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Terms & Conditions (Care Health Insurance)

By Arpit Jain June 30, 2025 1,089View
DescriptionWorldwide Excluding USA & Canada
Sum InsuredUS $ 50K, 100K

Benefits:-

Plan DetailsPlan DetailsWorldwide Excluding USA & Canada
BenefitDeductible/Time ExcessSum insured
Hospitalization Expenses
In-patient Care US $ 100 Up to SI
Out-patient Treatment US $ 100 Up to SI
Daily Allowance 2 daysUS $ 25 per day, max 5 consecutive days
Dental Treatment US $ 100 Up to US $ 400
Personal Accident US $ 20,000
Burglary(Home Contents) INR 1 Lac
Reimbursement of Golf FeesMin 5 Days of HospitalizationUS $ 2,000
Repatriation of Mortal RemainsUp to US $ 50,000
Loss of Checked-in Baggage US $500 Up to US $ 750
Loss of Passport US $ 300;
Personal Liability US $ 100 Up to US $ 100,000
Hijack Distress Allowance$100 per day for max. 5 consecutive days
Life Threatening Condition due to PEDUS $ 100 Up to 10%; Max. up to $10000
Medical Evacuation 10% of SI max up to $50,000

Sub Limit applicable for above 60 years of age:

Medical ExpenseSub-limit
Room Rent including boarding and lodging1.5% of the Sum Insured subject to a maximum of US $2,000 per day / € 1,500 per day
ICU Charges2% of the Sum Insured subject to a maximum of US $ 3,000 per day / € 2,250 per day
Operation Theatre charges (including Surgeon Charges)10% of the Sum Insured subject to a maximum of US $ 20,000 per Claim / € 15,000 per Claim
Anesthesia 25% of the surgery cost payable per claim
Ambulance Services US $ 500 per Claim / € 375 per Claim
Diagnostics and Radiology ServicesUS $ 1,000 per Claim / € 750 per Claim
Medical Practitioners visit feesUS $ 100 per visit / € 75 per visit subject to maximum of 10visits per Claim

Terms & Conditions

Hospitalization & Additional Coverage

Hospitalization Expenses include in-patient and out-patient medical expenses, Daily Allowance, and the following (if opted): Waiver of Deductible, Waiver of Sub-limits, Co-payment, Adventure Sports Coverage, and Home to Home Coverage. 

In-Patient Treatment

Coverage: Up to Sum Insured

Deductible: USD $100 Covers hospitalization for over 24 hours due to emergencies. 

Out-Patient Treatment

Coverage: Up to Sum Insured

Deductible: USD $100 Includes emergency treatment in hospital outpatient departments. 

Daily Allowance

Coverage: USD $25 per day (Max 5 days)

Deductible: 2 days Payable for each day of in-patient care. 

Dental Treatment

Coverage: Up to USD $400

Deductible: USD $100 For emergency dental treatment due to pain or injury (excluding cosmetic/prosthetic procedures).  

Personal Accident

Coverage: USD $20,000

  • Accidental Death: 100%
  • Permanent Total Disablement
    • Complete loss of both eyes/limbs: 100%
    • Loss of one eye/limb: 50%

Burglary (Home Contents)

Coverage: INR 1,00,000 

Reimbursement of Golf Fees

Coverage: USD $2,000 (Minimum 5 days hospitalization) 

Repatriation of Mortal Remains

Coverage: Up to USD $50,000 Covers transportation of remains or local burial. Assistance providers may charge handling fees. 

Loss of Passport / International Driving License

Coverage: Up to USD $300 (passport), USD $100 (IDL) Conditions: 

  • Must be reported to police within 24 hours 
  • No coverage: if loss due to detention/confiscation by authorities 

Personal Liability

Coverage: Up to USD $100,000

Deductible: USD $100 Covers legal liability for accidental injury or property damage to third parties. Conditions: 

  • Immediate intimation (within 60 days) 
  • Insurer’s consent needed before settling claims 
  • All expenses reduce the available Sum Insured 

Hijack Distress Allowance

Coverage: USD $100/day (Max 5 days) Payable if insured is held hostage on a common carrier during travel. 

Life-Threatening Conditions due to Pre-existing Diseases

Coverage: Up to 10% of Sum Insured; Max USD $10,000

Deductible: USD $100 Applicable to hospitalization and extended benefits like daily allowance, compassionate visit, etc. 

Claim Notification Procedure:

In the event of a claim, promptly notify the insurance company or its assistance provider by calling the toll-free number mentioned in your policy or by writing to them. Share the following details: 

  1. Policy Number 
  2. Policyholder’s Name 
  3. Name of the Insured Person involved
  4. Nature of illness/injury and applicable benefit
  5. Date of hospitalization or occurrence 
  6. Hospital and attending doctor’s details 
  7. Any additional documents requested 

Cashless Facility

Available at network hospitals for in-patient treatment. You must: 

  • Call the assistance center. 
  • Submit a cashless request form. Once approved, medical bills will be settled directly, excluding non-medical costs. 

Reimbursement Claims

Submit the following within 30 days of the event: 

  • Duly filled and signed claim form 
  • Medical information release form 
  • Original medical reports, discharge summary, case papers, and prescriptions
  • Passport and visa copies with entry/exit stamps
  • Original bills and payment receipts for hospitalization, consultation, tests, and medicines
  • Additional documents if requested by the insurer 

Exclusions: 

Specific to Hospitalization: 

  • Treatment that can be delayed until return to India 
  • Pre-existing conditions (unless specified) 
  • Cosmetic, dental (non-emergency), experimental, and elective treatments
  • Conditions related to pregnancy, childbirth, infertility, and hormone therapy
  • Treatment from unlicensed practitioners
  • Non-medical services and personal comfort items
  • Prosthetics, medical equipment, sleep aids, and corrective devices 
  • Obesity-related treatment
  • Sleep disorders, general debility, custodial care 
  • Congenital anomalies, mental retardation, aesthetic procedures
  • Gender reassignment treatments 

General Exclusions (All Benefits): 

  • Claims outside policy period 
  • Suicide, self-harm, substance abuse
  • Criminal acts
  • Sexually transmitted diseases (except HIV)
  • Expenses from routine checkups and diagnostics unrelated to treatment
  • Claims not reported on time or without adequate proof 

Policy Terms: 

1. Endorsements 

  • After the end date of policy, no endorsement would be allowed. 
  • Policy Period Start Date can be changed after the policy period has commenced only if the customer renders sufficient proof that the trip could not commence. 
  • Any Pre-existing Disease shall be included only after underwriter’s review.
  • No endorsement is allowed unless documents as specified are submitted.
    • Customer Name /Passport/Date of Birth – in case of more than one change – Passport Copy is required. 
    • Trip start date changed after Policy Period Start Date – Scanned Passports with all Pages & Ticket Cancellation/Rescheduling. 
  • The Company may ask for additional documents including but not limited to passport copy, medical reports, good health declaration, etc. before it effecting an endorsement.

2. Minimum Entry Age: 1 day

2. Maximum Entry Age: As specified in the individual plan details 

3. Age of Proposer: 18 years or older 

4. Eligible Family Members (Family Option): Self, spouse, dependent children (up to 25 years of age), and parents 

5. Eligibility: Applicants must reside in India 

7. Policy Period Start Date: The policy will commence at 00:00 hours on the day following the later of: 

  • Proposal receipt at the branch 
  • The requested policy start date 
  • The date of receipt of premium payment or instrument date 

Annexure I:

List I: Generally Excluded (Non-Medical) Expenses

  1. Baby Food
  2. Baby Utilities Charges
  3. Beauty Services
  4. Belts/ Braces
  5. Buds
  6. Cold Pack/ Hot Pack
  7. Carry Bags
  8. Email/ Internet Charges
  9. Food Charges (Other Than Patient’s Diet Provided By Hospital)
  10. Leggings
  11. Laundry Charges
  12. Mineral Water
  13. Sanitary Pad
  14. Telephone Charges
  15. Guest Services
  16. Crepe Bandage
  17. Diaper Of Any Type
  18. Eyelet Collar
  19. Slings
  20. Blood Grouping And Cross Matching Of Donors Samples
  21. Service Charges Where Nursing Charge Also Charged
  22. Television Charges
  23. Surcharges
  24. Attendant Charges
  25. Extra Diet Of Patient (Other Than That Which Forms Part Of Bed Charge)
  26. Birth Certificate
  27. Certificate Charges
  28. Courier Charges
  29. Conveyance Charges
  30. Medical Certificate
  31. Medical Records
  32. Photocopies Charges
  33. Mortuary Charges
  34. Walking Aids Charges
  35. Oxygen Cylinder (For Usage Outside The Hospi- tal)
  36. Spacer
  37. Spirometre
  38. Nebulizer Kit
  39. Steam Inhaler
  40. Armsling
  41. Thermometer
  42. Cervical Collar
  43. Splint
  44. Diabetic Foot Wear
  45. Knee Braces (Long/ Short/ Hinged)
  46. Knee Immobilizer/ Shoulder Immobilizer
  47. Lumbo Sacral Belt
  48. Nimbus Bed Or Water Or Air Bed Charges
  49. Ambulance Collar
  50. Ambulance Equipment
  51. Abdominal Binder
  52. Private Nurses Charges- Special Nursing Charges
  53. Sugar Free Tablets
  54. Creams Powders Lotions (Toiletries Are Not Pay- able, Only Prescribed Medical Pharmaceuticals Payable)
  55. Ecg Electrodes
  56. Gloves
  57. Nebulisation Kit
  58. Any Kit With No Details Mentioned [Delivery Kit, rthokit, Recovery Kit, Etc]
  59. Kidney Tray
  60. Mask
  61. Ounce Glass
  62. Oxygen Mask
  63. Pelvic Traction Belt
  64. Pan Can
  65. Trolly Cover
  66. Urometer, Urine Jug
  67. Ambulance
  68. vasofix Safety

List II: Items Subsumed Under Room Charges 

  1. Baby Charges (Unless Specified/ Indicated)
  2. Hand Wash
  3. Shoe Cover
  4. Caps
  5. Cradle Charges
  6. Comb
  7. Eau-De-Cologne/ Room Freshners
  8. Foot Cover
  9. Gown
  10. Slippers
  11. Tissue Paper
  12. Tooth Paste
  13. Tooth Brush
  14. Bed Pan
  15. Face Mask
  16. Flexi Mask
  17. Hand Holder
  18. Sputum Cup
  19. Disinfectant Lotions
  20. Luxury Tax
  21. HVAC
  22. House Keeping Charges
  23. Air Conditioner Charges
  24. IM IV Injection Charges
  25. Clean Sheet
  26. Blanket/ Warmer Blanket
  27. Admission Kit
  28. Diabetic Chart Charges
  29. Documentation Charges/ Administrative Expenses
  30. Discharge Procedure Charges
  31. Daily Chart Charges
  32. Entrance Pass/ Visitors Pass Charges
  33. Expenses Related To Prescription On Discharge
  34. File Opening Charges
  35. Incidental Expenses/ Misc. Charges (Not Ex- plained)
  36. Patient Identification Band/ Name Tag
  37. Pulseoxymeter Charges

List III: Items Subsumed Under Procedure Charges 

  1. Hair Removal Cream
  2. Disposables Razors Charges (For Site Prepara- tions)
  3. Eye Pad
  4. Eye Sheild
  5. Camera Cover
  6. DVD, CD Charges
  7. Gause Soft
  8. Gauze
  9. Ward And Theatre Booking Charges
  10. Arthroscopy And Endoscopy Instruments
  11. Microscope Cover
  12. Surgical Blades, Harmonicscalpel, Shaver
  13. Surgical Drill
  14. Eye Kit
  15. Eye Drape
  16. X-Ray Film
  17. Boyles Apparatus Charges
  18. Cotton
  19. Cotton Bandage
  20. Surgical Tape
  21. Apron
  22. Torniquet
  23. Orthobundle, Gynaec Bundle

List IV: Items Subsumed Under Costs of Treatment 

  1. Admission/ Registration Charges
  2. Hospitalisation For Evaluation/ Diagnostic Pur- pose
  3. Urine Container
  4. Blood Reservation Charges And Ante Natal Book- ing Charges
  5. Bipap Machine
  6. Cpap/ Capo Equipments
  7. Infusion Pump- Cost
  8. Hydrogen Peroxide\Spirit\ Disinfectants etc
  9. Nutrition Planning Charges – Dietician Charges- Diet Charges
  10. HIV Kit
  11. Antiseptic Mouthwash
  12. Lozenges
  13. Mouth Paint
  14. Vaccination Charges
  15. Alcohol Swabes
  16. Scrub Solutionisterillium
  17. Glucometer & Strips
  18. Urine Bag

About Care Health Insurance: 

Care Health Insurance is a dedicated health insurance provider offering a comprehensive range of products across both retail and corporate segments. Its portfolio includes: 

  • Health Insurance 
  • Top-up Plans 
  • Personal Accident Cover 
  • Maternity Coverage 
  • International Travel Insurance 
  • Critical Illness Plans 
  • Group Health and Personal Accident Insurance for Corporates 
  • Micro Insurance for the rural sector 
  • A wide range of Wellness Services 

The company operates on a strong foundation of customer-centricity, consistently leveraging technology to enhance service delivery, introduce innovative products, and ensure value-driven offerings. 

Contact Details for Claims & Policy Assistance: 

Registered Office: Care Health Insurance Limited 5th Floor, 19 Chawla House, Nehru Place, New Delhi – 110019 

Correspondence Office: Vipul Tech Square, Tower C, 3rd Floor, Golf Course Road, Sector-43, Gurugram – 122009

Customer Support:

  • WhatsApp (Toll-free): 8860402452 
  • Claims Email: claims@careinsurance.com 
  • Submit Queries: careinsurance.com/contact-us.html 
  • Website: www.careinsurance.com 

Disclaimer & Legal Information: 

This is a summary of the product. For full details on coverage, terms, and risk factors, please refer to the official sales brochure. We recommend consulting a licensed insurance advisor for further clarity or specific concerns. 

Important Regulatory Information: 

  • IRDAI Registration No.: 148 
  • UAN: 25036635 
  • CIN: U66000DL2007PLC161503 
  • UIN: RHITIOP20134V031920

FAQ

What if you contracted a severe infection during your trip?

Medical Cover: Covers your emergency hospitalization or treatment if during your travel you are diagnosed with an illness, or any Life Threatening Previous illness. In case you require further treatment even after your return, expenses for the same will be covered up to a period of 30 days or up to policy end date, whichever is earlier.

What if you have a medical emergency during your trip and there is no hospital in the near vicinity?

Medical Evacuation: Covers costs incurred for any emergency transportation and evacuation services, to transfer you to an appropriate medical facility within our network.

What if the vehicle you are traveling in met with an accident?

Personal Accident: Covers any unfortunate situation arising out of an accident, death or permanent total disability, while you’re traveling abroad.

What if the aircraft you’re traveling in is involved in a mid-air mishap?

Common Carrier Accidental Death: Lumpsum payment of Sum Insured in case of accidental death as a passenger on a common carrier/transport. Even covers mounting and unmounting during your trip.

What if you have a painful fall during your trip and end up with missing teeth?

Dental Expenses: Covers dental expenses incurred in connection with any injury while on your trip.

What if regaining your Checked-in Baggage becomes a concern?

Loss of Checked-in Baggage: Covers expenses for your checked-in baggage that you lost while in custody of the Common Carrier.

What if you can’t find your passport?

Worry not! We even cover this. Loss of Passport: Covers expenses for the issue of a new or duplicate passport.

What if you dropped your heavy suitcase, fracturing an old woman’s foot?

Personal Liability: Covers expenses against legal liability for bodily injury or property damage that occurred accidentally to third parties during your trip.

What if you wish to make a phone call to your spouse often while hospitalized?

Daily Allowance in case of Hospitalization: Pays a specified amount per day of stay at the hospital to meet numerous allied expenses such as attendant’s meals, transportation and communication incurred, in case of hospitalization for over two consecutive days, for a period of maximum 5 consecutive days.

What is not covered?

• Expenses arising out of or attributable to alcohol or drug use/misuse/abuse
• War and Nuclear perils or consequences thereof
• Any intentional self-injury, suicide or attempted suicide
• Any claim relating to hazardous activities
• The insured being involved in Breach of Law

How & where to reach out for any claim?

In case of Claim, notify us immediately on any of the below touch-points for hassle free processing and speedy settlements.

Falck Global Assistance (Assistance Service Provider)
USA & Canada: +1 844 301 3135 | +1 844 301 3146 (Toll Free)
Any other country: +91 124 4498760 (Call Back Facility)

Email us at travelassistance@careinsurance.com

Office of the Insurance Ombudsman – Contact Details and Jurisdictions

LocationAddressContactJurisdiction
AhmedabadInsurance Ombudsman, Jeevan Prakash, 6th Floor, Tilak Marg, Near S.V College Relief Road, Ahmedabad – 380 001.Tel.: 079 – 25501201/02
Email: bimalokpal.ahmedabad@cioins.co.in		Gujarat, Dadra & Nagar Haveli, Daman and Diu
BengaluruJeevan Soudha Building, PID No. 57-27-N-19, Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078.Tel.: 080 – 26652048 / 26652049
Email: bimalokpal.bengaluru@cioins.co.in		Karnataka
BhopalLIC of India Zonal Office Building, 1st Floor, South Wing, Jeevan Shikha, Opp. Gayatri
Mandir, 60-B, Hoshangabad, Road, Bhopal – 462011.		Tel.: 0755 – 2769201 / 2769202 / 2769203
Email: bimalokpal.bhopal@cioins.co.in		Madhya Pradesh &
Chhattisgarh
Bhubaneshwar62, Forest Park, Bhubaneshwar – 751 009.Tel.: 0674 – 2596461 / 2596455 / 2596429 / 2596003
Email: bimalokpal.bhubaneswar@cioins.co.in		Orissa
ChandigarhJeevan Deep, Ground Floor, LIC of India Building, SCO 20-27, Sector 17-A, Chandigarh – 160 017.Tel.: 0172 – 2706468 / 2707468
Email: bimalokpal.chandigarh@cioins.co.in		Punjab, Haryana, Himachal Pradesh, Jammu & Kashmir, Chandigarh
ChennaiFatima Akhtar Court, 4th Floor, 453 (old 312), Anna Salai, Teynampet, Chennai – 600 018.Tel.: 044 – 24333668 / 24333678
Email: bimalokpal.chennai@cioins.co.in		Tamil Nadu,
Pondicherry Town, and Karaikal
Delhi2/2 A, 1st Floor, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002.Tel.: 011 – 23232481 / 23213504 / 46013992
Email: bimalokpal.delhi@cioins.co.in		Delhi, Haryana
(including Gurugram, Faridabad, Sonepat, Bahadurgarh)
GuwahatiJeevan Nivesh Building, 5th Floor, Near Panbazar, S.S. Road, Guwahati – 781001 (Assam).Tel.: 0361 – 2632204 / 2632205 / 2631307
Email: bimalokpal.guwahati@cioins.co.in		Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland, Tripura
Hyderabad6-2-46, 1st Floor, “Moin
Court”, Lane Opp. Hyundai Showroom, A.C. Guards, Lakdi-Ka-Pool, Hyderabad – 500 004.		Tel.: 040 – 23312122 / 23376599 / 23376991 / 23328709 / 23325325
Email: bimalokpal.hyderabad@cioins.co.in		Andhra Pradesh,
Telangana, Yanam (Pondicherry
Territory)
JaipurJeevan Nidhi – II Bldg., Ground Floor, Bhawani Singh Marg, Ambedkar Circle, Jaipur – 302 005.Tel.: 0141 – 2740363
Email: bimalokpal.jaipur@cioins.co.in		Rajasthan
Kochi10th Floor, LIC Building, Jeevan Prakash, Opp. Maharaj College Ground, M.G. Road, Ernakulam– 682 011.Tel.: 0484 – 2358759
Email: bimalokpal.ernakulam@cioins.co.in		Kerala, Lakshadweep, Mahe (Pondicherry Territory)
Kolkata7th Floor, Hindusthan Building (Annex), 4, C.R. Avenue, Kolkata – 700 072.Tel.: 033 – 22124339 / 22124341
Email: bimalokpal.kolkata@cioins.co.in		West Bengal,
Andaman & Nicobar Islands, Sikkim
Lucknow6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow – 226 001.Tel.: 0522 – 4002082 / 3500613 Email:
bimalokpal.lucknow@cioins.co.in		Multiple districts of Uttar Pradesh
(including Allahabad, Varanasi, Lucknow, and others)
Mumbai3rd Floor, Jeevan Seva Annexe, S.V. Road, Santacruz West, Mumbai – 400 054.Tel.: 022 – 69038800 / 33
Email:
bimalokpal.mumbai@cioins.co.in		Goa, Mumbai
Metropolitan Region excluding Navi
Mumbai & Thane
Patna2nd Floor, Lalit Bhawan, Baily Road, Patna.Tel.: 0612-2547068
Email: bimalokpal.patna@cioins.co.in		Bihar, Jharkhand
NoidaBhagwan Sahai Palace, 4th Floor, Main Road, Naya Bans, Sector 15, Gautam Buddh Nagar, U.P – 201301.Tel.: 0120-2514252 / 2514253 Email: bimalokpal.noida@cioins.co.inUttaranchal and
parts of Uttar
Pradesh (including Agra, Aligarh,
Meerut, etc.)
PuneJeevan Darshan, LIC of India Bldg., 3rd Floor, N.C. Kelkar Road, Narayan Peth, Pune – 411 030.Tel.: 020-24471175
Email: bimalokpal.pune@cioins.co.in		Maharashtra
including Navi
Mumbai and Thane (excluding Mumbai Metropolitan Region)

Address: 3rd Floor, Jeevan Seva Annexe,
S.V. Road, Santacruz (W), Mumbai – 400 054.

Contact: Tel: 022-69038800 / 33
Email: inscoun@cioins.co.in

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