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In this Policy the
following definitions apply:
Accident
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Means a sudden unexpected
and specific event caused solely and directly by violent, external and
visible means which occurs at an identifiable time and place, resulting in
Injury.
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Aids
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Means an
opportunistic infection or a malignant neoplasm. For the purpose of this
definition, the term "Acquired Immune Deficiency Syndrome" shall have the
meaning assigned to it by the World Health Organization “Acquired Immune
Deficiency Syndrome” shall include H.I.V. (Human Immune Deficiency Virus),
encephala (dementia) or H.I.V. wasting syndrome. |
Beneficiary
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Means the
person or persons nominated by the Insured Person as stated on the Policy
Schedule, if not mentioned then the Beneficiary will be the legal heirs of the
Insured Person.
If Family Plan is
selected then the beneficiary in case of death of the spouse or the child is the
Insured Person.
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Children
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Means the
Insured Person’s dependant children who are not in full-time employment and who
are between the ages of 3 months and 18 years (or under the age of 23 years
provided they are in full-time education), unmarried, not pregnant, without
children and primarily dependent on the Insured Person for maintenance and
support. |
Common
Carrier
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Means any land, water or air conveyance operated under a valid license for the
transportation of passengers for hire. |
Contact Sport
Country of
Residence
| Means the country
of which the Insured Person is a citizen or permanent resident.
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Day
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Means a period of 24 consecutive hours including the day of admission but
excluding the day of discharge. |
Effective Date of Coverage
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Means the date of departure or start date of cover as shown on the Policy
Schedule |
Excess
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Means the first amount, or period, of each and every loss payable by the Insured
Person. |
Hospital
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Means a place that: (a) holds a valid license (if required by law); (b) operates
primarily for the care and treatment of sick or injured persons; (c) has a staff
of one or more physicians available at all times; (d) provides 24-hour nursing
service and has at least one registered professional nurse on duty at all times;
(e) has organized diagnostic and surgical facilities, either on premises or in
facilities available to the hospital on a pre‑arranged basis; and (f) is not,
except incidentally, a clinic, nursing home, rest home, or convalescent home for
the aged, or a facility operated as a drug and/or alcohol treatment centre.
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Illness
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Means any fortuitous sickness or disease contracted, commencing or first
manifesting itself during an Insured Journey.
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Injury
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Means physical trauma to an Insured Person caused by an Accident resulting,
solely and independently of any other cause or any other physical defect or
infirmity existing prior to the Accident, in an Insured Event within six (6)
months of the date of the Accident. Physical trauma caused by exposure to the
elements of nature as a direct result of an Accident will be deemed to be an
injury. |
Insured Event
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Means an event stated in the Table of Benefits.
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Insured Journey
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Means a journey commencing at the time when the Insured Person leaves his usual
place of residence or business to travel in a direct, uninterrupted manner,
including the return journey to the Point of Departure on an International
Journey. The Insured Journey should start and end within the time frame of the
Period of Coverage.
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Insured Person
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Means the person whose name appears on the Policy and with respect to whom
premium has been paid and who is a permanent resident of the country of Policy
issuance.
For Family Plan Insured Person will mean the person whose name appears on
the Policy as an Insured Person, his/her spouse, and his/her children also whose
names appears on the Policy and with respect to whom premium has been paid and
who are permanent resident of the country of Policy issuance
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International Journey
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Means an Insured Journey commencing from the Point of Departure to the
destination, outside the territorial limits of the Country of Residence,
including the return journey to the Point of Departure. |
Manual Labor
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Means physical labor involving the use of hands or the use or operation of
mechanical or non-mechanical machinery or equipment. |
Medical Expenses
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Means all Reasonable and Customary Charges for Illness or Injury on an
International Journey resulting in hospitalization, surgical or other diagnostic
or remedial treatment given or prescribed by a Medical Practitioner. |
Medical Practitioner
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Means a person registered with a current, legal license to practice medicine,
but excludes an Insured Person or a member of any Insured Person’s Relative. |
Medical Treatment
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Means a Medical Practitioner's medical advice, treatment, consultations and
prescribed or repeat maintenance medication. |
Period of coverage:
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Means the period chosen by the insured person as per the policy schedule , for
which premium has been paid , starting on the Start date , of cover as shown on
the policy schedule and expiring at the end of period chosen . |
Permanent Total Disablement
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Means total and absolute disablement which entirely prevents the Insured Person
from engaging in or giving attention to any occupation and which will in all
probability be lasting and continuous for his lifetime. |
Personal Effects
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Means spectacles, dentures, purses, wallets, cosmetics, mobile phone and other
personal effects normally worn or carried on the person. |
Point of Departure
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Means the point from which an Insured Person commences an Insured Journey, from
within the territorial limits of his Country of Residence. |
Policy
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Means this document embodying the contract of insurance and shall include any
subsequent Terms and Conditions, Tables, Exclusions, Terminations and
Endorsements. |
Pre-Existing Medical
Conditions
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A condition for which
medical care, treatment, or advice was recommended by or received from a
Physician within a two year period preceding the Effective Date of Coverage, or
a condition for which hospitalization or surgery was required within a five year
period preceding the Effective Date of Coverage. |
Professional Player
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Means an Insured Person who earns in excess of 50% of his income from playing
sport or who participates in a sport that remunerates him as a means of
livelihood. |
Public Conveyance
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Means any scheduled or chartered conveyance legally licensed to carry passengers
for hire operating commercially in accordance with all locally applicable laws
and regulations and in which the Insured Person is traveling only as a
fare-paying passenger, including taxis and hired motor vehicles but excluding
minibuses, non-standard motor vehicles and non-pressurized single engine piston
aircraft. |
Reasonable and Customary Charges
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Means the charges which: (a) are medically required for the treatment, supplies
or medical service to treat an Insured Person's condition; (b) do not exceed the
usual level of charges for similar treatment, supplies or medical services in
the locality where the expenses are incurred, and (c) do not exceed the
charges for treatment that would have been made if no insurance existed. |
Related Expenses
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Means additional accommodation and traveling expenses, excluding telephone
costs, meals and beverages of necessity incurred by any one person, who on the
advice of a Medical Practitioner appointed by the Company remains with or
escorts the Insured Person until completion of his journey or until he resumes
the Insured Journey or returns to the Point of Departure, whichever occurs
first. |
Relative
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Means a
Spouse, parent, parent-in-law, grandparent, step-parent, Children, grandchild,
brother, brother-in-law, sister, sister-in-law, daughter-in-law, son-in-law,
fiancée, fiancé, half-brother, half-sister, aunt, uncle, niece or nephew of the
Insured Person. |
Spouse
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Wherever used in the policy shall mean the Insured Person’s legally married
husband or wife between the ages of 18 years and 65 years. |
Terrorist Act
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Means any actual or threatened use of force or violence directed at or causing
damage, Injury, harm or disruption, or commission of an act dangerous to human
life or property, against any individual, property or government, with the
stated or unstated objective of pursuing economic, ethnic, nationalistic,
political, racial or religious interests, whether such interests are declared or
not. Robberies or other criminal acts, primarily committed for personal gain and
acts arising primarily from prior personal relationships between perpetrator/s
and victim/s shall not be considered Terrorist Acts. ‘Terrorist Act’ shall also
include any act which is verified or recognized as an act of terrorism by the
(relevant) government of the country where the act occurs. |
War
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Means war, whether
declared or not, or any warlike activities (including use of military force) by
any sovereign nation to achieve economic, geographic, nationalistic, political,
racial, religious or other ends. | |