Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 1 of 23
UIN: LIBTGDP22171V012122
Optional Travel Insurance for E-ticket passengers- IRCTC
Liberty General Insurance Limited (“the Company, We, Our, or Us”), having received a Proposal from the
Proposer, along with declaration(s), reports and such other documents as may be required, upon receipt of such
proposal and upon occurrence of the Insured event(s) agree to pay the compensation having become payable
under Part 2 of this Policy, i.e. that the Sum Insured/ appropriate benefit (s), subject however to the terms,
conditions, provisos, exclusions contained herein or endorsed or otherwise expressed herein.
Part I: Definitions
The following words and terms shall have the meaning as described herein, wherever they appear in this Policy.
The references to singular or masculine will include references to plural and female wherever the context permits
and vice versa.
1. “Accident” - An Accident means sudden, unforeseen and involuntary event caused by external, visible and
violent means.
(a) When in the course of working a railway, an accident occurs, being either a collision between trains of
which one is a train, carrying passengers or the derailment of or other accident to a train or any part of a
train carrying passenger.
(b) When in the course of working a railway an untoward incident occurs, in the train carrying passengers
(any part of the train) or at the actual departure from the originating station to actual arrival of train at
the destination station.
2. “Act of terrorism”- means the calculated use of violence (or the threat of violence) against civilians, harmful
to human life, tangible or intangible property or infrastructure in order to attain goals that are political,
economical, religious or racial interests; this is done through intimidation or coercion or instilling fear.
Terrorism shall also include any act which is verified or recognized by the relevant Government as an act of
Terrorism.
3. “Age”– means age of the Insured person on last birthday as on date of commencement of the Policy.
4. “Condition Precedent” - means a Policy term or condition upon which the Company’s liability under the
Policy is conditional upon.
5. “Congenital Anomaly” - refers to a condition(s) which is present since birth, and which is abnormal with
reference to form, structure or position.
a) “Internal Congenital Anomaly” - Congenital anomaly which is not in the visible and accessible parts
of the body.
b) “External Congenital Anomaly” - Congenital anomaly which is in the visible and accessible parts of
the body.
6. “Day Care Centre” - means any institution established for day care treatment of disease/ injuries or a medical
setup within a hospital and which has been registered with the local authorities, wherever applicable, and is
i) Conditions precedent to the contract
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 2 of 23
UIN: LIBTGDP22171V012122
under the supervision of a registered and qualified medical practitioner AND must comply with all minimum
criteria as under:
i. has qualified nursing staff under its employment;
ii. has qualified medical practitioner (s) in charge;
iii. has a fully equipped operation theatre of its own where surgical procedures are carried out
iv. maintains daily records of patients and shall make these accessible to the Company’s authorized
personnel.
7. “Day Care Treatment” - means medical treatment, and/or surgical procedure which is:
i. undertaken under General or Local Anesthesia in a hospital/Day Care Centre in less than twenty four
(24) hours because of technological advancement, and
ii. which would have otherwise required a hospitalization of more than twenty four (24) hours.
Treatment normally taken on an out-patient basis is not included in the scope of this definition.
8. “Deductible”- Deductible means a cost-sharing requirement under a health insurance policy that provides
that the Insurer will not be liable for a specified rupee amount in case of indemnity policies and for a specified
number of days/hours in case of hospital cash policies which will apply before any benefits are payable by
the Insurer. A deductible does not reduce the sum insured. Deductible will be applicable for each event
claimed by the Insured.
9. “Declaration”–means explicitly written or verbal statement/ information provided by the Insured during
the course of Insurance, which forms the basis of this contract.
10. “Dental Treatment” - Dental treatment means a treatment related to teeth or structures supporting teeth
including examinations, fillings (where appropriate), crowns, extractions and surgery.
11. “Disclosure to information norm” - The Policy shall be void and all premium paid hereon shall be forfeited
to the Company, in the event of misrepresentation, mis-description or non-disclosure of any material fact.
12. “Doctor/Physician/Medical practitioner”- means a person who holds a valid registration from the
Medical Council of any state or Medical Council of India or Council for Indian Medicine or for Homeopathy
set up by the Government of India or a State Government and is thereby entitled to practice medicine within
its jurisdiction; and is acting within the scope and jurisdiction of his licence provided that this person is not a
member of the Insured Person's family.
13. “Emergency Care” - Emergency care means management for an illness or injury which results in symptoms
which occur suddenly and unexpectedly, and requires immediate care by a Medical Practitioner to prevent
death or serious long term impairment of the Insured Person’s health.
14. “Geographical Scope” - The geographical scope of this Policy will be India and the claims shall be settled
in India in Indian rupees only. The laws of India shall govern the construction, interpretation and meaning of
the provisions of this Policy for the time being in force. The parties hereto unconditionally submit to the
jurisdiction of the courts in India.
15. “Group”-A group shall mean and include the customers of IRCTC holding a valid e-travel ticket.
16. “Hospital”- A hospital means any institution established for in- patient care and day care treatment of
illness and / or injuries and which has been registered as a hospital with the local authorities under the
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 3 of 23
UIN: LIBTGDP22171V012122
Clinical Establishments (Registration and Regulation) Act, 2010 or under the enactments specified under the
Schedule of Section 56(1) of the said Act OR complies with all minimum criteria as under:,
- has qualified nursing staff under its employment round the clock;
- has at least ten inpatient beds, in towns having a population of less than ten lakh and fifteen inpatient
beds in all other places;
- has qualified Medical Practitioner (s) in charge round the clock;
- has a fully equipped operation theatre of its own where surgical procedures are carried out
- Maintains daily records of patients and make these accessible to the Insurance Company’s authorized
personnel.
17. “Hospitalization” - Means admission in a Hospital for a minimum period of twenty four (24) consecutive
‘In- patient Care’ hours except for specified procedures/ treatments, where such admission could be for a
period of less than twenty four (24) consecutive hours.
18. “ICU (Intensive Care Unit) Charges” - means the amount charged by a Hospital towards ICU expenses
on a per day basis which shall include the expenses for ICU bed, general medical support services provided
to any ICU patient including monitoring devices, critical care nursing and intensivist charges
19. “Illness”- means a sickness or a disease or pathological condition leading to the impairment of normal
physiological function which manifests itself during the policy period and requires medical treatment.
a) Acute Condition - Acute condition is a disease, illness or injury that is likely to respond quickly to
treatment which aims to return the person to his or her state of health immediately before suffering the
disease/illness/injury which leads to full recovery.
b) Chronic Condition - A chronic condition is defined as a disease, illness or injury that has one or more
of the following characteristics:
1. it needs ongoing or long term monitoring through consultations, examinations, check-ups, and/or
tests.
2. it needs ongoing or long term control or relief of symptoms.
3. it requires rehabilitation for the patient or for the patient to be special trained to cope with it
4. it continues indefinitely.
5. it recurs or is likely to recur.
20. “Immediate family member” – means Insured’s spouse, children, parents, siblings, children in law, parents
in law, siblings in law, grandchildren, grandparents, legal guardian who reside in India
21. “Injury” - Injury means accidental physical bodily harm excluding illness or disease solely and directly caused
by external, violent and visible and evident means which is verified and certified by a Medical Practitioner.
22. “Inpatient Care” - Inpatient care means treatment for which the Insured person has to stay in a hospital for
more than twenty four (24) hours for a covered event.
23. “Intensive Care Unit” - means an identified section, ward or wing of a hospital which is under the constant
supervision of a dedicated medical practitioner(s), and which is specially equipped for the continuous
monitoring and treatment of patients who are in a critical condition, or require life support facilities and where
the level of care and supervision is considerably more sophisticated and intensive than in the ordinary and
other wards
24. “Insured/ You/ Your/ Yourself” - means a Group Policyholder on whose name the Policy is issued.
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 4 of 23
UIN: LIBTGDP22171V012122
25. “Insured Person (s)” - Insured Person/s or Insured Beneficiary means the persons, or his Family members,
named in the Schedule travelling by Indian Railway of all class who book the e-ticket through IRCTC site and
opt for this insurance cover by paying an appropriate premium, irrespective of the class of the ticket and the
benefit will be only against the accident and untoward incident that takes place during actual departure to
actual arrival of the train. including ‘process of entraining ‘ and ‘process of detraining the train’ and Vikalp
train, short termination and diverted route.
26. “Insured Journey / Journey” - means a one-way journey and/or return journey during the Policy Period to
a destination within India.
27. “Limb” - means the hand above the wrist joint or foot above the ankle joint.
28. “Limit of Indemnity” - means the amount stated in the Schedule against each relevant Section, which shall
be Our maximum liability under this Policy (regardless of number of Claims made) for any one claim and in
the aggregate for all claims under such Section subject to deductible specified in the Policy Schedule.
29. “Medical Advise” - Medical Advice means any consultation or advice from a Medical Practitioner including
the issue of any prescription or follow-up prescription.
30. “Medical Expenses” - Medical Expenses means those expenses that an Insured Person has necessarily and
actually incurred for medical treatment on account of Illness or Accident on the advice of a Medical
Practitioner, as long as these are no more than would have been payable if the Insured Person had not been
Insured and no more than other hospitals or doctors in the same locality would have charged for the same
medical treatment.
31. “Medically Necessary Treatment” - Medically necessary treatment means any treatment, tests,
medication, or stay in hospital or part of a stay in hospital which
- is required for the medical management of the illness or injury suffered by the Insured;
- must not exceed the level of care necessary to provide safe, adequate and appropriate medical care in
scope, duration, or intensity;
- must have been prescribed by a Medical Practitioner,
- must conform to the professional standards widely accepted in international medical practice or by the
medical community in India.
32. “Nominee” - means the person named in the Proposal or Schedule to whom the benefits under the Policy
is nominated by the Insured Person.
33. “Notification of Claim” - Notification of claim means the process of intimating a claim to the Insurer or
TPA through any of the recognized modes of communication.
34. “Out-Patient (OPD) Treatment” - means treatment in which the insured visits a clinic / hospital or
associated facility like a consultation room for diagnosis and treatment based on the advice of a medical
practitioner. The insured is not admitted as a day care or in-patient.
35. “Passenger” -means a traveller travelling against a confirmed e-ticket on a train managed by IRCTC.
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 5 of 23
UIN: LIBTGDP22171V012122
36. “Permanent Partial Disability” - means an accidental Injury caused by accident, which as a direct
consequence thereof, disables any part of the limbs or organs of the body of the Insured person and which
falls into one of the categories listed in the Table of Benefits.
37. “Permanent Total Disablement” - means Doctor certified total, continuous and permanent physical or
functional loss of body parts as a result of accidental bodily injury.
38. “Policy”– means this document of Policy describing the terms and conditions of this contract of insurance
including the Company’s covering letter to the Insured if any, the Schedule attached to and forming part of
this Policy, the Insured’s declarations made at proposal of Insurance and any applicable endorsement
attaching to and forming part thereof either at inception or during the period of insurance.
39. “Policy Period” - means the period between and including actual departure time to actual arrival time of the
train including ‘process of entraining‘ and ‘process of detraining’ the train and Vikalp train, short termination
and diverted route.
40. “Policy Schedule” - means the Policy Schedule attached to and forming part of the Policy.
41. “Proposal and Declaration Form” - means any initial or subsequent declaration made by the Insured/
Insured Person/s and is deemed to be attached and forming part of this Policy.
42. “Qualified Nurse” - means a person who holds a valid registration from the Nursing Council of India or
the Nursing Council of any state in India.
43. “Reasonable and Customary Charges” – Reasonable and customary charges means the charges for
services or supplies, which are the standard charges for the specific provider and consistent with the prevailing
charges in the geographical area for identical or similar services, taking into account the nature of the illness
/ injury involved.
44. “Room rent” - Room Rent means the amount charged by a Hospital towards Room and Boarding expenses
and shall include the associated medical expenses
45. “Surgery” or “Surgical Procedure” Surgery or Surgical Procedure means manual and / or operative
procedure (s) required for treatment of an illness or injury, correction of deformities and defects, diagnosis
and cure of diseases, relief from suffering and prolongation of life, performed in a hospital or day care center
by a medical practitioner.
46. “Train Accident” is as defined under section 123 read with Sections 124 and 124A of the Railways Act, 1989
subject to the qualification that the coverage will be valid from the actual departure of train from the originating
station to actual arrival of train at the destination station including ‘process of entraining’ and ‘process of
detraining’ the train.
47. “Trip” - shall mean a travel or journey undertaken by the Insured Person (s) travelling with a valid train e-
ticket booked from IRCTC, from the date and time of actual boarding the train to the date of time of actual
arrival of the train at the destination station as mentioned in the Policy schedule including ‘process of
entraining’ and ‘process of detraining’ the train.
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 6 of 23
UIN: LIBTGDP22171V012122
48. “Trip Duration”- means the time period commencing from the date & time when the Insured Person (s)
boards the train and ending on the date & time of arrival at the destination station as mentioned in the Policy
schedule including ‘process of entraining’ and ‘process of detraining’ as specifically mentioned in the Policy
Schedule for the journey undertaken within the Policy period.
49. “Unproven/Experimental treatment” - Unproven/Experimental treatment means the treatment including
drug Experimental therapy, which is not based on established medical practice in India, is treatment
experimental or unproven.
50. “Untoward incident”- means
(a) The commission of a terrorist act within the meaning of sub-section (1) of section 3 of the Terrorist and
Disruptive Activities (Prevention) Act, 1987(28 of 1987), or
(b) The making of a violent attack or the commission of robbery or dacoity; or
(c) The indulging in rioting, shoot-out or arson, by any person in or any train carrying passengers or, from
the actual departure from originating station to actual arrival of train at destination station including
‘process of entraining ‘and ‘process of detraining the train’ and Vikalp train, short termination and
diverted route
(d) The accident falling of any passenger from a train carrying passengers.
51. “War” – means Open and declared conflict between the armed forces of two or more states or nations to
achieve economic, geographic, nationalistic, political, racial, religious or other ends.
52. “We, Us, Our, Company” – means Liberty General Insurance Limited.
Part II: Scope of Cover
Section 1- Accidental Death
In case of Death due to accident 100% of sum insured will be paid by the Insurance Company.
Coverage:
The Insurance Company shall compensate the nominee or their legal heirs as the case may be for any injury (whilst
on a trip covered in the policy) solely and directly caused by accident occurring during the period of insurance
resulting death within12 calendar months of occurrence of the accident. The sum insured as specified above shall
be limit per passengers per policy period payable only to the nominee/ insured person's legal heirs.
Special Conditions
A. If the Insured Person dies as a result of the Accident within 12 months of its occurrence, or thereafter for any
other covered reason, and a claim for permanent impairment had been made prior to the death, then payment will
be made of the Sum Insured less any sum paid for the permanent impairment, and any sum that was due to be
paid for the permanent impairment shall not be paid.
B. If the Insured Person is not found within 7 years of the disappearance, sinking or wrecking of the Scheduled
Railway Carrier in which he was travelling as a fare paying passenger, the Insured Person will be presumed to have
died as a result of the Accident.
ii) Conditions applicable during the contract
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 7 of 23
UIN: LIBTGDP22171V012122
Section 2- Permanent Total Disablement
In case of Permanent total disability the 100% of sum insured will be paid by the Insurance Company.
If during the policy period, the insured person sustains Accidental Bodily injury which directly and independently
of all other causes results in permanent total disability within 12 months from the date of accident. For the purpose
of this cover, Permanent total disability shall mean either of the following and compensation will be paid as per
table below.
Permanent Total Disability Sum Insured Rs. 10,00,000/-
The Disablement
Compensation Expressed as a
Percentage of Total Sum Insured
1. Permanent Total Disablement
100%
2. Permanent and incurable insanity
100%
3. Permanent Total Loss of two Limbs
100%
4. Permanent Total Loss of Sight in both eyes
100%
5. Permanent Total Loss of Sight of one eye and one Limb
100%
6. Permanent Total Loss of Speech
100%
7. Complete removal of the lower jaw
100%
8. Permanent Total Loss of Mastication
100%
9. Permanent Total Loss of the central nervous system or the thorax
and all abdominal organs resulting in the complete inability to engage in
any job and the inability to carry out Daily Activities essential to life
without full time assistance
100%
10. Permanent disablement not otherwise provided for under above
Items inclusive up to a maximum of Sum Insured.
100%
Section 3- Permanent Partial Disablement
In case of Permanent partial disability the 75% of sum insured will be paid by the Insurance Company.
If during the policy period, the insured person sustains Accidental Bodily injury which directly and independently
of all other causes results in permanent partial disability within 12 months from the date of accident. For the
purpose of this cover, Permanent partial disability shall mean either of the following and compensation will be
paid as per table below.
Permanent Partial Disability Sum Insured upto Rs. 7,50,000/-
The Disablement
Compensation Expressed as a
Percentage of Total Sum Insured
1. Permanent Total Loss of Hearing in both ears
100%
2. Permanent Total Loss of one Limb
67%
3. Permanent Total Loss of Sight of one eye
67%
4. Permanent Total Loss of Hearing in one ear
20%
5. Permanent Total Loss of the lens in one eye
33%
6. Permanent Total Loss of use of four fingers and thumb of either hand
53%
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 8 of 23
UIN: LIBTGDP22171V012122
7. Permanent Total Loss of use of four fingers of either hand
27%
8. Permanent Total Loss of use of one thumb of either hand
27%
9. Permanent Total Loss of one finger of either hand
7%
10. Permanent Total Loss of use of toes
20%
11. Established non-union of fractured leg or kneecap
13%
12. Shortening of leg by at least 5 cms.
10%
13. Any loss is of the elbow, hip or knee
27%
14. Any other Permanent Partial not included in above items.
% as assessed by Doctor.
Specific Condition
1) The total amount payable in respect of more than one disablement due to the same Accident is arrived at by
adding together the various percentages shown in the Table of Benefits, shall not exceed the Total Sum
Insured.
2) If an Insured Person dies as the result of the Bodily Injury any amount claimed and paid to an Insured under
the Permanent Disablement Section will be deducted from any payment under the Accidental Death and/or
Permanent Total Disablement Section.
Section 4 – Hospitalization Expenses for Injury
The Company shall indemnify the Insured Person for the expenses upto Rs. 2 lakhs, incurred by the Insured
Person for hospitalization and medical treatment, taken on account of any injury sustained by the Insured person
whilst on a trip during the period of Insurance.
The Medical Expenses incurred for hospitalization treatment during the risk period for:
a) Room rent, boarding expenses (Room rent to be capped at 2% of the sum insured and ICU/CCU to be capped
at 4% of the sum insured)
b) Nursing
c) Intensive care unit
d) Medical practitioner
e) Anesthesia, blood, oxygen, operation theatre charges, surgical appliances
f) Medicines, drugs and consumables
g) Diagnostic procedures
h) The cost of prosthetic and other devices or equipment if implanted internally during a surgical procedure.
i) Medical expenses incurred as out-patient are not covered. However, procedures followed under day care stands
covered.
j) No OPD charges to be covered. However, procedures followed under day care shall also be covered.
k) In case happening of an accident, initial treatment be taken from nearest hospital of accident site and upon
written referral of this hospital, treatment be taken from any specialized hospital
Section 5- Transportation of Mortal Remains
If the Insured Person dies during the Risk Period, then the Company will reimburse INR 10,000/- as the cost of
either transporting his mortal remains to his usual place of residence or to a cremation or burial ground subject to
a valid claim admissible under Section 1- Accidental Death.
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
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UIN: LIBTGDP22171V012122
COMPANY’S MAXIMUM LIABILITY
Any payment in case of more than one claim in respect of any Insured Person under this Policy during any one
Period of Insurance should not exceed the Sum Insured applicable to such Insured Person. However, the
amount relating to carriage of dead body of the Insured Person and medical expenses would be payable in
addition, if applicable.
Part III: Exclusions applicable to all the Sections
The Company shall not be liable to make any payment under this benefit in respect of the following:
General Exclusions:
1. Accident while crossing the Railway tracks
2. Accident due to breach of law with criminal intent.
3. Damage of health caused by curative measures, radiations, infection, poisoning except where arise from
the accident.
4. From intentional self-injury, suicide or attempted suicide.
5. Whilst engaging in any sort or form of adventurous sport.
6. Committing any breach of law with criminal intent.
7. Influence of intoxication, liquor or drugs.
8. Directly or indirectly caused or contributed by congenital anomaly, venereal disease, or insanity caused
by, contributed to or aggravated or prolonged by child birth or from pregnancy
9. Any natural cause or disease or medical or surgical treatment unless such treatment becomes necessary
due to injury caused by the said untoward incident.
10. War (whether declared or not), civil war, invasion, act of foreign enemies, rebellion, revolution,
insurrection, mutiny, military or usurped power, seizure, capture, arrest, restraint or detainment,
confiscation or nationalization or requisition of or damage by or under the order of any government or
public local authority.
11. Nuclear energy, radiation.
12. Claim on account of injury due accident prior to the date & time of journey & post the date & time of
journey would be excluded from the scope of the policy, however any delay in the time of departure &
arrival of the respective train would be taken into consideration
13. Claim in instances wherein ticket was booked by the insured; however the train was not boarded. This is
irrespective of whether the train ticket was cancelled or not.
14. Claim in instances wherein ticket was booked by the insured; however the ticket was not confirmed but
still the passenger boarded the train.
Exclusion for hospital expenses:
1. The treatment of any illness even if caused by the Accident suffered by the Insured Person except any
caused by Accident and requiring immediate medical treatment in order to maintain life or relieve
immediate pain or distress.
2. Any medical treatment which was not medically necessary.
3. Plastic or cosmetic surgery unless this is certified by the attending Medical Practitioner to be medically
necessary for reconstruction following an Accident.
4. Dental treatment or surgery of any kind, unless to sound natural teeth and necessitated by an Accident.
5. Any health check-ups or examinations or measures primarily carried out for diagnostic or investigative
reasons for any purpose other than treatment related to an Accident
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 10 of 23
UIN: LIBTGDP22171V012122
6. Any costs relating to physiotherapy unless undertaken while the Insured Person is hospitalized.
7. Any costs or periods of residence incurred in connection with rest cures or recuperation at spas or health
resorts, sanatorium, convalescence homes or any similar institution.
8.
9. Any costs relating to the Insured Person’s pregnancy, childbirth or the consequences of either.
10. Any congenital internal or external diseases, defects or anomalies.
Part IV: General Conditions Applicable to all Sections
A. Declaration
The Company shall have no liability towards any claim arising under this Policy if Insured Person makes any false/
incorrect declaration/information while proposing for insurance, which is material for accepting the risk and
offering the cover under the Policy.
B. Transfer of Interest
The insurance Policy forms a Contract between the Company and the Insured Person. The Person under the
Policy is not eligible to transfer, assign, alienate or in any way pass the benefits and/or liabilities to any other
person, Institution, Hospital, Company or Corporate without specific prior approval in writing from the
authorized officer of the Company. However, if the Insured Person is permanently incapacitated or deceased, the
legal heirs of the Insured may represent him in respect of Claim under the Policy.
C. Arbitration
In the event any dispute arises between the Parties out of or in connection with this Agreement, including the
validity thereof, the Parties hereto shall endeavor to settle such dispute amicably in the first instance. The attempt
to bring about an amicable settlement shall be treated as having failed as soon as one of the Parties hereto, after
reasonable attempts, which shall continue for not less than 30 days, gives a notice to this effect, to the other party
in writing. In case of any dispute, controversy or claim arising out of or relating to this Agreement, the Services or
any matter or issue arising there from (‘Dispute’) shall be resolved in accordance with Arbitration and conciliation
Act 1996. Such dispute, controversy, or claim shall be referred to the Sole Arbitrator to be mutually appointed by
the parties as per the provisions of “The Arbitration and Conciliation Act-1996’.In case, the parties fail to appoint
Sole Arbitrator within 30 days, the event shall be referred to a three member Arbitral tribunal. One member each
shall be appointed by both the parties. They shall, within 30 days of their appointment, mutually decide on the
name of the third arbitrator. Arbitration proceedings shall be deemed to commence only on the first date of
meeting of all the three arbitrators. The award of the arbitrator shall be final and binding on the parties to this
contract. The venue of the Arbitration shall be New Delhi. The fees and expenses of the Arbitration Tribunal all
other expenses of the Arbitration shall be borne jointly by the Parties in equal proportion and shall be governed
by Circular No. 2011/IRCTC/Co/Legal/App. Arbitrator dated 18.10.2019 The Parties submit to the exclusive
jurisdiction of the Courts of Delhi. This Agreement shall be interpreted in accordance with Indian law.
D. Electronic Transaction
The Insured agrees to adhere to and comply with all such terms and conditions as the Company may prescribe
from time to time, and hereby agrees and validates that all transactions effected by or through facilities for
conducting remote transactions including the Internet, World Wide Web, electronic data interchange, call centers,
teleservice operations (whether voice, video, data or combination thereof) or by means of electronic, computer,
automated machines network or through other means of telecommunication, established by or on behalf of the
Company, for and in respect of the Policy or its terms, or the Company’s other products and services, has his
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 11 of 23
UIN: LIBTGDP22171V012122
concurrence and full understanding of the terms and conditions affecting this Contract and shall constitute legally
binding and valid transactions when done in adherence to and in compliance with the Company’s terms and
conditions for such facilities, as may be prescribed from time to time. The Company may exchange, share or part
with any information to or with other group companies or any other person in connection with the Policy, as may
be determined by the Company and shall not hold the Company liable for such use/application when done so
after agreement with Insured.
E. Cancellation/Termination of the Policy
This Policy will terminate at the expiration of the period for which premium has been paid or on the Expiration
Date shown in Policy Schedule.
Cancellation by Insured/Insured Person:
No cancellation of the policy by the insured will be allowed in case the insured has reported and received payment
for a claim under any of the covers of this Policy prior to the date of notice of cancellation.
In case of ticket cancellation, Policy Schedule issued to Insured Person may be cancelled by the Insured Person
within 10 days from the policy period end date, by intimation in writing to the Company as long as the Insured
Person is able to establish to the Company’s satisfaction that the Insured Person’s Trip has not commenced. In
this case we will process refund of premium after deduction of administration charges @ 20% of the premium.
F. Notifications & Declarations
The Insured/Insured Person needs to send any and all notices and declarations to the Company in writing only.
Any and all notices and declarations for the attention of the Company shall be sent to the address specified in the
Policy Schedule.
G. Fraud
If any claim made by the insured person, is in any respect fraudulent, or if any false statement, or declaration is
made or used in support thereof, or if any fraudulent means or devices are used by the insured person or anyone
acting on his/her behalf to obtain any benefit under this policy, all benefits under this policy shall be forfeited.
Any amount already paid against claims which are found fraudulent later under this policy shall be repaid by all
person(s) named in the policy schedule, who shall be jointly and severally liable for such repayment.
For the purpose of this clause, the expression "fraud" means any of the following acts committed by the Insured
Person or by his agent, with intent to deceive the insurer or to induce the insurer to issue a insurance Policy:
(a) the suggestion ,as a fact of that which is not true and which the Insured Person does not believe to be true;
(b) the active concealment of a fact by the Insured Person having knowledge or belief of the fact;
(c) any other act fitted to deceive; and
(d) any such act or omission as the law specially declares to be fraudulent
The company shall not repudiate the policy on the ground of fraud, if the insured person / beneficiary can prove
that the misstatement was true to the best of his knowledge and there was no deliberate intention to suppress the
fact or that such mis-statement of or suppression of material fact are within the knowledge of the insurer. Onus
of disproving is upon the policyholder, if alive, or beneficiaries.
H. Governing Law
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 12 of 23
UIN: LIBTGDP22171V012122
The construction, interpretation and meaning of the provisions of this Policy shall be determined in accordance
with the laws of India. The section headings of this Policy are included for descriptive purposes only and do not
form part of this Policy for the purpose of its construction or interpretation. The terms of this Policy shall not be
waived or changed except by endorsement issued by the Company.
I. Eligibility
The scheme is applicable to those who book their e-ticket through IRCTC website. It will be an optional cover
however the coverage will be compulsory for all passengers booked under one PNR number if the option is to be
exercised.
In case of children below 5 years travelling with passengers, the required details should be entered in the reservation
form [online form] and accordingly travel insurance premium will be added to the total amount payable, if detail
not filled then the travel insurance cover will not be applicable for the children below 5 years.
J. Entire Contract
The Policy constitutes the complete contract of insurance. No change or alteration in this Policy shall be valid or
effective unless approved in writing by the Company, which approval shall be evidenced by an endorsement on
the Policy. No agent shall or has the authority to change in any respect whatsoever any term and conditions and
exclusions under this Policy or waive off any of its provisions.
K. Nomination
The policyholder is required at the inception of the policy to make a nomination for the purpose of payment
of claims under the policy in the event of death of the policyholder. Any change of nomination shall be
communicated to the company in writing and such change shall be effective only when an endorsement on
the policy is made. For Claim settlement under reimbursement, the Company will pay the policyholder. In
the event of death of the policyholder, the Company will pay the nominee {as named in the Policy
Schedule/Policy Certificate/Endorsement (if any)} and in case there is no subsisting nominee, to the legal
heirs or legal representatives of the Policyholder whose discharge shall be treated as full and final discharge
of its liability under the Policy.
L. Notification of Claims
Upon the happening of any event giving rise or likely to give rise to a claim under this Policy, the Insured/Insured
Person(s) shall give immediate notice to Us but not later than 4 months after the event has taken place through
on-line module or calling toll-free number or in writing to the address as shown in the Schedule with Particulars
below:
i. PNR no.
ii. Policy Number/ Certificate No.
iii. Type of claim
iv. Name of the Insured Person availing treatment
v. Details of injury
vi. Name and address of the Hospital
vii. Any other relevant information
iii) Conditions when a claim arises
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 13 of 23
UIN: LIBTGDP22171V012122
The Company’s liability under this Policy will be subject to the following provisos, upon the happening of any
event giving rise to or likely to give rise to a Claim under any Section of this Policy,
i) An immediate notification is made to the Insurance Company in respect of any Claim under Medical expenses
and disability or train delay, by the Insured Person or, if deceased, his legal or other representative or
immediate family member, and provided with the name of the treating Physician, the name and telephone
number of the hospital at which treatment is being obtained, and the fact or matter giving rise to the need for
medical treatment, all the original bills, receipts and documentation or information as mentioned in Annexure
‘A’- Claim Documents Checklist or any other documents or information that might be required or
requested by the Company for assessment of the claim.
ii) The Insured Person/Claimant need to fill in the claim form (including online form) and forward the same to
the Company along with all the bills, receipts and other supporting documentation or additional information
requested by the Company for assessment of the claim.
M. Assessment of Claim & Payment
Reimbursement Claims - Notice of claim with particulars relating to Policy numbers, Policy schedule no, name
of the Insured Person in respect of whom claim is made, nature of injury and name and address of the attending
Medical Practitioner/ Hospital/ Nursing Home should be given to Us immediately on hospitalization due to
injury/ death, failing which admission of claim would be based on the merits of the case as per the board approved
underwriting policy of the Company. The Insured Person shall after intimation as aforesaid, further submit
documents as per Annexure A at his/her own expense to Us within 15 days of discharge from the hospital.
The Insured Person/s shall at any time as may be required authorize and permit the Company to obtain any further
information or records from the Hospital, Medical Practitioner, Lab or other agency, in connection with the
treatment relating to the claim. The Company may call for additional documents/information and/or carry out
verification on a case to case basis to ascertain the facts/collect additional information/documents of the case to
determine the extent of loss. Verification carried out will be done by professional Investigators or a member of
the Service Provider and costs for such investigations shall be borne by the Company.
The Company may accept claims where documents have been provided after a delayed interval in case such delay
is proved to be for reasons beyond the control of the Insured/ Insured Person (s). The Insured shall tender to the
Company all reasonable information, assistance and proofs in connection with any claim hereunder.
No person other than the Insured /Insured Person(s) and/ or nominees declared at proposal can claim under this
Policy.
Payment of Claim
i. We will make payment to Insured Person or Insured Person’s Nominee. If there is no Nominee and Insured
Person are incapacitated or deceased, We will pay Insured Person’s heir, executor or validly appointed legal
representative and any payment We make in this way will be a complete and final discharge of our liability to
make payment.
ii. On receipt of all the documents as mentioned under Annexure ‘A’- Claim Documents Checklist as provided
hereunder and on being satisfied with regards to admissibility of the claims as per Policy terms and conditions,
We shall settle the claim within 15 days of the receipt of the documents in accordance with the provisions of
‘Protection of Policyholders’ Interest Regulations, 2017’ as amended from time to time.
iii. The Policy - excludes the List of excluded items - attached in the Policy document.
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 14 of 23
UIN: LIBTGDP22171V012122
iv. The following will apply specifically in respect of a Claim under Accidental Hospitalization:
The Insured Person shall present himself for medical examination by a Medical Advisor as considered
necessary by the Company at his expense and the Insured Person agrees that the Company may approach
anyone who may have treated the Insured Person for information and/or documentation in respect of the
Claim.
N. Withdrawal of Product
In the likelihood of this product being withdrawn in future, the Company will intimate the insured person about
the same 90 days prior to expiry of the policy.
Insured Person will have the option to migrate to similar health insurance product available with the Company at
the time of renewal with all the accrued continuity benefits such as cumulative bonus, waiver of waiting period. as
per IRDAI guidelines, provided the policy has been maintained without a break..
O. Due Observance
The due observance of and compliance with the terms, provision, warranties and conditions of this Policy in so
far as they relate to anything to be done or complied with by the Insured shall be a condition precedent to the
Company’s liability under this Policy.
P. Benefit Schedule:
Sections
Scope of Cover
Description
Sum Insured-INR
Section 1
Accidental Death
Covers death due to an accident during the trip.
10,00,000
Section 2
Permanent Total
Disablement
Covers Permanent Total Disability caused due
to an accident during the trip.
10,00,000
Section 3
Permanent Partial
Disablement
Covers Permanent Partial Disability caused due
to an accident during the trip.
Max Upto 7,50,000
Section 4
Emergency Accidental
Hospitalization
Covers medical expenses incurred towards
hospitalization on account of accidental injury
occurring during the trip.
Max upto 2,00,000
Section 5
Transportation of
Mortal Remains
Covers cost of transportation of mortal remains
or equivalent amount for burial or cremation of
the Insured at the location where death has
occurred, in case of death on account of
accidental injury during the trip.
Max upto 10,000
Part V: Grievance Redressal Procedure
We are concerned about You and are committed to extend the best possible services. In case You are not
satisfied with our services or resolutions, please follow the below steps for redressal.
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 15 of 23
UIN: LIBTGDP22171V012122
Step 1
Call us on Toll free number: 1800-266-5844
(8:00 AM to 8:00 PM, 7 days of the week)
or
Email us at: [email protected]
or
Write to us at:
Customer Service
Liberty General Insurance Ltd.
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai 400 013
Step 2
If our response or resolution does not meet
Your expectations, You can escalate at
Step 3
If You are still not satisfied with the resolution
provided, You can further escalate at
Insured person may also approach the grievance cell at any time of the Company’s branches with the details of
the grievance.
If the insured person is not satisfied with the redressal of the grievance through one of the above methods, insured
person may contact the grievance officer at [email protected].
For updated details of grievance officer kindly refer https://www.libertyinsurance.in/customer-
support/grievance-redressal
If Insured person is not satisfied with the redressal of grievance through above methods, the insured person may
also approach the office of Insurance Ombudsman of the respective area/region for redressal of grievance. The
contact details of the Insurance Ombudsman offices have been provided as Annexure-B
Grievance may also be lodged at IRDAI Integrated Grievance Management System - https://igms.irda.gov.in/
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 16 of 23
UIN: LIBTGDP22171V012122
Annexure A- Claim Documents Checklist
Following is the indicative document list for reimbursement claims:
1. In case of Death Claim:
Submit the duly filled in claim form signed by nominee/legal heir along with the NEFT mandate details and
cancelled cheque with the following documents:
• Report of the Railway Authority confirming the accident of the train.
• Report of the Railway Authority carrying the details of the passengers declared dead.
• Duly Completed Personal Accident Claim Form signed by Nominee / Legal Heir along with the NEFT
mandate details & cancelled cheque
• Photo identity proof of nominee
• For Death Claims, claim will be settled only to nominee declared at the time of buying insurance through
IRCTC portal
• In absence of nominee, claim will be paid to Legal Heir only –as per Legal Heir / Succession Certificate
2. Permanent Total Disablement & Permanent Partial Disablement:
• Report of the Railway Authority confirming the accident of the train.
• Report of attending doctor confirming the extent of disability.
• Medical bills corresponding to doctor’s prescription.
• Duly Completed Personal Accident Claim Form signed by insured / Nominee
• Attested copy of disability certificate from Civil Surgeon of that Hospital in which the treatment has
undergone stating percentage of disability.
• Attested copy of FIR.
• All X-Ray / Investigation reports and films supporting to disablement.
• Claim form with NEFT details & cancelled cheque of the beneficiary
• Photograph before & after disability
3. In case of Hospitalization Expenses for Injury
• Report of the Railway Authority confirming the accident of the train.
• Medical bills corresponding to doctor’s prescription
• Duly completed personal accident claim form signed by the Insured Person/Nominee
4. In case of Transportation of mortal remains
• Report of the Railway Authority confirming the accident of the train.
• Report of the Railway Authority carrying the details of the passengers declared dead
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 17 of 23
UIN: LIBTGDP22171V012122
• Photo identity proof of nominee.
• In absence of nominee, claim will be paid to Legal Heir only – as per Legal Heir / Succession Certificate.
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 18 of 23
UIN: LIBTGDP22171V012122
Annexure-B
The contact details of the
Insurance Ombudsman
offices are as below-
Areas of
Jurisdiction
Office of the Insurance
Ombudsman
Gujarat , UT of Dadra
and Nagar Haveli,
Daman and Diu
AHMEDABAD - Shri Kuldip Singh
Office of the Insurance Ombudsman,
Jeevan Prakash Building, 6th floor,
Tilak Marg, Relief Road,
Ahmedabad – 380 001.
Tel.: 079 - 25501201/02/05/06
Email: bimalokpal.ahmedabad@cioins.co
.in
Karnataka
BENGALURU -
Office of the Insurance Ombudsman,
Jeevan 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.be[email protected]
n
Madhya Pradesh and
Chhattisgarh
BHOPAL -
Office of the Insurance Ombudsman,
Janak Vihar Complex, 2nd Floor,
6, Malviya Nagar, Opp. Airtel Office,
Near New Market,
Bhopal – 462 003.
Tel.: 0755 - 2769201 / 2769202
Fax: 0755 - 2769203
Email: bimalokpal.bhopal@cioins.co.in
Orissa
BHUBANESHWAR - Shri Suresh
Chandra Panda
Office of the Insurance Ombudsman,
62, Forest park,
Bhubneshwar – 751 009.
Tel.: 0674 - 2596461 /2596455
Fax: 0674 - 2596429
Email: bimalokpal.bhubaneswar@cioins.
co.in
Punjab,
Haryana(excluding
Gurugram, Faridabad,
Sonepat and
Bahadurgarh)
Himachal Pradesh,
Union Territories of
Jammu & Kashmir,
Ladakh & Chandigarh.
CHANDIGARH -
Office of the Insurance Ombudsman,
S.C.O. No. 101, 102 & 103, 2nd Floor,
Batra Building, Sector 17 – D,
Chandigarh – 160 017.
Tel.: 0172 - 2706196 / 2706468
Fax: 0172 - 2708274
Email: bimalokpal.c[email protected]o.
in
Tamil Nadu,
Tamil Nadu
Puducherry Town and
Karaikal (which are
part of Puducherry).
CHENNAI -
Office of the Insurance Ombudsman,
Fatima Akhtar Court, 4th Floor, 453,
Anna Salai, Teynampet,
CHENNAI – 600 018.
Tel.: 044 - 24333668 / 24335284
Fax: 044 - 24333664
Email: bimalokpal.chennai@cioins.co.in
Delhi &
Following Districts of
Haryana - Gurugram,
Faridabad, Sonepat &
Bahadurgarh.
DELHI - Shri Sudhir Krishna
Office of the Insurance Ombudsman,
2/2 A, Universal Insurance Building,
Asaf Ali Road,
New Delhi – 110 002.
Tel.: 011 - 23232481/23213504
Email: bimalokpal.de[email protected]
Assam,
Meghalaya,
Manipur,
Mizoram,
Arunachal Pradesh,
Nagaland and Tripura.
GUWAHATI -
Office of the Insurance Ombudsman,
Jeevan Nivesh, 5th Floor,
Nr. Panbazar over bridge, S.S. Road,
Guwahati – 781001(ASSAM).
Tel.: 0361 - 2632204 / 2602205
Email: bimalokpal.g[email protected]
Andhra Pradesh,
Telangana,
Yanam and
part of Union
Territory of
Puducherry.
HYDERABAD -
Office of the Insurance Ombudsman,
6-2-46, 1st floor, "Moin Court",
Lane Opp. Saleem Function Palace,
A. C. Guards, Lakdi-Ka-Pool,
Hyderabad - 500 004.
Tel.: 040 - 23312122
Fax: 040 - 23376599
Email: bimalokpal.hyderabad@cioins.co.i
n
Rajasthan
JAIPUR -
Office of the Insurance Ombudsman,
Jeevan Nidhi – II Bldg., Gr. Floor,
Bhawani Singh Marg,
Jaipur - 302 005.
Tel.: 0141 - 2740363
Email: bimalokpal.ja[email protected]
Kerala,
Lakshadweep,
Mahe-a part of Union
Territory of
Puducherry.
ERNAKULAM - Ms. Poonam Bodra
Office of the Insurance Ombudsman,
2nd Floor, Pulinat Bldg.,
Opp. Cochin Shipyard, M. G. Road,
Ernakulam - 682 015.
Tel.: 0484 - 2358759 / 2359338
Fax: 0484 - 2359336
Email: bimalokpal.ernakulam@cioins.co.
in
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 19 of 23
UIN: LIBTGDP22171V012122
West Bengal,
Sikkim,
Andaman & Nicobar
Islands.
KOLKATA - Shri P. K. Rath
Office of the Insurance Ombudsman,
Hindustan Bldg. Annexe, 4th Floor,
4, C.R. Avenue,
KOLKATA - 700 072.
Tel.: 033 - 22124339 / 22124340
Fax : 033 - 22124341
Email: bimalokpal.kolka[email protected]
Districts of Uttar
Pradesh :
Lalitpur, Jhansi,
Mahoba, Hamirpur,
Banda, Chitrakoot,
Allahabad, Mirzapur,
Sonbhabdra, Fatehpur,
Pratapgarh,
Jaunpur,Varanasi,
Gazipur, Jalaun,
Kanpur, Lucknow,
Unnao, Sitapur,
Lakhimpur, Bahraich,
Barabanki, Raebareli,
Sravasti, Gonda,
Faizabad, Amethi,
Kaushambi,
Balrampur, Basti,
Ambedkarnagar,
Sultanpur,
Maharajgang,
Santkabirnagar,
Azamgarh,
Kushinagar,
Gorkhpur, Deoria,
Mau, Ghazipur,
Chandauli, Ballia,
Sidharathnagar.
LUCKNOW -Shri Justice Anil Kumar
Srivastava
Office of the Insurance Ombudsman,
6th Floor, Jeevan Bhawan, Phase-II,
Nawal Kishore Road, Hazratganj,
Lucknow - 226 001.
Tel.: 0522 - 2231330 / 2231331
Fax: 0522 - 2231310
Email: bimalokpal.lucknow@cioins.co.in
Goa, Mumbai
Metropolitan Region
excluding Navi
Mumbai & Thane
MUMBAI -
Office of the Insurance Ombudsman,
3rd Floor, Jeevan Seva Annexe,
S. V. Road, Santacruz (W),
Mumbai - 400 054.
Tel.:
69038821/23/24/25/26/27/28/28/29/
State of Uttaranchal
and the following
Districts of Uttar
Pradesh:
Agra, Aligarh, Bagpat,
Bareilly, Bijnor,
Budaun,
Bulandshehar, Etah,
Kanooj, Mainpuri,
Mathura, Meerut,
Moradabad,
Muzaffarnagar,
Oraiyya, Pilibhit,
Etawah, Farrukhabad,
Firozbad,
Gautambodhanagar,
Ghaziabad, Hardoi,
Shahjahanpur, Hapur,
Shamli, Rampur,
Kashganj, Sambhal,
Amroha, Hathras,
Kanshiramnagar,
Saharanpur.
NOIDA - Shri Chandra Shekhar
Prasad
Office of the Insurance Ombudsman,
Bhagwan Sahai Palace
4th Floor, Main Road,
Naya Bans, Sector 15,
Distt: Gautam Buddh Nagar,
U.P-201301.
Tel.: 0120-2514252 / 2514253
Email: bimalokpal.noida@cioins.co.in
Bihar,
Jharkhand.
PATNA - Shri N. K. Singh
Office of the Insurance Ombudsman,
2nd Floor, Lalit Bhawan,
Bailey Road,
Patna 800 001.
Tel.: 0612-2547068
Email: bimalokpal.pa[email protected]
Maharashtra,
Area of Navi Mumbai
and Thane excluding
Mumbai
Metropolitan Region
PUNE - Shri Vinay Sah
Office of the Insurance Ombudsman,
Jeevan Darshan Bldg., 3rd Floor,
C.T.S. No.s. 195 to 198,
N.C. Kelkar Road, Narayan Peth,
Pune – 411 030.
Tel.: 020-41312555
Email: bimalokpal.pune@cioins.co.in
For updated details of Insurance Ombudsman Offices You may visit Council of Insurance Ombudsmen website
at https://www.cioins.co.in//ombudsman.html or our website at https://www.libertyinsurance.in/customer-
support/grievance-redressal
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 20 of 23
UIN: LIBTGDP22171V012122
LIST OF EXCLUDED ITEMS
(Applicable for Claim under Accidental Hospitalization only)
List I – Items for which coverage is not available in the policy
Sl
No
Item
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 HOSPITAL)
36
SPACER
37
SPIROMETRE
38
NEBULIZER KIT
39
STEAM INHALER
40
ARMSLING
41
THERMOMETER
42
CERVICAL COLLAR
43
SPLINT
44
DIABETIC FOOT WEAR
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 21 of 23
UIN: LIBTGDP22171V012122
List II – Items that are to be subsumed into Room Charges
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 payable, only prescribed medical pharmaceuticals payable)
55
ECG ELECTRODES
56
GLOVES
57
NEBULISATION KIT
58
ANY KIT WITH NO DETAILS MENTIONED [DELIVERY KIT, ORTHOKIT, 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
Sl
No
Item
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
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 22 of 23
UIN: LIBTGDP22171V012122
List III – Items that are to be subsumed into Procedure Charges
List IV – Items that are to be subsumed into costs of treatment
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 EXPLAINED)
36
PATIENT IDENTIFICATION BAND / NAME TAG
37
PULSEOXYMETER CHARGES
Sl
No.
Item
1
HAIR REMOVAL CREAM
2
DISPOSABLES RAZORS CHARGES (for site preparations)
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
Sl
No.
Item
1
ADMISSION/REGISTRATION CHARGES
2
HOSPITALISATION FOR EVALUATION/ DIAGNOSTIC PURPOSE
3
URINE CONTAINER
4
BLOOD RESERVATION CHARGES AND ANTE NATAL BOOKING CHARGES
Liberty General Insurance Limited
10
th
Floor, Tower A, Peninsula Business Park,
Ganpatrao Kadam Marg, Lower Parel, Mumbai – 400 013
Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656
Optional Travel Insurance for E-ticket passengers - IRCTC Page 23 of 23
UIN: LIBTGDP22171V012122
5
BIPAP MACHINE
6
CPAP/ CAPD 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 SOLUTION/STERILLIUM
17
GLUCOMETER& STRIPS
18
URINE BAG
