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Travel insurance FAQs on claims

Wondering what if you are admitted to a hospital at two different times in the year for different problems, whether you can claim for both medical expenses in a travel insurance policy? Here' the answer and more.

Apnainsurance.com Research Bureau

14 Jan 2008

What does deductible imply? Does this mean each time I am hospitalized or visit a doctor, the deductible will be paid by me?
Yes, you are right.
In case of hospitalization, you have to pay the first US$ 50 or US$ 100 for each hospitalization.
In case of a doctor's visit, this deductible is payable per illness, not visit. For instance, let's assume the deductible specified in your travel insurance policy is US$ 50. You have visited the doctor for a stomach infection five times. Let's assume that the doctor charged US$ 50 per visit, thus making her total bill US$ 250. Given that you have to pay the first US$ 50 as the deductible, the balance US$ 200 towards doctor fees will be paid by the insurance company.

If I am admitted to a hospital at two different times in the year for different problems, can I claim for both medical expenses?
Yes you can make the claims for the different problems. This, provided that you have adequate cover in your travel insurance policy.

How do I avail of the cashless hospitalization facility?
You simply have to get in touch with the insurer or the Third Party Administrator (TPA) and register yourself. The TPA then provides you with the cashless facility at the nearest hospital, or lets you know the hospital where you can avail of the treatment. In case of an out-patient treatment, claims will only be reimbursed.

What is the percentage of the claim payable?
Claims payable depend on a few factors. If your policy carries a deductible, irrespective of the value of your claim, a standard US$ 50 to US$ 100 is deducted from the claim.
Also, the sum insured under your plan isn't automatically valid for all expenses; there is a limit for each type of expense. For example, a US$ 100,000 policy has a personal accident cover of a maximum of US$ 20,000. Similarly, dental expenses are capped at US$ 500. This cap could vary company to company.

What is the time frame within which the claim intimation has to be made?
Most companies recommend you intimate the Third Party Administrator (TPA) or register the claim abroad. However, if no prior intimation has been given to the TPA or the insurance company, the claim should be lodged immediately on your return to India or within 30 days of expiry of policy, whichever is earlier.

Is there a limit to the number of claims I can make in a year?
No, there is no limit to the number of claims you can make in a year. For example, assume that you have purchased a policy for a sum insured of US$ 200,000. You had an accident and subsequently filed a claim for US$ 10,000. Two months later, you have to make a sickness claim. In this event, you will be eligible for the US$ 200,000 cover in full i.e. it is not reduced by the US$ 10,000 claim that you made previously.

How is the reimbursement claim settled?
The claim settlement is made after the Third Party Administrator (TPA) authenticates and validates of the claims. The insurance company then makes a cheque payment, which is sent directly to your address in India.

Within how many days should the claim for insurance benefit be submitted?
Typically, claims should be submitted within 30 days of the completion of treatment. In the event of death, they can be submitted after the repatriation of the person's remains or burial.

Does my premium vary by country/region?
Yes. Insurance premium varies by geography. It is divided into three categories:

  • Asian countries excluding Japan
  • Excluding USA & Canada
  • Worldwide
See also:
What is travel insurance?
Travel insurance FAQs on coverage
Basic FAQs
Types of claim settlements
Tips to buy travel insurance
Travel insurance exclusions



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