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TATA AIG Travel Medical Health Insurance - Frequently Asked Questions
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FAQ Page < 1 2 3
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How will the hospitalization claims be settled?
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Upon notification of the claim, the Assistance Company will get in touch with the treating doctor or hospital as necessary for obtaining details of treatment. After verification and processing that the claim falls within the scope of the policy the Assistance Company will take necessary steps for Guarantee of Payment (GOP) and subsequent settlement of bills.
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What are the basic requirements for obtaining a GOP? How is it done?
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A GOP is Guarantee of Payment to the hospital wherein the insured is being treated as an indoor patient. We require insured's kind cooperation in providing following details to our assistance company to proceed with the GOP to hospital.
Basic requirements are:
- Duly filled in authorization form from the treating Physician.
- Contact details of the Local Family Physician.
- Duly filled and signed Release Of Medical Information Form
In case where it is not possible to provide GOP to the insured it is advised to self pay the medical expenses and file the claim for reimbursement On submission of documents, claim shall be processed and decision on payability shall be taken accordingly.
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Does it cover emergence surgery, by-pass, and angioplasty if needed?
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Yes. Provided the same doesn't fall under the scope of pre-existing sickness/illness.
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What are the exclusions of the policy?
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Some of the General exclusions are as follows:
- 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 Professional Sports, any bodily contact sport or any other hazardous or potentially dangerous sport for which You are untrained
- 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
- Congenital anomalies or any complications or conditions arising therefrom; or
- Participation in winter sports, skydiving/parachuting, hand 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
- 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; chemical materials, (However, the above only applies if 50 or more persons sustain death within 90 Days of the date of the incident)
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Is there any refund of premium on travel guard policies in case of early return?
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No, there is no refund of premium for unused policy period for any of the travel guard polices in case of early return
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If I take a room in a hospital? Will it covered?
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Yes it will be covered. If the stay in the hospital room is less than 24 hours, then the insured has to bear and claim for reimbursement.In case if the stay exceeds 24 hours, then it will be covered hospitalization expenses and direct billing will be done by the insurance company.
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Does this policy covers emergency illness?
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Yes it covers emergency illness. If it is an outpatient the insured has to bear the expenses and claim for reimbursement. In case if the insured stays in the hospital for more than 24 hours then the insurance company does direct billing.
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| TATA-AIG Citation |
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Mr. Rodney Fernandez, Head Travel Services at Tata AIG says "NRIOL has been one of our key partners in India for the past 7 years and has been pivotal in providing Tata AIG customers an opportunity to purchase their Travel policies online".
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