fits or convulsions which affect the entire body and pathological
disturbances caused by the mental reaction to the same. |
| (b) |
Damage to health caused by curative measures, radiation, infection,
poisoning except where these arise from an Accident. |
| (c) |
Any payment under this Benefit whereby the Company's liability would exceed the sum payable in the event of death |
| (d) |
Any other claim after a claim for death has been admitted by the Company and becomes payable. |
| (e) |
Any claim which arises out of an Accident whilst engaging in aviation or ballooning, whilst mounting into or dismounting from or traveling in any
balloon or aircraft or which occurs during parachuting except when the Insured Person is flying as a fare paying passenger on a multi engine, commercial aircraft. |
| (f) |
Any claim arising out of an Accident related to pregnancy or childbirth, venereal disease or infirmity, whether directly or indirectly. |
| (g) |
Any claim for death or Disablement of the Insured Person from
(a) intentional self-injury, suicide or attempted suicide
(b) whilst under the influence of intoxicating liquor or drugs
(c) self-endangerment unless in self-defense or to save life. |
| (h) |
Any exclusion mentioned in the 'General Exclusions' section of this Policy. |
|
| BENEFIT 3 - TRAVEL INCONVENIENCE |
| BENEFIT 3(a) - LOSS OF CHECKED-IN BAGGAGE |
| The Company will reimburse up to the limits specified in the Schedule of the policy in the event of the Insured Person suffering Total Loss of entire piece of Checked in Baggage which is under the care control and custody of the Common Carrier, while the Insured Person is a ticketed passenger on the Common Carrier during
the course of the Insured Period |
| Special Condition: |
| (i) |
Benefits for Baggage Loss will be in excess of any amount paid or payable by the Carrier responsible for the loss and/or in excess of all other valid and collectible insurance |
| (ii) |
The maximum amount reimbursable per bag is 50% of the Sum Insured and the maximum value per article contained in any bag is 10% the Sum Insured. |
|
| Terms & Conditions: |
The Insured Person has to provide the following documents to Paramount:
- Property Irregularity Report.
- Boarding pass(s) and baggage coupon(s)/tag(s) of Insured Person and above mentioned travel companion if applicable.
- List of articles lost and their value.
- Proof of ownership for articles valued more than 100 USD.
- Any further required documents requested by Paramount to confirm loss of baggage and amount recovered from airlines.
|
| Exclusions |
| The Company shall not be liable to make any payment under this benefit in connection with: |
| (a) |
Any non-compliance with the terms & conditions as stated above. |
| (b) |
Any partial loss of items contained within a bag. |
| (c) |
The Company will not be liable for any Valuables , perishables and consumables |
| (d) |
Losses arising from any delay, detention, confiscation by customs officials or other public authorities. |
| (e) |
Loss due to complete or partial damage of the baggage |
| (f) |
Any amount recovered under Delayed Baggage cover of the policy from the same event |
| (g) |
Any exclusion mentioned in the 'General Exclusions' section of this Policy. |
|
| BENEFIT 3(b) DELAY OF CHECKED-IN BAGGAGE |
| The Company will reimburse up to the Sum Insured for necessary emergency purchase of essential clothes and toiletries in the event that the Insured Person suffers a delay of more than 12 hours from the Scheduled Arrival time at the destination for delivery of Baggage that has been checked by a Common Carrier
for an international outbound flight from the Republic of India |
| Special Condition |
- Benefits for Baggage Loss will be in excess of any amount paid or payable by the Carrier responsible for the loss and/or in excess of all
other valid and collectible insurance
|
| Terms & Conditions: |
| The Company will pay provided that |
| 1. |
The Baggage is delayed on arrival in a country abroad (outward flight). |
| 2. |
The Insured Person has to provide the following documents to Paramount:
- Property Irregularity Report issued by the Common Carrier
- Certificate from airlines confirming duration of delay
- Any further documents requested by Paramount to confirm delay of baggage and amount recovered from airline
- Proof of purchase - original.
|
|
| Exclusions: |
| The Company shall not be liable to make any payment under this benefit in connection with: |
| (a) |
Losses arising from any delay, detention, confiscation by customs officials or other public authorities. |
| (b) |
Any baggage delay on arrival in the Republic of India (inward flight) |
| (c) |
Benefits for Baggage Delay paid or payable by the Carrier, provided however this insurance shall apply in excess of the amount recoverable
from carrier/ other insurers. |
| (d) |
Any exclusion mentioned in the 'General Exclusions' section of this Policy. |
|
| BENEFIT 3(c) LOSS OF PASSPORT, VISA |
| In the event that the Passport, Visa belonging to the Insured Person is lost, the Company will reimburse up to the limit mentioned in the Schedule to
cover only the direct expenses necessarily and reasonably incurred in connection with obtaining emergency travel documents in lieu of passport /visa or duplicate or new
passport.
|
| Terms & Conditions: |
The Company will pay provided that
- The loss of Passport, Visa was reported to police authority within 24 hours of the Insured Person becoming aware of such loss and an official Police report is provided to Paramount.
- The proof of emergency travel documents is provided to Paramount.
- Any further documents requested by Paramount to confirm delay of baggage and amount recovered from airlines.
|
| Exclusions: |
| The Company shall not be liable to make any payment under this Benefit in connection with: |
| (a) |
Loss of the Passport/Visa due to delay or confiscation or detention by the Customs, Police or Public Authorities. |
| (b) |
Loss of the Passport/Visa due to theft unless it has been reported to the Police within 24 hours the Insured Person becoming aware of the theft
and a written Police Report obtained. |
| (c) |
Loss of the Passport/Visa due to it being left unattended or forgotten by the Insured Person in a public place or public transport, hotel/apartment. |
| (d) |
Loss or theft of the Passport/Visa in a private place or in a private vehicle unless it was located in a locked hotel room or apartment and forcible and violent entry was used to gain access to it. |
| (e) |
The applicable Excess as mentioned in the Schedule. |
| (f) |
Any exclusion mentioned in the 'General Exclusions' section of this Policy. |
|
| BENEFIT 3(d) HIJACK DISTRESS ALLOWANCE |
| In the event of any Common Carrier, in which the Insured Person is traveling being hijacked on the trip abroad and captivated for more than 24 continuous hours, then the Company will pay a lump sum, for each consecutive 24 hours in captivity, in excess of the first 24 hours, to each Insured Person, up to the maximum limit per policy. |
| The amount payable per 24 hours per Insured Person and the maximum limit per Insured Person as mentioned in the Schedule hereto. |
| Terms and Conditions |
| The Company will pay provided that: |
| (i) |
The proof of travel is provided to us |
| (ii) |
Any further required documents requested by Paramount. |
|
| Exclusions: |
| The Company shall not be liable to make any payment under this benefit in connection with or: |
| (a) |
Any claim where the Insured Person is considered as the principal or accessory in the hijacking. |
| (b) |
Any exclusion mentioned in the 'General Exclusions' section of this Policy. |
|
| BENEFIT 3 (e) - TRIP DELAY |
| The Company will reimburse reasonable expenses towards food and beverages and emergency purchase of essential clothing, toiletries, if the Insured Person's Common Carrier commencement is delayed for more than 12 continuous hours while undertaking a Trip, due to any Covered Occurrence and when no alternative
travel arrangement is available, up to the limit provided in the Schedule of the Policy. |
| Exclusions: |
| The Company shall not be liable to make any payment under this benefit in connection with or in respect of any expenses whatsoever incurred by the Insured Person in connection with or in respect of: |
| (a) |
Failure to check in on time |
| (b) |
Negligence of fault of the travel agent. |
|
| Subject to exclusions mentioned in the 'General Exclusions' section of this Policy |
| BENEFIT 4 - HOME INSURANCE: |
The Company will pay for the loss and/or damage caused by Fire and Allied Perils, House breaking and /or attempted House breaking of Contents, whilst contained in the home of the Insured Person, stated as Address of the Insured Person (in India) under the policy, up to Sum insured.
The Company shall not pay more than 20% of the Sum Insured in respect of any one item.
This Benefit is applicable for the entire Family unit and not on Insured Person.
Contents means the following, not used for Business or Business Purposes, so long as they are owned by the Insured Person and/or Insured Persons Family and are legally responsible for them: |
| (i) |
Household goods, such as furnitures, fixtures, fittings, home appliances and interior decorations and items of like nature |
| (ii) |
Personal effects such as clothes and other articles of personal nature likely to be worn used or carried but excluding money, jewellery and
valuables. |
|
| Exclusions: |
| The Company shall not be liable to make any payment under this Benefit in connection with: |
| 1. |
the Insured Person's home is unoccupied by his or her family for a period of more than 90 consecutive days. |
| 2. |
the Insured Person/ any member/s of the Insured Person's Family or their domestic servant is directly/indirectly in any way involved in or concerned with the actual or attempted House breaking. |
| 3. |
the Insured Person's home is a building of Kutcha construction |
| 4. |
livestock, motor vehicles, pedal cycles, Valuables. |
| 5. |
any consequential losses destruction or damage |
| 6. |
any exclusions mentioned in the 'General Exclusions' section of this Policy. |
|
| Basis of loss settlement |
| 1. |
In the event of a total loss or damage of an item, the Company will pay the Market Value of the item less any value for salvage. In the event of repairs of any item damaged, the Company will pay the repair expenses, up to the Market Value of the item damaged. |
| 2. |
The Company may at its option repair reinstate or replace instead of paying the amount of loss or damage of the item |
| 3. |
No payment will be made for any cost of any improvements/alterations enhancements additions effected by the Insured Person. |
| 4. |
If there be any other insurance covering the same property, then this Policy will not pay more than the rate able proportion of the loss as the
Sum Insured bears to the total sum insured under all such policies |
|
| Duty of the Insured Person |
| 1. |
The Insured Person shall at all times take reasonable care of the property |
| 2. |
Notification of any changes in the location or any other factor affecting the Company's risk must be made by the Insured Person immediately to the Company |
| 3. |
If an event occurs giving rise to a claim under the policy the same must be notified in writing to the Company and also lodge a complaint with the police giving details of the items lost. |
| 4. |
The Insured Person should protect the rights and remedies against others |
|
| BENEFIT 5 - PERSONAL LIABILITY |
The Company will compensate the Insured Person, in the event of the Insured Person becoming legally liable to a Third Party (under statutory liability provisions or in common law for an incident which results in death, injury of such third party or damage to his/ her properties), but not exceeding the Sum Insured, provided the incident occurs during the Period of Insurance and whilst on a Trip abroad and provided that the claim is reported to the Company immediately and subject to the Special conditions and the Exclusions below.
The Excess in respect of this benefit, if any, shall be of an amount as specified in the
Schedule of this Policy. |
| Special Condition(s): |
| 1. |
The Company shall be responsible for contesting unjustified claims against the Insured Person and providing indemnity for damages, which the Insured Person has to pay. For indemnity to be provided against damages, the damages must be payable under an acceptance of liability given or approved by the Company or under a judicial decision rendered by a Court of Law. |
| 2. |
If there is a legal action in process against the Insured Person over a personal liability issue, the Company may conduct the legal action, including appointment of legal counsel, at the Company's expense in the name of the Insured Person at the Company's sole discretion. |
| 3. |
The Company will have the right, but in no case the obligation, to take over and conduct in the name of the Insured Person the defence of any claim and will have full discretion in the conduct of any proceedings and in the settlement of any claim and having taken over the defence of any claim, the Company may
relinquish the same. |
| 4. |
In the event the Company, in its sole discretion, chooses to exercise its right in pursuance of the above Special Condition 3, no action taken by the Company in the exercise of such right will serve to modify or expand in any manner, what the Company's liability or obligations under this Policy would have otherwise
been had it not exercised its rights under this condition. |
|
| Exclusions: |
| The Company shall not be liable to make any payment under this benefit in connection with: |
| 1. |
Any claim arising from Employers' liability or Insured Person's contractual liability |
| 2. |
Any claim of personal liability of the Insured Person towards his/ her Family, relations and traveling companions, friends or colleagues whether personal or official. |
| 3. |
Any claim resulting from transmission of an illness or disease by the Insured Person |
| 4. |
Any claim or damage resulting from professional activities involving the Insured Person. |
| 5. |
Any liability that is expected by or intended for the Insured Person |
| 6. |
Any claim for liability arising directly or indirectly from or due to:
| a) |
The possession of animals. Either own or under care control and custody of the Insured Person. |
| b) |
The ownership or possession of vehicles, aircrafts, watercrafts, or activities of the Insured Person involving parachuting, hang-gliding,
hot air ballooning or use of firear |
| c) |
Legal costs and proceedings that result from any criminal or illegal act |
| d) |
Any willful, malicious or unlawful act. |
| e) |
Insanity, the use of any alcohol/ drugs (except as medically prescribed) or drug addiction. |
| f) |
Any supply of goods or services on the part of the Insured Person arising out of the Insured Person's business. |
| g) |
Any ownership or occupation of land or buildings other than the occupation of any temporary residence. |
| h) |
Liability arising out of use sale manufacture delivery transfer or possession by any person of a controlled substance or contraband as defined by the appropriate Authority or the Federal Food and Drug Agency or equivalent or similar organization |
| i) |
Any exclusion mentioned in the 'General Exclusions' section of this Policy. |
|
|
| BENEFIT 6 - AUTOMATIC EXTENSION OF THE POLICY |
| Automatic extension of the Period of insurance is granted upto a period of 7 days, from the Policy Expiry Date, if the extension is necessary following delay of a Common Carrier, due to a Covered Occurrence and when no alternative travel arrangement is available. |
| GENERAL EXCLUSIONS (APPLICABLE TO ALL BENEFITS UNDER THE POLICY): |
| The Company shall not be liable to make any payments in respect of: |
| 1. |
Any claim relating to events occurring before the commencement of the cover or otherwise outside of the Period of Insurance. |
| 2. |
Any claim in respect of Pre-existing conditions. |
| 3. |
Any claim if the Insured Person-
| a) |
is traveling against the advice of a physician. |
| b) |
is receiving, or is on a waiting list to receive, specified medical treatment declared in a physician's report or certificate. |
| c) |
has received terminal prognosis for a medical condition. |
| d) |
is taking part in a naval, military or air force operation. |
|
| 4. |
Any claim arising out of illnesses or Accidents that the Insured Person has caused intentionally or by committing a crime or as a result of drunkenness or addiction (drugs, alcohol). |
| 5. |
Any claim arising out of mental disorder, suicide or attempted suicide self inflicted injuries, or sexually transmitted conditions anxiety, stress, depression, venereal disease or any loss directly or indirectly attributable to HIV (Human Immunodeficiency Virus) and / or any HIV related illness including AIDS
(Acquired Immunodeficiency Syndrome) and / or any mutant derivative or variations thereof howsoever caused. |
| 6. |
Any claim arising from the Insured Person engaging in Air Travel unless he/she flies as a fare paying passenger on an aircraft properly licensed to carry passengers. For the purpose of this exclusion Air Travel means being in or on or boarding an aircraft for the purpose of flying therein or alighting there from following a flight. |
| 7. |
Any claim for any losses in whole or in part and/expenses directly or indirectly in respect of the Insured Person riding on a motor cycle or any other two- wheeled and two-wheeled motorized mode of conveyance as driver or passenger. |
| 8. |
Illness and Accidents that are results of war and warlike occurrence or invasion, acts of foreign enemies, hostilities, civil war, rebellion, insurrection, civil commotion assuming the proportions of or amounting to an uprising, military or usurped power, seizure capture arrest restraints detainments of all
kings princes and people of whatever nation condition or quality whatsoever. |
| 9. |
Participation in riots, confiscation or nationalization or requisition of or destruction of or damage to property by or under the order of any government or local authority. |
| 10. |
Any act of Terrorism. |
| 11. |
Any claim arising from damage to any property or any loss or expense whatsoever resulting or arising from or any consequential loss directly or
indirectly caused by or contributed to or arising from:
| a) |
Ionizing radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel or from any nuclear waste from combustion (including any self sustaining process of nuclear fission) of nuclear fuel. |
| b) |
Nuclear weapons material. |
| c) |
The radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof.
|
|
| 12. |
Any claim arising out of sporting activities in so far as they involve in training or participation in competitions of professional or semi-professional sports persons, unless declared beforehand and necessary additional premium paid. |
| 13. |
Any claim for participation in Hazardous Sports/Hazardous Activities. |
| 14. |
Any claim for self exposure to needless peril(except in an attempt to save human life). |
| 15. |
Any loss of which a contributing cause was the Insured Person's actual or attempted commission of or willful participation in an illegal act or any violation or attempted violation of the law. |
| 16. |
Any claim directly or indirectly arising from the Insured Person engaging in any manual work. |
| 17. |
Any claim for/expenses incurred after the Expiry Date of the Policy or Insured Person's return to India whichever is earlier, except what is specifically provided. |
| 18. |
Any claim arising out of consequential loss or contractual liability. |
| 19. |
Any claim up to the Excess as shown in the Policy Schedule. |
|
| GENERAL CONDITIONS (APPLICABLE TO ALL BENEFITS UNDER THIS POLICY) |
| The conditions below apply throughout this insurance. Failure to comply with them may be prejudicial to a claim. |
| 1. |
Points to be noted: The minimum age limit for the Insured Person is 3 months, and the maximum age limit for the Insured Person is 70 years. Professional and semi-professional sportsmen, physically or mentally challenged persons are not eligible to be insured under this Policy unless specifically agreed to by the
Company. |
| 2. |
Reasonable Precautions:
The Insured Person shall take all reasonable and proper care to safeguard against Accident or illness or loss or damage to his/her property as if this insurance was not in force. Failure to do so will prejudice the Insured Person's claim under this insurance. |
| 3. |
Claim Procedure:
| a) |
The Insured Person shall immediately contact the Alarm Center of Paramount and it's assistance cooperation partners. stating the
necessary details. The phone numbers of the Alarm Centers are as follows:
Paramount Alarm Center + 91 (0)22 28267115
USA Toll Free Number 001 866 978 |
| b) |
Paramount will verify the identity of the caller by asking his/her Passport Number. |
| c) |
In the event of an Accident or sudden illness where it is not possible to do so before consulting a Physician or going to the Hospital, the Insured Person shall contact the Alarm Center as soon as possible. In either case, when being admitted as a patient, the Insured Person shall show the concerned Physician or personnel this Policy if requested. |
|
| 4. |
Claims Settle:
| a) |
Benefits payable under this policy will be paid within reasonable time upon receipt of due written evidence of such loss and any further
documentation information and assistance that Paramount and it's assistance cooperation partners or the Company may require. |
| b) |
Reimbursement of all claims will be in Indian Rupees at the exchange applicable on the date the amount is billed. If, however, it can be proved
that the necessary foreign currency to pay the bill was obtained at a less favorable rate, this will be taken as the applicable exchange rate. |
| c) |
The Company shall not be liable to pay any interest/ penalty for sums paid or payable under this Policy other than as provided by IRDA regulations |
|
| 5. |
Claim Documentation:
| i) |
The original bills and vouchers must be submitted along with all claims. |
| ii) |
Bills/ Prescriptions/vouchers/ reports/ discharge summary must contain the name of the person treated, the type of illness, details of the individual items of medical treatment provided and the dates of treatment. Prescriptions must clearly show the medicines prescribed, the price and the receipt stamp of the pharmacy. In the case of dental treatment, the bills/ vouchers/ reports must give the details of the tooth treated and the treatment performed. |
| iii) |
Bills/ Prescriptions/vouchers/ reports/ discharge summary must contain the name of the person treated, the type of illness, details of the individual items of medical treatment provided and the dates of treatment. Prescriptions must clearly show the medicines prescribed, the price and the receipt stamp of the pharmacy. In the case of dental treatment, the bills/ vouchers/ reports must give the details of the tooth treated and the treatment performed. |
| iv) |
For reimbursement of extra expenses of transportation of Insured Person to the Republic of India, a medical statement indicating the cause of
illness and the necessity of the transportation. Medical statements from relations or spouses will not be accepted. |
| v) |
In case of loss of baggage, a Property Irregularity Report or other report usually issued by the carriers in the event of loss of baggage. |
| vi) |
For personal liability, proof of judicial decision rendered by a court of law. |
| vii) |
For personal Accident, bills/ vouchers/ reports/ discharge summary, Death Certificate, First Information Report, Post Mortem Report Legal
Heir Certificate and such other documents as may be required. The relevant documents must contain the name of the person treated, the cause of Accident, details of the individual items of medical treatment provided and the dates of treatment |
| viii) |
Any other document(s) that the Company requires from the Insured Person to process the claim. |
|
|
| If Paramount or it's assistance cooperation partners or the Company requests that bills/ vouchers in a foreign language be accompanied by an appropriate translation in English then the costs of such translation must be borne by the Insured Person.
|
| 6. Obligations of the Insured Person/his Nominee |
| (i) |
Claims for insurance benefits must be submitted to Paramount not later than one (1) month after the completion of the treatment or transportation
home, or in the event of death, after transportation of the mortal remains/ burial. |
| (ii) |
The Insured Person shall provide Paramount or it's assistance cooperation partners on demand any information that is required to
determine the occurrence of the Insured Event or the Company's liability to pay the benefits. In particular, upon request, proof shall be furnished of the actual commencement date of the Trip abroad. |
| (iii) |
If requested to do so by Paramount or it's assistance cooperation partners, the Insured Person is obliged to undergo a medical examination
by a Physician designated by Assistance Company. |
| (iv) |
Paramount and it's assistance cooperation partners are authorized by the Insured Person to take all measures that are suitable for loss prevention and claim minimization, which includes the Insured Person's transportation back to the Republic of India. |
| (v) |
The Company shall be released from any obligation to pay insurance benefits if any of the aforementioned obligations are breached. |
|
7. Transfer and Set-off of Claims:
| (i) |
If the Insured Person has any outstanding claims against third parties covered under the Policy, such claims shall be transferred in writing to the Company up to the amount for which the Company in accordance with the terms makes the reimbursement of costs hereunder. |
| (ii) |
In so far as an Insured Person receives compensation for costs he/ she has incurred either from third parties liable for damages or as a result of other legal circumstances, the Company shall be entitled to set off this compensation against the insurance benefits payable, if any. |
|
| Claims to the insurance benefits may be neither encumbered nor transferred / assigned by the Insured Person, except indemnity for loss of life. |
| 8. Geographical Scope: The insurance cover applies to all countries stated in the Policy Schedule. |
| STANDARD TERMS AND CONDITIONS (APPLICABLE TO ALL BENEFITS UNDER THIS POLICY) |
| 1. Incontestability and Duty of Disclosure |
| The Policy shall be null and void and no benefit shall be payable in the event of untrue or incorrect statements, misrepresentation, mis-description or on non-disclosure in any material particular in the proposal form, personal statement, declaration and connected documents, or any material information having
been withheld, or a claim being fraudulent or any fraudulent means or devices being used by the Insured Person or any one acting on his behalf to obtain any benefit under this Policy. |
| 2. Observance of terms and conditions |
| The due observance and fulfillment of the terms, conditions and endorsement of this Policy in so far as they relate to anything to be done or complied with by the Insured Person, shall be a condition precedent to any liability of the Company to make any payment under this Policy. |
| 3. Material change |
| The Insured Person shall immediately notify the Company by fax and in writing of any material change in the risk and cause at his own expense such additional precautions to be taken as circumstances may require to ensure safe operation of the Insured items or trade or business practices thereby containing the circumstances that may give rise to the claim and the Company may, adjust the scope of cover and / or premium, if necessary, accordingly. |
| 4. Records to be maintained |
| The Insured Person shall keep an accurate record containing all relevant particulars and shall allow the Company to inspect such record. The Insured
Person shall within one month after the expiry of each period of insurance furnish such information as the Company may require. |
| 5. Notice of charge etc. |
| The Company shall not be bound to notice or be affected by any notice of any trust, charge, lien, assignment or other dealing with or relating to this Policy but the receipt of the Insured Person or his legal personal representative shall in all cases be an effectual discharge to the Company. |
| 6. Automatic Termination of Insurance |
This policy shall automatically terminate
- upon the Insured Person's death
- at the expiration of the period for which the premium has been paid or on the Expiry Date whichever is earlier.
|
| 7. Special Provisions |
| Any special provisions subject to which this Policy has been entered into and endorsed in the Policy or in any separate instrument shall be deemed to be part of this Policy and shall have effect accordingly.
|
| 8. Electronic Transactions |
| The Insured Person agrees to adhere to and comply with all such terms and conditions as the Company may prescribe from time to time, and hereby
agrees and confirms that all transactions effected by or through facilities for conducting remote transactions including the Internet, World Wide Web, electronic data interchange, call centers, teleservice operations (whether voice, video, data or combination thereof) or by means of electronic, computer, automated machines network or through other means of telecommunication, established by or on behalf of the Company, for and in respect of the Policy or its terms, or the Company's other products and services, shall constitute legally binding and valid transactions when done in adherence to and in compliance with the Company's terms and conditions for such facilities, as may be prescribed from time to time. |
| 9. Duties of the Insured Person on occurrence of loss |
On the occurrence of any loss, within the scope of cover under the Policy the Insured Person shall:
| (i) |
Forthwith file/submit a Claim Form in accordance with 'Claim Procedure' Clause. |
| (ii) |
In no event shall Paramount be notified later than 30 days after the end of the Trip. |
|
| If the Insured Person does not comply with the provisions of this Clause or other obligations cast upon the Insured Person under this Policy, in terms of the other clauses referred to herein or in terms of the other clauses in any of the Policy documents, all benefits under the Policy shall be forfeited, at the option of the Company. |
| 10. Subrogation |
In the event of payment under this Policy, the Company shall be subrogated to all the Insured Person's rights or recovery thereof against any person or
organization, and the Insured Person shall execute and deliver instruments and papers necessary to Online such rights.
The Insured Person and any claimant under this Policy shall at the expense of the Company do and concur in doing and permit to be done, all such acts and things as may be necessary or required by the Company, before or after Insured Person's indemnification, in enforcing or endorsing any rights or remedies, or of obtaining relief or indemnity, to which the Company shall be or would become entitled or subrogated. |
| 11. Contribution |
If at the time of the happening of any loss or damage covered by this Policy, there shall be existing any other insurance of any nature whatsoever covering the same, whether effected by the Insured Person or not, then the Company shall not be liable to pay or contribute more than its rateable proportion of any
loss or damage.
This does not apply to Personal Accident Claims, which the Company will pay in full.
If any claim is in any respect fraudulent, or if any false statement, or declaration is made or used in support thereof, or if any fraudulent means or devices are used by the Insured Person or anyone acting on his behalf to obtain any benefit under this Policy, or if a claim is made and rejected and no court action or suit is commenced within twelve months after such rejection or, in case of arbitration taking place as provided therein, within twelve(12) calendar months after the Arbitrator or Arbitrators have made their award, all benefits under this Policy shall be forfeited. |
| 12. Cancellation / termination |
| The Company may at any time, cancel this Policy, by giving 7 days notice in writing by Registered post to the Insured Person at the address shown in the Schedule in which case the Company will refund Pro-rata premium for the unexpired period, provided no claim has occurred thereunder. The Insured Person may also give 7 days notice in writing, to the Company, for the cancellation of this Policy. |
| For Single |
Cancellation of policy by the Insured Person may be done only in cases where a journey is not undertaken and only on production of the Insured Person's
passport as a proof that the journey has not been undertaken. Any request for cancellation will be entertained up to 14 days after the first day of insurance as
indicated in the schedule of the policy subject to a deduction of Rs.250/-
No refund of premium or part thereof will be allowed:
- in case Insured Person returns to India before the expiry of the Policy.
- if any claim has been preferred under the policy before invoking cancellation request
|
| For Multi Trip: |
| The Company will retain the applicable Short Period rates as below for the period, for which, the Insurance was in force subject to a minimum retention of Rs.250/- and also subject to no claim having occurred.
|
| SHORT PERIOD RETENTION RATES |
| For a period |
0-45 Days |
30% of Annual premium |
| For a period |
46-90 Days |
50% of Annual premium |
| For a period |
91-120 Days |
80% of Annual premium |
| For a period |
121-140 Days |
90% of Annual premium |
| For a period exceeding |
140 Days |
Annual premium |
|
| The Insured Person has to produce the Passport as proof of the Trip Days undertaken during the Policy Period. |
| 13. Currency for payments |
| All claims payable in India shall be paid in Indian Rupees only. |
| 14. Policy Disputes |
| Any dispute concerning the interpretation of the terms, conditions, limitations and/or exclusions contained herein is understood and agreed to by both the Insured Person and the Company to be subject to Indian Law. Each party agrees to submit to the exclusive jurisdiction of the High Court of Chennai and to comply with all requirements necessary to give such Court the jurisdiction. All matters arising hereunder shall be determined in accordance with the law and practice of such court. |
| 15. Arbitration clause |
If any dispute or difference shall arise as to the quantum to be paid under this Policy (liability being otherwise admitted) such difference shall independently of all other questions be referred to the decision of a sole arbitrator to be appointed in writing by the parties to the dispute/difference, or if they cannot
agree upon a single arbitrator within 30 days of any party invoking arbitration, the same shall be referred to a panel of three arbitrators, comprising of two
arbitrators, one to be appointed by each of the parties to the dispute/difference and the third arbitrator to be appointed by such two arbitrators. Arbitration shall be conducted under and in accordance with the provisions of the Arbitration and Conciliation Act, 1996.
It is clearly agreed and understood that no difference or dispute shall be referable to arbitration, as hereinbefore provided, if the Company has
disputed or not accepted liability under or in respect of this Policy.
It is hereby expressly stipulated and declared that it shall be a condition precedent to any right of action or suit upon this Policy that the award by such
arbitrator/ arbitrators of the amount of the loss or damage shall be first obtained.
It is also further expressly agreed and declared that if the Company shall disclaim liability to the Insured Person for any claim hereunder and such claim shall not, within three calendar months from the date of such disclaimer have been made the subject matter of a suit in a Court of Law, then the claim shall for all purposes be deemed to have been abandoned and shall not thereafter be recoverable hereunder. |
| 16. Notices |
Any notice, direction or instruction given under this Policy shall be in writing and delivered by hand, post, or facsimile to
In case of the Insured Person, at the address specified in Part I of the Schedule.
In case of the Company.
Royal Sundaram Alliance Insurance Company Limited
Regd. Office: 21, Patullos Road,
Chennai 600 002
Notice and instructions will be deemed served 7 days after posting or immediately upon receipt in the case of hand delivery, facsimile or e-mail. |
| 17. Customer Service |
| If at any time the Insured Person requires any clarification or assistance, Insured Person may contact Customer Service Helpline 1800-345-8899 at
Sundaram Towers, 45 & 46, Whites Road, Chennai-600 014.
|
| 18. Grievances |
In case the Insured Person is aggrieved in any way, the Insured Person may contact the Company at the specified address, during normal business
hours for the following grievances:
| (a) |
any partial or total repudiation of claims by the Company. |
| (b) |
any dispute regard to premium paid or payable in terms of the policy. |
| (c) |
any dispute on the legal construction of the policies in so far as such disputes relate to claims. |
| (d) |
delay in settlement of claims. |
| (e) |
non-issue of any insurance document to customer after receipt of the premium. |
|
| The Insured Person may approach the Insurance Ombudsman, within whose jurisdiction the branch or office of Royal Sundaram Alliance Insurance
Company Limited is located. The Insurance Ombudsman's offices are located at Ahmedabad, Bhubaneshwar, Bhopal, Chandigarh, Chennai, Guwahati, Kochi, Kolkatta, Lucknow, Hyderabad, Mumbai and Delhi.
|
| 19. RENEWAL CLAUSE |
| The Company shall not be bound to accept any renewal premium nor give notice that such is due. Every renewal premium (which shall be paid and
accepted in respect of this policy) shall be so paid and accepted upon the distinct understanding that no alteration has taken place in the facts contained in the proposal or declaration herein before mentioned and that nothing is known to the Insured Person that may result to enhance the risk of the Company under the insurer. Nothing herein or otherwise shall oblige the Company to offer renewal terms or restrict any renewal terms as to premium or otherwise. |
| For Claims Assistance or Enquiry: |
| Originating Country |
International Access Code (+) |
UIFN Number |
| Australia |
0011 |
800-80008400 |
| Austria |
00 |
800-80008400 |
| Belgium |
00 |
800-80008400 |
| China |
00 |
800-80008400 |
| Denmark |
00 |
800-80008400 |
| Finland |
990 |
800-80008400 |
| Finland |
999 |
800-80008400 |
| France |
00 |
800-80008400 |
| Germany |
00 |
800-80008400 |
| Hong Kong |
001 |
800-80008400 |
| Hungary |
00 |
800-80008400 |
| Ireland |
00 |
800-80008400 |
| Isreal |
014 |
800-80008400 |
| Italy |
00 |
800-80008400 |
| Japan |
001-010 |
800-80008400 |
| Japan |
0033-010 |
800-80008400 |
| Japan |
0061-010 |
800-80008400 |
| Japan |
0041 |
800-80008400 |
| S.Korea |
001 |
800-80008400 |
| S.Korea |
002 |
800-80008400 |
| Malaysia |
00 |
800-80008400 |
| Netherlands |
00 |
800-80008400 |
| New Zealand |
00 |
800-80008400 |
| Norway |
00 |
800-80008400 |
| Phillipines |
00 |
800-80008400 |
| Portugal |
00 |
800-80008400 |
| Singapore |
001 |
800-80008400 |
| Spain |
00 |
800-80008400 |
| Sweden |
00 |
800-80008400 |
| Switzerland |
00 |
800-80008400 |
| Thailand |
001 |
800-80008400 |
| UK |
00 |
800-80008400 |
| Canada |
001 |
18663771177 |
| USA |
001 |
18663815720 |
Way to dial a UIFN number from the originating country
The international access code + UIFN number
For example if the ITU UIFN number is 800 80008400, the way this number is
dialled is international access code + 800 8000 8400.
For eg : The international access code for Australia is 0011, so the above number
will be dialled as 0011 800 8000 8400 from Australia
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