COMPREHENSIVE TRAVEL PROTECTION

TRAVEL PROTECTION CARD

NAME : RANJANA RAJDHAMI BHANDARI A S S I S T N O.

1021130142

ADDRESS : T H A P A D E R A , S TA RT D AT E E N D D AT E
27/07/2023 26/07/2024

BARAHATAL2 SURKHET SMART

Assist Fees : 3763( Incl GST @ 18% )

You can now enjoy exclusive travel assistance including insurance benefits on your trip. Kindly
ensure to carry this document for a pleasant travel experience.

Travel hassle-free with...

TRAVEL ASSISTANCE TRAVEL INSURANCE

24x7 Medical Lifestyle Domestic Roadside Arranged with an IRDAI authorised underwriter - ICICI
Assistance Assistance Assistance Lombard General Insurance Company Ltd.

Travel Support Services

Emergency Assistance Expert Intensive Care & Consultation 24/7 Customer Helpline

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Note: Assistance provided by ASEGO TRAVEL LLP,
24x7 helpline: +91 22 67872 037
Insurance underwritten by ICICI Lombard General
Assistance: customercare@asego.in Insurance Company Ltd.
Claims: claims@asego.in Customer will bear any cost or expenses arising
from availing the assistance services through a
Whatsapp message only for claims: +91 86478 34444 third par ty service provider.

travel.asego.in

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 ICICI LOMBARD GENERAL INSURANCE COMPANY LTD.
ICICI Lombard House, 414, Veer Savarkar Marg, Prabhadevi,Mumbai – 400025
IRDAI Registration No: 115
Telephone: 18001032292
Certificate Of Insurance

We would like to inform you that Bharti AXA General Insurance has merged with ICICI Lombard General Insurance w.e.f. Sept
8,2021. Enjoy our seamless services while exploring our enhanced offerings and diverse non-life insurance solutions

Customer Details:
Insured Name : RANJANA RAJDHAMI BHANDARI Date of Birth:20/06/1989 Passport Number:PA0266758
Address : THAPADERA BARAHATA 2 SURKHET
Travel Assure - Group Overseas Travel Insurance Mobile no :9981213570 Landline no :
E Mail :N/A CR no :
Issue Date :31/05/2023

Certificate No : SX1003 13570 Intermediary Code :IM-1335344

Travel Assure - Group Overseas Travel Insurance Intermediary Name : ASEGO INSURANCE LLP
T his Gro u p Travel I n s uranc e p o li c y 41 98/O /2 64 0 8874 8 /0 0/ 0 00 dated 2 0- 10- 2 0 22 ha s b e en i ssued at Mum b ai by ICI CI Lom bard G eneral I nsu rance Co m pany Ltd. to the m aster
poli cy holde r, AS EGO TR AV EL L LP. and gove rned by the ter ms , co nd iti ons a nd exc lusion s the re in co ntai ne d or othe r wi se ex p res se d i n the sa id cer t ifi cate, bu t no t exce edi n g t h e
Sum I ns ured a s s pecif i ed i n the S c hedul e. Thi s Cer t i ficate, iss ued und er t he fa csimi le sig natu re of I C IC I Lo mba rd Gene ral Ins uranc e C om p any Ltd. repres ent s t he avai labi l i ty o f
benefi t to th e ab ove m e nt i one d I nsured Pe rso n. Throug h t he maste r pol i cy ho ld er I CICI L o mbard G e n eral I ns uran ce C om pany Ltd. h as re ceived an amo unt o f Rs . 5 6 7. 2 0 (Inc l
GST @ 1 8 %) towards cover in g the r is k ben efi t s, on b ehalf o f t he a bove me nt i one d i nsu re d.

Insurance Details :

Commencement Date:From: 27/07/2023 End Date: mid-night on: :26/07/2024 No. of Days:365
Plan Name :IC Multi Trip B-2 (365Days)- Geographical Coverage :Excluding USA and CANADA
Assignee 500000 :Legal heir Relation :Legal Heir
Exclusions :

Coverages Sum Insured Deductibles Coverages Sum Insured Deductibles

Emergency Medical Expenses Emergency
Medical Evacuation Repatriation of Mortal USD 250000 USD 100 Dental Treatment Expenses USD 250 USD 50
remains
Personal Accident
Accidental Death
USD 10000 NA Total Loss of checked - in Baggage USD 1000 NA
Permanent Total Disability(PTD)
Permanent Partial Disability(PPD)
Delay of Checked-in Baggage USD 150 12 HRS Loss of Passport and documents USD 250 USD 25
USD 75 per
Personal Liability USD 200000 USD 100 Hijack Distress Allowance day upto 4 12 HRS
days
Accidental Death -Common Carrier
USD 25 per
Permanent Total Disability-Common Carrier
Daily Allowance in case of Hospitalization day upto 5 2 Days USD 2500 NA
Permanent partial Disability -Common
days
Carrier
Bounced Hotel Booking USD 1000 USD 100 Child Escort USD 500 NA
Trip Cancellation and/or Interruption USD 1000 USD 100 Missed connection USD 500 3 HRS
USD 100 per
Trip Delay day upto 1 6 HRS Home Burglary Insurance (Contents) INR 200000 NA
day
Loss of International Driving Licence USD 500 USD 50 Loss of Gadgets USD 1000 USD 100
Car Rental Excess Insurance USD 500 USD
This policy covers adventure sports upto the limits specified under 'Other Terms & Conditions' and will be a part of Emergency Medical Expenses sum
insured
Emergency Assistance Details :
For claims, Contact ICICI Lombard 24hr Help Line number for assistance and registering your claim:
In USA & Canada (Toll Free) +1 844 871 1200;
Rest of the World (Call Back Facility) +91 124 449 8778
National Toll Free Number 1800 102 5721;
Fax Number +91 124 4006674
Email Address : icicilombard@falck.com
OR Login to the e-claim link https://fgaindia.com/FalckMLink/
 Other Terms & Conditions :
• This policy covers Emergency Medical Expenses incurred due to sudden and unexpected injury or any acute Sickness including COVID-19, arising when insured
is outside the 'Republic of India' up to the limits as mentioned in the policy schedule.
• This Travel Insurance policy is only limited to customers of ASEGO TRAVEL LLP.
• Certificate is only valid to the customers who are travelling from India.
• This policy covers the insured if travelling to any Schengen & its associate countries to a minimum of Euro 30000 minus deductibles (if any).
• This policy consist of following coverage’s which will be treated as benefit covers i.e. Personal Accident- Accidental Death Permanent Total Disability (PTD)
Permanent Partial Disability (PPD), Accidental Death—Common Carrier, Permanent Total Disability - Common ,Permanent Partial Disability - Common carrier,
Daily Allowance in case of Hospitalization, and Hijack Distress Allowance subject to policy terms and conditions applicable to these sections. All others
coverage’s will be treated as indemnity.
• Sum insured for Emergency Medical Evacuation and Repatriation of mortal remains will be sublimited to sum insured specified in Emergency Medical Expenses.
• Pre-existing condition(s) are excluded from the policy including but not limited to unforeseen emergency measures to save the Insured/Insured person’s life.
This exclusion will apply to the following sections: Emergency Medical Expenses, Emergency Medical Evacuation, Dental Treatment Expenses, Daily Allowance in
case of Hospitalization, Permanent Total Disability (PTD), Permanent Partial Disability (PPD). This exclusion has been waived to the extent of USD 10000 per
policy or upto 10% Sum Insured whichever is lesser & limited to section i.e. Emergency Medical Expenses, Emergency Medical Evacuation, Dental Treatment
Expenses, Daily Allowance in case of Hospitalization, Permanent Total Disability (PTD), Permanent Partial Disability (PPD).
• Any claim arising out of sporting activities in so far as they involve the training or participation in competitions of professional or semi-professional sports
persons, Adventure Sports is not covered This exclusion has been waived to the extent of USD 20000 per policy if specifically opted or mentioned above.
• Sanctions Limitation and Exclusion Clause: Not applicable for sanctioned countries listed in certificate of insurance.
• No (re)insurer shall be deemed to provide cover and no (re)insurer shall be liable to pay any claim or provide any benefit hereunder to the extent that the
prevision of such cover, payment or such claim or provision of such benefit would expose that (re)insurer to any sanction, prohibition or restriction under United
Nations resolutions or the trade or economic sanction, laws or regulations of the European Union, United Kingdom or United States of America. Excluding
from/to and or countries places prohibited by GOI & also Specifically Excluding Iran I Iraq/Syria/ Sudan/ North Korea/Cuba/Crimea.
• Below Sublimit is applicable for the age above 60 Years upto the age of 80 years for Emergency Medical Expenses.
S ub lim i t Ap p lica bl e - Above 6 0 Years- 80 Ye ars
Room Rent in c luding Bo ard ing l odg ing $ 15 00/ day up to 3 0 d ays
Inten si ve C are unit $ 30 00 /day up to 7 days
O pe rat io n The at re cha rge s (In cl usive surgeon ch a rges )” Max imu m Up to USD 1 0 00 0
A nest het i st se r v ice s U p to 2 5% o f S urgi cal Tre at m ent
Phys i ci a n V isi t Max $ 75 / day up to 1 0 vi sits
Dia g no st ic and Ra di o l ogy s er vi c es M ax u p to USD 10 00
Amb u l ance Ser v ice s Max up to $ 5 00
Hos pi tal Misc el la n eo us Ex pens es M ax im um o f U SD 1 00 0
• Above mentioned sub limits are not applicable for Emergency medical Expenses section if sublimit waiver has been opted by insured & clearly mentioned on
above coverage section

• Subject to the terms, conditions and exclusions of the ICICI Lombard General Insurance Company Ltd.

A uth or ised Sig nato r y

S ca n the co de of a uth e nt icate (IC ICI Lo m ba rd G en era l
pol ic y In surance C o mp any Ltd.)
The certificate has been issued based on the information provided by you/your representative and the policy is not valid if any of the information
provided is incorrect, subject otherwise to the Terms, Conditions and Exclusions mentioned in the policy.
•• Treatm ent a bro ad i f t hat i s t he so le reaso n o r one o f t he rea son s for t he Insu red/In sured p ers on's te mpo ra r y stay
abroa d• Any cl ai m i f t he I ns ured Perso n 1. I s t ravel lin g a gain st t he adv ice o f a M e dical Pract it io ner ;2 . Is re ce iv i ng , or i s
o n a wai ti n g li st to recei ve, sp ec ifi ed me d i cal t re at ment de cla re d i n th e Medical Pra cti tio ner ’s repo rt o r c ert i f icate ;

• H as rece ived termi naI p rog no si s fo r a m ed ical co ndi t io n; I s taki ng p ar t i n a navaI, mi l itar y o r a ir fo rce O p erati o n.•
1 G en eral E xcl us io ns
Conge ni ta l ex te r na l disea s es , de le cts or a nom al ies • D i sease s , illnes s an d a ccide nts that are resu l ts o f war an d wa r l i ke
o ccur ren ce o r invas ion , a cts o f fo re ign ene mi es , ho st il it i es, c iv i l war, rebe l li on, i ns ur rec ti on, c i vi l com mo t io n as su mi n g
th e p rop or ti on s o f o r am ount ing to an up ri s i ng , m il i tar y or u sur pe d powe r, acti ve pa r ti cipat i o n i n r io ts , co nf i scatio n or
nat io nali zati on or requisit io n of or de st ruct ion o f or d a ma ge to pro pe r ty by or u nde r the o rder o f any gover nm ent or
lo cal aut ho r i t y.
For any claim relate d q u er y, i nt i mati on o f clai m and su b mi ss io n of cl aim re l ate d d ocu ments you may contac t ou r
Em erge ncy A ss i stance Ser vi ce Provid e r.
In case o f a c laim , you may re ach us at 8 44- 69 1 -8 88 3 (Fo r Can ad a ), 84 4- 691 -88 85 ( Fo r USA ) or +91 11 4 2221 40 3 (For
2 N ot ice o f Clai m o the r pa rt s o f the wor ld ) or em ai l u s at cu sto mersupp ort b a@ ic ici lo mbard .com
Alternat i ve l y you can contac t us t hroug h: To ll F re e -1 80 0- 10 3- 229 2
Em ail -c usto me rsu ppo rt ba@i c i c il ombard.co m Po st /co uri e r to Co m pa ny - I CI CI L om bard G eneral I n sura nc e C omp any Ltd . ,
IC IC I Ban k Tower, P lo t N o. 12, F i na n ci al D i str ic t, N anak ram Gu da, G ac hi b owl i, H yde raba d-5 00 032
Cl a i ms P roc edu re
1. In t h e eve nt o f an a ccide nt or s udde n i ll ness which i s li ke l y to gi ve rise to a c laim u nd e r thi s Po li cy, th e Insured Pers on
sha ll imm ed iate ly conta ct t h e Eme rgen cy A ssistan ce Ser v ic e Prov i der g iv i ng deta ils o f the Poli cy iss u ed to him /her. Th e
deta ils of ph on e numbers and H elp L ine are given i n t he N ot ice o f claim se ct io n .
2. A ll nec es sar y cl aim d oc um e nt s s hou l d be f ur nished to the C om pany / Em erge ncy As s istan c e Ser vic e Prov id er by th e
pol i c y hol d er / insure d to ma ke a cl ai m . H oweve r, clai ms f i led eve n beyon d s uc h p eri od s houl d be consi de red i f th ere are
va l id reaso n s o f a ny d e lay.
3 Cl ai m Pro ce du re & D oc um e ntati o n 3. C lai m Se r vice Gu ara ntee : T he C o mpany sh all sett le t he c la im w ithi n 3 0 days from the d ate o f re ce i pt o f l ast ne ce ss ar y
doc um e nt i n accord anc e w it h th e p rovisi on o f re gu lati o n 2 7 o f I RDA I (H e alt h In su rance ) Re gu l ati ons , 2 0 16 . I n the case o f
delay i n the payment of a c laim , t he C om pany sha l l b e l iabl e to p ay i nte re st fro m the d ate o f recei pt of l ast ne cess a r y
doc um e nt to the d ate o f p aym ent o f cl aim at a rate 2 % ab ove t he ban k rate
Cl a i ms Do cu m entati on -
• D ul y fil led in an d sig ned cl a im for m • Cer ti f icate o f I nsura n ce • Any ad dit io n a l d ocu m ent re levant to cla im and s pec i f ied
in th e Po li c y wordi n gs T hi s is o nly a sum m ar y of th e pro du c t feat ure s. T he a ctual b enef it s avail ab l e are as d esc ri bed i n
th e p ol i c y wo rd i ngs and wi l l be s u bjec t to th e po licy ter m s, condi t io ns and exc l us io ns .
Fo r D etai l ed Ter ms & Condi ti on s o f yo ur Travel I n su rance Po l ic y Ki n dl y Clic k h ere
o r paste the lin k "https: //a se go .co/as e go t rave l/new/ Travel - A ssure -Grou p - Overse as - Travel - Insu ran ce- Po li cy-Word ing s. pdf " o n yo ur browse r.
We bsi te: w w w. bha rt i- axagi .co . i n; IR DA I Reg i strat io n N o : 1 15, E m ai l: custom ersup po r tb a@ i cici lo mb ard.co m
ICIC I L om bard G eneral Ins u ra nce C o mp any Ltd. , , IC IC I Lo mba rd H ous e, 4 14 , Veer Sava rka r Marg , Prabhadevi, Mum bai – 40 00 2 5
UI N: IC I TGOP 2 22 0 3V 022 12 2, CIN :L 6 7 200 MH 200 0 PLC 129 40 8