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Terms of Service
Please review the following terms and indicate your agreement below
The terms and condition here in apply to the provisions of membership facility by "Accident Relief Care" (ARC) Definitions 1 a. "Applicant means a person who sign an application form seeking Membership of ARC b. A unique ID number as per the provision of clause 3 below. c. "ARC" means Accident Relief Care. Membership : 2 Every applicant will be enrolled as a ARC member only after the application is found complete & eligible for processing. 3 On enrollment, every member will be allotted a unique ID number; ARC will then issue to the member an ID card containing member name, blood group and contact number. 4 The member are advised always to carry the ID card with them so as enable prompt identification at all times, this is important for ARC to provide emergency medical help to the member in the event of an accident. 5 The ID Card will carry the date until which the card is valid and the member would be entitled to avail the benefits of the membership only till such date. 6 If a card / Certificate is lost or stolen of disfigured, the member shall intimate ARC immediately of the same in writing. A duplicate Card / Certificate shall be issued by ARC on payment of a nominal service charge of Rs.50/-. 7 Membership fee is not transferable and non-refundable. 8 On cash payment the coverage begins after seven working days. (excluding Sat, Sun & Govt. holidays) On cheque payment the coverage begins after 7 working days from the of realization of cheque (excluding Sat, Sun & Govt. holidays). 9 The member shall give immediate notice to the company of any charge in his / her address or Occupation, Name phone No, Blood group etc, in writing to ARC. 10 In case the card is misused, the person will be prosecuted under the court of law. 11 Original bills have to be submitted to ARC for all claim settlements. 12 Any person who is suffering from physical defect / infirmity and or mentally disabled / physically challenged / deformed / hearing / speech / visually impaired or any others such significant aliments / medical condition are excluded from scope of Insurance cover. Insurance Facility : 13 Incase of non-cashless facility, ARC will reimburse for all the claims only up to the amount by the insurance company. 14 Insurance company and ARC reserve the right / final decision for all claim settlements. 15 ARC has entered into an agreement with New india Assurance co Ltd Co, Ltd under which every member shall be covered by medical for Hospitalization expenses following accident up to the limit prescribed below. Special Coverage. A. Individual Person: a) Sum insured for death due to Accident Rs.1,00,000/- b) Hoslitalization Expenses incluse of OPD expenses for treatment of injuries in an sustained in an Accident : Maximum Rs.1,00,000/- per accident. However , the OPD expenses is restricted to Rs.10,000/- only. the OPD Expenses and Hospitalization Expenses are subjected to an excess of Rs.500/- for each and every claim. Family Coverage: a) Sum insured for death due to accident Rs.2,00,000/- for entire insured family on floater basic with an inner of Rs.100,000/- per Family Member. Howeve, the OPC expenses is restricted to Rs.10,000/-only per person and Rs.20,000/- for the entire family on floater basis. The OPD Expenses and Hospitalization Expenses are subjected to an excess of Rs.500/- for each and every claim. Conditions: 1. FIR / ID proof to be produced whenever required. 2. The term Hospitalization Expenses / OPD Expenses shall not include Registration Charge, Medico Legal Cases Fees, television charge, Telephone charge, food and Refreshment to visitors. Removal of implants and any expenses incurred after the discharge from the hospital, documentation / Record charge / Expenses incurred for Treatment and management of any existing injuries, aliments or illness prior to the accident. 3. In the event of the attending surgeon / medical practitioner substantiating necessity of procedure. The treatment taken in such event shall be reckoned as one accident only. 4. All the claims in respect of Hospitalization Expenses / OPD expenses are reimbursable as per the scheduled rates mutually by Accident Relief Care with the empanelled Hospitals. The insured member shall ascertain the list of empanelled hospitals and details of scheduled as per the scheduled rates mutually agreed by Accident Relief Care with the empanelled Hospitals. The insured member shall ascertain the list of empanelled hospitals and details of scheduled charges from Accident Relief Care. In respect of occurred Bangalore and treatment obtained in any Hospital outside Bangalore, the claims in respect of such accident shall also be Scheduled Charges. 5. ARC should be informed within 48 hours of an accident. 6. This risk covers towards medical expenses reimbursement only. If treated by an allopathic Doctors with qualification of MBBS and Registered with medical council. 7. Cashless facility is not compulsory. Cashless facility can be defined in case of incomplete information / improper support of documentation. However, denial of 8. If any bills and receipts are not supported by valid document the claimed amount of the bills would be disallowed. 9. ARC card issued to your is not a Credit Card, just complimentary to your policy. Definition Accident: The accident should be unexpected, un-designed and unlocked for mishap or untoward event which is not expected or designed. Accident injury : Bodily injury resulting solely and directly from an Accident caused by external violent means and excludes nervous disturbance, shock grail etc.External & visible Bodily injury due to some outside event which is Cleary visible. Hospital / Nursing Home : Which means any institution in India established for indoor care an Treatment of Sickness and injuries and which has been registered as a hospital or nursing home with the local Authorities. OPD Expenses : The expenses necessarily incurred for treatment of accidental injuries in a OPD Department of Hospital / Nursing Home. Hospital Expenses : The expenses necessarily incurred for treatment of accidental injuries as an Inpatient in a hospital / Nursing Home from the of admission till the date of discharges subject to minimum period stay of 24 hours. Provision : Provided that all sums payable hereunder shall be payable. I. In case of death only after deleting by an Endorsement, the name of insured person in respect of whom such shall become payable with out any refund of premium. II. The policy shall be subject to automatic reinstatement of sum insured to the extent of the claims paid in respect of the hospitalization expenses claims. The insurer shall be entitled to deduct the reinstatement premium for the period from the date of accident till the expiry of the policy from the claim amount on prorate basic subject to minimum of Rs.50/- from each and every claim. The reinstatement Sum insured will, however, be applicable only to the subsequent accidents occurring before the expiry of the policy coverage. Exclusion : 1. Intentional self injury, attempted suicide, homicide, war Nuclear invasion, racing on wheels or horse back, big game hunting, mountaineering, winter sports, skilling or ice hockey ballooning or poloparagliding skydiving and similar sport of hazardous nature. 2. The primary cause of injury being under the influence of intoxication liquor or drugs 3. Cosmetic Surgery, Cosmetic fitting, Physiotherapy and Dental treatment charges( Crow fitment RCT etc) 4. Follow up to the Accident after discharge from the Hospital i.e., Re-admission / second admission for the same injury. 5. Removal of an implant prior to insurance for any previous accident will not be paid. 6. In the event of major accident, follow up treatment charges will not be paid to the patient. 7. Pregnancy and miscarriage. 8. Expenses incurred other than accident nature that is [Expenses incurred towards General aliment like DM, HT, Fever, Asthma any chronic illness etc] will not be reimbursed. 9. Treatment charge toward Chronic Degenerative diseases and Development anomalies not payable. 10. The discharge given by Accident Relief Care on behalf of the insured shall be full and final. 11. Medical Expenses for general illness. 12. Homeopathy / Naturopathy / Ayurvedic treatments 13. Claims : Accident to be intimated to ARC with 48 hrs including out station Accident. All the expenses incurred towards Out-Patient treatment will reimbursed only up to 30 days from the date of accident. All the claims should be submitted to ARC with 60 days of the accident. Letter from Employer for industrial accident, FIR required in case where the injuries are grievous in nature. Outstation accident Victims (member) brought to Bnagalore will not be provided with cashless Hospitalisation, however the medical bills will be reimbursed after necessary documents are submitted /Produced, Restricted to schedules charges. I declare that the information provided by the herein above is true and correct to the best of my knowledge. I desire to apply for a membership as per the terms and condition mentioned overleaf. I have read and understood the same and abide by them.
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