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Exclusions - Travel Insurance Policy

Exclusions applicable for overseas health cover, dental cover, emergency evacuation & hospital daily allowance

1. Medical treatment abroad if that is the sole reason or one of the reasons for temporary stay abroad.
2. Medical expenses / services, the need for which arises out of a Pre-Existing Condition.
3. 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 TPA and its assistance cooperation partners as the case may be.
4. Service, supplies or treatment including the period of hospitalisation confinement determined as excess of Reasonable and Customary charges by TPA and its assistance cooperation partners.
5. 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.
6. 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.
7. Any costs related to mental or psychiatric disorders.
8. Routine physicals or examinations where there are no objective indications or impairment in normal health.
  a. 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.
9. Medical treatment of typical symptoms suffered during pregnancy and their consequences, including changes in other chronic conditions as a result of pregnancy.
10. Any medical check-ups during pregnancy or treatment of the pregnancy.
11. Expenses incurred in connection with weak strained or flat feet corns calluses or toe nails.
12. Diagnosis and treatment of acne.
13. Organ transplants which are considered experimental in nature.
14. Well child care including exams and immunizations.
15. Expenses which are not exclusively medical in nature.
16. Congenital (external or internal) anomalies or any complications or conditions arising there from.
17. Any expenses incurred in India unless authorized and approved by TPA and it’s assistance cooperation partners in advance.
18. Rehabilitation and/or physiotherapy or the costs of prostheses/ prosthetics (artificial limbs, eye glasses, contact lenses, hearing aids) etc.
19. Medical expenses covered under Workman’s Compensation or similar policy.
20. Medical expenses incurred as a result of alcohol and/or drug abuse, addiction or overdose.
21. Treatment by Relatives.
22. Dental crowns and bridges.
23. Expenses recoverable from any medical or hospital benefit fund.
 
Exclusions applicable for Accidental Death & Dismemberment
 
1. 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.
2. Damage to health caused by curative measures, radiation, infection, poisoning except where these arise from an Accident.
3. Any payment under this Benefit whereby the Company’s liability would exceed the sum payable in the event of death
4. Any other claim after a claim for death has been admitted by the Company and becomes payable.
5. Any claim which arises out of an Accident whilst engaging in aviation or ballooning, whilst mounting into or dismounting from or travelling 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
6. Any claim arising out of an Accident related to pregnancy or childbirth, venereal disease or infirmity, whether directly or indirectly
7. 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.
 
Exclusions applicable for Travel Inconvenience & Loss of checked in baggage
 
1. Any partial loss of items contained within a bag.
2. The Company will not be liable for any Valuables , perishables and consumables
3. Losses arising from any delay, detention, confiscation by customs officials or other public authorities.
4. Loss due to complete or partial damage of the baggage
5. Any amount recovered under Delayed Baggage cover of the policy from the same event
 
Exclusions applicable for Delay of checked in baggage
 
1. Losses arising from any delay, detention, confiscation by customs officials or other public authorities.
2. Any baggage delay on arrival in the Republic of India (inward flight)
3. 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.

Exclusions applicable for Loss of Passport / Visa

1. Loss of the Passport/Visa due to delay or confiscation or detention by the Customs, Police or Public Authorities.
2. 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.
3. 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
4. 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.
5. The applicable Excess as mentioned in the Schedule.

Exclusions applicable for Hijack Distress Allowance

1. Any claim where the Insured Person is considered as the principal or accessory in the hijacking.

Exclusions applicable for Trip Delay
 
1. Failure to check in on time
2. Negligence of fault of the travel agent. Subject to exclusions mentioned in the ‘General Exclusions’ section of this Policy

Exclusions applicable for Trip cancellation

1. The Insured Person and / or Travel Companion changing his / her mind about undertaking the Trip.
2. Negligence or fault of the travel agent.
3. The Insured Person / his or her travel companion is / are aware of the possible cancellation prior to commencement of the Trip.
4. Suspension of services by the Common Carrier whether voluntarily or pursuant to any order from any authority.
5. Additional penalty charges incurred that would not have been imposed had the Cancellation done as soon as reasonably possible.
 
Exclusions applicable for Home insurance

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
 
Exclusions applicable for Personal Liability

1. Any claim arising from Employer’s liability or Insured Person’s contractual liability.
2. Any claim of personal liability of the Insured Person towards his/ her Family, relations and travelling 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 firearms.
 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.

General Exclusions

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 travelling 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 Immuno deficiency 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
9. 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.
10. 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.
11. Any act of Terrorism.
12. 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.
13. 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
14. Declared beforehand and necessary additional premium paid.
15. Any claim for participation in Hazardous Sports/Hazardous Activities.
16. Any claim for self exposure to needless peril (except in an attempt to save human life).
17. 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.
18. Any claim directly or indirectly arising from the Insured Person engaging in any manual work.
19. 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.
20. Any claim arising out of consequential loss or contractual liability.
21. Any claim up to the Excess as shown in the Policy Schedule.
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