{"id":565,"title":"INDUSIND OVERSEAS TRAVEL CARE POLICY - CLAIM FORM","purpose":"claim","insurer":{"slug":"indusind-general-insurance","name":"IndusInd General Insurance Company Limited"},"source_pdf":"https://www.indusindinsurance.com/downloads/travel-claim-form-main","sha256":"59ce11f3b4d9fd08ed18913f4f575e5c8a62c49dbb212e0cf70f5a22e4616e58","pages":4,"collected":"2026-10-17","instructions":{"about":"This form is for insured persons or claimants to file a travel insurance claim under the IndusInd Travel Care Policy.","notes":["Fill all details in BLOCK LETTERS.","Use original bills only.","Mandatory to call Emergency Assistance Service Provider before claim.","All payments to insured will be made only through electronic mode as per IRDAI.","Politically Exposed Persons (PEPs) must declare their status as per PMLA rules."],"title":"INDUSIND OVERSEAS TRAVEL CARE POLICY - CLAIM FORM","submit":{"to":"","how":"","address":"Health Care Unit: IndusInd General Insurance, No.1-89/3/B/40 to 42/ks/301, 3rd floor, Krishe Block, Krishe Sapphire, Madhapur, Hyderabad - 500081. Email: healthcare@indusindinsurance.com."},"purpose":"claim","sections":[{"title":"Details of Insured","fields":[{"help":"Select appropriate title and write full name in block letters","type":"choice","label":"Name of the Insured","options":["Mr.","Mrs.","Ms.","M/S."],"required":null,"pdf_field":""},{"help":"Fill complete address and contact details in block letters","type":"text","label":"Address for Communication\nFlat/Building/Door/Block No.\nRoad/Street/Sector\nArea\nTaluka/Village/District/City\nPin Code\nState\nCountry\nPhone\nMobile\nOverseas Contact No If Any\nEmail\nFax","options":[],"required":null,"pdf_field":""},{"help":"","type":"choice","label":"Relationship of the Patient/Insured Person with the Insured","options":["Self","Spouse","Son","Daughter"],"required":null,"pdf_field":""},{"help":"","type":"choice","label":"Source of Funds","options":["Business","Profession","Salary","Agricultural Income","Savings","Others"],"required":null,"pdf_field":""},{"help":"","type":"choice","label":"Monthly Income","options":["Upto ` 20,000","` 20,001 to ` 50,000","` 50,001 to ` 1,00,000","` 1,00,001 and above"],"required":null,"pdf_field":""},{"help":"","type":"yes-no","label":"Does Insured have any other insurance coverage out of India?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Fill details only if other insurance coverage exists","type":"text","label":"If Yes, please specify\nName of the Insurance Company\nPolicy No.\nSum Insured `\nPolicy Start Date\nPolicy End Date","options":[],"required":null,"pdf_field":""},{"help":"Select title and write full name in block letters","type":"choice","label":"Name of the Patient/Insured Person","options":["Mr.","Mrs.","Ms.","M/S."],"required":null,"pdf_field":""},{"help":"DD/MM/YYYY format","type":"date","label":"Date of Birth","options":[],"required":null,"pdf_field":""},{"help":"","type":"choice","label":"Sex","options":["M","F"],"required":null,"pdf_field":""},{"help":"Fill complete address and contact details in block letters","type":"text","label":"Address for Communication\nFlat/Building/Door/Block No.\nRoad/Street/Sector\nArea\nTaluka/Village/District/City\nPin Code\nState\nCountry\nPhone\nMobile\nEmail\nFax","options":[],"required":null,"pdf_field":""}],"filled_by":"insured or claimant"},{"title":"Claim Details","fields":[{"help":"","type":"yes-no","label":"Has the Emergency Assistance Service Provider been intimated?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide reference number if Emergency Assistance was intimated","type":"text","label":"If yes, please provide the reference number","options":[],"required":false,"pdf_field":""},{"help":"Enter passport number","type":"text","label":"Passport No.","options":[],"required":null,"pdf_field":""},{"help":"Tick all applicable claim types","type":"checkbox","label":"Please indicate whether claim is respect of","options":["Medical Expenses","Dental Care Expenses","Repatriation/Evacuation","Compassionate Visit","Personal Accident","Accidental Death-Common Carrier","Loss of checked Baggage","Delay of checked Baggage","Loss of Passport","Trip Delay","Trip Cancellation/Interruption","Missed Connection","Hijack Distress Allowance","Personal Liability","Emergency Cash Assistance","Home Burglary","Bounced Booking of Airline and Hotel","Up-gradation to Business Class : Travel Form","Return of Minor Child","Fraudulent Charges (Payment Card Security)","Political Risk and Catastrophe Evacuation","Golfer’s Hole in One","Daily Allowance in case of Hospitalisation","Fire Cover for Building (Home in India)","Fire Cover for Contents (Home in India)","Loss of International Driving License","Adventure Sports","Reinstatement of Sum Insured"],"required":null,"pdf_field":""}],"filled_by":"claimant"},{"title":"Claimant's Bank Details","fields":[{"help":"Select title and write full name in block letters","type":"choice","label":"Name of the Bank Account Holder","options":["Mr.","Mrs.","Ms.","M/S."],"required":null,"pdf_field":""},{"help":"Enter bank account number","type":"text","label":"Bank Account No.:","options":[],"required":null,"pdf_field":""},{"help":"Select account type","type":"choice","label":"Account","options":["Saving","Current"],"required":null,"pdf_field":""},{"help":"Enter bank name","type":"text","label":"Name of the Bank","options":[],"required":null,"pdf_field":""},{"help":"Enter branch name","type":"text","label":"Branch","options":[],"required":null,"pdf_field":""},{"help":"Enter PAN number","type":"text","label":"PAN No.","options":[],"required":null,"pdf_field":""},{"help":"Enter 9 digit MICR code from cheque","type":"text","label":"MICR Code (9 digit MICR code number of the bank and branch appearing on the cheque issued by the bank)","options":[],"required":null,"pdf_field":""},{"help":"Enter 11 character IFSC code","type":"text","label":"IFSC Code (11 character code appearing on your cheque leaf)","options":[],"required":null,"pdf_field":""},{"help":"Mandatory consent for electronic payment as per IRDAI","type":"checkbox","label":"I understand that any refund due on the premium payment / any payment / claims to be directly credited to my aforesaid Bank Account.*","options":[],"required":true,"pdf_field":""}],"filled_by":"claimant"},{"title":"PEP Declaration","fields":[{"help":"","type":"yes-no","label":"Are you a Politically Exposed Person (PEP)?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide position if PEP","type":"text","label":"If yes, please mention the position held","options":[],"required":false,"pdf_field":""},{"help":"","type":"yes-no","label":"Is any of your close relation or family member a PEP?","options":["Yes","No"],"required":null,"pdf_field":""},{"help":"Provide details if applicable","type":"text","label":"If yes, please mention the name and relation and the position held by such close relative/family member.","options":[],"required":false,"pdf_field":""},{"help":"Location of signing","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Date of signing (DD/MM/YYYY)","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Sign here","type":"signature","label":"Signature of Proposer","options":[],"required":true,"pdf_field":""}],"filled_by":"proposer/insured"},{"title":"Declaration and Authorization","fields":[{"help":"Date of signing (DD/MM/YYYY)","type":"date","label":"Date","options":[],"required":null,"pdf_field":""},{"help":"Location of signing","type":"text","label":"Place","options":[],"required":null,"pdf_field":""},{"help":"Sign here","type":"signature","label":"Signature of Insured Person","options":[],"required":true,"pdf_field":""}],"filled_by":"insured"}],"deadlines":[],"applies_to":"IndusInd Overseas Travel Care Policy claims","attachments":["All bills, receipts, payment card slips pertaining to your claim","Doctor's Report as per format (mandatory for Accident & Sickness Section)","Additional sheet if space is insufficient"],"declarations":["Issuance of the form is not an admission of liability or waiver of terms, conditions & exceptions of the insurance contract.","Answer all questions completely; attach additional sheet if needed.","Attach all bills, receipts, and payment card slips related to the claim.","No claim under Accident & Sickness Section will be admitted without Doctor's Report as per format.","Failure to call Emergency Assistance Service Provider shall invalidate your claim.","I declare that if I make any false or untrue statement or concealment, my claim shall be forfeited and no benefits are admissible under any other medical scheme or insurance.","I authorize any hospital, physician, or other person who has attended or examined me to furnish the company any information or medical records related to my illness or injury.","I confirm that all premiums have been/will be paid from bonafide sources and not from proceeds of crime.","The company has the right to call for documents to establish sources of funds and to cancel the contract if found guilty under money laundering laws.","I agree that in case of mismatch in KYC or PAN details, the policy will be issued as per proposal form and I will be responsible for consequences."],"dropped_labels":0},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"claim","channel":"email","value":"services@indusindinsurance.com","label":"Health Insurance Claims Email","level":1,"hours":null,"applies_to":"health","source_url":"https://www.indusindinsurance.com/health-insurance-claims","quote":"nce Claim\nTravel Insurance Claim\nCommercial Insurance Claim\nSupport\nSign In\nSelf Help\nVideo Chat\nContact Us\nEmail us at\nservices@indusindinsurance.com\ngrievances@indusindinsurance.com\ncareers@indusindinsurance.com\nCall us at\n+91 22 48903009 (Paid Number)\n+91 22 65934185","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"email","value":"indusind@europ-assistance.in","label":"Travel Insurance Claims Email","level":null,"hours":null,"applies_to":"travel","source_url":"https://www.indusindinsurance.com/travel-insurance-claim","quote":"91-22-67347844\nInternational Travel (while in India):\n1800 209 5522\nWhatsApp:\n7400422200 for Inland Travel Claim\nEmail:\nindusind@europ-assistance.in\nMobile Application:\nIndusInd Insurance App\nWebsite:\nOnline Claim Intimation\nOffline Visit:\nLocate your nearest branch\nh","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"+91 22 48903009","label":"Car Insurance Claim Intimation","level":null,"hours":null,"applies_to":"motor","source_url":"https://www.indusindinsurance.com/car-insurance-claim","quote":"Us\nEmail us at\nservices@indusindinsurance.com\ngrievances@indusindinsurance.com\ncareers@indusindinsurance.com\nCall us at\n+91 22 48903009 (Paid Number)\n+91 22 65934185 (Senior Citizen)\n+91 7400422200 (WhatsApp)\n+91 22 48903051 (Become our Partner)\nVisit us:","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"022 65934189","label":"Motor Claims Helpline","level":null,"hours":null,"applies_to":"motor","source_url":"https://www.indusindinsurance.com/car-insurance-claim","quote":"ation.\nNeed Guidance on Car Coverage?\nTalk to Our Professional Advisors\nCall Us\nCall Us!!\nHealth -\n022 65934188\nMotor -\n022 65934189\nTravel -\n022 65934184\nSteps to Take After a Car ​Accident\nThe following steps can expedite the road accident insurance","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"022 65934188","label":"Health Claims Helpline","level":null,"hours":null,"applies_to":"health","source_url":"https://www.indusindinsurance.com/health-insurance-claims","quote":"your nearest location.\nExpert health advice you can trust\nGet in touch with our team today!\nCall Us\nCall Us!!\nHealth -\n022 65934188\nMotor -\n022 65934189\nTravel -\n022 65934184\nCommon Reasons for Health Insurance Claim Rejection\nIncomplete Documentation","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"022 65934184","label":"Travel Claims Helpline","level":null,"hours":null,"applies_to":"travel","source_url":"https://www.indusindinsurance.com/health-insurance-claims","quote":"e you can trust\nGet in touch with our team today!\nCall Us\nCall Us!!\nHealth -\n022 65934188\nMotor -\n022 65934189\nTravel -\n022 65934184\nCommon Reasons for Health Insurance Claim Rejection\nIncomplete Documentation\nYour claim gets rejected when you don't gi","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"+912248903009","label":"Inland Travel Helpline","level":null,"hours":null,"applies_to":"travel","source_url":"https://www.indusindinsurance.com/travel-insurance-claim","quote":"rds your registered bank account.\nHow to Contact Us For Travel Insurance Claim?\nContact Details\nInland Travel Helpline:\n+912248903009\nInternational Travel (while abroad):\n91-22-67347843/ 91-22-67347844\nInternational Travel (while in India):\n1800 209 552","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"91-22-67347843","label":"International Travel Helpline (abroad)","level":null,"hours":null,"applies_to":"travel","source_url":"https://www.indusindinsurance.com/travel-insurance-claim","quote":"For Travel Insurance Claim?\nContact Details\nInland Travel Helpline:\n+912248903009\nInternational Travel (while abroad):\n91-22-67347843/ 91-22-67347844\nInternational Travel (while in India):\n1800 209 5522\nWhatsApp:\n7400422200 for Inland Travel Claim\nEmail","fetched_at":"2026-10-20"},{"purpose":"claim","channel":"phone","value":"1800 209 5522","label":"International Travel Helpline (in India)","level":null,"hours":null,"applies_to":"travel","source_url":"https://www.indusindinsurance.com/travel-insurance-claim","quote":"912248903009\nInternational Travel (while abroad):\n91-22-67347843/ 91-22-67347844\nInternational Travel (while in India):\n1800 209 5522\nWhatsApp:\n7400422200 for Inland Travel Claim\nEmail:\nindusind@europ-assistance.in\nMobile Application:\nIndusInd Insurance","fetched_at":"2026-10-20"}],"how_to_use":"Ask the user for each field in order, in plain words; never invent an answer. Labels are as printed. If fillable_pdf is true, pdf_fields gives the PDF's own field names so the file can be filled directly. The printed form decides if anything differs.","url":"https://indiainsurances.com/forms/indusind-general-insurance/565-indusind-overseas-travel-care-policy-claim-form"}