Travel Insurance Policy
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HDFC ERGO General Insurance Company Limited
2919100007547500000
Policy Schedule Policy No. 2919 1000 0754 7500 000 Travel Insurance Policy Proposer Name MR. NEELESH SURESH TAMBE Correspondence NEEL NIKETAN RAMDAS SWAMI NAGAR TAKLI ROAD, Address BEHIND GANDHI NAGAR NASIK, MAHARASHTRA, 422006 Mobile 9920858379 Phone E Mail Insurance Plan
Single Trip Inc USA / Canada (Worldwide)
Period of Insurance
From Date & Time
Maximum any one life limit (US$)
11/11/2013 00:01 hrs
100000
0
Permanent Address
NEEL NIKETAN RAMDAS SWAMI NAGAR TAKLI ROAD, BEHIND GANDHI NAGAR NASIK, MAHARASHTRA, 422006 [email protected] Overseas Ph. No. Countries of Visit
WorldWide
To Date & Time
10/12/2013 Midnight
Operative Time*
As mentioned below
*Operative Time: A trip outside the territorial limits of the country of residence. The insurance starts from the time an Insured Person leaves the territorial limits of the country of residence, and ends when an Insured Person returns to the territorial limits of the country of residence.
Insured Person's Details & Sum Insured Insured’s Name NEELESH SURESH TAMBE
Category
Gender
Date of Birth
Passport No.
Nominee Name
Relationship
Self
Male
07/07/1979
F6275073
Venu suresh tambe
Mother
Coverage Details Benefits Emergency Medical Expenses(EME) Accidental Death - Common Carrier Permanent Disablement - Common Carrier Hospital Cash Emergency Dental Treatment Loss of Baggage & Personal Documents Medical Evacuation Loss of Checked Baggage Delay of Checked Baggage Accidental Death Permanent Disablement / Table B Personal Liability Financial Emergency Assistance Hijack Distress Allowance Flight Delay Hotel Accomodation
Sum Insured (US$) 100000 5000 5000 $15 per day/Max 150 500 250 Included in EME 1000 200 15000 15000 100000 700 $75 per Day/Max 525 $10 per Hour/Max 120 3000
Deductible (US$) 100 Nil Nil 1 Day 150 30 Nil Max 50% Per Bag/10% Per Item 12 Hours/$10 per 8 Hours Nil Nil 200 Nil 1 Day 6 Hours Nil
Premium Details (`) Basic Premium
1,462.00
Loadings
0.00
Service Tax (Including Education Cess & Higher Education Cess, wherever applicable)
181.00
Total Premium
1,643.00
Payment Details Cheque No./DD/Fund Transfer RT1310001311
Date 09/10/2013
Bank Name Drawn On HDFC Bank
Special Conditions
Exclusions
List of Endorsements Endt No
Description
Effective Date
I f the premium i s not realised the policy shall be void from inception. The stamp duty of ` 0.50 paid by Demand Draft, vide Receipt/Challan no 30347 dated 10/12/2012 as prescribed in Government Notification Revenue and Forest Department No Mudrank 2004/4125/CR 690/M-1, dated 31/12/2004 . Policy Issuing Office: Mumbai
For HDFC ERGO General Insurance Company Ltd.
Duly Constituted Attorney The Policy wording attached herewith includes all the standard coverage offered by the Company to its customers. Your entitlement for coverage/benefits shall be restricted to the coverage/benefits as mentioned in this policy schedule. For any clarification please call our toll free number.
Corporate Off.: 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri(E), Mumbai 400 059. Toll-Free No.1800-2-700-700 Fax 91 22 66383699 [email protected] www.hdfcergo.com Registered Off.: Ramon House, H.T.Parekh Marg, 169, Backbay Reclamation, Mumbai 400 020, India.
HDFC ERGO General Insurance Company Limited Frequently Asked Question’s (FAQs) - Travel Insurance Policy
CAN THE TRAVEL POLICY BE EXTENDED?
FOR HOW MANY DAYS CAN THE POLICIES BE EXTENDED?
Extensions are applicable to original policies of 30 days or more and provided only if the Policy is still in force. Please note that extension on a policy can be availed only once.
The Policy may be extended maximum upto 180 Days. The total policy period including extension should not exceed 360 days.
HOW DO I EXTEND MY POLICY?
CAN THE POLICY BE CANCELLED?
You can send a mail to [email protected]. You will receive a revert from our end with the detailed procedure and the additional premium amount to be paid.
CAN THE PLAN COVERAGE PERIOD BE REDUCED? No, the plan coverage cannot be reduced, irrespective of the fact whether journey has commenced or not.
The policy may be cancelled via request on Email/Fax, The intimation of cancellation has to reach us latest upto 14 days from the inception date of the policy. If the policy has already incepted, a copy of all 40 pages of the passport needs to be submitted as proof. Cancellation charges of Rs. 250/shall be applicable and the balance shall be refunded.
WHOM DO I NEED TO CONTACT TO MAKE CHANGES OR CORRECTIONS IN MY POLICY? You can mark a mail to [email protected]. On receipt of the request the endorsement will be processed within 48 hours and the documents will be sent to your registered email address.
HOW TO CONTACT US? Call Toll-free : 1800 2 700 700 / 1800 226 226 Fax : 022 6638 3669 E-Mail : [email protected] Write to us at : HDFC ERGO General Insurance Company Limited (Corporate Office) 6th floor, Leela Business Park, Andheri Kurla Road, Andheri(East), Mumbai - 400 059
WHERE CAN ONE AVAIL THE CLAIM FORMS? On registration of a claim, claim form will be forwarded to you by mail, email or fax along with the intimation for the various documents required. The forms are also available on the website.
HOW DO I FILE A CLAIM? In the event of a covered emergency and to register claims, call our International Emergency Service Provider, International SOS - 24 hour Helpline Centre and quote Policy Holders’ Name, Policy Number, Insurance Company, Passport Number when seeking assistance within 24 Hours. The contact details are: Land line: 011-41898872 Fax: 011-41898801 Email: [email protected] Toll Free No. 1866 202 4700 (For USA Only)
WHOM TO CONTACT IN CASE OF HOSPITALIZATION? International SOS should be contacted for all claims. The contact details are as provided above.
WHAT DOES 'DEDUCTIBLE’ MEAN?
WILL THE CLAIMS BE SETTLED ON MY RETURN TO INDIA? Claims are settled on the receipt of original documents
Manage Your Portfolio @ hdfcergo.com / Smartphones*
Deductible means the amount of a claim which has to be borne by the insured.
Add/View your policy details Register motor/health claims Track your claim status online
* supports smart phones based on Blackberry, iPhone, Windows8, Android & Symbian platforms
Change your personal details on the go Track your interactions on endorsement dispatch status Find branches, garages and cashless network hospitals Download IPO mobile application from IPO website post log in
This document is a summary of the benefits offered. The information mentioned above is illustrative and not exhaustive. Information must be read in conjunction with the policy wordings. In case of any conflict between this document and the policy wordings, the terms and conditions mentioned in the policy wordings shall prevail.
Corporate Off.: 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri(E), Mumbai 400 059. Toll-Free No.1800-2-700-700 Fax 91 22 66383699 [email protected] www.hdfcergo.com Registered Off.: Ramon House, H.T.Parekh Marg, 169, Backbay Reclamation, Mumbai 400 020, India.
2919100007547500000
Policy Schedule Policy No. 2919 1000 0754 7500 000 Travel Insurance Policy Proposer Name MR. NEELESH SURESH TAMBE Correspondence NEEL NIKETAN RAMDAS SWAMI NAGAR TAKLI ROAD, Address BEHIND GANDHI NAGAR NASIK, MAHARASHTRA, 422006 Mobile 9920858379 Phone E Mail Insurance Plan
Single Trip Inc USA / Canada (Worldwide)
Period of Insurance
From Date & Time
Maximum any one life limit (US$)
11/11/2013 00:01 hrs
100000
0
Permanent Address
NEEL NIKETAN RAMDAS SWAMI NAGAR TAKLI ROAD, BEHIND GANDHI NAGAR NASIK, MAHARASHTRA, 422006 [email protected] Overseas Ph. No. Countries of Visit
WorldWide
To Date & Time
10/12/2013 Midnight
Operative Time*
As mentioned below
*Operative Time: A trip outside the territorial limits of the country of residence. The insurance starts from the time an Insured Person leaves the territorial limits of the country of residence, and ends when an Insured Person returns to the territorial limits of the country of residence.
Insured Person's Details & Sum Insured Insured’s Name NEELESH SURESH TAMBE
Category
Gender
Date of Birth
Passport No.
Nominee Name
Relationship
Self
Male
07/07/1979
F6275073
Venu suresh tambe
Mother
Coverage Details Benefits Emergency Medical Expenses(EME) Accidental Death - Common Carrier Permanent Disablement - Common Carrier Hospital Cash Emergency Dental Treatment Loss of Baggage & Personal Documents Medical Evacuation Loss of Checked Baggage Delay of Checked Baggage Accidental Death Permanent Disablement / Table B Personal Liability Financial Emergency Assistance Hijack Distress Allowance Flight Delay Hotel Accomodation
Sum Insured (US$) 100000 5000 5000 $15 per day/Max 150 500 250 Included in EME 1000 200 15000 15000 100000 700 $75 per Day/Max 525 $10 per Hour/Max 120 3000
Deductible (US$) 100 Nil Nil 1 Day 150 30 Nil Max 50% Per Bag/10% Per Item 12 Hours/$10 per 8 Hours Nil Nil 200 Nil 1 Day 6 Hours Nil
Premium Details (`) Basic Premium
1,462.00
Loadings
0.00
Service Tax (Including Education Cess & Higher Education Cess, wherever applicable)
181.00
Total Premium
1,643.00
Payment Details Cheque No./DD/Fund Transfer RT1310001311
Date 09/10/2013
Bank Name Drawn On HDFC Bank
Special Conditions
Exclusions
List of Endorsements Endt No
Description
Effective Date
I f the premium i s not realised the policy shall be void from inception. The stamp duty of ` 0.50 paid by Demand Draft, vide Receipt/Challan no 30347 dated 10/12/2012 as prescribed in Government Notification Revenue and Forest Department No Mudrank 2004/4125/CR 690/M-1, dated 31/12/2004 . Policy Issuing Office: Mumbai
For HDFC ERGO General Insurance Company Ltd.
Duly Constituted Attorney The Policy wording attached herewith includes all the standard coverage offered by the Company to its customers. Your entitlement for coverage/benefits shall be restricted to the coverage/benefits as mentioned in this policy schedule. For any clarification please call our toll free number.
Corporate Off.: 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri(E), Mumbai 400 059. Toll-Free No.1800-2-700-700 Fax 91 22 66383699 [email protected] www.hdfcergo.com Registered Off.: Ramon House, H.T.Parekh Marg, 169, Backbay Reclamation, Mumbai 400 020, India.
HDFC ERGO General Insurance Company Limited Frequently Asked Question’s (FAQs) - Travel Insurance Policy
CAN THE TRAVEL POLICY BE EXTENDED?
FOR HOW MANY DAYS CAN THE POLICIES BE EXTENDED?
Extensions are applicable to original policies of 30 days or more and provided only if the Policy is still in force. Please note that extension on a policy can be availed only once.
The Policy may be extended maximum upto 180 Days. The total policy period including extension should not exceed 360 days.
HOW DO I EXTEND MY POLICY?
CAN THE POLICY BE CANCELLED?
You can send a mail to [email protected]. You will receive a revert from our end with the detailed procedure and the additional premium amount to be paid.
CAN THE PLAN COVERAGE PERIOD BE REDUCED? No, the plan coverage cannot be reduced, irrespective of the fact whether journey has commenced or not.
The policy may be cancelled via request on Email/Fax, The intimation of cancellation has to reach us latest upto 14 days from the inception date of the policy. If the policy has already incepted, a copy of all 40 pages of the passport needs to be submitted as proof. Cancellation charges of Rs. 250/shall be applicable and the balance shall be refunded.
WHOM DO I NEED TO CONTACT TO MAKE CHANGES OR CORRECTIONS IN MY POLICY? You can mark a mail to [email protected]. On receipt of the request the endorsement will be processed within 48 hours and the documents will be sent to your registered email address.
HOW TO CONTACT US? Call Toll-free : 1800 2 700 700 / 1800 226 226 Fax : 022 6638 3669 E-Mail : [email protected] Write to us at : HDFC ERGO General Insurance Company Limited (Corporate Office) 6th floor, Leela Business Park, Andheri Kurla Road, Andheri(East), Mumbai - 400 059
WHERE CAN ONE AVAIL THE CLAIM FORMS? On registration of a claim, claim form will be forwarded to you by mail, email or fax along with the intimation for the various documents required. The forms are also available on the website.
HOW DO I FILE A CLAIM? In the event of a covered emergency and to register claims, call our International Emergency Service Provider, International SOS - 24 hour Helpline Centre and quote Policy Holders’ Name, Policy Number, Insurance Company, Passport Number when seeking assistance within 24 Hours. The contact details are: Land line: 011-41898872 Fax: 011-41898801 Email: [email protected] Toll Free No. 1866 202 4700 (For USA Only)
WHOM TO CONTACT IN CASE OF HOSPITALIZATION? International SOS should be contacted for all claims. The contact details are as provided above.
WHAT DOES 'DEDUCTIBLE’ MEAN?
WILL THE CLAIMS BE SETTLED ON MY RETURN TO INDIA? Claims are settled on the receipt of original documents
Manage Your Portfolio @ hdfcergo.com / Smartphones*
Deductible means the amount of a claim which has to be borne by the insured.
Add/View your policy details Register motor/health claims Track your claim status online
* supports smart phones based on Blackberry, iPhone, Windows8, Android & Symbian platforms
Change your personal details on the go Track your interactions on endorsement dispatch status Find branches, garages and cashless network hospitals Download IPO mobile application from IPO website post log in
This document is a summary of the benefits offered. The information mentioned above is illustrative and not exhaustive. Information must be read in conjunction with the policy wordings. In case of any conflict between this document and the policy wordings, the terms and conditions mentioned in the policy wordings shall prevail.
Corporate Off.: 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri(E), Mumbai 400 059. Toll-Free No.1800-2-700-700 Fax 91 22 66383699 [email protected] www.hdfcergo.com Registered Off.: Ramon House, H.T.Parekh Marg, 169, Backbay Reclamation, Mumbai 400 020, India.
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