Travel Guard Policy

Policy Number : 7101873929

Policy Schedule

Policy Holder Name Mr VIVEK SRIVASTAVA Policy Issue Date 15/07/2024

Policy Holder Address H NO 111 2ND FLOOR POCKET-5, SEC- Insurance Plan Gold
21 ROHINI NEW DELHI, DELHI, DELHI -
110086 Zone Worldwide Excluding
USA/Canada
Policy Holder Contact 9818016663
From: 04/08/2024 To:
Travel Dates
No. 10/08/2024
Email ID Policy.mcs@gmail.com Duration 7 days

Customer GSTIN No. Producer Code 2489790000

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Thank you for choosing our Travel Insurance Policy.

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Premium

Premium INR 742.00

IGST (18%) INR 0.00

CGST (9%) INR 67.00

SGST (9%) INR 67.00

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Total Premium INR 876.00
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Sr.No Insured Name Passport Number Gender Date Of Birth Age Nominee

1 Mr VIVEK SRIVASTAVA R0070851 Male 26/10/1986 37 SANT KUMARI SHRIVASTAVA

Agent/Intermediary Name TANISHQ VASHISHT

Agent/Intermediary License Code AGINCBTPV2240P

Agent/Intermediary Contact No. 9990555488

Registered office : Peninsula Business Park, Tower A, 15th Floor, G.K Marg, Lower Parel, Mumbai - 400013, Maharashtra, India.
24x7 Toll Free No.: 1800 266 7780 or 1800 22 9966 (For Senior Citizens) • Email: customersupport@tataaig.com • Website: www.tataaig.com
IRDA of India Registration No: 108 • CIN: U85110MH2000PLC128425 • Travel Guard Policy • UIN: TATTIOP23097V032223

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 Travel Guard Policy

Policy Number : 7101873929

TATA AIG GSTIN 07AABCT3518Q1ZY MOTI NAGAR

Service Accounting Code 9971

Benefits Maximum Coverage Deductible

Accidental Death & Dismemberment Benefit (24 hrs) $15,000

Accidental Death & Dismemberment (Common Carrier) $5,000

Accident & Sickness Medical Expense Reimbursement $2,50,000 $100

Sickness Dental Relief $500 $150

Emergency Medical Evacuation Benefit Included*

Repatriation of Remains Included*

Assistance Included*

Baggage Delay $200 12 hours

Baggage Loss# $1000

Loss of Passport $250 $30

Personal Liability $2,00,000 $200

Flight Delay^ $100 12 Hrs.

Hijacking^^ $500 1 Day

Automatic extension of policy (upto 7 days) Available

Emergency Cash Transfers and Advances $1000

Fraudulent Charges $1000

Home Burglary (In Rs.) Rs.2,00,000

Trip Cancellation $750 $75

Trip Curtailment $750 $75

Missed Connections/Missed Departure $750 $75

Bounced Hotel / Airline booking $750 $75

Registered office : Peninsula Business Park, Tower A, 15th Floor, G.K Marg, Lower Parel, Mumbai - 400013, Maharashtra, India.
24x7 Toll Free No.: 1800 266 7780 or 1800 22 9966 (For Senior Citizens) • Email: customersupport@tataaig.com • Website: www.tataaig.com
IRDA of India Registration No: 108 • CIN: U85110MH2000PLC128425 • Travel Guard Policy • UIN: TATTIOP23097V032223

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 Travel Guard Policy

Policy Number : 7101873929

Notes:
Annual Multi-Trip means two or more trips to a destination outside the Republic of India during the Policy period.
Under annual multi-trip, entry age is up to 70 years.
Cashless Settlements for Inpatient Treatment Abroad.
Reimbursement for outpatient medical expenses and travel emergencies.
*Included under the benefit limit of Accident and Sickness Medical Expense Reimbursement.
Notice of a medical condition/event must be provided to your assistance contact (see below) at time of care or as soon as possible
after emergency care; failure to do so may affect benefits and coverage. For details on sublimits for insured 56 years of age please
see the next page of this Policy schedule or refer to the Policy wordings schedule of benefit Part H supplied along with this
schedule.
#The benefits mentioned in this table are applicable for every single insured individually covered under this Policy. Sum insured is
in USD ($) wherever $ sign is mentioned and Coverage for Burglary is in INR.
#Maximum amount to be reimbursed per bag is 50% and maximum value per article contained in any bag is 10% of the sum(s)
insured.
^Flight Delay: Deductible of 12 hrs, $10 per 12 hours and Maximum $100.
^^Hijack: Deductible of 1 day, $100 per day and Maximum $500.

For complete set of benefits, terms & conditions, please refer to Policy wordings:
https://www.tataaig.com/s3/Travel_Guard_Policy_Policy_Wording_91e623b072.pdf

Important : Any pre-existing medical condition/ailments declared or undeclared will be excluded from the Policy. The
coverage provided is subject to the details and declaration made in the proposal to the company and attached Policy
wording.

Sub-limits :
The following maximum eligible expenses per disease/illness are automatically applicable to Insured persons aged 56 years
onwards, regardless of the plan/option purchased at the inception/its subsequent renewals if applicable.
Sublimits can be waived or by payment of additional premium. If waived then this will appear in Insurance Plan on Page 1. The
maximum limit would be as mentioned below or upto the sum insured whichever is lower.

I. Hospital Room Rent, Board and Hospital misc. maximum $1500 per day up to 30 days
II. Intensive Care Unit : Maximum $3000 per day up to 7 days
III. Surgical Treatment : Maximum USD $10000
IV. Anesthetist Services : Maximum up to 25% of Surgical treatment
V. Physician's Visit : Maximum $75 per day up to 10 visits
VI. Diagnostic and Pre-admission testing : Maximum up to $500
VII. Ambulance Services : Maximum up to $400

Declaration:
I/We hereby declare and state that all statements and information furnished in the proposal to the company and as captured in
the above schedule of insurance are true and complete. If found that the said statements and information furnished/stated is
incorrect or untrue in any respect or manner whatsoever, I agree and acknowledge that the insurance company shall not be liable
in any manner whatsoever in respect of the insurance coverage under this Policy.

Consolidated Stamp Duty Paid to state exchequer Signature of the Insured/Proposer: Mr VIVEK SRIVASTAVA

Registered office : Peninsula Business Park, Tower A, 15th Floor, G.K Marg, Lower Parel, Mumbai - 400013, Maharashtra, India.
24x7 Toll Free No.: 1800 266 7780 or 1800 22 9966 (For Senior Citizens) • Email: customersupport@tataaig.com • Website: www.tataaig.com
IRDA of India Registration No: 108 • CIN: U85110MH2000PLC128425 • Travel Guard Policy • UIN: TATTIOP23097V032223

Page 3 of 16
 Travel Guard Policy

Policy Number : 7101873929

In case you need any assistance please call or write to us:

For Cashless claims (For Insured only) For Reimbusement Claims (For US Medical Claims (For Providers
Insured Only) Only)

Customers calling from USA/Canada: Claims Department : Plan Type: Gold

Please call: +1-833-440-1575 Tata AIG General Insurance company Policy Certificate Number: 7101873929
(Tollfree within US and Canada) Ltd. 7th and 8th Floor, Romell Tech Mail Medical Claims to :
Email : tata.aig@europ- Park, Cama Industrial Estate,
Europ Assistance India Star Hub
assistance.in Western Express Highway, Goregaon
Building number 2, floor 7, Near ITC
(E), Mumbai, Maharashtra 400063.
Customers calling from countries Maratha, Andheri E Mumbai – 400 059
other than USA/Canada & India: Visit our website :
Please call: +1-833-440-1575
www.tataaig.com OR
Please call : +91 – 22 68227600 (Call (Tollfree within US and Canada)
Email :
back facility Available) Email : tata.aig@europ-
customersupport@tataaig.com
Email : ea.tataclaims@europ- assistance.in
OR Call our 24x7 toll free helpline
assistance.in
1800-266-7780 (Accessible from all
lines) OR 1800-22-9966 (Accessible
from\BSNL/ MTNL Lines)

Coverage of COVID - 19

We wish to bring it to the notice of our Overseas Travel Insurance customers, intermediaries, embassies, and consulates that this
Policy offers coverage towards medical expenses related to COVID – 19, subject to policy terms and conditions.
Coverage for medical expenses is available up to the limits mentioned in the Policy Schedule for expenses incurred due to sudden
and unexpected sickness or accident arising when insured is outside the Republic of India. Policy wordings can be referred for
detailed terms and conditions.
Sum Insured: $250000 per person (Sum Insured as per the plan opted)
Insured Name - 1 : Mr VIVEK SRIVASTAVA
Please get in touch with our customer support team at Email : customersupport@tataaig.com or call us at 1800 266 7780 for
any clarifications/queries.

Registered office : Peninsula Business Park, Tower A, 15th Floor, G.K Marg, Lower Parel, Mumbai - 400013, Maharashtra, India.
24x7 Toll Free No.: 1800 266 7780 or 1800 22 9966 (For Senior Citizens) • Email: customersupport@tataaig.com • Website: www.tataaig.com
IRDA of India Registration No: 108 • CIN: U85110MH2000PLC128425 • Travel Guard Policy • UIN: TATTIOP23097V032223

Page 4 of 16
 Travel Guard Policy

Policy Number : 7101873929

Policy Servicing Address

A-2, 1ST FLOOR, KIRTI NAGAR,,MAIN NAJAFGARH ROAD,NEAR KALRA,HOSPITAL, NEW DELHI - 110015.,110015,MOTI NAGAR

Regards,

docit-digital-sign
Digitally Signed by: Malpa Devi Maharana
Date: 15/07/2024
Location: Mumbai

Registered office : Peninsula Business Park, Tower A, 15th Floor, G.K Marg, Lower Parel, Mumbai - 400013, Maharashtra, India.
24x7 Toll Free No.: 1800 266 7780 or 1800 22 9966 (For Senior Citizens) • Email: customersupport@tataaig.com • Website: www.tataaig.com
IRDA of India Registration No: 108 • CIN: U85110MH2000PLC128425 • Travel Guard Policy • UIN: TATTIOP23097V032223

Page 5 of 16
 Travel Guard Policy

Policy Number : 7101873929

PROPOSAL FORM
1. This is an application for insurance and issuance of this does not amount to acceptance of proposal by us. Commencement of risk under this proposal is subject to
acceptance of risk by us and receipt of premium.
2. The information declared by you in this form is the basis for issuance of the Policy.
3. Please answer all questions carefully. Any incomplete, incorrect or partially correct answers may lead to rejection of the proposal and also might lead to cancellation of the
policy.

POS PAN No.*: Proposal Form No. : PR/24/7100438200

(Mandatory for POS Agent)

Producer Name: TANISHQ VASHISHT Producer Code: 2489790000

Proposer Details

Proposer Name: Mr VIVEK SRIVASTAVA

Proposer Details of person proposed for Insurance

Person Name: Mr VIVEK SRIVASTAVA
Date Of Birth: 26/10/1986 Gender: Male Passport No: R0070851
PAN Card No: In absence of Pan Card, please give details of any other authorised photo
identification car Type and Number:
Pre-existing details (if any): Yes No If yes, Details: Suffering since:
Residential Address: H NO 111 2ND FLOOR POCKET-5, SEC-21 ROHINI NEW DELHI,
City: DELHI State: DELHI PIN: 110086
Tel. With area code: In India: 9818016663
While Overseas:
E-mail: Policy.mcs@gmail.com
Sources of funds (Tick where Salary Business If Others, please specify:
applicable):

Purpose of visit: Leisure Employment Business Study Others

Nominee Details

In the event of the death of the Proposer any payment due under the Policy shall become payable to the nominee in accordance
with the Policy terms and conditions. The nominee must be an immediate relative of the Proposer. The nominee for all other
Insured Persons proposed to be insured shall be the Applicant himself/herself

Nominee Name DOB Relationship Address

SANT KUMARI SHRIVASTAVA Spouse

Additional Insured Family members (Spouse or Dependent Children)

S. Name Sex Date of Passport No. Pre-Existing Details Suffering since

No. Birth details (if any)

Travel Details

Your trip includes: Including Americas Excluding Americas (* America includes North, Central, South America and Canada)
Places of Travel: GERMANY
Departure from India: 04/08/2024 Return to India: 10/08/2024 Number of Days: 7 days

Registered office : Peninsula Business Park, Tower A, 15th Floor, G.K Marg, Lower Parel, Mumbai - 400013, Maharashtra, India.
24x7 Toll Free No.: 1800 266 7780 or 1800 22 9966 (For Senior Citizens) • Email: customersupport@tataaig.com • Website: www.tataaig.com
IRDA of India Registration No: 108 • CIN: U85110MH2000PLC128425 • Travel Guard Policy • UIN: TATTIOP23097V032223

Page 6 of 16
 Travel Guard Policy

Policy Number : 7101873929

Insurance plan Requested: With Sub limit Without Sub limit

Single Trip: Silver Silver Plus Gold Platinum Senior Plan Silver With Family Silver Plus With
Family
Annual Multi Trip: Gold Platinum Any Single Trip not exceeding 30 days
Any Single trip not exceeding 45 days

(I understand that sub limits will apply on Accident and Sickness Medical Expenses Reimbursement Cover for Insured Person
above 56 years of age, if opted for "With sub limits Plan". Under Annual Multi Trip, entry age is up to 70 years.)

Payment Details

Name of the Premium Payer: VIVEK SRIVASTAVA

Relationship with the proposer: Premium Amount (in Rs.): 876.00
Insturment type: Cash Cheque Debit Card Credit Card Other, paymentLinkCustomer
Please make a Crosed Cheque/DD/pay Order in favour of 'TATA AIG General Insurance Company Limited' only.

BANK DETAILS
As per the Regulatory requirements, we can effect payment of refund / claims only through Electronic Clearing System (ECS) / National Electronic Funds
Transfer (NEFT) / Real Time Gross Settlement (RTGS) / Interbank Mobile Payment Service (IMPS). For this purpose please submit the following details of
the insured's bank account#

Name of the Account Holder:

Name of the Bank: Branch:

Type of Account: SB Account Current Account Others (please specify):

Account Number : IFSC Code of Bank :
If the premium cheque is not paid from the above mentioned account then a cancelled cheque leaf of the above mentioned
account is to be attached. #mandatory if annualized premium is more than Rs.10,000

Registered office : Peninsula Business Park, Tower A, 15th Floor, G.K Marg, Lower Parel, Mumbai - 400013, Maharashtra, India.
24x7 Toll Free No.: 1800 266 7780 or 1800 22 9966 (For Senior Citizens) • Email: customersupport@tataaig.com • Website: www.tataaig.com
IRDA of India Registration No: 108 • CIN: U85110MH2000PLC128425 • Travel Guard Policy • UIN: TATTIOP23097V032223

Page 7 of 16
 Travel Guard Policy

Policy Number : 7101873929

DECLARATION & WARRANTY ON BEHALF OF ALL PERSONS PROPOSED TO BE INSURED

• I/We hereby declare, on my behalf and on behalf of all persons proposed to be insured that the above statements, answers
and/or particulars given by me are true and complete in all respects to the best of my knowledge and that I/We am/are
authorized to propose on behalf of these other persons.
• I understand that the information provided by me will form the basis of insurance policy, is subject to the Board approved
underwriting policy of the Insurance company and that the policy will come into force only after full receipt of the premium
chargeable.
• I/ We further declare that I/We will notify in writing any change occurring in the occupation or general health of the life to be
insured/proposer after the proposal has been submitted but before communication of the risk acceptance by the company.
• I/We declare and consent to the company seeking medical information from any hospital who at anytime has attended on
the life to be insured/proposer or from any past or present employer concerning anything which affects the physical and
mental health of the life to be assured/proposer and seeking information from any insurance company to which an
application for insurance on the life to be assured/proposer has been made for the purpose of underwriting the proposal
and/or claim settlement.
• We authorize the company to share information pertaining to my proposal including the medical records for the sole
purpose of proposal underwriting and/or claims settlement and with any Governmental and/or Regulatory Authority.
• I authorize Tata AIG General Insurance Company Limited anesociate partners to contactmevia e-mail, phone or SMS.

Date: 15/07/2024 Place: MOTI NAGAR Mr VIVEK SRIVASTAVA

Signature of Proposer

AML Guidelines:

1. I/we hereby confirm that all premiums paid / payable in future will be from bonafide sources and not paid out of proceeds
of crime and that such premiums are not disproportionate to my/our income. I / we understand that the Company has the
right to call for documents to establish sources of funds and to cancel the insurance policy in case I / we are found guilty by
any competent court of law under any of the statutes, directly or indirectly governing the prevention of money laundering
law in India.
2. I / we are not Politically Exposed Persons * nor are their close relatives / family members / associates. I / we shall keep the
company informed if we subsequently become a Politically Exposed Person / close relative / family member / associate of
Politically Exposed Persons.

“Politically Exposed Persons” shall have the meaning assigned to it under Prevention of Money-Laundering (Maintenance of
Records) Amendment Rules, 2023 as amended from time to time.
Nationality: Indian Non-Indian; If Non-Indian, please specify Country:

Type of Organization

Corporations Governments Non-Governmental Organizations Society

Trust Partnership International Organization Cooperatives Section 25 Company

Additional Information
(If there is insufficient space to provide additional relevant information, whether as requested or otherwise, please attach extra
sheet duly signed.)
Signature of the Insured Person / Proposer: Mr VIVEK SRIVASTAVA Date: 15/07/2024

Registered office : Peninsula Business Park, Tower A, 15th Floor, G.K Marg, Lower Parel, Mumbai - 400013, Maharashtra, India.
24x7 Toll Free No.: 1800 266 7780 or 1800 22 9966 (For Senior Citizens) • Email: customersupport@tataaig.com • Website: www.tataaig.com
IRDA of India Registration No: 108 • CIN: U85110MH2000PLC128425 • Travel Guard Policy • UIN: TATTIOP23097V032223

Page 8 of 16
 Travel Guard Policy

Policy Number : 7101873929

Declaration : The content of this form along with product benefits, term/conditons and exclusions have been clearly explained to
me. I/We have understand those and confirm to abide by the policy term and conditions.
Signature of the Proposer: Mr VIVEK SRIVASTAVA
Name & Signature of agent/intermediary: TANISHQ VASHISHT Code: 2489790000

AGENT DECLARATION Vernacular Declaration

I,TANISHQ VASHISHT (Full Name) in my capacity as an Insurance Advisor/ Specified (Certification in case the proposer
Person of the Corporate Agent/Authorized employee of the Broker/Relationship has signed in vernacular/thumb
Officer, do hereby declare that I have explained all the contents of this Proposal Form, print)
including the nature of the questions contained in this Proposal Form to the Proposer
including statement(s), information and response(s) submitted by him/her in this The content of this form along with
Proposal Form to questions contained herein or any details sought herein will form product benefits, terms/conditions
the basis of the Contract of Insurance between the Company and the Proposer, if this and exclusions have been clearly
Proposal is accepted by the Company for issuance of the Policy. I have further explained by me in vernacular to the
explained that if any untrue statement(s)/ information/response(s) is/are contained in proposer who has understood and
this Proposal Form/including addendum(s), affidavits, statements, submissions, confirmed the same.
furnished/to be furnished, the Company shall have the right to vary the benefits
which may be payable and further more if there has been a non-disclosure of any
Signature/Thumb impression of the
material fact, the policy issued to his/her favor pursuant to this Proposal may be Proposer:
treated by the Company as null and void and all premiums paid under the Policy may
be forfeited to the company Mr VIVEK SRIVASTAVA

License No.(Intermediary/Corporate AGINCBTPV2240P

Agent/Broker/Relationship Officer) Name & Signature of
Name of the specified Person and code TANISHQ VASHISHT and 2489790000 agent/intermediary:

Place :MOTI NAGAR Date :15/07/2024 TANISHQ VASHISHT

Signature of Agent :TANISHQ VASHISHT

Prohibition of Rebates - Section 41 of the Insurance Act, 1938 as amended by Insurance Laws (Amendment) Act, 2015

1. No person shall allow or offer to allow either directly or indirectly as an inducement to any person to take out or renew or
continue an insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of
the commission payable or any rebate of premium shown on the policy, nor shall any person taking out or renewing or
continuing a policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectus
or tables of the insurer.
2. Any person making default in complying with the provisions of this section shall be liable for penalty which may extend to
ten lakh rupees.

Disclaimer: Insurance is a subject matter of solicitation. For more details on benefits, exclusions, limitaions, terms and conditions,
please refer sales brochure / policy wording carefully, before concluding a sale.

Section 64 VB of the Insurance Act 1938: Commencement of risk cover under the policy is subject to receipt of premium by Tata
AIG General Insurance Company Limited.

Registered office : Peninsula Business Park, Tower A, 15th Floor, G.K Marg, Lower Parel, Mumbai - 400013, Maharashtra, India.
24x7 Toll Free No.: 1800 266 7780 or 1800 22 9966 (For Senior Citizens) • Email: customersupport@tataaig.com • Website: www.tataaig.com
IRDA of India Registration No: 108 • CIN: U85110MH2000PLC128425 • Travel Guard Policy • UIN: TATTIOP23097V032223

Page 9 of 16
 Travel Guard Policy

Policy Number : 7101873929

CUSTOMER INFORMATION SHEET / KNOW YOUR POLICY

This Policy provides key information about your policy. You are also advised to go through your policy document.

Refer to Policy Clause

S.No. Title Description
Number
1. Name of the Insurance
Travel Guard Policy
Product / Policy
2. Policy Number 7101873929
Type of Insurance
3. Both Indemnity and Benefit
Product/Policy
Sum Insured Basis: Individual Sum Insured
Sum Insured Amount: As per Sum Insured mentioned in Policy
4. Sum Insured
schedule

Section 1. Accidental Death and Dismemberment - coverage for

Death and Dismemberment arising due to an Accident while the
insured is abroad.
Section 2. Accidental Death and Dismemberment (Common
Carrier) - coverage for Death and Dismemberment arising due to
an Accident while riding as a passenger in or on, boarding or
alighting from, a Common Carrier.
Section 3. Accident & Sickness Medical Expenses - coverage for
Accident and/or Sickness when insured is abroad.
Section 4. Sickness Dental Expense - coverage for Emergency
dental sickness.
Section 5. Assistance - coverage for required assistance with
respect to Medical Assistance, Medical Evacuation, Repatriation,
Policy Coverage (What Legal Assistance, Lost Luggage or Lost Passport, General Assistance,
5.
the Policy Covers?) Pre-Departure Services, Emergency Travel Agency, Emergency Cash
Transfers and Advances.
Section 6. Baggage Delay - We will reimburse You for the expense
of necessary personal effects, if Your Checked Baggage is delayed or
misdirected by a Common Carrier from the time You arrive at the
destination stated on Your ticket.
Section 7. Baggage Loss (Common Carrier) - covers loss, in the
case of permanent loss of an entire piece of Checked Baggage, held
in the care, custody and control of a Common Carrier, due to theft
or due to misdirection by a Common Carrier or due to non- delivery
at its destination while insured is a ticketed passenger on the
Common Carrier.
Section 8. Emergency Medical Evacuation - Medical evacuation of
insured to nearest hospital or back to India for medical treatment.

Registered office : Peninsula Business Park, Tower A, 15th Floor, G.K Marg, Lower Parel, Mumbai - 400013, Maharashtra, India.
24x7 Toll Free No.: 1800 266 7780 or 1800 22 9966 (For Senior Citizens) • Email: customersupport@tataaig.com • Website: www.tataaig.com
IRDA of India Registration No: 108 • CIN: U85110MH2000PLC128425 • Travel Guard Policy • UIN: TATTIOP23097V032223

Page 10 of 16
 Travel Guard Policy

Policy Number : 7101873929

Section 9. Repatriation of Remains - covers cost of repatriating

mortal remains of the insured to India.
Section 10. Hijacking - distress allowance if insured’s common
carrier has been hijacked.
Section 11. Loss of Passport - coverage for necessary and
reasonable expenses for obtaining a duplicate or new passport.
Section 12. Personal Liability - covers damages for claims legally
filed on insured against property damage and medical expenses to
others as a result of bodily injury caused by insured in an accident.
Section 13. Flight Delay - coverage for additional expenses if
insured trip is delayed for more than 12 hours due to inclement
weather, strike with common carrier or equipment failure of the
common carrier.
Section 14. Automatic extension of policy - Automatic extension
of the period of insurance is granted upto a period of 7 days, from
the policy expiry date, if the extension is necessary, due to delay by
the Scheduled Airlines, which is beyond the control of the Insured,
and no alternative air transportation is made available to the
Insured.
Section 15. Trip curtailment - Converge for necessary curtailment
(Shortening and / or alteration) of the insured journey and You have
to directly return to the country of usual residence, where You
started Your Insured Journey.
Section 16. Trip Cancellation - In case of your trip cancellation we
will reimburse You for the unused, non-refundable cancellation
portion of the hotel cost and/or the Common Carrier ticket
cancellation charges.
Section 17. Missed Connections/Missed Departure - We will
reimburse Reasonable Additional Expenses due to Missed
Connections, or missed departure by Your scheduled airline, on
your return journey.
Section 18. Bounced bookings of Hotel and Airline - We will
reimburse you the hotel booking / airline ticket in case it is bounced
due to over booking.
Section 19. Fraudulent Charges - We will reimburse the
unauthorized charges that you are responsible for on your lost or
stolen payment card.
Section 20. Burglary - Coverage for damage, disappearance or
destruction due to burglary at your residence during your personal
trip travel time.

Registered office : Peninsula Business Park, Tower A, 15th Floor, G.K Marg, Lower Parel, Mumbai - 400013, Maharashtra, India.
24x7 Toll Free No.: 1800 266 7780 or 1800 22 9966 (For Senior Citizens) • Email: customersupport@tataaig.com • Website: www.tataaig.com
IRDA of India Registration No: 108 • CIN: U85110MH2000PLC128425 • Travel Guard Policy • UIN: TATTIOP23097V032223

Page 11 of 16
 Travel Guard Policy

Policy Number : 7101873929

This entire Policy does not provide benefits for any loss resulting in
whole or in part from, or expenses incurred, directly or indirectly in
respect of:
1. where the Insured Person is travelling against the advice of a
Physician; or receiving or on a waiting list for receiving specified
medical treatment; or is travelling for the purpose of obtaining,
treatment; or has received a terminal prognosis for a medical
condition; or
2. any Pre-existing Condition or any complication arising from it;
or
3. Any claim of Insured Person arising from:
a) suicide or attempted suicide
b) willful self-inflicted illness or injury except injury in self-
defense or to save life; or

4. sexually transmitted conditions; or

5. serving in any branch of the Military or Armed Forces of any
country, whether in peace or War, and in such an event We,
upon written notification by You, shall return the pro rata
premium for any such period of service during the Trip; or
6. whilst under the influence of intoxicating liquor or drugs or
other intoxicants except where the insured is not directly
Exclusions (what the
6. responsible for the injury / accident though under influence of Exclusions
policy does not cover)
intoxication or
7. participation in an actual or attempted felony, riot, crime,
misdemeanor, or civil commotion; or
8. operating or learning to operate any aircraft, or performing
duties as a member of the crew on any aircraft or Scheduled
Airline; or
9. any loss arising out of War, civil war, invasion, insurrection,
revolution, act of foreign enemy, hostilities (whether War be
declared or not), rebellion, mutiny, use of military power or
usurpation of government or military power; or
10. any loss, damage cost or expense of whatsoever nature directly
or indirectly caused by, resulting from or in connection with any
act of terrorism regardless of any other cause or event
contributing concurrently or in any other sequence to the loss.
The warranty also excludes loss, damage, cost or expenses of
whatsoever nature directly or indirectly caused by, resulting
from or in connection with any action taken in controlling,
preventing, suppressing or in any way relating to action taken in
respect of any act of terrorism. If the Company alleges that by
reason of this Exclusion, any loss, damage, cost or expenses is
not covered by this insurance the burden of proving the
contrary shall be upon the Insured.

Registered office : Peninsula Business Park, Tower A, 15th Floor, G.K Marg, Lower Parel, Mumbai - 400013, Maharashtra, India.
24x7 Toll Free No.: 1800 266 7780 or 1800 22 9966 (For Senior Citizens) • Email: customersupport@tataaig.com • Website: www.tataaig.com
IRDA of India Registration No: 108 • CIN: U85110MH2000PLC128425 • Travel Guard Policy • UIN: TATTIOP23097V032223

Page 12 of 16
 Travel Guard Policy

Policy Number : 7101873929

11. any loss arising out of the intentional use of military force to
intercept, prevent, or mitigate any known or suspected Act of
Terrorism; or
12. the use, release or escape of nuclear materials that directly or
indirectly results in nuclear reaction or radiation or radioactive
contamination; The dispersal or application of pathogenic or
poisonous biological or chemical materials; The release of
pathogenic or poisonous biological or chemical materials,
(However, the above only applies if 50 or more persons sustain
death within 90 Days of the date of the incident) or
13. the radioactive, toxic, explosive or other dangerous properties
of any explosive nuclear equipment or any part of that
equipment; or
14. performance of manual work for employment or any other
potentially dangerous occupation; or
15. congenital anomalies or any complications or conditions arising
therefrom; or
16. osteoporosis (porosity and brittleness of the bones due to loss
of protein from the bones matrix) or pathological fracture (any
fracture in an area where pre-existing Disease has caused the
weakening of the bone)
17. participation in winter sports, skydiving/ parachuting, hang
gliding, bungee jumping, scuba diving, mountain climbing
(where ropes or guides are customarily used), riding or driving
in races or rallies using a motorized vehicle or bicycle, caving or
pot-holing, hunting or equestrian activities, skin diving or other
underwater activity, rafting or canoeing involving white water
rapids, yachting or boating outside coastal waters (2 miles),
participation in any Professional Sports, any bodily contact
sport or potentially dangerous sport for which You are
untrained; or
18. any loss, injury, damage or legal liability arising directly or
indirectly from: Travel in, to, or through Afghanistan, Cuba or
Democratic Republic of Congo; or
19. pregnancy and all related conditions, including services and
supplies related to the diagnosis or treatment of infertility or
other problems related to inability to conceive a child; birth
control, including surgical procedures and devices; This
however does not include ectopic pregnancy proved by
diagnostic means and is certified to be life threatening by the
Physician; or
20. for any loss of which a contributing cause was Your actual or
attempted commission of, or willful participation in, an illegal
act or any violation or attempted violation of the law or Your
resistance to arrest;

Registered office : Peninsula Business Park, Tower A, 15th Floor, G.K Marg, Lower Parel, Mumbai - 400013, Maharashtra, India.
24x7 Toll Free No.: 1800 266 7780 or 1800 22 9966 (For Senior Citizens) • Email: customersupport@tataaig.com • Website: www.tataaig.com
IRDA of India Registration No: 108 • CIN: U85110MH2000PLC128425 • Travel Guard Policy • UIN: TATTIOP23097V032223

Page 13 of 16
 Travel Guard Policy

Policy Number : 7101873929

21.Any loss, injury, damage or legal sustained directly or indirectly

by: Any terrorist or member of a terrorist organization,
narcotics trafficker, or purveyor of nuclear, chemical or
biological weapons
22.Any non-medical expenses (list enclosed- AnnexureI)

7. Benefits Covered
Waiting Period NIL
under the Policy
8. Financial Limits of
Coverage
•Sub-limit (It is a pre-
defined limit and the
insurance company
will not pay any
amount in excess of
this limit)
• Deductible (It is a
specified amount): General Terms and
Please refer to point no. 4
- Up to which an Clauses
insurance
company will not
pay any claim, and
-Which will be
deducted from
total claim amount
(if claim amount is
more than the
specified amount)

9. Turn Around Time (TAT) for claims settlement: Where the

circumstances of a claim warrant an investigation in the opinion of
the Company,it shall initiate and complete such investigation at the
earliest, in any case not later than 30 days from the date of receipt
of last necessary document- ln such cases, the Company shall settle
or reject the claim within 45 days from the date of receipt of last
Claims/Claims necessary document General Terms and
Procedure For Excluding Americas Policies: Clauses

Call: +91 - 22 68227600

Email - EA.TATAclaims@europ-assistance.in
For the Americas Policies:
Please call: +1-833-440-1575 (Toll free within US and Canada)
Email - tata.aig@europ-assistance.in

Registered office : Peninsula Business Park, Tower A, 15th Floor, G.K Marg, Lower Parel, Mumbai - 400013, Maharashtra, India.
24x7 Toll Free No.: 1800 266 7780 or 1800 22 9966 (For Senior Citizens) • Email: customersupport@tataaig.com • Website: www.tataaig.com
IRDA of India Registration No: 108 • CIN: U85110MH2000PLC128425 • Travel Guard Policy • UIN: TATTIOP23097V032223

Page 14 of 16
 Travel Guard Policy

Policy Number : 7101873929

While in India
contact at below numbers for any claim related assistance - Toll
Free No 1800 119966 from BSNL/MTNL Landline or 1800 22 9966
(only for senior citizen policy holders)
Call these local helpline numbers in your respective cities from any
other line:
Mumbai - 66939500, Delhi - 66603500, Bangalore - 66272829, Pune -
66014156, Chennai - 66841050, Hyderabad - 66629882, Ahmedabad
- 66610201
Email: general.claims@tataaig.com
Write to:
A&H Claims Department TATA AIG General Insurance Co. Ltd.
7th and 8th Floor, Romell Tech Park, Cama Industrial Estate,
Western Express Highway, Goregaon(E), Mumbai, Maharashtra
400063
Visit the Website: www.tataaig.com
• Claims for which prior intimation has not been given to the
Assistance Companies must be lodged with TATA AIG within 30
days. However, it is advisable to register a claim abroad by
informing the assistance companies on the applicable numbers
(refer the policy certificate or the numbers as given above for
the same). Please note that issuance of claim reference number
and claim form is not an admission of liability for any claim

Company Officials :
• If you are not satisfied with our services and wish to lodge a
complaint, please feel free to call our 24X7 Toll free number
10. Policy Servicing Redressal of Grievance
1800-266-7780 or Senior Citizen No. 1800 22 9966 (tolled) or
you may email to the customer service desk at
customersupport@tataaig.com

IRDAI :
• In case of no reply from Us within 15 days, You can approach
Grievance Redressal Cell of the Consumer Affairs Department
Grievances/ of IRDA of India by calling Toll Free Number 155255 (or) 1800
11. 4254 732 or send email to complaints@irdai.gov.in Redressal of Grievance
Complaints
Ombudsman :
• Details as mentioned in the policy wordings or alternatively
please refer our web-site (www.tataaig.com).

Registered office : Peninsula Business Park, Tower A, 15th Floor, G.K Marg, Lower Parel, Mumbai - 400013, Maharashtra, India.
24x7 Toll Free No.: 1800 266 7780 or 1800 22 9966 (For Senior Citizens) • Email: customersupport@tataaig.com • Website: www.tataaig.com
IRDA of India Registration No: 108 • CIN: U85110MH2000PLC128425 • Travel Guard Policy • UIN: TATTIOP23097V032223

Page 15 of 16
 Travel Guard Policy

Policy Number : 7101873929

Free Look Period:

(a) Single Trip Insurance - Free look period is not applicable.
(b) Annual Multi Trip Insurance - You have a period of 15 days
from the date of receipt of the Policy document to review the
terms and conditions of this Policy provided no trip has been
commenced. If You have any objections to any of the terms and
conditions, You have the option of cancelling the Policy stating General Terms and
12. Things to remember the reasons for cancellation and You will be refunded the Clauses
premium paid by You after adjusting the amounts spent on
stamp duty charges and proportionate risk premium. You can
cancel Your Policy only if You have not made any claims under
the Policy. All Your rights under this Policy will immediately
stand extinguished on the free look cancellation of the Policy.
Free look provision is not applicable and available at the time of
renewal of the Policy.

• Please disclose all condition/s before buying a policy. Non-

disclosure may result in claim not being paid and termination of General Terms and
13. Your Obligations:
Your policy. Clauses

Declaration by the Policy Holder : Mr VIVEK SRIVASTAVA

I have read the above and confirm having noted the details.

Place: Mr VIVEK SRIVASTAVA

Date: (Signature of the Policyholder)

In case of any conflict, the terms and conditions mentioned in the policy document shall prevail .

Registered office : Peninsula Business Park, Tower A, 15th Floor, G.K Marg, Lower Parel, Mumbai - 400013, Maharashtra, India.
24x7 Toll Free No.: 1800 266 7780 or 1800 22 9966 (For Senior Citizens) • Email: customersupport@tataaig.com • Website: www.tataaig.com
IRDA of India Registration No: 108 • CIN: U85110MH2000PLC128425 • Travel Guard Policy • UIN: TATTIOP23097V032223

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