Overseas Mediclaim Policy Insurance
This policy covers medical expenses by the insured persons when not in India. It takes account of body injuries and sickness and other ailments.
There are many other benefits listed below:
- Expenses for both inpatient and outpatient is covered.
- Medical Repatriation to India is also provided.
- Cashless settlement through overseas services provider is also provided.
- Covers loss of checked baggage , passport , trip cancellation , personal liability , personal accident cover.
- Hijack cover
- Missed departure upto specific time limit as mentioned in the policy
- Delayed checked baggage.
- In outpatient case if person informed but didn’t claim can claim after reaching India.But make sure that you obtained all original documents required
How to claim for overseas mediclaim?
Inform the overseas Insurer for medical emergencies and submit documents required for process as suggested by insurance company you choosed.
- Submit correctly filled claim form with below other document.
- Copy of policy with passport copy for identification.
- Pre authorization of insured who is admitted to hospital insurance claim department who will process the claim and approve.
- In Outpatient case if person didn’t claim at the time of treatment but informed , can claim after coming to India by submitting all necessary documents.
- In case claim got rejected by overseas service provider the insured can lodge the claim in India.
- Personal accident claims:
- Incase of death
- Death certificate and enquiry report.
- FIR report by police authorities at overseas.
- Incase of Injury
- FIR report
- In case of disability percentage of disablement supported by Medical Practitioner through reports.
- Copies of treatment acquired.
What are the reasons of rejecting claims?
- All pre-existing disease/illness.
- Not following medical advice or medical treatment as instructed by physician.
- If it’s a suicide case or self-inflicted injury, mental disorder, anxiety/stress/depression having no underlying physical illness.
- Alcoholism/abuse of drugs.
- Venereal disease.
- Self-exposure to needless controversy or engaged in any criminal activities or illegal act.
- Pregnancy resulting in childbirth , miscarriage , abortion or complications.
- Experimental , unproven and non-standard treatment carried out.
- Treatment by any other medicinal system apart from modern medicine (Allopathy).
- Cost of spectacles, contact lenses, hearing aids and other medical appliances used for diagnosis or treatment.
- Delay of baggage when the insured person is in India.
- Loss or damage to the insured`s passport which results to confiscation or detention by customs, police or any other authority.
- Loss which was not reported to the police authority within 24 hours of loss discovery, and in respect to that official report is not obtained.
- Loss caused by the insured`s failure to take reasonable steps to guard against the loss of passport.
What to do if claim is rejected for no-reason?
- Notify this to Insurance company/Third-Party Agent(TPA).
- If there is no response in 15 days then inform about the same to Grievance cell.
- Still no response? Take this to Quasi-Judicial Body or Insurance Ombudsman centre who can help you.
- If all above doesn’t work , then it’s high time to take this matter to court.
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