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Travel Claim Guide · Cashless during admission; reimbursement portion 30-60 days from final document submission post-return.

Travel insurance medical emergency

Calling the assistance helpline, cashless abroad, and the documents you bring home.

A travel-insurance medical-emergency claim is the process by which the insurer covers hospitalisation, treatment, and (where required) medical evacuation when an Indian traveller falls ill or is injured during international travel. The mechanics are materially different from a domestic health-insurance claim because every step is mediated by an 'assistance company' — a third-party medical-assistance provider whose 24x7 helpline is your single point of contact abroad. The assistance company speaks the local language, has pre-negotiated rates with network hospitals in the destination country, and can authorise cashless treatment directly with the hospital so you do not have to fund a foreign-currency bill upfront. The payout architecture has three layers. The base medical-cover layer pays the hospital bill up to the policy sum insured, typically USD 50,000 to USD 500,000 for international plans. The emergency-evacuation and repatriation layer (a separate sum, often higher than the medical layer itself) funds an air-ambulance transfer to a competent regional facility or to India when the assistance company's medical opinion judges it necessary. The repatriation-of-mortal-remains layer covers the cost of returning the body to India in the worst case. Each layer has its own sub-limits and conditions, and the assistance company is the gatekeeper for all three. This guide walks through the entire sequence: pre-departure preparation (saving the helpline number, carrying the policy certificate), at-emergency calls (local emergency services first, then the assistance helpline), the cashless-versus-reimbursement choice, the document set you bring back to India for any reimbursement portion, and the pre-existing-disease ('PED') exclusion which is the single most common reason for a medical-emergency claim being reduced or denied. The worked example used throughout is a 58-year-old Indian traveller in Bangkok suffering a cardiac event, undergoing angioplasty and a 4-day ICU stay, with the bill of about USD 14,500 (≈ ₹12 lakh) settled cashless and only the USD 250 deductible borne by the patient.

Before you start — keep these ready

  • Travel insurance policy certificate showing the international sum insured and the 24x7 assistance-helpline number
  • Photocopy of the passport (front and back pages) and a soft copy on the phone
  • List of pre-existing conditions and current medications, with prescription names and dosages
  • List of allergies, blood group, and any medical-history notes the doctor at home gave you
  • Emergency contact in India (next of kin) with their phone number written down — phones get lost or break
  • International debit / credit card with sufficient limit as backup if cashless is somehow not available

Step-by-step

  1. 1

    Save the helpline number and policy certificate before leaving India

    Before departure

    Before departure, save the insurer's 24x7 international assistance-helpline number on your phone, on a written note in your wallet, and on the phone of the family member you would call from abroad. Carry a printed copy of the policy certificate in cabin baggage; the soft copy on email is fine but unreliable when the phone battery is dead in a foreign airport. Without the helpline number and the policy reference, the assistance company cannot identify you when you call.

    • Note the WhatsApp / international-toll-free variants if the policy provides them — they work even when the local SIM cannot dial India
    • Email the policy certificate to your travelling companion's email as well
  2. 2

    Call local emergency services first in any genuine emergency

    Immediately on emergency

    If the medical situation is life-threatening — chest pain, severe injury, breathing difficulty, loss of consciousness — call the local emergency number first (911 in the US, 112 across Europe, 999 in the UK, 119 in Japan, 1669 in Thailand). Local first responders stabilise the patient and transport to the nearest competent facility, which is what your insurance policy will accept. Calling the assistance helpline first is fine for non-life-threatening situations, but never delay emergency response to navigate insurance.

  3. 3

    Call the insurer's 24x7 assistance helpline as soon as the patient is stable

    Within hours of admission

    Once the patient is being treated by local emergency responders or stabilised at a hospital, call the insurer's 24x7 international assistance helpline. State the policy number, the patient's name and date of birth, the hospital name and city, and a brief description of the condition. The assistance company opens a case file, assigns a case manager, and contacts the hospital directly to set up the cashless arrangement.

    • If you cannot speak the local language, ask the hotel front desk or a passing English-speaker to help translate the address
    • The case manager will give you a case-reference number — note it down and use it in every later call
  4. 4

    Move to a network hospital where cashless is available

    As medically advised

    The assistance company maintains a network of hospitals in major cities worldwide where cashless settlement is pre-arranged. The case manager directs you to the nearest network hospital appropriate to the medical condition, or — if no network hospital is reachable — confirms cashless setup at the nearest competent facility you are already in. For genuine emergencies stabilised at a non-network hospital, the assistance company can typically extend cashless to the treating facility on a case-by-case basis.

  5. 5

    Present the policy certificate at admission

    At admission

    At hospital admission, present the policy certificate, the case-reference number, and your passport. The hospital insurance desk co-ordinates with the assistance company to confirm cover, deductible, and pre-authorisation. Treatment proceeds on the basis of the assistance company's pre-authorisation; you sign the patient consent and admission forms but do not pay anything beyond the deductible at this stage.

    • Keep family members or hotel staff aware so they can help with translation and paperwork while the patient is being treated
    • Ask the hospital admission desk to share copies of every signed form via email — useful for any later reimbursement portion
  6. 6

    Assistance company pre-authorises and settles cashless

    Through admission

    The assistance company reviews the admission documents against your policy schedule, your declared pre-existing conditions, and the medical justification, then issues a pre-authorisation letter to the hospital for an initial amount. As treatment proceeds, the case manager extends the authorisation for additional days, an upgraded procedure, or an unexpected investigation. On discharge, the assistance company settles the bill directly with the hospital in the local currency.

  7. 7

    Pay only the deductible at discharge

    At discharge

    The patient pays only the policy deductible (typically USD 50, USD 100, or USD 250 depending on the plan) and any clearly inadmissible items at discharge. The hospital hands you a discharge summary, an itemised final bill marked 'settled by insurer', and the doctor's prescription for any continuing medication. Keep all of these — they are needed even when the cashless settlement is complete, in case any post-trip query arises.

  8. 8

    Trigger emergency evacuation only on assistance-company medical opinion

    On medical advice during admission

    Emergency-evacuation and repatriation cover (typically a high cap like USD 100,000 to USD 500,000) is triggered by the assistance company's medical opinion, not by your request. The case manager consults a network of doctors, decides whether the local facility is competent for the condition, and arranges air-ambulance transfer to a regional centre or back to India if needed. You cannot self-evacuate by booking a commercial flight and then claim the cost; the assistance-company pre-authorisation is mandatory.

  9. 9

    Collect the document set if cashless was not available (reimbursement route)

    Before leaving the destination country

    In the rare scenario where cashless was not available — a remote area, a hospital without insurer relationships, an emergency where there was no time to call — you pay the bill upfront and reimburse later. Collect: the detailed itemised bill in English (or with a notarised English translation), every doctor's prescription, all diagnostic reports, the discharge summary, every pharmacy receipt, the original boarding passes for the trip, the passport copy showing entry and exit stamps, and a completed insurer claim form.

    • If the bill is in a language other than English, get a notarised English translation before flying back — local notaries are cheaper than India-based ones
    • Pay through traceable channels (credit card or bank transfer) so the insurer can confirm payment from the card statement
  10. 10

    File the reimbursement portion within the policy window post-return

    Within 30 days of return to India

    If there is a reimbursement portion, file the claim with the insurer within the policy-specified window post-return (typically 30 days). Submit the document bundle, the policy certificate, KYC, and a cancelled cheque of the policyholder for INR credit. The insurer converts the foreign-currency bill to INR at the policy-specified exchange rate (typically the RBI reference rate on the date of incident or settlement) and credits the admissible amount.

  11. 11

    Escalate any pre-existing-disease deduction in the right order

    Within 90 days of partial settlement

    The single most common reduction in a medical-emergency claim is the 'pre-existing disease' (PED) exclusion — the insurer treats the condition as related to a pre-declared chronic illness and applies a sub-limit (often capped at USD 1,500 to USD 5,000 for emergency stabilisation only). If the deduction is incorrect — for example the cardiac event was unrelated to a declared diabetes — write to the insurer with the treating doctor's opinion. Escalate to the IRDAI 'Bima Bharosa' portal and the Insurance Ombudsman if the insurer does not revisit.

Common pitfalls

  • Do not call the insurer's helpline before calling local emergency services in a life-threatening situation — minutes matter, and insurance never overrides emergency response
  • Do not assume the assistance helpline number on your domestic health-insurance card works abroad; travel insurance has its own dedicated international helpline
  • Do not self-evacuate by booking a commercial flight back to India and expect reimbursement under the evacuation cover — the assistance company's pre-authorisation is mandatory
  • Do not understate or omit a pre-existing condition on the proposal form to lower the premium; an undisclosed PED is the single most common ground for full repudiation of a foreign hospital bill
  • Do not pay any hospital bill yourself when cashless is available — once you have paid, the insurer reimburses (which is slower) instead of settling cashless (which is direct)
  • Do not throw away foreign-currency receipts even after cashless settlement — for any disputed deductible or post-discharge medication, the receipts are the only audit trail

Frequently asked questions

Worked example: ₹12 lakh cardiac admission in Bangkok
A 58-year-old Indian traveller in Bangkok suffers a cardiac event. Local emergency services take him to a network hospital. The family calls the insurer's assistance helpline within an hour. The case manager pre-authorises treatment, the patient undergoes angioplasty and a 4-day ICU stay, and the total bill of USD 14,500 (about ₹12 lakh) is settled cashless directly. The patient pays only the USD 250 deductible at discharge.
What is an 'assistance company' and why does the helpline route through it?
An assistance company is a third-party medical-assistance provider (the insurer outsources international assistance to a specialist firm) that operates a 24x7 helpline, maintains the global hospital-network panel, employs case-manager doctors, and co-ordinates direct settlement with foreign hospitals. The model exists because no Indian insurer can practically run hospital relationships in 200 countries; the assistance company is the operational arm that makes 'cashless abroad' work.
What is the pre-existing-disease (PED) exclusion and how does it apply?
A pre-existing disease is any medical condition diagnosed or treated in the 48-60 months before the policy start date (the exact window varies by policy). Standard travel policies exclude PED treatment entirely or cap PED-related emergency stabilisation at a sub-limit (often USD 1,500-5,000). Some policies explicitly cover declared and accepted PEDs after an additional premium and waiting period; those are the ones to look for if you have a chronic condition.
What does emergency-evacuation cover actually pay for?
It funds an air-ambulance transfer (or stretcher seat on a commercial flight, or two seats reclined for a critical patient) from the destination country to a competent regional centre or back to India. Costs run USD 30,000 to USD 250,000 depending on distance and medical equipment needed. The cap on the policy is typically USD 100,000 to USD 500,000. The trigger is the assistance-company case-manager's written medical opinion that local facilities are not competent for the condition.
What if the local hospital does not accept the assistance company's authorisation?
It is rare but possible at very small or remote facilities. The assistance company's first option is to transfer the patient to a network hospital once stable. If transfer is not safe, the case manager may approve a partial direct payment, with the rest settled by reimbursement after return. In any such scenario, keep every receipt and every approval letter from the case manager — they are the audit trail.
Is COVID-19 / pandemic illness covered abroad?
Most current Indian travel policies treat COVID-19 like any other infectious illness — emergency hospitalisation, including ICU and oxygen support, is covered up to the medical sum insured, subject to standard PED rules and the policy schedule. Trip-cancellation cover for pandemic-related restrictions is more variable and depends on the specific policy wording. Read the schedule's pandemic exclusion, if any, before assuming.
Do I need to file an FIR if I am injured in an accident abroad?
For road-traffic accidents, slip-and-fall in public spaces, and any criminal injury (assault, robbery), file a report with the local police and obtain a copy of the report or a police memo. Many travel policies require police documentation as a precondition for accident-related medical cover, and the assistance company will guide you through the local procedure. For purely illness-driven hospitalisation, no police report is needed.

Further reading