Travel Secure - Asia Plan - Claims Process

Following shall be the claims process:

 

In the case of claim, the specified documents shall have to be forwarded to the Assistance Service Provider within a period of 30 days from the date of return to the Country of Residence of the Insured person. In case the Trip is terminated any time before the completion of the Trip covered hereunder, the Insured shall submit all the documents as soon as such termination shall take place, but before 30 days from the date of such termination. Each and every

claim lodged under the policy irrespective of the Benefits covered shall invariably be supported by original used ticket/boarding pass together with a photocopy of the passport indicating the travel dates, in relation to all the travels being part of the Trip. Please also note the following additional aspects in connection with every claim:

• Submission of documents shall be a condition precedent to admission of liability under the Policy.
• Wherever, details pertaining to a potential claim are reported to the Assistance Service Provider after the 30 days threshold period, reasons for the delay will have to be adduced. Upon submission of the same, depending upon the circumstances, the company may condone the delay in submission or restrict or deny liability depending upon the circumstances of each claim.
• The Insured person shall at all times take steps to recover the loss from party who has been responsible for such loss. Wherever any recovery is effected, the company’s liability shall only be in excess of such recovered amount subject to the policy terms and conditions. In the event of such recovery happening after the settlement of any claim by us, the insured shall repay the Company the actual amount recovered which has been additionally compensated by us.

 

Claims Settlement:

 

• 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  Service Provider and  it’s assistance  cooperation partners or the Company may require.
• 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.
• All admissible claims  under   this  policy  shall  be  offered for  settlement  within   30  days  from   the  receipt   of  last necessary document. Wherever settlement offer has been made and accepted by Insured Person / Nominee / Legal heir as the case may be, the company shall pay the offered claim   amount within   7   days   from   the   date   of   such acceptance, failing which the Company shall be liable to pay interest at 2% above the bank rate prevalent at the beginning of the financial year in which the claim is reviewed.
• At the  time  of claim  settlement, Company may  insist  on KYC documents of the  Proposer  as per  the  relevant  AML guidelines  in force.

 

Claim Documentation:

 

Please ensure to submit the following documents in respect of each and every claim:

 

• Original Claim form duly filled in and signed (including attending Medical Practitioner’s format    where required) 
• The original bills and vouchers must be submitted along with all claims.
• Air ticket copy and boarding pass together with copy of passport indicating travel dates together with visa stamping and entry and exit stamping.
• KYC documents (address proof and ID proof for all claims exceeding INR 1,00,000
• Cancelled cheque leaf of SB account in the policy holder’s name for effecting NEFT settlement
•  Any other document(s) that the Company requires from the Insured Person to process the claim.

 

If  Service Provider  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.

 

Specific claims provisions applicable to Medical Expenses (including Medical Evacuation)

 

For Cashless Claims:

 

In the case of emergency Hospitalization, the insured person shall inform the Service Provider within one day of hospitalization but in any case before discharge from the Hospital. The Company is not obliged to provide cashless facility if the above mentioned timelines are not adhered to.

 

Reimbursement Claims:

 

The Insured should report the contingency/ claim to the Service Provider immediately and not later than 30 days from the date of illness/diagnosis

• In any case, the Insured Person shall immediately contact the Alarm Center   of Service Provider and   it’s assistance   cooperation partners stating the necessary details.
• Service Provider will verify the identity   of the caller by asking his/her Passport Number.
• In  the  event  of an  Accident  or  sudden illness  where  it is not  possible   to  intimate the Service Provider 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 person is being   admitted as a patient,   the Insured   Person shall   show   the   concerned Physician   or personnel this Policy if requested.

 

Documents to be submitted in support of the claim for Medical Expenses:

 

• Original claim form duly signed and filled in (including attending Medical Practitioner’s format)
• The original bills and vouchers must be submitted along with all claims.
• 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

 

Documents to be submitted in support of the claim for Medical Evacuation

 

• Medical reports and transportation details issued by the evacuation agency, prescriptions and medical report by the attending Medical Practitioner providing the name of the Insured and details of treatment rendered along with the statement confirm the necessity of evacuation.
• Bills, vouchers in support of expenses incurred
• Any other document as required by the Company on a case to case basis.

 

Note: In respect of all claims payable hereunder, the Company may effect settlement either in the form of cashless treatment facility or by reimbursement of the amount of claim to the Insured, at its sole discretion. Cashless treatment facility cannot be demanded by the Insured as a matter of right.

 

Documents to be submitted if specifically, sought

 

1.Copy of indoor case records (including nurse's notes, OT notes and anesthetists' notes, vitals chart)

2.Attending Medical Practitioner’s certificate clarifying 

• reason for hospitalization and duration of hospitalization
• history of any self-inflicted injury
• history of alcoholism, smoking
• history of associated medical conditions, if any

3. Medical records for treatment done in India

4. Any other document necessary in support of the claim on case to case basis

 

Specific claims provisions applicable to Accidental Death & Dismemberment (24 hours and Common Carrier coverage):

 

Death Claim (Submit the duly filled in claim form with the following documents)

 

• Original Death Certificate.
• Autopsy Report (If conducted)
• Police Report
• Accident/Medico Legal Certificate
• Investigation Reports like Laboratory test, X-rays and reports essential for confirmation of the Injury
• Chemical analysis report/viscera report if preserved for analysis
• Admission/Discharge/Death summary issued by the hospital authority
• Hospital records.
• English translation of foreign language documents
• Any other document sought by the investigator
• Legal Heir Certificate / Succession Certificate or Alternate set of legal documents sought in the absence of nomination.
• News Paper cuttings if any and any other relevant records.
• Certificate given by Indian Embassy for repatriation of mortal remains, if any
• Any other supporting documents as may be required by the Company.

 

Disablement Claim (Submit the duly filled in Claim form with the following documents).

 

Permanent Total or Partial Disablement.

• Disability Certificate issued by attending physician.
• Police Report
• Accident/Medico Legal Certificate
• Hospital Records.
• Investigation Reports like Laboratory test, X-rays and reports essential for confirmation of the Injury
• Photographs of the insured exhibiting disability
• News Paper cuttings if any and any other relevant records.
• English Translation of foreign language documents.
• Any other document as may be required by the Company.

 

Specific claims provisions applicable to Delay of Checked-in Baggage 

 

The Insured Person has to provide the following documents to Service Provider:

 

• Original claim form duly signed and filled in
• Property   Irregularity Report issued by the Common Carrier
• Certificate from airlines confirming duration of delay
• Boarding pass (s) and   baggage coupon(s)/tag(s) of Insured Person and above mentioned travel companion if applicable.
• Any   further    documents   requested   by    TPA   to    confirm delay of baggage and amount recovered from airlines.
• Original receipts for emergency purchases made in case of delay of baggage.

 

Specific claims provisions applicable to Loss of Checked-in Baggage 

      

The Insured Person has to provide   the following   documents to Service Provider:

 

• Original claim form duly signed and filled in
• 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 Rs.7000/-
• Letter from the airlines confirming that the baggage has been permanently lost and compensation if any paid towards settlement of claim for lost baggage
• Any   further    required    documents   requested   by   Service Provider   to confirm loss of baggage and amount recovered from airlines.

 

Specific claims provisions applicable to Loss of Passport 

 

Documents to be submitted in support of the claim

 

• Original claim form duly signed and filled in
• Air ticket jacket / boarding pass
• Copy of old and New Passport .
• Police Report.
• Statement of claim for the expenses incurred including details of the attempts made to trace the passport.
• Receipt for payment of charges for obtaining an emergency certificate at the place of loss of the passport.
• Payment proof/receipts for obtaining duplicate passport / travel documents. e.g. Payment made to embassy of India for making duplicate passport, Emergency Certificate issued by embassy of India. stamps, cost of a professional account or solicitor, excluding any transportation involved in getting duplicate passport
• And any other document as may be appropriately applicable for the claims preferred under this section of the Policy.

 
In event the passport originally reported lost being traced and made available to the Insured, any time before the emergency certificate at the place of loss of the passport or the duplicate passport at the Country of Residence of the Insured is issued to the Insured, the Insured shall intimate the concerned authorities forthwith and apply for the refund of the money paid with the application for emergency certificate or duplicate passport, as the case may be. The Insured shall then refund to the Company such amount as has been refunded by the authorities to the Insured in this regard.
 
For details on claim documentation pertaining to the other sections, please refer to the detailed policy terms and conditions.

 
The Claim documents should be sent to:
Health Claims Department
M/s.Royal Sundaram General Insurance Co. Ltd.,
Vishranthi Melaram Towers,
No.2/319, Rajiv Gandhi Salai (OMR),
Karapakkam, Chennai 600 097.
Tel.No:044-7117 7117.
 
Claim documents may be submitted to local Royal Sundaram Offices address of which can be obtained by calling our Toll Number 1860 425 0000.