Tata AIG General Insurance Company Ltd.

BUSINESS TRAVEL ACCIDENT

Policy No.: BTA0000298

SCHEDULE
Name of the policy holder : Infosys Ltd.
Address Electronics City,Hosur Road,Bangalore- 561229

Eligible Persons: The following persons shall be eligible for insurance hereunder:
DESCRIPTION OF INSURED PERSONS HAZARD(S)

This policy provides coverage to employees of M/s. Infosys Ltd, their Spouse and
dependent children for the dates of travel as mentioned below. H-3
The persons insured are mentioned against "Name of the Policy holder" *.
* Single trip duration not to exceed 180 days per person.
Certificate No :I3243021
Validity Date : 1-Nov-2018 To 2-Nov-2018
Persons Insured : 1.

BENEFITS
ASSISTANCE SERVICE INCLUDED
ACCIDENT & SICKNESS MEDICAL EXPENSES REIMBURSEMENT including ACCIDENTAL $1,00,000
EXPENSES
Deductible $25
DENTAL LIMIT - $300 per occurrence and $100 per tooth **
Deductible $25
EMERGENCY EVACUATION INCLUDED
REPATRIATION OF REMAINS INCLUDED
HIJACK BENEFIT ($30 per day max of $300) INCLUDED
Deductible 1 day
AD & D 24 Hrs – During Business Trip $25,000
AD & D 24 Hrs – Common Carrier $25,000
BAGGAGE LOSS (CHECKED) $1,500
PER ARTICLE & PER BAG LIMITS 10% / 50%
BAGGAGE DELAY (After 12 hours only) $150
PERSONAL LIABILITY $500,000
Deductible (Third Party Property Damage only) $200
MATERNITY BENEFIT **** @ 10% co pay $2,000
Deductible $250
LOSS OF PASSPORT $250
Deductible $30
TRIP DELAY – Maximum $500
for every 8 hours $10
HOSPITALIZATION BENEFIT Maximum $500
Per day $50
Deductible 1 day
REPLACEMENT & REARRANGEMENT OF STAFF $5,000
CASHLESS OPD Included
US Deductible $25
NON US(EXCEPT MAURITIUS****) Deductible $100

(Authorized Signatory)
TATA AIG General Insurance Co. Ltd.

** Covered under Overall A & S Limit

**** Under the above mentioned Maternity Benefit, Pre existing maternity conditions is not covered. (Claims made by Employees who are pregnant at the
time of departure from India or joins on the policy whilst abroad will not be admissible)
a) * Deductible for employees traveling to Mauritius will be $ 2 per incident.
b) ** Covered under overall A&S Limit
c) ***Benefit per policy period, covers prenatal, birth & post natal periods. covers routine checks upto 8 months, twice upto 8 months, every week till birth and any
complications upto $ 2000
d) ****Maternity Benefit available only for Employees, not for spouses
e) Includes Vision & Hearing Benefit, Subject to exclusions related to Eyeglasses, Contact Lenses, Hearing aids and examination for the prescription or fitting thereof,
unless injury or sickness has caused impairment of vision or hearing
f) Routine checks not covered & Pharmacy drugs excluded - Pay and Claim.

Corporate Office: Ahura Centre, 4th Floor, 82,Mahakali Caves Road, Andheri (E), Mumbai-400093. Page 1 of 1
(Regd. Office: Bombay House, 24 Homi Mody Street, Mumbai 400001)
For more information call the Tata AIG Helpline at 1-600-119966
SUMMARY OF TOLL FREE SETUP FOR INFOSYS ACROSS ALL GEOGRAPHIES Travel Guard (For Non America Cases )

Toll Free from UK : 0800 169 9884

Toll Free from Japan
Toll Free from Germany
Toll Free from Australia
Toll Free from France
Toll Free from Belgium
: 0120-593700
: 0800 5895251
: 1 800 826461
: 08055 4 815
: 800 81303

Toll Number : + 603 2118 0742 / 743/ 744(Based out of Malaysia)

Fax : +603 2178 4753

Email : TGAP.TATAmedical@travelguard.com

SUMMARY OF TOLL FREE SETUP FOR INFOSYS ACROSS ALL GEOGRAPHIES Travelguard ( For America Cases )

Toll Free : 1-817-826-7028

Phone : 888-737-3918
Fax : 713-953-7506
Email : tata.aig@aig.com

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Tata AIG General Insurance Company Limited