ASIAN TRAVEL AND MEDICAL
SERVICES
131/1, Picnic Garden Road , Kolkata- 700039, India
Phone No: +91 033 – 23445577/88/99
Hotline Number: 0091 9836309173 /0091 9831558752
Fax Number :( 033) 23440170
www.asiantms.com assist@asiantms.com
AGREEMENT
THIS AGREEMENT FOR MEDICAL TOURISM SEVICES executed at Indonesia on
this Tuesday day of 6 june 2023 BETWEEN PT 4 PILLAR MEDIKA ., PT 4 PILLAR
MEDIKA , hereinafter referred to as “THE HOSPITAL” (which expression shall,
unless contrary to the context or meaning thereof, be deemed to mean and
include its successors and assigns) of the One Part; AND ASIAN TRAVEL AND
MEDICAL SERVICES a Proprietor ship ,having its Registered Office at 131/1
Picnic Garden Road Kolkata 7000039 West Bengal India, hereinafter referred to
as “THE SERVICE PROVIDER” (which expression shall, unless contrary to the
context or meaning thereof, be deemed to mean and include its successors
and assigns) of the OTHER PART;
WHEREAS:
(a) The Hospital is engaged in providing various medical services to the
public including multi specialty, broad specialty, super specialty; pre planned
hospitalization, emergency hospitalization and all other forms of diagnostic
and treatment modalities. The hospital is situated at Jl. Shvea Gili Air, Gili Indah,
Kec. Pemenang Kab.
Lombok Utara, Nusa Tenggara Barat
(“Medical Centre”).
(b) The Service Provider is in the business of providing various services
related to healthcare as medical travel and tourism, arranging preventive
ASIAN TRAVEL AND MEDICAL
SERVICES
131/1, Picnic Garden Road , Kolkata- 700039, India
Phone No: +91 033 – 23445577/88/99
Hotline Number: 0091 9836309173 /0091 9831558752
Fax Number :( 033) 23440170
www.asiantms.com assist@asiantms.com
health and medical services appointments in India for tourists/patients seeking
medical care and treatment for various ailments suffered by the patients in
countries all over the world.
(c) The parties have realized the potential of medical tourism in India and
are desirous of working together on a commercial understanding.
(d) The parties have agreed to an understanding pursuant to a detailed
discussion. Hence, the present Agreement.
NOW THIS AGREEMENT WITNESSES THAT:
1. SCOPE
The Hospital hereby envisages the promoting and developing by the Service
Provider of the In- Patient medical facilities of the Hospital by referring
patients from overseas to be treated at the Medical Centre of the Hospital. The
Hospital hereby engages the services of the Service Provider for the same on a
non-exclusive basis.
2. PERIOD AND TERMINATION
ASIAN TRAVEL AND MEDICAL
SERVICES
131/1, Picnic Garden Road , Kolkata- 700039, India
Phone No: +91 033 – 23445577/88/99
Hotline Number: 0091 9836309173 /0091 9831558752
Fax Number :( 033) 23440170
www.asiantms.com assist@asiantms.com
(i) This Agreement shall come into effect from the date of execution and
shall remain in force unless terminated by either Party in accordance with
Article ___.
(ii) Either Party shall be entitled to terminate this Agreement by giving to
the other party one month’s written notice. Upon the termination of this
Agreement, the Hospital shall settle all accounts and payments due to the
Service Provider as on the date of termination.
3. PATIENT REFERRAL AND PAYMENT PROCEDURE
(i) The Hospital shall provide the Service Provider with a tariff of Charges
and mode of payment of the same which shall be operative for the purposes of
this Agreement. If the Hospital wishes to amend the Tariff of Charges and
mode of payment thereof at any time, it shall do so and inform the Service
Provider accordingly at least 15 days before such tariff becomes effective.
(ii) The Service Provider shall at its discretion refer Patients for Medical
services/ treatments on the basis of their medical requirements and as per
their individual specific needs to the Hospital. The Service Provider shall
assimilate details of the medical history of the patients to be referred for
treatment to the Hospital and confirm the same by a report authenticated by
the patient’s local Doctor. This report shall be forwarded at least 6 days prior
to the arrival of patient to the Hospital.
ASIAN TRAVEL AND MEDICAL
SERVICES
131/1, Picnic Garden Road , Kolkata- 700039, India
Phone No: +91 033 – 23445577/88/99
Hotline Number: 0091 9836309173 /0091 9831558752
Fax Number :( 033) 23440170
www.asiantms.com assist@asiantms.com
(iii) The Hospital shall provide to Patients introduced by the Service
Providers with appropriate treatment as specifically required by the Patients
for their medical ailments. The Service Provider shall in no way be connected
with the decision-making regarding the actual provision of medical services/
treatment by the Hospital to the Patients.
(iv) Upon discharge, the invoice/bill for Identified Services shall be presented
to the Member for signature . All non-medical expenses like registration fees,
admission fees, telephone charges, food bills of attendants; ambulance
charges, toiletries etc. shall be recovered from the member at the time of the
discharge. Any difference amount over and above the Guarantee Letter limit
issued by ATMS would be collected from the patient directly before discharge.
IN CASE MEMBER REFUSES TO PAY, THE SAME SHALL BE RESPONSIBILITY OF
ATMS .The bill shall be complete with detailed break-up of miscellaneous,
consumables, pharmacy charges. The bill will have time of admission and time
of discharge written on the copy. The bill shall thereupon be submitted by the
Hospital to ATMS for payment along with the original discharge summary and
investigation reports. The billing shall be as per the published tariff of the
hospital.
4. OBLIGATIONS OF THE HOSPITAL
(i) The treatment shall be extended by the Hospital to the patients referred
by the Service Provider on terms and tariff normally charged by the Hospital
from time to time.
ASIAN TRAVEL AND MEDICAL
SERVICES
131/1, Picnic Garden Road , Kolkata- 700039, India
Phone No: +91 033 – 23445577/88/99
Hotline Number: 0091 9836309173 /0091 9831558752
Fax Number :( 033) 23440170
www.asiantms.com assist@asiantms.com
(ii) The Hospital will provide a soft copy for the entire treatment to the
service provider in order to obtain the coverage for the patient.
(iii) Where the patient referred to, after commencement of treatment,
declines to continue or declines to have the treatment for any reason not due
to any fault of the said Hospital, the advance payment made by the Patient/
Service Provider for such treatment shall be returned after adjusting the actual
expenditure incurred and the bills up to the time of stopping of the treatment.
5. EXCLUSION OF LIABILITY
(i) The Hospital while ensuring that all possible care and professional
expertise will be rendered while treating the patient, shall not be liable for any
death of a patient or complications including disablement and/or injury that
may arise during treatment.
(ii) Any improper response to the treatment by the patient, which would
entail sending him back to their hometown, will be entirely at the patient’s
own risk.
(iii) The Hospital shall not be bound by any act or omission, which is done
beyond the scope of this Agreement by the Service Provider.
ASIAN TRAVEL AND MEDICAL
SERVICES
131/1, Picnic Garden Road , Kolkata- 700039, India
Phone No: +91 033 – 23445577/88/99
Hotline Number: 0091 9836309173 /0091 9831558752
Fax Number :( 033) 23440170
www.asiantms.com assist@asiantms.com
(iv) In case of any consumer complaints or other complaints/ litigation by
any patient against the Hospital, the Service Provider shall assist and co-
operate the Hospital in settling/ defending the complaint.
6. OBLIGATIONS OF THE SERVICE PROVIDER
(i) The Service Provider shall refer patients to the Hospital through referrals
from overseas.
(ii) Atleast 6 days prior to sending the patient to the said Hospital for
treatment, the Service Provider shall ensure procurement of complete health
details of the patient and forward the same to the Hospital.
(iii) The Service Provider shall deploy an “international patient coordinator”
fluent in English so that cases treated get prompt response with regard to
medical opinion, cost and course of treatment. The Service Provider shall also
provide emergency contact regarding the patient (if needed in an emergency)
and such other contact as the parties agree.
(iv) It shall be the sole responsibly of the Service Provider to procure local
approvals / permits for sending the patient as also his return to his/her
hometown. The Service Provider will make all arrangements for travel of the
patients and also ensure that all necessary Insurance coverage is taken for the
patient as well as the accompanying persons for treatment and related risks
and also for all risks during travel and stay in India, including Coverage of Life.
In the unfortunate event of the death of a patient, the Hospital shall co-
ASIAN TRAVEL AND MEDICAL
SERVICES
131/1, Picnic Garden Road , Kolkata- 700039, India
Phone No: +91 033 – 23445577/88/99
Hotline Number: 0091 9836309173 /0091 9831558752
Fax Number :( 033) 23440170
www.asiantms.com assist@asiantms.com
operate for preservation of the body and in facilitating the shipment of the
body to the destination to which it belongs. However, all the responsibility for
the documentation, travel arrangements and all the incidental costs shall be
borne by the Service Provider.
(v) The Service Provider will ensure, through a local doctor in the country of
origin, to explain to the patient, the nature of his disease, the expected plan of
diagnostic and treatment plans, the possible time required for the diagnosis
and treatment, the short-term and long-term prognosis of such treatment and
to take a full ‘Informed Consent’ of the patient, in a language that he/she
understands, of all the above.
(vi) The Service Provider will undertake all necessary steps to comply with all
requirements of Insurance, reimbursement of moneys spent by the Patient in
the hospital through any source in the patient’s own country and its prompt
deposition with the Hospital on receipt.
(vii) The service Provider will take Special Consent from the patient that any
and all litigation arising out of any dispute regarding treatment will be subject
to the exclusive jurisdiction of Courts/Forums/Tribunals in Kolkata, India.
(viii) All travel facilities, visas and statutory travel requirements of the patient
will have to be completed prior to departure from the parent country of the
patient. The Service provider will check and ensure that all such requirements
have been met and any liability/loss arising out of non-compliance of the same
will be the sole responsibility of the Service Provider.
ASIAN TRAVEL AND MEDICAL
SERVICES
131/1, Picnic Garden Road , Kolkata- 700039, India
Phone No: +91 033 – 23445577/88/99
Hotline Number: 0091 9836309173 /0091 9831558752
Fax Number :( 033) 23440170
www.asiantms.com assist@asiantms.com
(ix) The Service Provider shall ensure that the patient and accompanying
persons abide by all rules and regulations of the Hospital and also do not
infringe any laws of India during the period of treatment.
(x) The Service Provider shall not be eligible for any other payment by the
Hospital except professional fees as per clause 7 below.
(xi) The Service Provider shall obtain prior permission from the Hospital
before advertising its name on any promotional material. The Service Provider
shall take care to ensure a good brand image for the Hospital through its
promotional and marketing activities. All cost for such promotional and
marketing activities shall be at the cost and expenses of the Service Provider.
(xii) The Service Provider agrees not to use the trademark of the Hospital or
its logo in any manner in connection with its business without the prior written
approval of the Hospital.
7. PROFESSIONAL FEES TO THE SERVICE PROVIDER
(i) For services provided by the Service Provider under this Agreement,
they shall be paid a fee of 15% of the total bill (excluding the amount for
various taxes levied by the Government) raised for In-Patient services. The said
fee shall be deducted by the Service Provider at the time of payment to the
Hospital.
(ii) Any taxes (including service tax and VAT) on the said fee amount
payable to the Service Provider shall be paid by the Service Provider as the
above fee amount is inclusive of the same.
ASIAN TRAVEL AND MEDICAL
SERVICES
131/1, Picnic Garden Road , Kolkata- 700039, India
Phone No: +91 033 – 23445577/88/99
Hotline Number: 0091 9836309173 /0091 9831558752
Fax Number :( 033) 23440170
www.asiantms.com assist@asiantms.com
(iii) No fee shall be paid for patients directly undergoing treatment with the
Hospital who are not referred by the Service Provider.
(iv) The Hospital shall maintain a true and correct account of all monies
received from each Patient referred by the Service Provider constituting the
Bill and provide such account to the Service Provider along with payment of
fees accrued thereon. The said fee shall be paid within a period of 30 working
days on a monthly basis.
8. LIABILITY
Both the parties are mutually responsible for any outstanding payment for
medical services/ treatment that have not been made by any Patient.
9. RELATIONSHIP OF THE PARTIES:
This Agreement and Understanding between the parties is on a principal-to-
principal basis and this Agreement shall not create a partnership, agency or
any other fiduciary relationship among the parties themselves.
10. BENEFIT OF THE AGREEMENT
ASIAN TRAVEL AND MEDICAL
SERVICES
131/1, Picnic Garden Road , Kolkata- 700039, India
Phone No: +91 033 – 23445577/88/99
Hotline Number: 0091 9836309173 /0091 9831558752
Fax Number :( 033) 23440170
www.asiantms.com assist@asiantms.com
This Agreement is solely for the benefit of the parties hereto. For avoidance of
doubt, this agreement does not and shall not confer rights upon a person who
is not a party to this Agreement.
11. EXCLUSIVITY AND RESTRICTIONS:
The parties shall not be directly and/or indirectly entitled to assign their
interest under this Agreement to any third party/outside party without the
written consent of the other party and any attempt to do so will be void and
not binding on the other party.
12. AGREEMENT. ARRANGEMENT AND MODIFICATION
(i) This Agreement shall constitute the entire agreement between the
parties hereto in relation to the subject matter hereof and supersedes all prior
understandings, letters of intent, contracts, correspondence, e-mails, etc.,
whether oral or written, between the parties hereto.
(ii) This Agreement shall inure for the benefit of and be binding upon the
parties and their respective successors, assigns and subsidiaries (if any) and
nothing in this Agreement, expressed or implied, is intended to confer on any
ASIAN TRAVEL AND MEDICAL
SERVICES
131/1, Picnic Garden Road , Kolkata- 700039, India
Phone No: +91 033 – 23445577/88/99
Hotline Number: 0091 9836309173 /0091 9831558752
Fax Number :( 033) 23440170
www.asiantms.com assist@asiantms.com
person other than the parties and their successors, assigns and subsidiaries any
rights, remedies, obligations or liabilities under or by reason of this Agreement.
(iii) This Agreement may be modified, varied or amended only by a written
instrument duly executed by each of the parties hereto.
13. CONFIDENTIALITY
(i) Any information relating to a Patient or about either Party obtained
during the subsistence of this Agreement shall remain confidential and the
Parties shall not disclose such confidential information to any third party.
(ii) Obligations of confidentiality contained herein shall not apply to any
information which is already in the public domain.
(iii) The Parties’ obligations for confidentiality shall survive the termination
of this Agreement.
(iv) The Hospital shall duly maintain all obligations of the confidentiality as
per codes of hospital / doctor patient relationship in accordance with the laws
of India.
14. INVALIDITY
If any term or provision in this Agreement is held to be illegal or
unenforceable, in whole or in part, under any enactment or rule of law, such
term or provision or part to that extent will be deemed not to form part of this
ASIAN TRAVEL AND MEDICAL
SERVICES
131/1, Picnic Garden Road , Kolkata- 700039, India
Phone No: +91 033 – 23445577/88/99
Hotline Number: 0091 9836309173 /0091 9831558752
Fax Number :( 033) 23440170
www.asiantms.com assist@asiantms.com
Agreement but the enforceability of the remainder of this agreement will not
be affected.
15. WAIVER
Any term or condition of this Agreement may be waived at any time by the
party that is entitled to the benefit thereof, but no such waiver shall be
effective unless set forth in a written instrument duly executed by or on behalf
of the party waiving such term or condition. No waiver by any party of any
term or condition of this Agreement, in any one or more instances, shall be
deemed to be or construed as a waiver of the same or any other term or
condition of this Agreement on any future occasion. All remedies either under
this Agreement or by law or otherwise afforded, will be cumulative and not
alternative.
16. NOTICES AND CORRESPONDENCE
All notices, demands or requests required or permitted under this Agreement
must be in writing, and shall be made by hand delivery, certified mail, Federal
Express or a similarly internationally recognized courier service or facsimile, as
follows:
(i) If to the Hospital at:
Not send to the hospital ,sent direct to service provider
ASIAN TRAVEL AND MEDICAL
SERVICES
131/1, Picnic Garden Road , Kolkata- 700039, India
Phone No: +91 033 – 23445577/88/99
Hotline Number: 0091 9836309173 /0091 9831558752
Fax Number :( 033) 23440170
www.asiantms.com assist@asiantms.com
(ii) If to the Service Provider at:Kihajardewantara street ,tiwu bokah
village ,central Lombok ,west nusa tenggara ,indonesia
Husnul Fitriana (ULFI)
Head Assist PT 4 PILLAR MEDIKA
17. APPLICABILITY OF LAWS, DISPUTES, ARBITRATION AND JURIDICTION
OF COURTS
(i) The parties shall at all times and from time to time comply with all
statutory laws, the rules, regulations, notifications of Indian laws including the
Reserve Bank of India (RBI) or any other statutory body or authority and to
comply with provisions of the Foreign Exchange Management Act, 1999
(FEMA), Companies Act, 1956 and other statutory laws.
(ii) This Agreement and any disputes, claims or controversies arising from,
related to or in connection with this Agreement shall be constructed in
accordance with the Laws of the Republic of India without regard to principles
of conflict of laws.
ASIAN TRAVEL AND MEDICAL
SERVICES
131/1, Picnic Garden Road , Kolkata- 700039, India
Phone No: +91 033 – 23445577/88/99
Hotline Number: 0091 9836309173 /0091 9831558752
Fax Number :( 033) 23440170
www.asiantms.com assist@asiantms.com
(iii) In the event that any dispute, difference, claims, questions or
controversies arise relating to this agreement or interpretation thereof or as to
any non-compliance, non-payment, breach or termination or any other
matters incidental or consequential thereto, the parties shall at first endeavor
to resolve the same mutually and amicably, failing which the same shall be
referred to Arbitration in accordance with the provisions of the Arbitration and
Reconciliation Act, 1996 (India) or any other Arbitral law in force in India for
the time being. The Arbitration proceedings shall be held in the City of Kolkata,
India and conducted in English language. Each party shall have the right to be
represented by Advocate, Attorney and Counsel of their choice. All the
documents submitted as evidence in such proceedings shall be submitted in
their original language with an English Translation.
(iv) The Arbitrators shall have no power to add to, modify or change any
provision of this Agreement.
(v) Notwithstanding the foregoing, each Party hereby acknowledges that
the remedies at law of the other Party for a breach or an apprehended breach
of this Agreement would be inadequate and, in recognition of this fact, either
Party, in addition to all other remedies that may be available, shall be entitled
to seek equitable relief in the form of specific performance, injunction or any
other equitable remedy from the Court of competent jurisdiction at Kolkata,
India.
(vi) Unless otherwise terminated in accordance with the terms hereof, this
Agreement and the rights and obligations of the Parties hereunder shall remain
ASIAN TRAVEL AND MEDICAL
SERVICES
131/1, Picnic Garden Road , Kolkata- 700039, India
Phone No: +91 033 – 23445577/88/99
Hotline Number: 0091 9836309173 /0091 9831558752
Fax Number :( 033) 23440170
www.asiantms.com assist@asiantms.com
in full force and effect for as long as any proceeding pursuant to Arbitration are
pending.
(vii) Subject to the above, the Courts at Kolkata, India, shall have exclusive
jurisdiction to try and entertain all disputes arising between the parties hereto
Accepted and Agreed Accepted and Agreed
DIRECTOR PT 4 PILLAR MEDIKA DIRECTOR/ AUTHORISED SIGNATORY
(dr.Anak Agung Gde A Cakrakusuma) (THE SERVICE PROVIDER)
Manager PT 4 PILLAR MEDIKA
(dr.Satria Buana AM )
