Oriental Insurance Overseas Mediclaim Policy

Organization : Oriental Insurance Company Ltd
Facility : Overseas Mediclaim Policy

Overseas Mediclaim Policy :
https://orientalinsurance.org.in/web/guest/overseas-mediclaim-policy?isSelected=onlineProducts
Home Page : https://orientalinsurance.org.in/web/guest/home?isSelected=home

Overseas Mediclaim Policy :

** Are you planning trip to picturesque Switzerland with your family or a romantic tour of Paris?
** Oriental Insurance Overseas Mediclaim Policy gives comprehensive cover for you and your family when you globe trot.

Related : Oriental Insurance Individual Mediclaim Policy : www.statusin.in/20087.html

** We want your trip to be stress-free so we cover you against medical and other financial emergencies that may incur during your travel.
** Now you can buy policies Online. Buy an Overseas Mediclaim Insurance Policy by registering yourself on our Portal and paying online through your debit card / credit card or Net-banking.
** To check out various online facilities available, you may login on the Portal.

The salient features of the policy are :
** Policy covers the medical expenses while the beneficiary is outside the Republic of India.
** It covers medical expenses both as inpatient as well as outpatient while in a foreign country.
** The sum insured available ranges from Rs.50000/- to Rs.500000/-
** Cashless settlement is provided through our Overseas Services Provider (at present M/s Coris International.)

Various Plans under the Overseas Mediclaim Policy are:
** Business and Holiday Travel cover for individuals.
** Study Policy for students undertaking studies abroad.
** Corporate Frequent Policy for Corporates sending their executives abroad.

Overseas Mediclaim – Business and Holiday :
Brief Description :
This policy provides indemnity for expenses incurred for medical treatment for illness, disease contracted or injury sustained during overseas travel and which is primarily in the nature of an emergency and which is necessary to be undertaken immediately.

Who all are covered :
Indian Residents undertaking bonafide trips abroad for:
a) business and offical purposes
b) holiday purpose

Foreign Nationals working in India. This insurance is valid from the first day of insurance and expires on the last day of the number of days specified in the policy, or on return to India, whichever is earlier. In case of a frequent traveler abroad, there is a special policy which covers all the trips undertaken during the period of 12 months.

Covered Risks :
Since the cover is available as per plans, the expenses would be reimbursed up to limits prescribed under the plan opted for.

General Conditions Applicable To All Sections :
The conditions below apply throughout this insurance. Failure to comply with them may be prejudicial to a claim.
1. (i) The policy will be valid only if the insured journey commences within 14 days of the first day of Insurance as indicated in the policy schedule.

(ii)Cancellation of the policy 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 not less than 14 days after the First Day of Insurance as indicated in the policy schedule. Such cancellation will be subject to deduction of cancellation charges by the underwriters as applicable.
(iii)No refund of premium or part thereof will be allowed in case insured person returns to India before expiry of policy.

2. It is a condition precedent to liability hereunder that in the event of any occurrence likely to give rise to a claim under this Insurance, that the Insured Person, or his representative, must notify American assist Travel Services immediately.

The Insured person or his representative should quote American assist Travel Services as much information concerning the illness, accident or occurrence as is available, including the name of the treating doctor, name and telephone number of the hospital, the OMP policy number and its date of issue.

For minor claims exceeding deductible, American assist Travel Services/ Heritage should be contacted upon return to the Republic of India, and a claim form completed. This document, together with invoices, travel documents and any other relevant details must be sent to American assist Travel Services / Heritage, clearly stating under which section of this policy a claim is being made.

Please note that if medical treatment has been received, medical certificates showing the nature of the injury or illness together with all bills, and receipts if already paid, should be forwarded to American assist Travel Services / Heritage. In no event should a claim be notified to American assist Travel Services / Heritage later than 31 days after the end of an insured trip.

3.Insurers shall be fully and completely subrogated to the rights of the Insured Person against parties who may be liable to provide indemnity or make a contribution in respect of any matter which is the subject of a claim under this insurance .

The Insured Person further agrees to co- operate fully with insurers in seeking such indemnity or contribution including where appropriate, insurers instituting proceedings at their own expense against such parties in the name of the Insured Person.

4.The Insurers may require the Insured Person to furnish at his own expense all certificates, information, proofs or other evidence of claims. The insurers may approach any physician who may have treated the Insured Person, and the Insured Person must co- operate in this respect.

5.No person shall admit liability or make any offer or promise of payment without the express written consent of the Insurers / American assist Travel Services.
6.The Insured Person shall take all reasonable and proper care to safeguard against accident or illness or loss of or damage to his property, as if this insurance was not in force. Failure to do so will prejudice the Insured Person’s claim under this insurance.

7.The Insured Person may not transfer his interest in this insurance. However, the legal representatives of the Insured Person shall have the right to act for the Insured Person who is incapacitated or deceased.
8.This insurance does not operate beyond a period of 180 days continuous absence from the Republic of India unless specifically agreed by Insurers.

9.This policy and the Overseas Mediclaim Policy Schedule shall be read together as one contract and any wording or expression to which a specific meaning has been attached in any part of the Overseas Mediclaim Policy and Schedule shall bear such specific meaning wherever it may appear.

Dispute resolution clause and procedure :

This Contract of insurance includes the following dispute resolution procedure which is exclusive and a material part of this Contract of Insurance.

a.Nature of coverage :
This policy is not a general health insurance policy. Coverage under the medical expense section of this insurance is intended for use by the Insured person in the event of a sudden and unexpected sickness or accident arising when the insured person is outside the Republic of India.

b.Pre-existing Exclusions :
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 as defined below in General Condition 10 (c).

c.Pre-existing condition :
Any sickness for which the Insured Person has sought medical advice or has taken medical treatment in the preceding 12 months prior to the commencement of travel.

d.Prior Consultation :
Any medical services or series of services with a cost of greater than US$ 100 shall not be covered by this policy unless the Insured Person consults with American assist Travel Services in the manner set out in the General Condition number 2.

e.Choice of Law :
The parties to this insurance policy expressly agree that the laws ofthe Republic Of India shall govern the validity, construction, interpretation and effect of this policy.

11.Arbitration :
Any claim, controversy or dispute of any kind or nature arising out of or relating to this Contract of Insurance or breach thereof or to the construction, existence , interpretation , meaning or validity thereof or to the operation or performance thereunder, involving any of the parties, or anyone claiming the rights of any party to this contract shall be by arbitration in the Republic of India in accordance with the provisions of The Indian Arbitration and Conciliation Act 1996 as amended from time to time and for the time being in force, and it is the intent and purpose of the parties hereto, to make the submission to arbitration or any dispute or controversy arising out of this condition precedent to any legal or equitable action or proceeding of any nature.

12.Any claim under this policy that is fraudulent, or if fraudulent means are used to secure payment of benefits under this policy, then such action shall render this policy null and void and all claims hereunder shall be forfeited.
13.No sum payable under this policy shall carry interest.
14.In the event of the Insured Person’s death, Insurers shall have the right to carry out a post mortem at their expenses.
15.Any claim which has not been conclusively proven and the amount thereof substantiated shall not be payable