PLAN – ‘A’ (World wide EXCLUDING USA & Canada)

Medical only – A to C Package policy – A to J
Age band 5 – 40 41 – 60 61 – 70 5 – 40 41 – 60 61 – 70
PERIOD US$ US$ US$ US$ US$ US$
DAY 1-7 25 30 38 28 32 44
DAY 8-14 32 34 45 35 37 52
DAY 15-21 33 35 47 36 39 54
DAY 22-28 35 38 53 39 43 61
DAY 29-35 41 45 62 47 51 70
DAY 36-47 46 49 70 52 57 81
DAY 48-60 50 56 79 60 66 93
DAY 61-75 61 67 98 73 80 113
DAY 76-90 70 78 114 85 95 132
DAY 91-120 113 123 182 140 147 219
DAY 121-147 137 150 216 167 175 268
DAY 148-180 168 183 275 208 220 325
Annual Multi Trip
Annual Multi Trip
Maximum any one
Trip 31 Days
102.50 112.50 185.00 117.50 127.50 210.00

THE ABOVE RATE IS APPLICABLE WITH EFFECT FROM 17.07.2007
Rs. 20 (Stamp duty) and 13% VAT is extra.

SCHEDULE OF COVER

Maximum Sum Insured ( US$ ) EXCESS
‘A’ Personal Accident Death – up to US$ 25,000 NIL
Loss of Limb – a) for 1 limb 50%
b) for 2 limb 100%
Loss of sight -a) for 1 eye 50%
b) for 2 eyes 100%
 Permanent Total Disability – up to US$ 25,000
Death benefit for children below 18 yrs &  over 65 yrs – US$ 5,000
‘B’ Medical and Emergency Exp. Up to US$ 100,000 US $ 100
‘C’ Hospital Benefit US$ 25 for each 24 hours of hospitalization up to a
maximum of US$ 250 NIL
‘D’ Loss of Checked Baggage US$ 2,000 US$ 100
‘E’ Delay of Checked Baggage US$ 50 for each 12 hour period of delay up to a
maximum of US$ 250 12 HOURS
‘F’ Loss of passport Up to US$ 500 NIL
‘G’ Personal Liability Up to US$ 250,000 US$ 250 in respect of third party property Damage Claims Only
‘H’ Travel Delay US$ 20 per hour upto maximum of US$ 500 12 hours
‘I’ Hijack US$ 50 per hour upto maximum of US$ 1500 24 hours
‘J’ Cancellation & Curtaliment US$ 1,000 US$ 100