Rent the Best 4G Wifi Modem
Your Bank Information is required for Deposit Refund. We will refund your deposit via bank transfer within 3 business days after modem returned. We highly suggest using BCA account, so that the refund deposit can be received real time after modem is returned. If there is a mistake in filling out the bank account number for the customer's refund deposit, it will be reprocessed resulting in a longer refund process. That is why filling out the bank account number must be correct, so that the refund can be done on time.
23 September 2019
24 September 2019
1 unit x NaN days x 0
1 unit x 500.000
Terms & Condition
This Policy is underwritten by PT. Asuransi Simas Insurtech, the Insurer. This Policy, the Policy Schedule and any endorsements attaching to it set out the contract between you, the Insured Person, and the Insurer.
The Insured Person agrees to pay the premium shown in the Policy Schedule and agrees to comply with the responsibilities laid out in this Policy.
The Insurer is relying on the information provided by the Insured Person and for this contract to be valid all the information must be true and correct. If the Insured Person’s circumstances change the Insured Person must ensure that the Insurer is advised as soon as practicable.
Please read this Policy carefully to ensure that you understand what is covered and what is not covered. The Insured Person or his Representatives should contact the Insurer if anything is unclear or incorrect. If the Insurer has not heard from the Insured Person within 7 (seven) days from the receipt of this Policy, then the Policy shall be deemed as approved by both parties.
INSURANCE APPLICATION FORM
Anyone who is intending to apply for Simas Insurtech Travel Overseas insurance Policy, shall complete and sign Insurance Application Form provided by the Insurer, giving information and statements in accordance with the facts as they stand at the time of application.
- Insurance Application Form which is fully completed and signed by the Insured Person and approved by the Insurer, shall form the basis to issue the Policy and shall form part of the Policy.
- If the information or statements provided in the Insurance Application Form are misstated or false and the Policy is in force, the Insurer reserves the right to decline any claims or to declare the Policy null and void entirely from the inception date.
- Insurer shall mean PT. Asuransi Simas Insurtech.
- Policy is shall mean a travel insurance contract made and signed by the Insurer based on the Insurance Application Form and the statement/representation made and sign by the Insured Person/Policy Holder.
- Policy Holder shall mean a person or an Institution to whom the Policy has been issued in respect of cover for persons specifically identified as Insured Persons in this Policy
- Family Policy is a Policy issued for the following participants :
- The insured’ spouse and/or
- The children of the insured
- Insured Person shall mean anyone for whom premiums are paid and insured in this Travel Insurance agreement :
- Individual Policy : all participants whose names are listed in Policy Schedule who is 17 (seventeen) to 80 (eighty) years old.
- Family Policy :
- The Insured who is 17 (seventeen) to 80 (eighty) years old.
- Spouse of the Insured who is 17 (seventeen) to 80 (eighty) years old.
- Children of the Insured who is 1 for 1 (one) – 17 (seventeen) years old.
- Beneficiary shall mean anyone entitled to the Sum Insured paid by the Insurer if the Insured Person dies as a result of an Accident and his/her name and relationship with Insured Person is clearly stated within this Policy.
- Period Of Coverage shall mean time, date, month and year stated in airline ticket or from the time the Insured Person leaves his/her permanent residence or business on a direct journey o the place of embarkation in Indonesia to commence the journey to the intended destination(s) until the time whichever of the following occurs first :
- The expiry date of the Insurance Policy Period stated in the Policy Schedule.
- The Insured Person return to his/her permanent place of residence or business in Indonesia;
- Period of coverage shall not exceed 180 (one hundred eighty) consecutive days from the date of departure stated in the airline ticket.
- Accident shall mean any bodily injury suffered by the Insured Person(s) and which is caused directly by violent, unexpected, external (coming from outside of the Insured Person) and visible means, unforeseen and is solely and independently of any other cause that occurs during the Policy period.
- Injury is bodily injury as sustained in an Accident directly and independently of all other causes that occurs during the Policy period.
- Serious Injury or Sickness is a condition which requires treatment by Legally Qualified Medical Practitioner who authorized the Insured suffering from illness/injury that can lead to death so that the Insured is not sufficient to travel or continue the journey.
- Qualified Medical Practitioner shall be any person legally authorized by the Government with jurisdiction in the geographical area of his/her practice to render medical or surgical service, but Qualified Medical Practitioner should not be authorized the Insured Person, or Relative(s) of the Insured Person.
Medically Necessary Expenses shall mean expenses incurred within the Policy Period as a result of Injury or Serious Injury or Sickness paid by the Insured Person to a legally Qualified Medical Practitioner, but excluding the cost of dental treatment unless such treatment is necessarily incurred to sound and natural teeth and is caused by Injury, and excluding any expenses which are exclude in this Policy.
All treatment must be prescribed by Qualified Medical Practitioner in order for expenses to be reimbursed under this Policy. In the event an Insured Person becomes entitled to a refund of all or part of such expenses from any other source, The Insurer will only be liable for the different of the amount recoverable from such other source.
Acquired Immune Deficiency Syndrome or “AIDS” wherever used in this Policy shall have the meanings assigned to it by the World Health Organization including Opportunistic Infection, Malignant Neoplasm, Human Immune Deficiency Virus (HIV), Encephalopathy (Dementia), HIV Wasting Syndrome or any Disease or Sickness in the presence of a sero-positive test for HIV.
Opportunistic Infection shall include but not be limited to Pneumocystis Carini Pneumonia, Orgarism of Chronic enteritis, Virus and/or Disseminated Fungi Infection.
Malignant Neoplasm shall include but not be limited to Kapoci’s Sacroma, Central Nervous System Lymphoma and/or other Malignancies now known or which become known as immediate causes of Death, Illness or Disability, in the presence of Acquired Immune Deficiency Syndrome.
Hospital shall mean any institution duly licensed and registered as a hospital intended to be used for the care and medical treatment of the sick and injured persons as paying bed-patients and which :
- has facilities for diagnosis and on its immediate premises an operating room for performing major surgeries
- provides nursing services by registered and graduate nurses at all hours of day and night
- is under the conduct of registered medical practitioner at all times and
- is not primarily a clinic, a place for alcoholics or drug addicts, a nursing home, rest or convalescent home or home for the aged or a mental institution or similar establishment.
- Confinement/Hospitalization shall mean confinement to Hospital as a Resident Inpatient for a period of 8 (eight) hours or more for Medically Necessary treatments for a covered Disability, for which the Hospital charges a full daily room and board rate, on the advice of and under the regular care and attendance of a Physician. In the event of surgery, the 8 (eight) hour period is waived and is not applicable.
- Illness, Sickness, Disease shall mean a physical condition marked by a pathological departure or deviation from a normal state of health and shall include the term "Disease" contracted by an insured or dependant while this Policy is in force.
- Chronical Disease shall mean an illness or injury which has one of the characters below :
- take place continuously
- recurrent or likely repeated
- fixed / permanent
- require rehabilitation or special training
- requires observation, consultation, check-ups, examinations or tests are sustainable in the long term.
- Pre Existing Condition or Illness shall mean An existing conditions and :
- which the Insured has been and / or are undergoing treatment or receiving medical advice, or
- in the case where the insured to show symptoms, or
- where the insured knew / know it, or
- where the insured should already know / knew it, prior to the Period of Coverage.
- Travel Documents shall mean:
- Travel Documents (comparable to passports)
- Other Equivalent Documents (to passport)
- Consequantial Loss shall mean Indirect loss which accompanies an insured loss, such as loss of earning resulting from accidental disabilities.
- Terrorist Act shall mean any actual or threatened use of force or violence directed at or causing damage, injury, harm or disruption, or commission of an act dangerous to human life or property against any individual, property or government with the stated or unstated objective of pursuing economic, ethnic, nationalistic, political, racial or religious interests, whether such intersests are declared or not. Robberies or other criminal acts primarilly committed for personal gain and acts arising primarily from prior personnal relationships between perpetrator(s) and victim (s) shall not be considered terrorism.
Terrorist act shall also include any act which is verified or recognized by the relevant government as an act of terrorist.
- Hijacking shall mean any seizure or exercise of control by force or violence or threat of force or violence and with wrongful intent, of a commercial aircraft or other mean of public transportations, or other actions defined as such by the government.
- Common Air Carrier shall mean any fixed-wing aircraft provided and operated by a commercial airline company which is duly licensed for the regular transportation of passengers and any helicopter provided and operated by an airline which is duly licensed for the regular transportation of fare-paying passangers and operating only between established commercial airports or licensed commertial heliports.
- Bankruptcy shall mean insolvency of the operations of a travel agent registered in Indonesia following the filling of a bankruptcy or winding-up petition whether voluntary or involuntary.
- Golfing Equipment shall mean golf clubs and golf bags.
- PERSONAL ACCIDENT
The Insurance afforded under this Section is only with respect to Injury or death which, directly caused by accident and independently of all other causes result in:
- Loss of a limb/loss use of a limb or loss of the entire sight of one eye
- Loss of two or more limbs or the entire sight of both eyes
- Permanent total disablement/permanent and incurable paralysis of all limbs
- Death on flight
if such Injury or death is certified by a Qualified Medical Practitioner within 90 (ninety) days after the date of the Accident.
- Table of Percentage of Benefits Sum Insured
- Death 100%
- Loss of a limb/loss use of a limb or loss 50% of the entire sight of one eye
- Loss of two or more limbs or the entire 100% sight of both eyes
- Permanent total disablement/permanent 100% and incurable paralysis of all limbs
- Death on flight 200%
- CONDITIONS :
- For participants with age > 70 (seventy) years old upto 80 (eighty) years old, the maximum overage is limited to 50% (fifty percent) of the maximum limit specified in the Policy Schedule.
- The following conditions shall applied for the FAMILY POLICY :
The Personal Accident Benefit paid to the family member will be limited to :
- 50% (spouse of the Insured)
- Maximum of 25% (each children of the Insured) of the limit stated in the Table of Percentage of Benefits Sum Insured
- Accidental Death shall mean accidental death caused by bodily Injury as defined in this Policy which within 90 days from its occurrence is the sole and direct cause of death.
- Permanent Total Disablement or Dismemberment shall mean Disablement which commences within 90 (ninety) days from the date of the Accident and which is permanent and entirely prevents an Insured Person from attending to any business or gainful occupation (of any and every kind) or if he/she has no business or occupation from attending to any duties, which would normally be carried out by him/her in his daily life.
- Loss Of Limbs shall mean loss by complete and permanent physical severance of hand at or above the wrist or of a foot at or above the ankle.
- Loss Of Sight shall mean permanent irrecoverable loss of sight in both eyes.
- The occurrence of any specific Injury for which indemnity is payable under this Article shall at once terminate all insurance under this Personal Accident Section of the policy, but such termination shall be without prejudice to any claim originating out of the Accident causing such loss.
- The maximum Benefit for this Article is up to the limit stated in the Policy Schedule for each Insured Person.
- EXCLUTIONS TO SECTION A
This Policy does not cover Death or Disablement directly or indirectly resulting from :
- Intentional self-inflicted Bodily Injury, suicide or attempted suicide.
- The participation of any criminal act, violation, strikes, riots,etc.
- Boxing, karate, judo, kung fu, ju jitsu, wrestling, water skiing, skydiving, mountaineering requiring ropes, rugby, football, hockey, motor car and motorcycle racing.
- Flying or taking part in other aerial-activities except where traveling in an aircraft as a passenger and not as aircrew nor for the purpose of any trade or technical operation in or on the aircraft.
- Serving in any Armed Forces whether in time of peace or War.
- Mental disorder, or being under the influence of intoxicants, drugs (unless under medical supervision), or alcohol.
- Kidnap and ransom
- More than one payment under this Policy in respect of one occurrence.
- In the event of Death following a payment for Bodily Injury then that payment shall be deducted from the payment for Death.
- As a result of an occurrence prior to inception of this policy.
- If the Bodily Injury is committed by any party directly or indirectly having an interest in the policy benefits.
- If the Bodily Injury is committed by the Insured Person or any other person related to the Insured Person.
- TRAVEL INCONVENIENCE
- B.1. LOSS OR DAMAGE OF BAGGAGE AND PERSONAL EFFECTS
This Section pays for loss or damage to the Insured Person’s Baggage and Personal Effects inside public transportation baggage during the period between the date of departure and the date of return to Indonesia or when the Policy expires as stated whichever occurs first.
Loss or damage to the baggage or personal effects will only be reimburse if occurs :
- while the item(s) is/are in the possesion of hotel staff or common carrier and proof such loss must be obtained in writing from the hotel management or the common carrier’s management and such written proof ,must be provided to the Insurer; or
- while in public places such loss or damage is covered only if due to the theft or robbery and it must be reported to the police having jurisdiction at the place of the incident not more than 24 (twenty four) hours from the incident. Any claim must be accompanied by written documentation from such police.
Conditions applied to this coverage are as follows :
- The amount payable in respect of Baggage shall not exceed to 20% from the maximum limit stated in the Policy Schedule. In respect of the lost/damage to one unit (set), it will be treated by the Policy as one (1) type of stuff.
- The basis of indemnity is replacement cost less 20% per year for depreciation.
- The Insured must take every step to ensure that their Baggage and/or Personal Effects are not left unattended.
- If the property insured be damaged, the Insured Person shall take all reasonable measures to protect, save and recover it.
- The Insured Person must report any event that might result in a claim on this policy to Police or responsible Officer of any aircraft, vessel or conveyance on which he/she is traveling and obtain a written acknowledgment from such Police or carrier or hotel management when available, unless failure to do so is demonstrably due to circumstances beyond his/her control.
- In case of damage of the Insured’s Baggage, the Insurer has the right to choose whether to pay the cost of repairs or to replace in cash in accordance with the Policy's provisions.
- If the Insurer have made a compensation for the damage of baggage at the maximum limit and the market value of the damaged baggage is equal to the amount claim paid, then the salvage shall become the property of the Insurer.
EXCLUSIONS TO SECTION B.1
- The following classes of property are excluded from the coverage: animals, motor vehicles (including accessories), motorcycles, boats, motors, any other conveyances, household effects, antiques, laptop computers (including software, accessories), electronic equipment, jewelery, contact or cornea lenses, artificial teeth or limbs, securities, money, bank notes, currency notes, cheques, travel checques, wessel, airline ticket, passport, petrol coupons, credit vouchers, souvenirs, and other items that are categorized easily damaged or broken.
- Loss or damage caused by wear and tear, scratching and denting, gradual deterioration, moths, vermin, inherent vice or damage sustained due to any process or while actually being worked upon or resulting there from.
- Loss or damage to hired or leased equipment.
- Loss or damage to property resulting directly or indirectly from insurrection, rebellion, revolution, civil war, usurped power, or action taken by Governmental Authorities in hindering, combating or defending against such an occurrence, seizure or destruction under quarantine or customs regulations, confiscation by order of any Government or Public Authority or risk of contraband or illegal transportation of trade.
- Strikes, riots, civil commotions and acts of terrorism or sabotage.
- Loss or damage to Baggage and Personal Effects under any other insurance policy, or loss or damage that would otherwise could be reimbursed by common carrier or hotel.
- Loss to Insured Person’s Baggage sent in advance or souvenirs and articles mailed or shipped separately.
- Loss or damage whilst in the custody of an airline or other carrier, unless an airline Property Irregularity Report is obtained.
- Loss to Insured Person’s Baggage or Personal Effects left unattended in any vehicle or public place or as a result of the Insured Person’s failure to take due care and precautions for the safeguard and security of such property.
- Loss of business goods or samples.
- Loss of data stored/recorded on tapes, cards, dics, Flashdisk, etc.
- The amount of 5% (from the maximum limit) of each and every claim each Insured Person.
- Mysterious disappearance.
- Any consequential loss.
B.2 BAGGAGE DELAY
This Section will reimburse the following :
- Up to 20% of the maximum limit for emergency purchase of essential clothing and toiletries if the checked-in-Baggage accompanying the Insured Person has been delayed, misplaced by the carrier after 6 (six) consecutive hours upon the Insured Person’s arrival at the airport of the scheduled destination abroad.
- On each 6 (six) consecutive hours following the previous 12 consequtive hours, a further 20% of the maximum limit under the plan of this Policy, will be allowed for additional Emergency purchases of essential clothing and toiletries which in fair amount if the same Baggage is still not in the physical possession of the Insured Person.
The Maximum compensation are subject to the limit as stated in each plan.
The Insured Person can not submit any claim under B.1 and B.2 for the same event.
B.3 TRAVEL DELAY
In the event of the delayed departure due to inclement weather, equipment failure, strike or other work-action of carrier or airport ground staff, bomb alert or other reason beyond the control of the Insured Person for at least 6 (six) consecutive hours from the time specified in the itinerary supplied to the Insured Person this article will pay for 10% of the maximum limit (for each full 6-hours delay) up to maximum limit as stated in the Schedule of Benefits.
EXCLUSION TO SECTION B.3
No benefit shall be payable for any delay:
- arising from failure of the Insured which is resulting to the overdue flight schedule.
- which do not have any written confirmation form the camers (or travel agent) of the number of hours delayed and the reason for such delay.
- arising from strike or industrial action existing on the date the trip is arranged, unless the strike/industrial action occurs when the Insured arrives at the airport or at the time of the Insured’s check in.
B.4 LOSS OF DEPOSIT AND CANCELLATION
This Section also pays for loss of travel and/or accommodation expenses paid in advance by the Insured Person and for which the Insured Person is legally liable and which are not recoverable from any other source consequent upon the cancellation of the journey necessitated by the following occurring within 10 (ten) days before the date of commencement of the journey :
- Death or Serious Injury or Serious Sickness or compulsory quarantine of the Insured Person
- Death of the Spouse, Parent, Parent in-law, Grandparent, Children, Brother or Sister domicile in Indonesia.
- Unexpected strike, riot or civil commotion arising out of circumstances beyond the control of the Insured Person.
- Severe damage from the insured residence in Indonesia due to fire, severe floods or other natural disasters that occurred within 10 days prior to departure date.
- Witness summons
EXCLUSION TO SECTION B.4
Claims arising directly or indirectly from in respect of or due to :
- Government regulations or control, bankruptcy, liquidation or default of travel agencies or common carrier, or hotel.
- Any loss that is covered by any other existing insurance scheme or Governmental program or which will be paid or refunded by any hotel, airline, travel agent or other provider of travel and/or accommodation.
- Disinclination to travel or financial circumstances of any Insured Person
- Any unlawful act or criminal proceedings of any person on whom the holiday plans depend, other than attendance under subpoena as a witness at a court of law.
- Failure to notify travel agent/tour operator or provider of transport or accommodation immediately it is found necessary to cancel or curtail the travel arrangements.
- Should this insurance be purchased less than 7 (seven) days before the date of departure (with the exception of death or serious injury resulting from accident only of the Insured, Spouse, Parent, Parent in-law, Grandparent, Children, Brother or Sister domicile in Indonesia.
Other Exclusion under these section is :
The amount of 1% (from the maximum limit) of each and every claim each Insured Person.
B.5 TRIP CURTAILMENT
This article pays up to the maximum limit stated in the Policy Schedule, for :
- Any additional air, land or sea travel (economy class fare whenever possible) and/or hotel expenses incurred
- Any loss of travel and/or accommodation expenses paid in advance or forfeited by the Insured Person after the commencement of the trip
In consequent upon the Insured Person having to return directly to Indonesia following to :
- Serious Injury or Sickness of the Insured Person;
- The unexpected Death of the Insured Person’s Spouse, or children who is resident in Indonesia;
- Due to natural disasters (such as typhoon, earthquake, blizzard/snowstorm) which prevent him/her from continuing with his/her scheduled trip;
- Due to unexpected strike, riot or civil commotion beyond his control.
This coverage is effective only if it is purchased before the Insured Person becomes aware of any circumstances which could lead to the disruption of his/her journey.
EXCLUSION TO SECTION B.5
Claims arising directly or indirectly from in respect of or due to :
- Government regulation or act;
- Travel Curtailment under the initiative of the Insured;
- Travel Curtailment by failure of the agent or tour operator through whom the trip was booked;
- Travel Curtailment due to financial circumstances of any Insured Person;
- Any unlawful act or criminal proceedings of any person which caused the travel curtailment;
- Failure to notify travel agent/tour operator or provider of transport or accommodation immediately it is found necessary to curtail the travel arrangements.
Other Exclusion under these section are :
- The amount of 5% (from the maximum limit) of each and every claim each Insured Person.
- Any loss that is covered by any other Insurance scheme or government program, or which will be paid or refunded by a hotel, airline, travel agent, or any provider of travel.
B.6 AIRCRAFT HIJACKING
This Section will pay the Insured Person an amount of 10% of maximum limit per day (every 24 hours) for delay or interruption of the journey in excess of waiting period of 12 (twelve) hours which prevents the Insured Person from reaching the Scheduled destination of aircraft on which he or she is the passenger as a result of an act of Aircraft Hijacking.
The Insurer will pay up to a maximum limit as stated in the Policy Schedule.
A covered “day” is the 24 (twenty four) hours period commencing 12 hours after the aircraft was scheduled to reach its destination plus the duration of time, if any, by which it was late in departing from the aircraft immediately proceeding the first act of Hijacking.
Coverage, including the 12-hours deductible period, applies to the same time commencing as stated above and running continuously thereafter until the earliest time the Insured Person would reasonably be able to reach the Aircraft original schedule destination, whether or not the Insured Person actually proceeds to such destination.
Aircraft Hijacking means, any seizure or exercise of control by force or violence or threat of force of violence and with wrongful intent, of an aircraft.
B.7 LOSS OF TRAVEL DOCUMENT
The Insurer will reimburse the Insured Person for the cost to reissue the lost travel documents up to the limit stated under the Policy, which arising out of robbery, burglary or theft whilst overseas during the Period of Coverage. Such losses must be reported to the local Police at the place of loss within 24 (twenty four) hours of the incident and a written statement from the Police must be obtained to substantiate the claim.
EXCLUSIONS TO SECTION B.1 ; B.2 ; B.3; B.7
The Insurer will not pay for claims in respect of :
- Loss or damage arising from delay or confiscation or detention by customs or any other airport/ government official.
- Losses not reported to the policy within 24 (twenty four) hours and a report not obtained at the place of loss.
- Loss or theft of travel documents left unattended in a public place or as a result of Insured Person’s failure to take due care and precautions to safeguard and secure such property.
B.8 FLIGHT MISSCONNECTION
In the event that the Insured’s confirmed onward travel connection whilst overseas is miss at the transfer point due to the late arrival of the Insured’s incoming confirmed connecting scheduled conveyance and no onward transportation is available to the Insured within 6 (six) consecutive hours on his arrival, the Insurer will pay for accommodation, foods and beverages up to the maximum limit states in the Policy Schedule. This benefit applies only 1 (one) time for each travel.
The flight mis-connection details to be obtained by Insured Person must be verified in writing by the operator(s) of the airline or their handling agent(s).
- MEDICAL BENEFITS AND SERVICES
C.1 MEDICAL EXPENSES DUE TO ACCIDENT AND SICKNESS
This Section will reimburse the Insured Person the usual customary and reasonable medically necessary expenses as defined, incurred up to the limit stated in the Policy Schedule, while traveling overseas for Injury or Serious Injury or Sickness suffered by the Insured Person solely and independently of any other causes.
The amount of medical expenses paid is in accordance with the receipt or the maximum limit per occurrence, which is up to 25% of the total limit stated in the policy, whichever is lower and not more than the maximum limit under selected plan.
EXCLUSION TO SECTION C.1
- All pre-existing medical or physical conditions of any Insured Person which has required consultation or treatment. Including under this exclusion, all chronic illness or condition before the commencement of the Journey, or a condition on which medical advice or treatment was recommended by a physician within 12 (twelve) month period preceding the effective date of the policy.
Chronic illness or condition such as but not limited to :
1.1. Multiple Sclerosis.
1.2. Asthma, Tuberculosis (TBC).
1.3. Varicose veins, haemorrhoids.
1.4. Cardio Vascular Disease, hypertension and hypotension, Coronary Heart Disease, Heart Disease (MCI), Heart Attack, etc.
1.5. Cerebro Vascular Disorder (stroke)
1.7. Cancer of all types and tumors of all kinds.
1.8. Thyroid gland disorders/mumps like hypothyroidsm, hyperthyroidism (thyroid gland enlargement),
1.9. Hepatitis B, Hepatitis Non A Non B, Hepatitis C.
1.10. Gastro-intestinal disorders, including stomach disorders thereto, Large Intestine, Small Intestine, Appendix / Appendix, Liver, Gall Bladder (example: Inflammation of Bile Stone) dyspepsia and other Digestive Tract Disorders.
1.11. Diabetes Mellitus and other metabolic diseases.
1.12. Diseases such as urinary tract / Ureter, Renal (kidney stones, colic), Vesica urethra urinary stones in the urinary tract including the above.
1.13. Joint disorders (rheumatic / Gout) or Bone Disorders (Osteoporosis) and other muscle diseases.
1.15. Abnormalities in the nasal septum or turbinates and sinuses, such as septum deviation.
1.16. Tonsils were sick and needed surgery / Tonsil Surgery.
1.17. Any type of hernia (example: HNP or nucleus pulposus hernia).
1.18. Ani Fistula.
1.19. Reproductive Tract Disease in women (Endometriosis, Cysts, myomas) and in men (Enlarged Protat, Varicocele, hydrocele), etc.
1.20. Skin abnormalities that do not require antibiotics for treatment.
1.21. Another illness/disease which is considered as a Chronic Disease.
- Medical treatment or surgery which, according to medical practitioners may be delayed by an Insured until the Insured returned to Indonesia.
- Additional costs which are not Medically Necessary. i.e: balm, ointment, oil wasps, eucalyptus oil, couterpain, toothpaste, betadine, contact lense cleaning fluid and others.
- Any treatment arising from quarantine regulations of the country visited by the Insured.
C.2 FOLLOW-UP TREATMENT
The Insurer will also pay Medical Expenses incurred in Indonesia upon returning from the trip, provided that the Insured Person (s) is (are) confined to a hospital directly as a result of an Injury or Serious Injury or Sickness (as defined) suffered overseas. Admission to hospital must be within 12 (twelve) hours after arrival into the territorial boundaries of Indonesia and must be a continuation of medical attention sought while overseas. The maximum sum payable for medical expenses incurred in Indonesia is for up to 7 (seven) consecutive days stay in hospital or as a maximal limit of selected plan as shown in the Policy Schedule, whichever is lower.
CONDITIONS TO SECTION C.1. and C.2.
For participants with age > 70 (seventy) years old upto 80 (eighty) years old, the maximum overage is limited to 50% (fifty percent) of the maximum limit specified in the Policy Schedule.
EXCLUSIONS TO SECTION C.1. and C.2.
The Insurer will not pay claims in respect of :
- The cost of care/treatment that is covered/paid by other parties. In this case the Insurer will only pay the excess costs which is not covered/paid by the other party, up to the limit specified in the Policy.
- Treatment or aid obtained in Indonesia except as specified in C.2.
- For additional cost of single or private room accommodation at a hospital clinic or nursing home except where the qualified medical practitioner Qualified Medical Practitioner treating the Insured Person deems it necessary for Insured Person to occupy such accommodation.
- Medical consultation or treatment unless received from a Qualified Medical Practitioner.
- Additional costs which are not Medically Necessary. i.e: balm, ointment, oil wasps, eucalyptus oil, couterpain, toothpaste, betadine, contact lense cleaning fluid and others.
- Sections C.1 until Insured Person is outside Indonesia.
C.3. EMERGENCY MEDICAL EVACUATION AND REPATRIATION
This Benefit is under the responsibility and authority of the GAH in cooperation with the Insurer.
C.3.1 EMERGENCY MEDICAL EVACUATION
GAH will arrange an emergency evacuation that is medically necessary to the nearest facility where appropriate medical case is available in the event that a participant have an Accidents or suffer serious medical condition that require immediate care, while adequate medical facilities are not available. The decision of an evacuation / repatriation including the transportation means will be determined by the team of Doctors of GAH. Following to consultation with local treating doctor who for maximum. 1 (one) service for each Insured's medical condition. Medical considerations, the nature of the emergency, the condition of the participants and the ability to travel, as well as other relevant circumstances including the availability of airfields, weather conditions and mileage, will determine whether the transport will be carried out by private aircraft equipped with medical equipment, helicopters, scheduled commercial flights, fire or ambulance. All evacuations made by GAH are conducted under continuous medical supervision, unless otherwise agreed by the Medical Doctor team of GAH.
GAH retains the absolute right to decide whether the Insured Person’s medical condition is sufficiently serious to warrant emergency medical evacuation. GAH further reserves the right to decide the place to which the Insured Person shall be evacuated and the means or method by which such evacuation will be carried out having regard to all the assessed facts and circumstances of which GAH is aware at the relevant time.
C.3.2 MEDICAL RAPATRIATION
GAH will arrange medical repatriation process that will only using a land ambulance or on a scheduled commercial flight if the team of GAH, in consultation with the treating local physician, decides that care should be continued at a medical facility in the host country of residence after stabilization is done to the participants.
C.3.3. MORTAL REPATRIATION
GAH will provide all possible assistance with the required formalities and pay the cost of transport related to the mortal repatriation in the event of death of the participant on the way to the location chosen by the authorized representative (individual) of the participant, subject to the maximum limit of Eligible expenses stated in the Policy Schedule.
Expenses such as but not limited to funeral services, flowers, coffins are not guaranteed by the Policy (remains the responsibility of the participants).
C.4. COMPASSIONATE VISIT
GAH will arrange and pay for the economy class round-trip for one person designated by the participant to follow if the person is being treated in a hospital abroad without a companion for more than 7 (seven) days. Visitor accommodation costs up to USD 50.00 (fifty US Dollars) for a maximum of 7 (seven) days. Other costs are paid by the participants.
C.5. RETURN OF MINOR CHILDREN
GAH will arrange and pay one-way economy class transport for children guaranteed by this policy who are left unattended as a result of an accident or serious medical illness of the parent, to their residence or to the residence of the immediate family or designated trustee, which only the most appropriate. Qualified companions will also be provided by GAH free, when required.
C.6. HOSPITAL INCOME
The Insurer will pay USD 50 (fifty US Dollar) per day up to the maximum limit stated in the Policy Schedule, if the Insured is hospitalized whilst overseas.
C.7. LOCAL BURIAL
Insurer will pay the actual cost of expenses incurred for the funeral of the insured up to the maximum limit stated in the Policy Schedule if the insured dies due to illness and accidents that are covered by the policy.
EXCLUSION SECTION C.3 to C.7
- Provision of Services, which are not described in the EXPLANATION OF BENEFIT, or as long as the premium has not been paid by the participant. Services provided without authorization and / or interference by GAH.
- Charges already paid by other parties that cause no need for intervention / service from GAH, or charges already covered by the insurance policy.
- Cases of illness or minor injuries, which in the opinion of the GAH Doctors team can be handled by local medical facilities and any illness or injury that will not prevent the participants from continuing their journey or work.
- Costs incurred by participants in the opinion of the team Doctor GAH physically able to travel and status as an ordinary passenger without medical escort, unless it is deemed necessary by the team of Doctor GAH.
- The circumstances in which a trip is specifically made with the intention of obtaining medical care. Included under this exemption, cases involving birth or pregnancy, unless unforeseen complications arise that endanger the life of the mother and / or baby in the womb.
- The circumstances in which a participant undertakes a journey contrary to a doctor's order or advice.
- Costs arising from illness or deliberate injury, psychiatric disorders, alcohol abuse, drugs or other substances or self-exposure to unnecessary harm (except for saving human life).
- Orders to, or attempts to commit, unlawful acts.
- Costs incurred as a result of participants undergoing a country's active military service. Active participation in war (whether declared or not), invasion, acts of foreign enemy, hostility, civil war, rebellion, riot, revolution or popular resistance.
- Any consequence or loss which is a direct result of nuclear reaction or radiation.
- Costs incurred or contributed by or arising directly or indirectly from war, invasion, civil war, armed conflict, terrorist activity, rebellion, revolution, riots, military force or unlawful power, seizure or nationalization or destruction or destruction of property owned by and on the orders of any government or local authority, except for claims in which the participant is not actively involved in any one or a number of such declared events and / or where the participant has not traveled or the participant does not continue to oppose the Government's official advice.
- Costs incurred or contributed by or arising directly or indirectly from Terrorist activities involving the use of nuclear, biological or chemical destroyers, however, are all likely to be disseminated or combined.
Upon this exclusion, it can be explained as follows:
- Terrorist activity means action, or any action, of a person, or any group of persons, related in political, religious, ideological or other purposes with the intention of influencing a government and / or placing society, or a particular part of society, in fear. Terrorist activity may include, but is not limited to, actual use of force or violence and / or the threat of its use. Furthermore, terrorist actors may act alone, or on behalf of, or in connection with any organization or government.
- The use of nuclear weapons of mass destruction means the use of nuclear weapons or explosive devices, as well as emissions, discharges, dispersions, releases, or discharges of fissile material which emit a level of radioactivity that may cause disability or death to persons or animals.
- The use of chemical weapons of mass destruction means emissions, discharges, dispersions, releases or discharges of solid, liquid or gaseous compounds, which, when properly split, may cause disability or death to persons or animals.
- The use of biological weapons of mass destruction means emissions, disposal, dispersal, release or discharge of pathogenic (causing disease) micro-organisms and / or toxins produced biologically (including genetically modified organisms and chemically synthesized tokens) which may cause disability or death of persons or animals.
It is also excluded from the Policy any loss or expense of any nature which arises directly from or caused or caused or arising out of, or relating to any action taken in controlling, preventing or suppressing any or all of the above mentioned in numbers 1 to 4 above
SPECIAL DEFINITIONS SECTION C.3. to C.7.
- GAH means Global Assistance & Healthcare, the party appointed by the Insurer to provide evacuation and repatriation services.
- Doctor GAH means doctors employed by GAH Alarm Center. Doctor GAH is responsible for determining, in conjunction with local doctors who take care of participants,medical needs for emergency transport or alternative medical measures.
- GAH ALARM CENTER means the service center provided and governed by GAH and its affiliates to provide services to the participants.
- SICKNESS means any sudden or serious medical condition declared by the doctor who in the opinion of Doctor GAH threatens safety or otherwise improperly handled can result in permanent health problems.
- ACCIDENT means any unexpected events and adverse events that may happened to the Insured, except injuries caused by self-injury or intentional conduct, which in the opinion of a physician GAH threaten safety or which, if not handled appropriately, may result in permanent health problems .
- HOME COUNTRY means the country where the participants have a permanent residence and as stated in the participant's passport.
- EMERGENCY CASE means the condition of participants who threaten the safety of the soul that if not handled properly should result in death / permanent health problems.
SPECIAL CLAIM PROCEDURE SECTION C.3 to C.7
- In the event that the Insured needs the service, the participant may contact the GAH Alarm Center at 62-021-29978999 by faxing the following data:
- Insured Name
- Policy Number and Register Number
- Insured Location
- Telephone Number (Active)
- Attending doctor (if hospitalization)
- GAH will perform membership verification of serving participants after the Insured is registered
- If the Insured has hospitalized, the GAH will contact the Hospital and decide the steps to be taken based on the medical report received by GAH from the Hospital
- If the condition of the Insured in no 4.3 according to GAH requires medical evacuation, GAH will plan and carry out medical evacuation to the hospital based on the medical condition and needs of the participant and supervise the examination given to the participant.
- If the condition of the Insured in no 4.3 according to GAH does not require an evacuation, then the Insured will remain hospitalized at the local Hospital and keep on supervising the patient's condition. After the participant in number 4.4 has received adequate care, GAH will make arrangements for the medical repatriation
- EXTENSION COVER
D.1. PERSONAL LIABILITY
The Insurer will indemnify the Insured Person for any legal liability including costs and expenses up to a maximum limit as specified in the Policy Schedule arising during the Period of Coverage as a result of :
- Injury to any person the cost of scheduled trip.
- Accidental loss or damage to property of any person
EXCLUSIONS TO SECTION D.1.
The insurer shall not pay for liability from :
- Damage to the property of any person who is the Insured Person’s relative or employee or deemed by law to be his/her employee.
- Damage to property which belongs to the Insured Person or someone under his/her legal custody or control.
- Damage relating to any liability assumed under contract
- Damage relating to the willful, malicious or unlawful act on the part of the Insured Person.
- The ownership, possession or use of vehicles, aircraft, firearms or animals.
- The undertaking of any trade, business or profession
- Any criminal activities.
- Judgments which are not in the first instance delivered by or obtained from a court of competent jurisdiction within Indonesia.
- Legal costs resulting from any criminal proceedings.
- The Insured’s participation in any motor rallies.
- Punitive, aggravated or exemplary damages.
- Bodily Injury or Property Damage resulting from an agreement whereas such loss would not occur if the agreement does not exist.
- Transmittable Diseases - Bodily Injury resulting directly or indirectly from any illness, sickness or disease transmitted intentionally or unintentionally to another person.
D.2. EMERGENCY TELEPHONE CHARGES
The Insurer will reimburse the Insured up to the limit specified in the Policy Schedule, the actual telephone charges incurred for personal mobile phone used for the sole purpose of engaging the services of GAH during a medical assistance/emergency.
EXCLUSION SECTION D.2.
No reimbursement will be payable for telephone calls made via standard LAN Line and public telephones using International Calling Card.
D.3. HOME GUARD
The Insurer will pay or repair to indemnify the Insured up to the specified limit stated in the Policy Schedule against physical loss or damage to the contents on the Insured home residence in Indonesia that was left vacant because the Insured’s trip, caused by fire during the period of insurance. This coverage applies when the insured is legally had left Indonesia.
EXCLUSION SECTION D.3.
- Wear and tear, depreciation, the process of cleaning, dyeing, repairing or restoring any article, the action of light or atmospheric conditions, moth, insects, vermin or any other gradually operating cause.
- Any loss or damage occassioned through the willful act of the Insured or with the connivance of the Insured.
- Loss (wether temporary or permanent) of the Insured’s property or any part thereof by reason of confiscation, requisition, detention or legal or illegal aoocupation of such property or of any premises, vehicle or thing containing the same by any govenrment authorities.
- Electrical or mechanical breakdown.
- Consequential loss or damage of any kind.
- Business or professional use in respect of photographic and sports equipment and accessories and musical instruments.
- Motor vehicle, boats, livestock, bicycles and any equipment or accessories relating thereto.
- Loss or damage insured under any other insurance policy, or reimbursed by any other party.
D.4. RENTAL VEHICLE EXCESS
The Insurer will reimburse the Insured for any or deductible which he/she becomes legally liable to pay in respect of loss or damage caused by an Accident to the rented. The Insured must be either a named driver or co-driver of the rental vehicle.
- The rental vehicle must be rented from a licensed rental agency.
- As part of the hiring arrangement. Insured must take up all comprehensive motor insurance against loss or damage to rental vehicle during the rental period.
- Insured must comply with all requirements of the rental organization under the hiring agreement and of the Insurer under such insurance, as well as the taws, rules and regulations of the country. The rental vehicle must be rented from a licensed rental agency.
EXCLUSION TO SECTION D.4.
- Loss or damage arising from operation of the rental vehicle In violation of the terms of the rental agreement or loss or damage which occurs beyond the limits of any public roads or in the violation of laws, rules and regulations of the country
- Loss or damage arising from wear and tear, gradual deterioration, damage from Insects or vermin, inherent vice, latent defect or damage.
D.5. GOLF ADVANTAGE
D.5.1. Damage or Loss of Golfing equipment
The Insurer will pay to the Insured up to the limit specified under section d.5 for loss or damage sustained overseas to golfing equipment taken, or purchase whilst overseas provided such event occurs in apublic place.
If as a result of any damage, the golfing equipment is proven to be beyond economical repair, hence a claim which submitted under this Policy as if the article had been lost.
The Insurer shall not liable for more than the limit stated in the Policy Schedule.
The Insurer may make payment or at its option reinstate or repair the golfing equipment subject to due allowance of wear and tear and depreciation. The lost must be reported to the police or relevant authority such as hotel, an airline management having jurisdiction at the place of the lost within 24 (twenty four) hour from the incident. Any claim must be accompanied by written documentation from such authorities. The Insured must take every possible step to ensure that his/her golfing equipment is not left unattended in a public place.
D.5.2. Entertain Expenses in Achieving Hole in One
If an Insured completes a hole in one in an organized event at any 18 hole golf course, the Insurer will pay up to the limit specified in the Policy Schedule to cover the cost of one round or celebratory drinks.
The Insured must provide confirmation from the golf club professional that the Hole In One was achieved.
The Insured must provide the receipts for the cost of celebratory drinks.
EXCLUSIONS TO SECTION D.5.
With regards to golfing equipment, the Insurer shall not liable for :
- Loss or damage to golf balls and clubs whilst actually in the course of play or practice
- Loss or damage due to wear and tear or damage due o any process of repair or while being worked upon resulting therefore.
- Loss of or damage resulting from willful act or negligence of the Insured.
- Loss of or damage arising from confiscation or retention by customs or other official.
- Loss or damage covered by any other Policy.
This Policy will only pay for any claim under any one of the sections B.1. or B.5.1.
In the event the Insured Person entitled for plan E of the Policy, the Insurer will pay all benefit from section A to section D for losses arising directly on indirectly from an act of terrorism whilst the Insured is on overseas travelling up maximum limit stated in the Policy Schedule.
EXCLUSION TO SECTION D.6.
The Insurer will not pay for any losses directly or indirectly suffered, contributed or attributed to or caused by from or in any connection with any act of nuclear, chemical or biological events.
GENERAL EXCLUSIONS TO ALL SECTIONS
The Insurer will not under any Section or article of this policy be liable for loss, damage or liability directly or indirectly arising as a result of :
- Any act of war, act of a foreign enemy, civil war, revolution, insurrection, terrorism (as per NMA 2920-08/10/2001), or military power.
- Loss, destruction or damage to any property what so ever or any loss contributed to, by, or arising from its consequential loss.
- Loss directly or indirectly caused or contributed to, by, or arising from ionizing radiations or contamination by radio-activity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel.
- Any illegal act by the Insured Person or confiscation, detention by customs or other Authorities.
- Any prohibition or regulations imposed by any Government.
- Any breach of Government regulation or any failure by the Insured person to take reasonable precaution to avoid a claim under the Policy following the warning of any intended strike, riot or civil commotion through or by general mass media.
- The Insured Person not taking all reasonable efforts to safeguard his/her property or to avoid or minimize any claim under the Policy.
- Hitchhiking, backpacking, motorcycling, big game hunting, riding or driving in any kind of race, professional sports, air travel (other than as a passenger on a scheduled commercial flight), mountaineering or rock climbing, hiking/tracking tours in remote areas unless with licensed guides and additional premium, any underwater activity involving the use of any artificial breathing apparatus (except under the supervision of a qualified diving instructor and with additional premium).
- Pregnancy or childbirth, and any Injury or Serious Injury or Sickness associated with pregnancy or childbirth, and venereal disease.
- Any Injury or illness arising form the Insured participant who is/are not fit to travel or is/are travelling against the medical advice of a qualified medical practitioner.
- Any loss, injury pr illness arising from the insured participant who is travelling to have Routine medical examination or medical check up
- Suicide or attempted suicide or intentional self Injury.
- Any pre-existing conditions for which the Insured Person received medical treatment, diagnosis, consultation or prescribed drugs within a twelve (12) month period preceding the effective date of this Policy, or a condition on which medical advice or treatment was recommended by a physician within a twelve (12) month period preceding the effective date of the Policy.
- AIDS or any Injury, Serious Injury or Sickness commencing in the presence of a sero-positive test for HIV, and related disease.
- Outbreaks of Disease, Epidemic, Pandemic
- Mental and nervous disorders, including but not limited to insanity.
- The Insured Person engaging in naval, military or air force service or operations, or testing any kind of conveyance or being employed as a manual worker or while engaging in offshore, mining, aerial photography or handling explosives.
- Any loses resulting directly or indirectly by the rain of volcanic ash or ash from the volcano eruption.
GENERAL CONDITIONS APPLICABLE TO ALL SECTIONS
- Complying with policy conditions : The due observance and fulfillment of the terms of this policy insofar as they relate to anything to be done or complied with by an Insured Person and the truth of the statements and answers in any proposal and/or application and evidence required from an Insured Person in connection with this insurance shall be conditions precedent to any liability of Insurer to make any payment under this policy.
- Misstatement/missrepresentation :
- 2.1. If the age or date of birth or other relevant facts relating to an insured person shall be found to have been misstated and if such misstatement affects the scale of benefits or has anything to do with the terms and conditions of this Policy, the true age and facts shall be used in determining whether insurance is in force under the terms of this Policy and the benefits payable therefrom, and equitable adjustment of premiums shall be made.
- 2.2. Where a misstatement of age or other relevant facts has caused an insured person to be insured hereunder when he is otherwise ineligible for insurance or where such statement has caused an insured person to remain insured when he would otherwise be disqualified for further insurance in accordance with the terms and limitations of this Policy, his insurance shall be void and there shall be a return of premiums paid in respect of the insured person, provided always that where there is fraud on the part of the Policy Holder or insured person, no premiums paid are to be returned.
- 2.3. If there is any fraud/manipulation of information of the data claims and other related documents, then the Insurer reserves the right to review the payment of claims that have been paid to the Insured/Participant, and then the Insurer reserves the right to cancel the membership of the participant without any refund of premiums and the Insurer shall entitled to withdraw all funds of claim has been paid to the Insured / Participant
- 2.4. If the Insured is discovering any fraud claim, all original documents related to such claim will be retained by the Insured.
- Notice of claim : Written notice of a claim must be given to the Insurer within 3 x 24 hours after occurrence of any event likely to give rise to a claim under this policy or as soon thereafter as is reasonably possible. Notice given by or on behalf of an Insured Person to the Insurer at the address of authorized managing agents with information sufficient to identify the Insured Person shall be deemed notice to the Insurer.
- Claim Documents :
- 4.1. Insurance Policy (original/copy)
- 4.2. Identity card (copy)
- 4.3. Claim Form (original)
- 4.4. Power Of Attorney (original)
- 4.5. Copy of passport with arrival and departure seal from each country of destination
- 4.6. Airline Ticket(original/copy)
- 4.7. Boarding Pass (original/copy)
- 4.8. Chronological letter of accident written by the Insured (original)
- 4.9. Doctor’s or Hospital’s bills and prescription (original)
- 4.10. Medical Record including the history of Illness or accident (original)
- 4.11. Proof of payment/Invoice (original)
- 4.12. Notification from Travel Agent about the accident or illnesses (original)
- 4.13. Notification from airline (original)
- 4.14. Notification from the local Police (original)
- 4.15. Property Irregularity Report /PIR (copy)
- 4.16. Notification letter of the death of the Insured (copy)
- 4.17. Picture of corpse or burial process
- 4.18. Visum et Repertum/Official Report from the Doctor (original)
- 4.19. Notification from the airport(original)
- 4.20 Other supporting documents required by the Insurer
- Subrogation : In the event of any payment under this policy the Insurer shall be subrogated to all of the Insured Person’s rights of recovery therefore against any person or organization. In addition, the Insured Person shall execute and deliver instruments and papers and do whatever else is necessary to secure such rights. The Insured Person shall take no action after the loss to prejudice such rights.
- Claim Forms : The Insurer, upon receipt of a notice of claim, will forward to the claimant the necessary claim forms as soon as possible for filing proof of loss.
- Proof of Loss : Written proof of loss including original Policy/ Certificate, original receipts, invoices and all other relevant documents must be furnished to the Insurer at one of its local offices within max 90 days after the date of such loss. Failure to furnish such proof within the time required shall not reduce any claim if it was not reasonably possible but the Insurer will not be liable if Proof of Loss has not be furnished with 180 (one hundred eighty) days from the date of loss.
- Time of Payment of Claims: Indemnity or Benefits payable under this policy for any loss, other than loss is provided, will be paid immediately upon receipt of due written proof of such loss. Subject to due written proof of loss, all accrued Indemnity or Benefit for loss for which periodic payment is provided will be paid monthly and balance remaining unpaid upon the liability will be paid immediately upon receipt of due written proof.
- Currency : If the claim under this Policy shall be performed in a foreign currency the payment shall made by using the selling rate of Bank Indonesia at the time of payment.
- Physical Examination and Autopsy : The Insurer at its own expense shall have the right and opportunity to examine the Insured Person when and as often as it may reasonably require during the tendency of a claim under Section 1 (Personal Accident) of this policy and to request an autopsy report in the case of Death where it is not forbidden by law.
- Legal Action : No action at law or in equity by Insured shall be brought to recover under this policy prior to the expiration of 60 (sixty) days after written proof of loss has been furnished in accordance with the requirements of the policy. No such action shall be brought after the expiration of 180 (one hundred eighty) days after the time written proof of loss is required to be furnished.
- To whom Indemnity or Benefit is payable : Indemnity or Benefit in the event of Death is payable to the Estate of the Insured Person. All other Indemnity or Benefit due under this Policy incurred directly by the Insured Person shall be payable to the Insured Person.
- One way trips : This Policy is extended to cover one-way trips, with policy notes end at the Insured up at the airport which is the final destination.Transits in other countries are allowed provided that the Insured Person is confined to the transit area of the airports in these countries.
- Rights of Recovery : In the event authorization of payment and/ or payment is made by the Insurer or GAH or an authorized representative of GAH for a medical claim not covered by this policy, the Insurer or GAH or an authorized representative of GAH reserves the right to recover against the Insured Person for the full sum which the Insurer or GAH or an authorized representative of GAH is liable to the medical institution which the Insured Person was admitted to.
- Compliance with Policy Provisions : Failure to comply with any of the provisions contained in this policy shall give the Insurer the right to reject a claim or to invalidate all claims here under.
- Fit to Travel : At inception of this policy of insurance, the Insured Person must be fit to travel and not be aware of any circumstances which could lead to cancellation or disruption of the journey, otherwise any claim could be jeopardized.
- Premium Payment Method : Payment of premiums uses a currency Indonesian Rupiah (IDR) and payments made by way of transfer to the account of PT. Asuransi Simas Insurtech. Policy is considered paid when payment has been received in the bank account of PT. Asuransi Simas Insurtech.
- Grace Period : Premium shall be paid in full after the Policy issuance. Grace Period for premium payment shall not applicable to this Policy.
- No Refund : The Insurer will not allow any refund of premium once the Policy has been issued.
- Law and Jurisdiction : This Policy shall be interpreted in accordance with the laws and jurisdiction of Indonesia.
- Defence : The Insurer has the right but not the duty to commence or take over any legal proceedings to defend the Insured Person provided The Insurer chooses to do so and to take any action to recover any payment made under this Policy. The Insured Person must co-operate with The Insurer to this end and do nothing to prejudice The Insurer’s position or make statements to anyone without written approval of the Insurer.
- No Admission of Liability : The Insured Person must not take any offer or promise to pay or admit his/her fault to any other party, or become involved in any litigation without the Insurer’s written approval.
- Other Insurance : In the event of other insurance being available this insurance policy shall only pay in excess of Sums Insured and Policy Limits of said other insurance.
- Extension of Time : This Policy may not be renewed. However, if due to a condition that is beyond the ability of the insured, the trip is extended beyond the period of insurance, the Insurer may extend the coverage period for a fee based on the period of insurance for which the maximum travel time is 90 (ninety) days and at the time of filing Insured was not filed claims.
- Governing Language : This Policy shall be in the language of English and Bahasa Indonesia. In the event of different interpretation between the both wording, The Bahasa Indonesia’s wording will be prevail by the Insurer and the Insured.
- Governing Law : This Policy shall be governed by and interpreted in accordance with Indonesia Law.
- Responsibility of Insurer : Unless under the benefit Loss of Deposit or Cancellation and Follow up Treatment, the Insurer's liability for all benefit covered in this policy shall begin since the effective date of this Policy up to the end of the policy period.
- In the event of a dispute arising between the Insurer and the Insured as a result of the interpretation of the responsibility or magnitude of the indemnity of this Policy, the dispute shall be settled through a peace forum or deliberation by the Insurer's internal unit which handles the Service and Complaints Solution for the Customer. The dispute arose since the Insured stated in writing disagreement over the disputed matter. Settlement of disputes through peace or deliberation shall be made within a period of no more than 60 (sixty) calendar days since the inception of the dispute.
- If dispute settlement through deliberation in paragraph 1 does not reach an agreement, then the disagreement must be stated in writing by the Insurer and the Insured. Furthermore, the Insured may choose the settlement of dispute outside court or through court by choosing one of the clause of dispute settlement as set out below.
- 2.1. ALTERNATIVE AGENCIES OF SETTLEMENT SETTLEMENT (LAPS)
It is hereby declared and agreed that the Insured and the Insurer will settle the dispute through the Indonesian Mediation and Arbitration Board (BMAI) in accordance with the Rules and Procedures of BMAI or through another Alternative Dispute Settlement Alternative Institution registered with the Financial Services Authority.
- 2.2. COURT
It is hereby declared and agreed that the Insured and the Insurer will settle the dispute through the District Court in the territory of the Republic of Indonesia.
TERROSISM EXCLUSIONS CLAUSE (NMA 2920-08/10/2001)
Notwithstanding any provision to the contrary within this insurance or any endorsement thereto it is agreed that this insurance excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any act of terrorism regardless of any other cause or event contributing concurrently or in any other sequence to the loss.
For the purpose of this clause an act of terrorism means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organization(s) or government(s), committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear.
This clause also excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to any act of terrorism.
If the Underwriters allege that by reason of this exclusion, any loss, damage, cost or expense is not covered by this insurance the burden of proving the contrary shall be upon the Assured. In the event any portion of this clause is found to be invalid or unenforceable, the remainder shall remain in full force and effect.