Please make sure you read and fully understand the policy details before you travel from the republic of India. Click here to view policy details.
Personal details
Are you an Indian National currently residing in India? *
Hint: The policy is available for Indian Nationals (possessing a valid Indian Passport) .If you are not an Indian National, kindly contact our nearest office for a suitable policy.
Date of birth *
Gender *
Travel details
Are you visiting any Schengen states? *
Are you visiting or your trip includes USA/Canada? *help
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Policy plan *help
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Purpose of visit *help
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Countries to be visited and duration of stay *help
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Date of departure from India (First day of insurance) *
Hint: Enter the date of departure from India. Please note that Insurance begins when the flight departs from India.
Insurance required till *
Hint: Enter the duration for which you need the policy. Please note that Insurance ends when the flight lands in India.
Number of days
Passport number *
Hint: Please enter the 8 digit passport number.
Date of expiry of passport *
Hint: Please enter the expiry date of your Indian passport.
Have you sought medical advice or taken medical treatment in the preceding 12 months. Please give the details. *help
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During your trip, will you be engaged in activities like Winter- sports and Mountaineering? *help
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Name and address of family physician help
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Name of family physician
Address of family physician
Beneficiary details  help
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Name of assignee *
Relationship with the assignee *
Select your branch office  help
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OICL Office State *
City/Town *
Branch/Office *
Policy Details

Policy details (these details are to be available at the beginning of the proposal form)

Medical expenses & repatriation

  1. Coverage of medical expenses in the event of sudden and unexpected sickness or accident arising when the insured person is Outside the Republic of India.
  2. If ‘AMERICAN ASSIST TRAVEL SERVICES’ recommends that continued treatment in India is appropriate, the policy is extended to cover medical expenses incurred in India (will only be paid for treatment incurred within the 90 days period immediately following the first manifestation of the bodily injury, sickness or disease).

3)     Up to US$ 225 per occurrence for dental services for immediate relief of dental pain only (no limit & no excess).

4)     Dental care due to covered accident is subject to limit of cover and deductible.

5)     Expenses for physician ordered emergency medical evacuation, including medically appropriate transportation and necessary medical care en route to the nearest suitable hospital when the insured person is  critically ill or injured and no suitable local care is available.( subject to prior approval by ‘AMERICAN ASSIST TRAVEL SERVICES’.

6)     Expenses for medical evacuation including transportation and medical care enroute to a hospital in the republic of India or the insured’s normal place of residence in India when advised by medical advisors and attending physician (subject to prior approval by ‘AMERICAN ASSIST TRAVEL SERVICES’).

7)     If the insured person dies outside India the expenses for preparing air transportation of the remains for repatriation to India or up to an equivalent amount for local burial or cremation in the country where death occurred (subject to prior approval by ‘AMERICAN ASSIST TRAVEL SERVICES’).

 

Important exclusions

1)     The policy does not cover any sickness for which the insured has sought medical advice or has taken medical treatment in the preceding 12 months prior to the commencement of travel.

2)     Any medical services with a cost of greater than $ 100 shall not be covered unless the insured person notifies ‘AMERICAN ASSIST TRAVEL SERVICES’ immediately.

3)     Each event is subject to a deductible of $ 100

4)     Cosmetic surgery not covered (unless necessary as a result of covered accident).

5)     Expenses related to pregnancy, childbirth, miscarriage, abortion or complication in any of these are not covered.

6)      No claim payable related to mental disorders, anxiety, stress or depression, Venereal diseases, Alcoholism, Drunkenness abuse of the drugs, HIV, AIDS, Suicide, Attempted Suicide or Willfully self inflicted injuries or illness.

 

Schengen States
Belgium, Czech republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia ,Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, Switzerland, Liechtenstein.
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Whether any agent is involved for this proposal?
* If 'NO' is selected, the policy will be issued under code of Development Officer without an Agent.
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