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Online Policy Issuance
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No Paper Work
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Hassle Free
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Pay Via Credit/Debit Card & Net Banking
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Overseas Travel Accident – Travel Guard Platinum & Annual
Multi Trip Insurance
Tata AIG General Insurance Company Limited (We, Our or Us) will
provide the insurance described in this Policy and any endorsements thereto for
the Insured Period as defined in this Policy, to the Insured Persons named in the
Policy Schedule and in reliance upon the statements contained in the Proposal and
Declaration Form filled and signed by the Insured Person(s), which shall be the
basis of this Policy and are deemed to be incorporated herein in return for the
payment of the required premium when due and compliance with all applicable provisions
of this Policy.
The insurance provided under this Policy is only with respect to such and so many
of the benefits as are indicated by a specific amount set opposite in the Policy
Schedule or the Schedule of Benefits.
This Policy will only be in force if a person we have authorized signs the Policy
Schedule.
Uniform Provisions
Entire contract - changes
This Policy, together with the Proposal and Declaration Form, as well as any forms,
riders and endorsements and papers hereto, constitutes the entire contract of insurance.
No change in this Policy shall be valid until approved by Our authorised officer
and such approval is endorsed hereon. No agent has authority to change this Policy
or to waive any of the provisions of this Policy.
Effective date
Single Trip Insurance: Your Policy will start on the Effective Date specified
on the Policy Schedule provided it is countersigned by Us and the total premium
has been paid
Annual Multi Trip Insurance: Your Policy will start on the latest of the
Effective Date specified on the Policy Schedule, or the commencement of a Trip and
the total premium has been paid
Renewal conditions:
This Policy will terminate at the expiration of the period for which premium has
been paid or on the Expiration Date shown in the Proposal and Declaration Form and
Schedule, whichever is earlier.
The Single Trip Insurance is non-renewable, not cancelable and not refundable while
effective. Cancellation of the Policy may be done only prior to the Effective Date
stated in the Policy Schedule and will be subject to deduction of cancellation charge
by Us.
The Annual Multi Trip Insurance may be renewed with Our consent by the payment in
advance of the total premium specified by Us, which premium shall be at Our premium
rate in force at the time of renewal. We, however, are not bound to give notice
that it is due for renewal. Unless renewed as herein provided, this Policy shall
terminate at the expiration of the period for which premium has been paid.
Expiration date
Single Trip Insurance
Your Policy will terminate on the last day for which premium has been paid or on
return to India or 90 days from the date of commencement of the Insured Journey,
whichever is earlier
Annual Multi-Trip Insurance
This Policy will terminate on the Expiration Date shown in the Proposal and Declaration
Form / Policy Schedule for which the premium has been paid. However, The Insured
Person’s coverage under this Policy ends on the earliest of :
- the Policy Expiration date as stated above; or
- the Policy is terminated; or
- the date the Insured Person requests, in writing, that his or her coverage be terminated;
or
- Termination of the Insured Journey.
In case of individual journey during the Insured Period, it shall expire 30 days
or less, from the commencement of each Insured Journey.
However We may cancel this Policy at any time by giving you a 7 Days notice delivered
to You, or mailed to Your last address as shown by Our records, stating when such
cancellation shall be effective. In the event of cancellation, We will return promptly
the pro-rata unearned portion of any premium You have actually paid. Such cancellation
shall be without prejudice to any claim originating prior thereto. If you cancel
the Policy, the earned premium shall be computed in accordance with Our short rate
table for the period the Policy has been in force, provided no claim has occurred
up to the date of cancellation in which case the whole premium shall be fully earned
and no return of premium will be made.
Territory
This Policy applies to incidents anywhere in the world outside India unless limited
by Us through endorsement.
Contribution
If at the time of a claim there is another insurance Policy or other contract in
Your or the Insured Person’s name which covers the Insured Person for the same expense
or loss, We will only pay Our proportionate share of the loss. Our Proportionate
share will be calculated by determining the percentage Our Policy maximum bears
to the total amount of insurance in force as to the loss. This does not apply to,
Accidental Death and Dismemberment, and Permanent Total Disability which We will
pay in full if available under this Policy.
Concealment or fraud
The entire Policy will be void if, whether before or after a loss, You have, related
to this insurance,
- intentionally or recklessly or otherwise concealed or misrepresented or not disclosed,
what we consider to be any material fact or circumstance;
- engaged in what we consider to be fraudulent, dishonest or deceitful conduct; or
- made false statements.
Notice of claim/ loss
It is a condition precedent to Our liability hereunder that written notice of claim
must be given by You to Us within 7 days after an actual or potential loss begins
or as soon as reasonably possible and in any event no later than 30 Days after an
actual or potential loss begins. If Your property covered under this Policy is lost
or damaged, You must:
- notify us as soon as possible;
- take immediate steps to protect, save and/or recover the covered property;
- give immediate notice to the carrier or bailee who is or may be liable for the loss
or damage;
- notify the police or other appropriate authority in the case of robbery or theft
within 24 hours.
Claim forms
We, upon receipt of a notice of claim, will furnish You with such forms as We may
require for filing proofs of loss.
Time for filing claim forms and evidence
Completed claim forms and written evidence of loss must be furnished to Us within
thirty (30) Days after the date of such loss. Failure to furnish such evidence within
the time required shall not invalidate nor reduce any claim if You can satisfy us
that it was not reasonably possible for You to give proof within such time. However,
no proof will be accepted if furnished later than one (1) year from the time the
loss occurred.
You shall obtain and furnish Us with all original bills, receipts and any other
documentation upon which a claim is based at your cost and shall also give Us in
a timely fashion such additional documentation, information and assistance as We
may require in dealing with the claim.
Time of payment of claim
Benefits payable under this Policy will be paid within a reasonable time upon receipt
of due written evidence of such loss and any other documentation, information and
assistance that We may request You pursuant to Uniform Provision 10 above. Subject
to due written evidence of loss all accrued benefits for loss for which this Policy
provides periodic payment will be paid monthly and any balance remaining unpaid
upon the termination of liability will be paid immediately upon receipt of due written
proof.
Payment of claim
All claims under this Policy that are payable to the You shall be paid in Indian
currency.
Arbitration
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 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 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 and arbitration shall be conducted under and in accordance
with the provisions of the Indian Arbitration and Conciliation Act, 1996.
It is clearly agreed and understood that no difference or dispute shall be referable
to arbitration as herein before 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.
Assignment of indemnities
Indemnity, if any, in case of Your loss of life is payable to the assignee named
in the Proposal and Declaration Form provided such assignee survives you ; otherwise,
indemnity is payable to Your estate. All other indemnities of this Policy are payable
to You. Any payment We make in good faith pursuant to this provision shall fully
discharge Us to the extent of the payment.
Consent of assignee
Consent of the assignee, if any, shall not be a pre-requisite for any change of
assignee or to any other changes in this Policy.
Change of assignee
No change of assignee under this Policy shall bind Us, unless consent thereto is
formally endorsed thereon by Our authorized officer.
Medical examination
We, at Our own expense, shall have the right and opportunity to examine You through
Our appointed agents whose details will be notified to You when and as often as
We may reasonably require during the pendency of a claim hereunder, and also the
right and opportunity to obtain a post mortem examination report of Your body as
permitted by law. Your or Your estate’s compliance with the need for such examination
report is a condition precedent to establishing liability under the Policy.
Legal actions
Without prejudice to Uniform Provision 13 above, no action at law or in equity shall
be brought to recover on this Policy prior to the expiration of sixty (60) Days
after written evidence has been furnished in accordance with the requirements of
this Policy. If no evidence has been furnished within one (1) year of the date upon
which it should have been furnished then the claim shall for all purposes be deemed
to have been abandoned and shall not thereafter be recoverable under this Policy.
If We disclaim liability to You or any Insured Person for any claim, and if You
do not notify Us in writing within one (1) year from the date of receipt of the
notice of such disclaimer that You do not accept such disclaimer and intend to recover
this claim from Us, then the claim shall for all purposes be deemed to have been
abandoned and shall not thereafter be recoverable under this Policy.
Misstatement of age
If Your Age has been misstated, all amounts payable under this Policy shall be adjusted
to the coverage amount that would have been purchased for the premium paid. In the
event Your Age has been misstated, and if according to Your correct Age, the coverage
provided by the Policy would not have become effective, or would have ceased prior
to the acceptance of such premium or premiums, then Our liability during the period
You are not eligible for coverage, shall be limited to the refund, upon written
request, of all premiums paid for the period not covered by the Policy.
Compliance with policy provisions
Failure to comply with any of the provisions contained in this Policy shall invalidate
all claims hereunder.
Excess provision
The plan benefits as shown in the Policy Schedule or the Schedule of Benefits (refer
to Part F. of this Policy) are payable for covered expenses, not covered and payable
by any other plan providing medical expense benefits. If there is no other valid
and collectible benefits available from any other source, this plan will pay the
covered expenses up to the limits or sub-limits of the policy.
Limitations
If an Insured Person incurs a covered Accident or an Injury, for which benefits
are payable under the same Policy issued by Us, the maximum amount payable under
all such Policies combined will not exceed the amount payable under the Policy which
pays the largest benefit. If benefits are determined on a daily or weekly basis,
‘the largest benefit’ as used herein will mean the largest Daily/ weekly Benefit.
Interest on the benefit we pay
We will not pay any interest on any benefit We pay.
Other interest
Your personal representatives cannot claim from or sue Us. If more than one person
or company has an interest in You, We will pay a benefit only once.
Reasonable care and assistance
You and each Insured Person must take all reasonable steps to avoid or reduce, as
far as possible, any loss or damage. You and they must also make every effort to
get back any property which has been lost.
In addition, You and each Insured Person must assist Us in any manner We may reasonably
require in relation to the investigation or settlement of a claim or the preservation
or enforcement of any rights of subrogation to which we may be entitled.
Settlement of loss
Claims for damage and/or destruction shall be paid within a reasonable time when
proof of the damage and/or destruction is presented to us. Claims for lost property
will be paid after the lapse of a reasonable time if the property has not been recovered.
You must present acceptable proof of loss and the value involved to us.
Valuation
We will not pay more than the actual cash value of the property at the time of loss.
Damage will be estimated according to actual cash value with proper deduction for
depreciation. At no time will payment exceed what it would cost to repair or replace
the property with material of like kind and quality.
Subrogation
In the event of any payment under this Policy, We shall be subrogated to all Your
rights of recovery thereof against any person or organization and You shall execute
and deliver instruments and papers to Us and do whatever else is necessary to secure
such rights and provide whatever assistance We might reasonably require of You in
the pursuance of Our subrogation rights. You shall take no action after the loss
to prejudice such rights.
Dispute resolution clause and procedure
This contract of insurance includes the following dispute resolution procedure which
is exclusive and a material part of this Policy:
- Nature of Coverages This Policy is not a general health insurance policy.
Coverage for medical expenses in Part D: Coverage of this Policy is intended for
Your use in the event of a sudden and unexpected Sickness or Accident arising when
You are outside the Republic of India.
- Pre-existing Exclusion This Policy is not designed to provide an indemnity
in respect of medical services, the need for which arises out of a Pre-existing
Condition.
- Prior Consultation Any medical services or series of services with a cost
greater than $ 1, shall not be covered by this Policy unless You consult with the
Assistance Company in the manner set out in the conditions of this Policy.
- Choice of Law This Policy will be governed by the law of the Republic of
India. Any disputes will be dealt with as provided for by Uniform Provision 13,
above and otherwise by the Indian courts.
Consideration
This policy is issued in consideration of the premium being paid in advance. No
receipt for premium shall be valid except on Our official form.
Compliance with policy provisions
Failure to comply with any of the provisions contained in this policy shall invalidate
all claims hereunder
Scope of Coverage
24 - hour protection (Insured Journey Only)
The hazards described in this Hazard H-3 apply only to those Insured Persons who
are within a class to which this Hazard applies as stated in the Policy Schedule
or the Schedule of Benefits.
Description of hazards
Such insurance as is afforded to an Insured Person to which this Hazard H-3 applies,
shall apply only to Injury sustained by such Insured Person during the course of
an Insured Journey.
Such Insured Journey shall be deemed to have commenced when the Insured Person leaves
his residence or place of regular employment for the purpose of going on such Insured
Journey, whichever last occurs, and shall continue until such time as he returns
to his residence or place of regular employment, whichever first occurs.
Such insurance includes such Injury sustained during such Insured Journey while
the Insured Person is riding as a passenger (but not as a pilot, operator or member
of the crew) in or on, boarding or alighting from any civilian aircraft having a
current and valid Airworthiness Certificate, and piloted by a person who then holds
a valid and current certificate of competency of a rating authorizing him to pilot
such aircraft. Provided that this Hazard H-3 shall not apply while such Insured
Person is riding in any civilian aircraft other than as expressly described herein,
unless previously consented to in writing by Us.
Travel Guard Policy Exclusions
This entire Policy does not provide benefits for any loss resulting
in whole or in part from, or expenses incurred, directly or indirectly in respect
of:
Where the Insured Person is travelling against the advice of a Physician; or receiving
or on a waiting list for receiving specified medical treatment; or is travelling
for the purpose of obtaining treatment; or has received a terminal prognosis for
a medical condition; or
Any Pre-existing Condition or any complication arising from it; or
Suicide, attempted suicide (whether sane or insane) or intentionally self inflicted
Injury or Illness, or sexually transmitted conditions, mental or nervous disorder,
anxiety, stress or depression, Acquired Immune Deficiency Syndrome (AIDS), Human
Immune deficiency Virus (HIV) infection; or
Serving in any branch of the Military or Armed Forces of any country, whether in
peace or War, and in such an event We, upon written notification by You, shall return
the pro rata premium for any such period of service during the Trip; or
Being under the influence of drugs, alcohol, or other intoxicants or hallucinogens
unless properly prescribed by a Physician and taken as prescribed; or
Participation in an actual or attempted felony, riot, crime, misdemeanor, or civil
commotion; or
Operating or learning to operate any aircraft, or performing duties as a member
of the crew on any aircraft or Scheduled Airline; or
Any loss arising out of War, civil war, invasion, insurrection, revolution, act
of foreign enemy, hostilities (whether War be declared or not), rebellion, mutiny,
use of military power or usurpation of government or military power; or
Any loss, damage cost or expense of whatsoever nature directly or indirectly caused
by, resulting from or in connection with any act of terrorism regardless of any
other cause or event contributing concurrently or in any other sequence to the loss
The warranty also excludes loss, damage, cost or expenses of whatsoever nature directly
or indirectly caused by, resulting from or in connection with any action taken in
controlling, preventing, suppressing or in any way relating to action taken in respect
of any act of terrorism.
If the Company alleges that by reason of this Exclusion, any loss, damage, cost
or expenses is not covered by this insurance the burden of proving the contrary
shall be upon the Insured.
Any loss arising out of the intentional use of military force to intercept, prevent,
or mitigate any known or suspected Act of Terrorism; or
The use, release or escape of nuclear materials that directly or indirectly results
in nuclear reaction or radiation or radioactive contamination; The dispersal or
application of pathogenic or poisonous biological or chemical materials; The release
of pathogenic or poisonous biological or chemical materials, (However, the above
only applies if 50 or more persons sustain death within 90 Days of the date of the
incident) or
The radioactive, toxic, explosive or other dangerous properties of any explosive
nuclear equipment or any part of that equipment; or
Performance of manual work for employment or any other hazardous occupation, self
exposure to needless peril (except in an attempt to save human life); or
Participation in winter sports, skydiving/parachuting, hang gliding, bungee jumping,
scuba diving, mountain climbing (where ropes or guides are customarily used), riding
or driving in races or rallies using a motorized vehicle or bicycle, caving or pot-holing,
hunting or equestrian activities, skin diving or other underwater activity, rafting
or canoeing involving white water rapids, yachting or boating outside coastal waters
(2 miles), participation in any Professional Sports, any bodily contact sport or
any other hazardous or potentially dangerous sport for which You are untrained
The Insured Person riding on a motorcycle or any other two wheeled motorized mode
of conveyance as driver or as passenger.
Any loss resulting directly or indirectly, contributed or aggravated or prolonged
by childbirth or from pregnancy, or
For any loss of which a contributing cause was Your actual or attempted commission
of, or willful participation in, an illegal act or any violation or attempted violation
of the law or Your resistance to arrest.
Common carrier
We will pay the Principal Sum shown in the Policy Schedule or the Schedule of Benefits
if Injury to You results in loss of life while riding as a passenger (but not as
a pilot, operator or member of the crew) in or on, boarding or alighting from any
Common Carrier provided that, this Hazard shall not apply while You are riding in
or on, or boarding or alighting from, any civilian aircraft that does not hold current
a valid Airworthiness Certificate and is piloted by a person who then holds a valid
and current certificate of competency of a rating authorizing him to pilot such
aircraft.
The term “Airworthiness” certificate used in this Hazard shall mean the standard
Airworthiness Certificate issued by the aviation agency or the governmental authority
having jurisdiction over civil aviation in the country of its registry.
General Definitions
Accident
means a sudden, unforeseen, uncontrollable and unexpected physical event to the
Insured Person caused by external, violent and visible means occurring during the
Insured Period.
Acquired immune deficiency syndrome
means the meanings assigned to it by the World Health Organization. Acquired Immune
Deficiency Syndrome shall include HIV (Human Immune-deficiency Virus), encephalopathy
(dementia), HIV Wasting Syndrome, and ARC (AIDS Related Condition).
Act of terrorism
An act of terrorism means an act, including but not limited to the use of force
or violence and / or the threat thereof, of any person or group(s) of persons whether
acting alone or on behalf of or in connection with any organisation(s) or government(s),
committed for political, religious, ideological or similar purpose including the
intention to influence any government and/or to put the public, or any section of
the public in fear.
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.
Annual multi trip insurance
means a Trip or Trips of not exceeding 30 days duration each, that You undertake
during the Insured Period as specified on the Proposal and/or Declaration Form /
Policy Schedule.
Assistance Company
in this case AIG Assist
Common carrier
means any civilian land or water conveyance or Scheduled Aircraft in each case operated
under a valid license for the transportation of passengers for hire.
Day
means a period of 24 consecutive hours.
Disease
means an illness or affliction of the body having a defined and recognized pattern
of symptom(s) which causes more than temporary indisposition and which illness or
affliction first manifested itself and was contracted during the Trip.
Deductible
means the amount of expenses or the number of Days to be paid or supported by the
Insured Person before the Policy benefits become payable.
Eligible children
means named dependent children including adopted and step children of the Insured
Person between Ages six (6) months and eighteen (18) years (twenty three (23) years
if attending as a full time student an accredited Institution of Higher Learning)
who are unmarried, who permanently reside with the Insured Person, and receive the
majority of maintenance and support from the Insured Person.
Eligible family
means the Insured Person and/or the Insured Person’s Spouse and/or, the Insured
Person’s Children
Franchise
means the amount of expenses or the number of Days to be paid or supported by the
Insured Person beyond which the Policy benefits become payable retroactively to
the first Day as an Inpatient.
Hospital
means a medically recognized establishment:
- that holds a valid license (if required by law) to practise medicine, and
- the primary function of which is to provide for the care and treatment of sick or
injured persons, and
- that has a staff of one or more Physicians actually available on the premises at
all times, and
- that provides a 24-hour nursing service and has at least one qualified and registered
professional nurse present and on duty at all times, and
- that has organised diagnostic and surgical facilities, either on its own premises
or in facilities available to the Hospital on a pre-arranged basis, and is not,
except incidentally to its primary function, a clinic, nursing home, rest home,
or convalescent home for the aged, or any similar institution.
Immediate family member
means an Insured Person's legal spouse; siblings; siblings-in-law; parents; parents-in-law;
legal guardian, ward; step-parents; who reside in India
Injury
means bodily Injury caused solely, independently and directly by Accident (as defined
in the Policy) and occurring during the Trip.
Inpatient
means a person: (a) who is confined in a Hospital as a registered bed patient; and
(b) for whom at least one Day’s room and board is charged by the Hospital.
Insured Journey
means any journey undertaken during the Trip which commences when the passenger
boards the aircraft for onward overseas journey and terminates when he disembarks
on return to India or the Expiration date whichever is earlier.
Insured period(s)
means with respect to the Policy, the period commencing with the Effective Date
of the Policy and terminating with the Expiration Date of the Policy as stated in
the Policy Schedule and any subsequent period for which the Policy may be renewed.
Insured person
means the Insured Person up to Age 70 who resides permanently in India, or eligible
Spouse and/or Eligible Children named in the Policy Schedule as being eligible to
become insured under this Policy and for whom an individual Proposal and Declaration
Form for insurance has been received and approved by Us.
Land/Sea arrangements
means pre-paid travel arrangements for a scheduled tour, trip or cruise included
within the description of covered Trips on the Proposal and Declaration Form and
arranged by a tour operator, travel agent, cruise line or other organization.
Physician
means a licensed medical practitioner acting within the scope of his license and
who holds a degree of a recognized institution and is registered by the Medical
Council of the respective country. The term Physician would include specialist and
surgeon.
Policy
means the insurance contract, the Policy Schedule, and any attached enrollment forms,
endorsements, papers or riders.
Policy schedule
means the Policy Schedule attached to and forming part of the Policy.
Pre existing condition
a condition for which care, treatment, or advice was recommended by or received
from a Physician or which was first manifested or contracted within a two year period
preceding the Policy Effective Date of Coverage, or a condition for which hospitalization
or surgery was required within a five year period preceding the Policy Effective
Date specified in the Schedule.
Proposal and declaration form
means the basis of this Policy and is deemed to be attached and which forms a part
of this Policy.
Professional sports
means a sport, which remunerates a player in excess of 50% of his or her income
as a means of their livelihood.
Scheduled airline
means any civilian aircraft operated by a civilian scheduled air carrier holding
a certificate, license or similar authorization for civilian scheduled air carrier
transport issued by the country of the aircraft’s registry, and which in accordance
therewith flies, maintains and publishes tariffs for regular passenger service between
named cities at regular and specified times, on regular or chartered flights operated
by such carrier.
Serious injury or sickness
means Injury or Sickness certified as being dangerous to life by a legally qualified
Physician.
Sickness
means illness first manifested and contracted during the Trip and commencing after
the Effective Date of the Policy Schedule.
Single trip insurance
means the Trip specified on the Proposal and Declaration Form and Policy Schedule
for which the Effective Date and Expiration Date are specified on the Proposal and
Declaration Form and Policy Schedule.
Sound natural teeth
means natural teeth that either are 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.
Spouse
means Your legal husband or wife, who is between the Ages of 18 and 70 years old,
and is living in Your residence.
Traveling companion
means up to two (2) named person(s) who is/are booked to accompany You on the Trip.
Trip
means any Insured Journey during the Insured Period:
- which starts and finishes in India and involves a destination(s) outside India
- which lasts or is expected to last for: 180 Days or less if covered under Single
Trip Insurance; or 30 Days or less per Trip, if covered under Annual Multi Trip
Insurance
Usual and customary charges
means a reasonable charge which is : 1) usual and customary when compared with the
charges made for similar services and supplies; and 2) made to persons having similar
medical conditions in the locality of the Provider. No payment will be made under
this policy for any expenses incurred which in the judgement of the Company are
in excess of Usual and Customary Charges.
War
means war, whether declared or not, or any warlike activities, including use of
military force by any sovereign nation to achieve economic, geographic, nationalistic,
political, racial, religious or other ends.
We, Us, Our -
means Tata AIG General Insurance Company Limited.
You/Your/Yourself
means the Insured Person(s) who is named in the Policy Schedule.
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Main Exclusions 1-Suicide or attempted
suicide 2-Being under the influence of drugs, alcohol, or
other intoxicants 3-AIDS 4-HIV & more
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