R8LIANce

General Insurance
Reliance Autoloan Care Insurance Policy

Preamble

WHEREAS the Insured / Insured Person designated in the Schedule to this Reliance Autoloan Care
Insurance Policy having by a proposal and declaration together with any statement, report or other
document which shall be t he basis of the contract and shaii be deemed to be incor porated her ein, has
applied to Reliance General Insurance Company Limited (hereinafter called "the Company") fo r the
insurance hereinafter set forth and paid appropriate premium for the number of days stated in the
Schedule.
NOW THIS POLICY WITNESSETH that subject to the definitions, terms, conditions and exclusions
contained, endorsed or otherwise expressed herein, the Company shall compensate, indemnify, pay and/or
reimburse the Insured / Insured Person or his/her legal representatives, as the case may be, in respect of
insured events occurring during the period of insurance, in the manner and to the extent set forth in this
Policy.

Definitions
"Accident(al)" is a sudden, unfores ee n and involuntary e vent caused by external, visibl e
& violent means.
"Auto Loan EMI" means the equated monthly instalment payable by the Insured to the financial institution
for the auto loan.
"Illness" means a sickness or a disease or pathological condit ion leading to the impairment of normal
physiological function which manifests itself during the Policy Period and requires medical treatment.
"Injury" means accidental physical bodily harm excluding illness or disease solely and directly caused by
external, violent and visible and evident means which is verified and certified by a medical practitioner.
"Insurable/Insured event" means an event, loss or damage for which the Insured is entitled to benefit/s
under this Policy
"Insurer" means Company i.e., Reliance General Insurance Co. Ltd.
"Insured Person/Insured" means the person specifically named as such in the Schedule, who has a
permanent place of residence in India and for whom the insurance is proposed and the appropriate
premium paid.
"Medical Practitioner" is a person who holds a valid registration from the Medical Council of any state or
Medical Council of India and is thereby entitled to practice medicine within its jurisdiction; and is acting
within the scope and jurisdiction of his license and should not be the policy holder/ insured or close family
member of the policyholder/ insured.

Reliance General Insurance Company Limited. An ISO 9001 :2008

Registered Office: 19, Reliance Centre, Walchand Hirachand Marg, Ballard Estate, Mumbai 40000 1. Certified Company
Corporate Office: 570, Rectifier House, Naigaum Cross Road, Next to Royal Industrial Estate, Wadala (W), Mumbai 40003 I.
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"Outstanding .Auto loan" me3ns the ;1mount outstanding on any given day to a financial instjtuliou of the
principal auto loan and interest thereon payable by the Insured.
"Permanent Total Disability" shall mean an injury which shall within twelve calendar months of its
occurrence be the sole and direct cause of the total and irrecoverable loss of:
• sight of both eyes, or of the actual loss by physical separation of two entire hands or two entire
feet, or of one entire hand and one entire foot, or of such loss of sight of one eye and such loss of
one entire hand or one entire foot,

• use of two hands or two feet, or of one hand and one foot, or of such loss of sight of one eye and
such loss of use of one hand or one foot.
"Policy" is the Company's contract of insurance with the policyholder providing cover as detailed in this
Policy Terms & conditions, the Proposal Form, Policy Schedule ,Endorsements, if any and Annexures, which
form part of the contract and must be read together.
"Policy period" means the period between the start date and the e nd date as specified in the Schedule or
the cancellation of this policy, whichever is earlier.
"Pre-existing disease" means any condition, illness or injury or related condition(s) for which the
Insured/Insured person had signs or symptoms and/or were diagnosed and/or received medical advice/
treatment, within 48 months prior to the first policy under which the Insured Person was covered with us.
"Schedule" means the document attached name so and to and the forming part of this Policy mentioning
the details of the Insured/ Insured Person/s, the Sum Insured, the period and the limits to which benefits
under the Policy are subject to..
"Sum Insured" means the sum as specified in the schedule, which sum represents the Company's maximum
liability for any or all claims under this Policy during the Policy period.
"Standard type of aircraft" means any aircraft duly licensed to carry passengers (for hire or otherwise) by
an appropriate authority irrespective of whether such an aircraft is privately owned o r chartered or
operated by a regular airline or whether such an aircraft has a single engine or multiengine.

Scope of Coverage

Section A - Accidental Death & Permanent Total Disability

1. What is covered
This Section covers the Insured/Insured person up to the Sum Insured specified in the Schedule, against
default in payment of his / her auto loan EM!s on account of injury sustained during the Policy Period
r esulting in death or permanent total disablement, as the case may be, of the Insured within 12 (twelve)
calendar months of occurrence of such injury.

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Additionally, this Section also provides for reimbursement, in the event of the dea th of the Insured /Insured
Person due to i njury o utside his/her home, of the expenses incurred for transportation of lnsu red's dead
ody to his/her place of residence subject to a maximum ofRs 2,500/- for the entir e Policy period.
In case of loans being under joint names of two persons, for each of the borrowers, the Sum Insured for the
purpose of claim under this Section, shall be 50% of the total Sum Insured opted by the Insured and
mentioned in the Schedule. Similarly in case of loans w ith more than two persons as joint borrowers, the
Sum Insured of the o utstanding loan amount will be divided amongst all of them in equal proportion of the
Sum Insured, subject otherwise to t erms conditions of the Policy.
The maximum liability of the Company shall in no case exceed the Sum Insured as mentioned in the
Schedule.

2. Basis of settlement

Subject to the Sum Insured specified in the Schedule, coverage under this Section shall be as follows:

% of Sum
Nature of Disablement
Insured

1. Death 100%
2. Total and irrecoverable loss of
i) Sight of both eyes or of the actual loss by physical separation of the two 100%
entire hands or two entire feet or one entire hand and one entire foot or of
such loss of sight of one eye and such loss of one entire hand or one entire foot

ii) Use of two hands or of two feet or of one hand and one foot or of such loss 100%
of sight of one eye and such loss of use of one hand or one foot.

For the purpose of items 2 i & ii above, physical separation of one e ntire hand shall mean
separation at or above wrist and/ or of the foot at or above ankle, respectively.

4. Permanent total and absolute disablement disabling the Insured from 100%
engaging in any employment or occupation of any description whatsoever.

The disablement/ death must occur w ithin one year of the accident.
The disablement must be confirmed and claimed for prior to the expiry of a period of 3 months since
occurrence of the disablement

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The Sum Insured un der t his Section is limited to the a 1.1Lo luau amount availed of by the insured on the date
of the claim. plus interest to accrue thereon. Where the Policy is taken after payment of one or more EMis
of the auto loan, the Sum Insured shall be limited to the principal auto loan outstanding as on the date of
taking the Policy plus interest to accrue thereon. Pre-closure charges, if any, payable to the financia l
institution concerned due to foreclosure of the loan will also be covered under the Policy.
In the event the outstanding auto loan amount of the Insured, inclusive of interest, if any, as on the date of
diagnosis is less than the Sum Insured, the outstanding auto loan amount inclusive of interest, if any, as on
date of diagnosis will be paid to the financial institution concerned and the balance of the Sum Insured, if
any, will b e paid to the Insured or his/ her legal representatives, as the case may be.

3. Wha t is not covered

The Company shall not be liable under this Section for:
1. Any pre-existing disability/ accidental injury.
2. Accidental death or permanent disability due to mental disorders or disturbances of consciousness,
strokes, fits or convulsions which affect the entire body and pathological d isturbances caused by the
mental reaction to the same.
3. Accidental death or permanent disability caused by cur ative measures, radiation, infection, poisoning
except where these arise from an accident.
4. Any other claim after a claim for death due to accidental injury has been admitted by t he Company and
becomes payable.
5. Any payment in case of more than one claim under the Policy during any one period of insurance by
which the maximum liability of the Company in that period exceeds the available sum payable.
6. Death or permanent disability resulting, directly or indirectly, caused by, contributed to or aggravated
or prolonged by child birth or from pregnancy or in consequence thereof.
7. Any claim in respect ofaccidental death or permanent disablement of the Insured
i. from intentional self-injury, suicide or attempted suicide
ii. whilst under the influence of liquor or drugs or other intoxicants
iii. whilst engaging in aviation or ballooning whilst mounting into, dismounting from or traveling in
any aircraft or balloon other than as a passenger (fare paying or otherwise) in any duly licensed
standard type of aircraft anywhere in the world
iv. directly or indirectly, caused by venereal disease, AIDS or insanity
v. arising or resulting from the Insured committing any breach of !aw or participating in an actual
or attempted felony, riot, crime, misdemeanor or civil commotion
vi. whilst engaging in racing, hunting, mountaineering, ice hockey, winter sports.

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8. Any consequential loss or damage cost or expense of whatsoever nature.

9. Death or permanent disablement due to accidental injury arising out of or directly or indirectly
connected with or traceable to war, invasion, act of foreign enemy, hostilities (whether war be declared
or not), civil war, rebellion, revolution, insurrection, mutiny, military or usurped power, seizure,
c<1pt11re, arrests, restraints and detainments of all Kings, Princes and people of whatsoever nation,
condition or quality.
10. Death or permanent disablement due to accidental injury, directly or indirectly, caused by or
contributed to by or arising from -
i. ionizing radiation or contamination by radioactivity from any nuclear fuel or from any nuclear
waste or from the combustion of nuclear fuel and for the purposes hereof, combustion shall
include any self-sustaining process of nuclear fission;
ii. nuclear weapons material.
11. Insured whilst engaging in speed contest or racing of any kind (other than on foot), bungee jumping,
parasailing, ballooning, parachuting, skydiving, paragliding, hang gliding,
mountain or rock climbing necessitating the use of guides or ropes, potholing, abseiling, deep sea
diving using hard helmet and breathing apparatus, polo, snow and ice sports.
12. Insured whilst flying or taking part in aerial activities (including cabin crew) except as a fare-paying
passenger in a regular Scheduled airline or air charter company.
4. Special Condition
Jn the event of permanent disablement, the Insured will be under obligation to:
a. Have himself/herself examined by the Panel Doctors appointed by the Company and the Company
will pay the costs involved thereof.
b. Authorize doctors providing treatment or giving expert opinion and any other authority to supply
the Company any information that may be required on the condition of the Insured.
If the above obligation is not met with due to whatsoever reason, the Company shall be relieved of its
liability to compensate under this benefit.
Section B - Critical Illnesses
1. What is covered
This Section covers the Insured up to the Sum Insured specified in the Schedule, against default in payment
of his/ her auto loan EM!s on being diagnosed as contracting any of the critical illnesses as defined below
and surviving for more than 30 days post such diagnosis, at any time during the Policy period.
The Sum Insured under this Section is limited to the auto loan amount availed of by the Insured plus
interest to accrue thereon. Where the Policy is taken after payment of one or more EM Is of the auto loan,
the Sum Insured shall be limited to the principal auto loan outstanding as on the date of taking the Policy

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plus interest to ~ccruc thereon. Prc-c1osure charges, if any, payable to the financial in!ititution concerned
due to foreclosure of the loan will also be covered under the Policy.
In the event the outstanding auto loan amount of the Insured, inclusive of interest, if any, as on the date of
diagnosis is less than the Sum Insured, the outstanding auto loan amount inclusive of interest, if any, as on
date of diagnosis will be paid to the financial institution concerned and the balance of the Sum Insured, if
any, will be paid to the Insured or his/ her legal representatives, as the case may be.
Cancer of specified severity
I. A malignant tumour characterized by the uncontrolled growth & spread of malignant cells with invasion
& destruction of normal tissues. This diagnosis must be supported by histological evidence of malignancy
& confirmed by a pathologist. The term cancer includes leukemia, lymphoma and sarcoma.
II. The following are excluded -
Tumors showing the malignant changes of carcinoma in situ & tumors which are
ii histologically described as pre-malignant or non invasive, including but not limited
iii to:Carcinoma in situ of breasts, Cervical dysplasia CI N-1, Cl N-2 & CIN-3.
iv Any skin cancer other than invasive malignant melanoma
v All tumors of the prostrate unless histologically classified as having a Gleason score greater
than 6 or having progressed to a t least clinical TNM classification T2NOMO
vi Papilary Micro-carcinoma of the thyroid less than 1 cm in diameter
vii Chronic lymphocyctic leukaemia less t han RAJ stage 3
viii Microcarcinoma of the bladder
ix All tumors in t he presence of HIV infection
Open chest Coronary Artery Bypass Graft
I. The actual undergoing of open heart chest surgery for the correction of one or more coronary arteries,
w hich is/are narrowed or blocked, by coronary artery bypass graft (CABG). The diagnosis must be supported
by a coronary angiography and the realization of surgery has to be confirmed by a specialist medical
practitioner.
II. The following are excluded:
- Angioplasty and/or any other intra-arterial procedures
- Any key-hole or laser surgery
Major Organ/ Bone Marrow Transplant
I. The actual undergoing of a transplant of:
(i). One of the following organs: heart, lung, liver, kidney, pancreas, that resulted from irreversible end-
stage failure of the relevant organ, or
(ii) Human bone marrow using haematopoietic stem cell. The undergoing of a transplant has to be

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confirmed by a specialist medical practitioner.

II. The following are excluded:
(i) Other stem-cell transplants
(ii) Where only islets oflangerhans are transplanted
Multiple Sclerosis With Persisting Symptoms
I. The definite occurrence of multiple sclerosis. The diagnosis must be supported by all of the following:
(i). Investigations including typical MRI and CSF findings, which unequivocally confirm the diagnosis
to be multiple sclerosis
(ii). There must be current clinical impairment of motor or sensory function, which must have
persisted for a continuous period of atleast 6 months, and
(iii). Well documented clinical history of exacerbations and remissions of said symptoms or neurological
deficits with atleast two clinically documented episodes atleast one month apart.
(iv). Other causes of neurological damage such as SLE and HIV are excluded.
Aorta Graft Surgery
The actual surgical repair of an aortic aneurysm (an abnormal bulge in the wall of the aortic blood vessel
causing the aorta to dilate or widen and the aortic valve to leak leading to bursting of arterial wall) for the
first time by a surgeon. The diagnosis to be evidenced by any two of the following:
• Computerised tomography (CT) scan
• Magnetic resonance imaging (MRI) scan
• Echocardiography (an ultrasound of the heart)
• Abdominal ultrasound (for associated abdominal aneursysms)
• Angiography (an x-ray of the blood vessels)
The benefit payment under this category shall be subject to survival of the Insured for more than 30 days
post diagnosis of the critical illness under this category.
Open Heart replacement or Repair of Heart Valves
The actual undergoing of open-heart valve surgery is to replace or repair one or more heart valves, as
a consequence of defects in, abnormalities of, or disease -affected cardiac valve(s). The diagnosis of
the valve abnormality must be supported by an echocardiography and the realization of surgery has
to be confirmed by a specialist medical practitioner. Catheter based techniques including but not
limited to, balloon valvotomy/ valvuloplasty are excluded.
Quadriplegia/Paralysis of four limbs
Total and irrecoverable loss of use of all four limbs as a result of injury or disease of the brain or spinal
cord. A specialist medical practitioner must be of the opinion that the paralysis will he permanent with no
hope of recovery and must be present for more than 3 months.

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Kid11ey Failure Requfring Regular Dialysis

I. End stage renal disease presenting as chronic irreversible failure of both kidneys to function, as a result
of which either regular renal dialysis (hemodialysis or peritoneal dialysis) is instituted or renal
transplantation is carried out. Diagnosis has to be confirmed by a specialist medical practitioner.
First Heart Attack - Of Specified Severity
I. The first occurrence of myocardial infarction which means the death of a portion of the heart muscle as a
result of inadequate blood supply to the relevant area. The diagnosis for this will be evidenced by all of
the following criteria:
(i) A history of typical clinical symptoms consistent with the diagnosis of Acute Myocardial Infarction
(for eg. Typical chest pain)
(ii) New characteristic electrocardiogram changes
(iii) Elevation of infarction specific enzymes, Troponins or other specific biochemical markers
II. The following are excluded:
(i) Non ST-segment elevation myocardial infarction (NSTEMI) with elevation ofTropon in l or T
(ii)Other acute Coronary Syndromes
(iii). Any type of angina pectoris
Stroke Resulting in Permanent Symptoms
I. Any cerebrovascular incident producing permanent neurological sequelae. This includes infarction of
brain tissue, thrombosis in an intracranial vessel, haemorrhage and embolisation from an extracranial
source. Diagnosis has to be confirmed by a specialist medical practitioner and evidenced by typical clinical
symptoms as well as typical finding in CT scan or MRI of the brain.Evidence of permanent neurological
deficit lasting at least 3 months has to be produced.
II. The following are excluded:
(i) Transient ischemic attacks (TIA) -
(ii) Traumatic injury of the brain
(iii) Vascular disease affecting only the eye or optic nerve vestibular functions
End Stage Liver Disease
End stage liver disease resulting in cirrhosis and evidenced by all of the following criteria: a) permanent
jaundice, b) ascites, c) encephalopathy, d) portal hypertension.
Liver disease secondary to alcohol or drug misuse is excluded
End Stage Lung Disease
Advanced stage emphysema or other chronic lung disease, resulting in all of the following:
o The need for regular oxygen treatment on a permanent basis.
o The permanent impairment of lung function tests as follows;

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Forced Vital Capacity (FVC) and

Forced Expiratory Volume at 1 second (FEV1) being less than 50% of normal
2. What is not covered
The Company will not be liable under this Section for any claim, directly or indirectly, caused by, based on,
arising out of or however attributable to any of the following:
1. the first time whether or not the Insured had knowledge of symptoms of having contracted any of the
critical illnesses at any time before commencement of t he Policy.
2. Any critical illness contracted by the Insured at the time of incept ion of the Policy or w ithin first three
months of inception of this Policy.
3. Diagnosis of any critical illnesses not evidenced by a certificate issued by the attending Doctor.
4. Death of the Insured before 30 days of diagnosis of the critical illness.
5. Medical Certification of contracting of critical illness by a family member or from persons not
registered as Medical Practitioners under recognized medical councils.
6. Any critical illness contracted by the Insured in performance of duties as serving member of a military
or a police force.
7. Any critica l illness contracted due to alcohol or drug abuse.
8. Any critical illness cont racted due to Ionizing radiation or contamination by radioactivity from a ny
nuclear fu el or from any nuclear waste from the combustion of nuclear fuel.
9. Any critical illness, directly or indirectly, caused by or contributed to by nuclear weapons/ materials or
radioactive contamination.
10. Any critical illness, directly or indirectly, caused by or arising out of any criminal act of the Insured.
11. Any critical illness directly or indirectly, caused by or arising from or attributable to foreign invasion,
act of foreign enemies, hostilities (whethe r war be declared or not), civil war, rebellion, revolution,
insurrection, military or usurped power, riot or civil commotion, act of terrorism.
12. Any critical illness, directly or indirectly, arising whilst the Insured being engaged in speed contest or
racing of any kind (other than on foot), bungee jumping, parasailing, ballooning, parachuting, skydiving,
paragliding, hang gliding, mountain or rock climbing necessitating the use of guides or ropes, potholing,
abseiling, deep sea diving using hard helmet and breathing apparatus, polo, snow and ice sports.
13 Any critical illness, directly or indirectly, arising whilst the Insured is flying or taking part in aerial
activities (including cabin crew) exce pt as a fare-paying passenger in a regular Scheduled airline or
air charter company
Section C - Loss of employment
1. What is covered
This Sect ion covers the Insured up to the Sum Insured specified in the Schedule against defa ult in payment

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of his/ her auto loan IU"1ls due to loss of en1ployn1ent on account of:
a. Termination of the Insured from employment on account of closure of the firm / body corporate /
establishment wherein the Insured is employed, due to poor financia l health or any merger/acquisition
of the firm / body corporate / establishment leading to the termination, dismissal or retrenchment of
the Insured.
b. Termination or dismissal, lay off, temporary suspension or retrenchment of the Insured from the
employment imposed on him/her by the firm/ body corporate/ establishment in compliance with any
law relating to this employment for the time being in force or any directives by any Public Authority.
c. Any ,retirement scheme of compulsory nature if the firm / body corporate / establishment is closing
down one division and a minimum of 20 employees are availing the retirement scheme.
The Sum Insured under this Section is limited to 6 auto loan EMis or the outstanding auto loan amount,
whichever is lower, at the time of claim.
2. What i s not covered:
The Company shall not be liable under this Section for:
1. In the event of termination, dismissal, temporary suspension or retrenchment from employment of the
Insured which is being attributed to any dishonesty or fraud on the part of the Insured or his willful
violat ion of any rules of the employer or laws for the time being in force.
2. In connection with or in respect of:
a. Self employed persons
b. Any claim relating to unemployment in respect of a job which is casual, temporary, seasonal or
contractual in nature or any claim relating to an employee not on the direct rolls of the employer.
c. Unemployment at the time of inception of the period of insurance or arising within first three
months of inception of the period of Insurance.
3. Termination, dismissal, temporary suspension or retrenchment from employment of the Insured which
does not commence during the period of insurance.
4. Termination, dismissal, temporary suspension or retrenchment from employment of the Insured which
is less than a period of thirty (30) days at a stretch.
5. Termination, dismissal, temporary suspension or retrenchment from employment of the Insured which
is attributed to poor performance of the Insured.
6. Termination, dismissal, temporary suspension or retrenchment from employment of the Ins ured
where insured was aware of the circumstance leading to such termination, dismissal, temporary
suspension or retrenchment beforehand at the time proposing for this insurance.
7. Unemployment of the Insured that is purely voluntary.
8. Resignation, Superannuation, early retirement of the Insured.

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3. Special Condition
Eligibility for claim under this Section:
• The Insured shall be out of his cur rent job on account of the reasons ment ioned herein above and
shall be out of any job at least for thirty days consecutively from the time of losing his/ her current
job.
• The benefit under this Section will stop once he/ she gets another job.
Section D - Child Care Allowance
What is covered
This Section provides for payment of allowance to the dependant child(ren) of the Insured up to the limits
of the Sum Insured as specified in the Schedule, in the event of death or permanent total disablement of the
Insured, due to accidental injury for which there is a valid claim under Section A of this Policy.
The allowance will be payable to the dependant children of the Insured (limited to a maximum of two
children below the age of 21 years) towards their educational expenses, provided that the children are
pursuing their education at the time of claim under this Section.
The Sum Insured is subject to a limit of 2% of the outstanding auto loan at the commencement of this
Policy.
All the exclusions applicable to Section A of this Policy above, shall apply to this Section also.

, Genera I Exclusions

Any default due to any event not provided under Sections A to C and E above shall be specifically excluded
from the cover granted by this Policy.
General Conditions
1. Duty of Disclosure
The Policy shall be void and all premium paid hereon shall be forfeited to the Company, in the event of
misreprese ntation, mis-description or non-disclosure of any material fact. In the event of untrue or
incorrect statements, misrepresentation, mis-description or non-disclosure of any material particulars
in the proposal form, personal statement, declaration and connected documents, or any material
information having been withheld, or a Claim being fraudulent or any fraudulent means or device being
used by the Policyholder/ Insured Person or any one acting on his/ their behalf to obtain a benefit
under t his Policy, the Compa ny may cancel this Policy at its sole discretion and the premium paid shall
be forfeited in its favor.
2. Observance of terms and conditions

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The due observance and fu:fi llment of the Policy Tenns & Com.liliun:; and Endorsements of this Poiicy
in so far as they relate to anything to be done or complied with by the Policyholder/ Insured Person,
shall be a condition precedent to any of the Company's liability to make any payment under this Policy.
3. Reas onable Care
The Policyholder/ Insured Person shall take all reasonable steps to safeguard the interests against any
Illness/ Injury that may give rise to a Claim.
4. Mate rial change
The Policyholder shall immediately notify the Company in writing of any material change in the risk
on account of change in occupation/ business at his own expense and the Company may adjust
the scope of cover and/ or premium, if necessary, accordingly
5. Records to be maintained
The Policyholder/ Insured Person shall keep an accurate record containing all relevant medical records
and shall allow the Company or its representative(s) to inspect such records. The Policyholder/
Insured Person shall furnish such information as the Company may require under this Policy at any
time during the Policy Period and up to three years after the policy expiration, or until final adjustment
(if any) and resolution of all Claims under this Policy.
6. No Constructive Notice
Any knowledge or information of any circumstance or condition in relation to the Policyholder/
Insured Person which is in possession of the Company and not specifically informed by the
Policyholder / Insured Person shall not be held to bind or prejudicially affect the Company
notwithstanding subsequent acceptance of any premium.
7. Complete discharge
Payment made by the Company to the Policyholder/ adult Insured Person or the Nominee of the
Policyholder or the legal representative of the Policyholder or to the Hospital, as the case may be,
of any Medical Expenses or compensation or benefit under the Policy shall in all cases be complete
and construe as an e ffectual discharge in favor of the Company.
8. Special Provisions
Any special provisions subject to which this Policy has been entered into and endorsed in the Policy or
in any separate instrument shall be deemed to be part of this Policy and shall have effect accordingly.
9. Electronic Transactions
The Policyholder/ Insured Person agrees to adhere to and comply with all such terms and conditions as
the Company may prescribe from time to time, and hereby agrees and confirms that all transactions
effected by or through facilities for conducting remote transactions including the Internet, World Wide
Web, electronic data interchange, call centers, t ele-service operations (whether voice, video, data or

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combination thereof) or by means of electronic, computer, automated machines network or through

other means of telecommunication, established by or on behalf of the Company, for and in respect of
the Policy or its terms, or the Company'sother products and services, shall constitute legally binding
and valid transactions when done in adherence to and in compliance with the Company's terms and
mnditions for such facilities. as may be prescribed from time to time.
10. Duties of the Insured on occurrence ofloss
On the occurrence of any loss, within the scope of this Policy the Insured shall:
a) Forthwith file/submit a Claim Form together with the auto loan particulars
b) Allow the Medical Practitioner or TPA appointed by the Company to inspect the medical
records and to examine the Insured.
c) Assist and not hinder or prevent the Company or any of its agents in pursuance of their duties.
If the Insured does not comply with the provisions of this Condition, all benefits under this Policy shall
be forfeited, at the option of the Company.
If the Insured shall sustain any bodily injury in respect of which a claim is or may be made hereunder
prompt written notice thereof shall be given to the Company as soon as possible but in any event
within fourteen days of the date of injury. If the Insured shall die, notice of death shall be given by the
nominees / legal representative(s) forthwith. All certificates, information and evidence whether from a
Medical Attendant or otherwise required by the Company shall be furnished at the expense of the
Insured or nominee or legal representatives, as the case may be, and shall be in such form and of such
nature as the Company may prescribe. The Insured must immediately after the occurrence of any
accident which may be the subject of a claim hereunder obtain medical treatment failing which the
Company will not be liable for any consequence thereof. The documents required are:
For all claims
1. Claim Form
2. Loan Statement and Confirmation of Principal Outstanding from Bank/Fl
In case of Personal Accident Death/ Disability claims
• Death Certificate ( in case ofDeath Claim)
• Disability Certificate ( in case of Disability Claim)
• Duly completed and signed Claim Form, in original
• Medical Practitioner's referral letter advising Hospitalization
• Medical Practitioner's prescription advising drugs/ diagnostic tests/ consultation
• Original bills, receipts and discharge card from the Hospital/ Medical Practitioner
• First Information Report/ Final Police Report
• Post mortem report, if available

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• Any oll11::1 uucume11l as re4uireu by the Company to assess the Ciaim.

In case of Critical Illness
a. Duly completed and signed Claim Form, in original
b. Medical Practitioner's referral letter advising Hospitalization
c. Medical Practitioner's prescription advising drugs/ diagnostic tests/ consultation
d. Original pathological/ diagnostic test reports and payment receipts
e. Indoor case papers
f. First Information Report/ Final Police Report, if applicable
g. Any other document as required by the Company to assess the Claim
In case of Loss of Employment
a. The letter of the employer terminating, dismissing or suspending the Insured from the present
job
b. Proof towards not having any employment
c. Any other document as required by the Company to assess the Claim
In case of Child Care Allowance
a. Age proof of the Dependent Children of the Insured
b. Dependency Proof/Proof towards the Dependent Children of the Insured being enrolled in any
educational institution
c. Any other document as required by the Company to assess the Claim
The Insured shall forward to the Company forthwith every written notice or information of any verbal
notice of claim and shall send to the Company any writ, summons or other legal process issued or
commenced against the Insured and shall give all necessary information and assistance to enable the
Company to settle or resist any claim or to institute proceedings. The Insured shall not incur any
expenses in making good any claim without the written consent of the Company and shall not negotiate,
pay, settle, admit or repudiate any claim without such consent.
11. Position after a claim
The benefit of claim under Section A and B together is applicable only once during the Policy Period.
Accordingly if the Insured / legal representatives report a claim under either Section A or B and the
same is acknowledged by the Company, then the Policy becomes in-operative for both these Sections
and no further claim can be reported under the Sections A or B of the Policy.
At all times during the period of this Policy the insurance cover will be ma intained to the full extent
of the respective Sum Insured in consideration of which upon the settlement of any loss under this
Policy, pro-rata premium for the unexpired period from the date of such loss to the expiry of period
of insurance for the amount of such loss shall be payable by the Insured to the Company.

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The additional premium referred above shall be deducted from the net claim amount payable under
the Policy. This continuous cover to the full extent will be available notwithstanding any previous loss
for which the Company may have paid and irrespective of the fact whether the additional premium as
mentioned above has been actually paid or not following such loss. The intention of this condition is to
ensure continuity of the cover to the Insured subject only to the right of the Company for deduction
from the claim amount, when settled, of pro-rata premium to be calculated from the date of loss till
expiry of the Policy.
Notwithstanding what is stated above, the Sum Insured shall stand reduced by the amount of loss in
case the Insured immediately on occurrence of the loss exercises his option not to reinstate the sum
insured as above.
12. Subrogation
Subrogation shall mean the right of the Company to assume the rights of the Insured
Person/Policyholder to recover expenses paid out under the Policy that may be recovered from any
other source.
The Policyholder/ Insured Person shall at his own expense do or concur in doing or permit to be done
all such acts and things that may be necessary or reasonably required by the Company for the purpose
of enforcing and/or securing any civil or criminal rights and remedies or obtaining relief or indemnity
from any other party to which the Company is/or would become entitled upon the Company paying for
a Claim under this Policy, whether such acts or things shall be or become necessary or required before
or after its payment. Neither the Policyholder nor any Insured Person shall prejudice these subrogation
rights in any manner and shall at his own expense provide the Company w ith whatever assistance or
cooperation is required to enforce such rights. Any recovery the Company makes pursuant to this
clause shall first be applied to the amounts paid or payable by the Company under this Policy and any
costs and expenses incurred by the Company of effecting a recovery, where after the Company shall pay
any balance remaining to the Policyholder. This clause shall not apply to any Benefit offered on fixed
benefit basis.
13. Contribution
Contribution is essentially the right of the Company to call upon other Insurers liable to the same
Insured to share the costs of an indemnity claim on a rateable proportion of Sum Insured.
If at the time when any Claim arises under this Policy, there is any other insurance which covers (or
would have covered but for the existence of this Policy), the same Claim (in whole or in part), t hen the
Company shall not be liable to pay or contribute more than its ratable proportion of any Claim.
This clause shall not apply to any Benefit offered on fixed benefit basis.
This provision, however, shall not be applicable to benefits under Sections A & B of the Policy.

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If a Claim is in any way found to be fraudulent, or if any false statement, or declaration is made or used
in support of such a Cla im, or if any fraudulent means or devices are used by the Policyholder/ Insured
Person or anyone acting on his/ their behalf to obtain any benefit under this Policy, then this Policy
shall be void and all claims being processed shall be forfeited for all Insured Persons and all sums paid
under this Policy shall be repaid to the Company by the Policyholder/ all Insured Persons who shall be
jointly liable for such repayment.
15. Feature of Claims
If a claim is made and rejected and no Court action or suit is commenced within twelve months after
such rejection or, in case of arbitration taking place as provided therein, within twelve (12) calendar
months after the Arbitrator or Arbitrators have made their award, all benefits under this Policy shall be
forfeited.
16. Cancellation/ Termination
The Company may at any time, cancel this Policy, by giving 7 days notice in writing by Registered Post
Acknowledgment Due to the Insured at his / her last known address in which case t he Company shall
be liable to repay on demand a rateable proportion of the premium for the unexpired term from the
date of the cancellation. The Insured may a lso give 7 days notice in writing, to the Company, for the
cancellation of this Policy, in which case the Company shall from the date of receipt of notice cancel the
Policy and retain the premium for the period this Policy has been in force at the Company's short period
scales.
Table of Short Period Scales
Period of Risk Premium to be retained
(Not exceeding) (% of Premium amount)
1 year 50%
2 year 75%
3 year 100%

17. Cause of Action / Currency for Payment

Claims shall be payable under this Policy only if the cause of action arises in India.
All claims shall be payable in India and in Indian Rupees only.
18. Policy Disputes
Any and all disputes or differences under or in relation to validity, construction, interpretation and
effect to this Policy shall be determined by the Indian Courts and subject to India n law.

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19. Arbitration clause

If any dispute or difference shall arise as to the quantum to be paid under this Policy (liability being
otherwise admitted) such difference shall independently of a ll other questions be referred to the
decision of a sole arbitrator to be appointed in writing by the parties thereto or if they cannot agree
upon a single ;cirhitrator within 30 days of any party invoking arbitration, the same shall be referred to a
panel of three arbitrators, comprising of two arbitrators, one to be appointed by each of the parties to
the dispute/difference and the third arbitrator to be appointed by such two arbitrators and arbitration
shall be conducted under and in accordance with the provisions of the Arbitration and Conciliation
Act,1996.
It is clearly agreed and understood that no difference or dispute shall be referable to arbitration, as
hereinbefore provided, if the Company has disputed or not accepted liability under or in respect of this
Policy.
It is hereby expressly stipulated and declared that it shall be a condition precedent to any right of action
or suit upon this Policy that the award by such arbitrator/arbitrators of the amount of the loss or
damage shall be first obtained.
20. Renewal Notice
a. This Policy will automatically terminate at the end of the Policy Period. All renewal applications
should reach the Company before the end of the Policy Period.
b. Every renewal premium (which shall be paid and accepted in respect of this Policy) shall be so paid
and accepted upon the distinct understanding that no alteration has taken place in the facts
contained in the proposal or declaration herein prior mentioned and that nothing is known to the
Policyholder/ Insured Person(s) that may result in enhancing the Company's risk
c. This Policy may be renewed by mutual consent and in such event the renewal premium shall be
paid to the Company on or before the date of expiry of this Policy and in any case not later than the
expiry of the Grace Period.
Grace period refers to a period of 30 days immediately following the premium due date during
which a payment can be made to renew this Policy without Joss of continuity benefits such as
Waiting Periods and coverage of Pre-existing Disease. Coverage is not available for the period for
which Premium is not received. The Company shall not be liable for any Claims incurred during
such period.
d. Ordinarily renewals will not be refused by the Company except on ground of fraud, moral hazard
or misrepresentation.
e. Renewal premium can vary subject to prior regulatory approval.

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f. This policy shall not be renewed and the lnsured shall not be eligible for any new simiiar poiicy(es)
if a claim is paid or admitted under this Policy or if there no outstanding loan for which this Policy
was issued
g. If the customer desires to continue to avail of the Critical Illness insurance benefits then he will
have the option to migrate to a suitable Critical Illness policy of the Company as per the existing
guidelines and rates applicable for that Policy with continuity benefits provided such migration
happens within 30 days of expiry of this Policy
h. Policy shall be renewed, provided there is an outstanding loan subject to no claim.
21. Notices
Any notice, direction or instruction given under this Policy shall be in writing and de livered by hand,
post, or facsimile to -
• In case of the Insured, at the address specified in the Schedule.
• In case of the Company, to the Policy issuing office/ nearest office of the Company.
22. Portability

Portability means transfer by an individual health insurance policyholder (including family cover) of the
credit gained for pre-existing conditions and time bound exclusions if he/she chooses to switch from one
Insurer to another.

If t he Policyholder/ Insured Person renew with the Company, without break, any similar individual health
insurance policy from any insurance company registered with IRDA, then the Waiting Periods as defined in
exclusions shall be reduced by the number of years of continuous coverage under such health insurance
policy with the previous insurer(s).

The Company's total liability for payment of all claims in aggregate, incurred during the Policy Period, on
account of Portability shall not exceed Sum Insured Limit for Portability with a capping upto Applicable Sub-
limit for Portability for each Insured Person as defined in Policy Schedule

The Waiting Periods as defined in Section A.3(1) & Section B.2.(1)& (2) and shall be applicable individually
for each Insured Person and Claims shall be assessed accordingly.

23. Free Look Period

The Policyholder would be given a period of 15 days (Free Look Period) from the date of receipt of the
Policy to review the entire Policy. Where the Policyholder disagrees to any of those terms or
conditions, the Policyholder has the option to return the Policy stating the reasons for his objection and
the Policyholder shall be entitled to a refund of the premium paid, provided no Claim has been incurred

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under this Policy, subject only to a deduction of the expenses incurred by the Company on medical
examination and the stamp duty charges. In cases where the risk has already commenced when the
option of returning this Policy is exercised, within the free look period, by the Policyholder, the refund
of the premium paid will also be subject to a deduction for proportionate risk premium for the period
on mvf'r. Where only part of the risk (e.g. only accidental hospitalization risk) has commenced, such
proportionate risk premium shall be calculated as commensurate with the risk covered during such
period.
This clause shall not be applicable on renewal of this Policy
24. Pre-policy Health Check up

The prospect whose medical test is conducted and for whom the company grants an insurance cover
under this policy and whose name specifically appears as Insured Person in the Schedule, the company
shall be liable to reimburse 50% of the cost of such medicals conducted at the Company's designated
centre.
25. Withdrawal/Revision/Modification of the Product

The Company reserves the right to withdraw, revise or modify this product /policy in the future.
The revision/modification may be in respect of Benefits, coverages, premiums, policy terms and
conditions &/or exclusions.
In the event of any such withdrawal of product the company will notify in advance to the policyholder
providing him the option to port to the specified existing health products of the company with
continuity benefit.
In the event of any revision or modification of the product/terms of policy/premium , the company will
notify the policyholder 3 months in advance of such changes.
26. Mid Tenn Enhancement
Mid term enhancement of Sum Insured or plans or scope of cover not permitted.
27. Payment of Interest
In the event of delay in settlement of claim beyond the period as specified by the Insurance Regulatory
& Development Authority of India (IRDA)the Company shall be liable to pay interest on demand as per
the rate as defined by !RDA
28. Customer Service
If at any time the Insured requires any clarification or assistance, the Insured can contact the Policy
issuing office of the Company. Alternatively the Insured may also contact our customer service desk at
1800-3009 or write to us a services.rgicl@rcap.co.in.

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ln respect of any disputes or difference which i"e,naiu unresoived and where the ciai m amount is not
more than Rs. 20 lakhs, the individual Insured can approach the Insurance Ombudsman set up at
different territorial locations for resolution. The details of the Insurance Ombudsman and their
jurisdiction is available in their websites www.ombudsmanindia.org/ www.gbic.co.in
29. Communication

Any communication meant for the Company must be in writing and be delivered to its address shown
in the Policy Schedule. Any communication meant for the Policyholder will be sent by the Company to
his last known address or the address as shown in the Policy Schedule.
All notifications and declarations for the Company must be in writing and sent to the address specified
in the Policy Schedule. Agents are not authorized to receive notices and declarations on the Company's
behalf.

Notice and instructions will be deemed served 10 days after posting or immediately upon receipt in
the case of hand delivery, facsimile or e-mail.
3 0. Overriding effect of Policy Schedule
In case of any inconsistency in the terms and conditions in this Policy vis-a-vis the information
contained in the Policy Schedule, the information contained in the Policy Schedule shall prevail.
31. Grievances

If the Policyholder has a grievance that the Policyholder wishes the Company to redress, the
Policyholder may contact the Company with the details of his grievance through:
Website : www.reliancegeneral.co.in
e-mail : services.rgicl@rcap.co.in
Telephone : 1800-3009
Fax : +91-22-30479650

Post/Courier : Any branch office or the correspondence address, during normal business hours
If the Policyholder is not satisfied with the Company's redressal of the Policyholder's grievance through
one of the above methods, the Policyholder may contact the Company's Head of Customer Service at:
The Grievance Cell, Reliance General Insurance Company Limited
Address: Corrospondence Unit, C-42, Pawane, T.T.C, Industrial Area, M.I.D.C, Turbhe, Navi
Mumbai, Maharas htra, INDIA 400705
If the Policyholder is not satisfied with the Company's redressal of the Policyholder's grievance through
one of the above methods, the Policyholder may approach the nearest Ins urance Ombudsman for
resolution of the grieva nce. The contact details of Ombudsman offices are mentioned below :
Areas of Addresses of the Ombudsman Telephon
Jurisdiction Offices eNo. Fax No. E-mail ID

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Gujarat and
Dadra & 2nd Floor, Shree JayshreeAmbica
Nagar Haveli Chambers, Nr. C U Shah College,
and Daman 5,Navyug Colony, Ashram Road, 079- 079- insombalhd@rediffm

and Diu AH MEDABAD-380014 27546150 27546142 ail.com

Madhya 1st Floor, 117, Zone II (Above D M 0755-
Pradesh and Motors Pvt. Ltd.), Maharana Pratap 2578100, 0755- insombmp@satyam.n
Chhattisgarh Nagar, BHOPAL-462 011 2578102 2578103 et.in
62, Forest Park, BHUBANESWAR- 0674- 0674-
0rissa 751 009. 2535220 2531607 ioobbsr@vsnl.net

Punjab,
Haryana,
Himachal
Pradesh,
jammu & S.C.O No.101,102 & 103, 2nd
Kashmir and Floor,Batra Building, Sector 17 D, 0172- 0172-

Chandigarh CHANDIGARH-160 017 2706196 2708274

Tamil Nadu
and 044-
Pondicherry Fatima Akhtar Court , 4th Floor, 24333678,
Town and 453 (Old 312) AnnaSalai, 24333668, 044- insom bu d@md4.vsnl.
Karaikal Teynampet, CHENNAl-600 018 24335284 24333664 net.in

Delhi and 2/2 A, Universal Insurance Bldg, 011- 011- insombudsmandel@n

Rajasthan Asaf Ali Road, NEW DELHI-110 002 23239611 23230858 etcracker.com

Andhra
Pradesh,
Karnataka 6-2-46, Yeturu Towers, Lane Opp.
and Yanam - a Saleem Function Palace, A C
part of Guards, Lakdi-Ka-Pool, 040- 040- insombud@hd2.vsnl.
Pondicherry HYDERABAD-500 004 55574325 23376599 net.in

Kerala, 2nd Floor, CC 27 /2603 PulinatB!dg, 0484- insuranceombudsma

Lakshadweep Opp. Cochin Shipyard, M G Road, 2373334, 0484- n kochi@hclinfinet.co
, Mahe-a part ERNAKULAM-682 015 2350959 2373336 m

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of
Pondicherry

West Bengal,
Bihar, Sikkim,
Jharkhand 033-
and Andaman Hindustan Bldg. Annexe, 4, C.R. 22124346 033-
and Nicobar Avenue, 4th Floor, Kolkata - 700 /2212433 22124341 insombudsmankolkat
Islands 072 9 a@gmail.com
0522-
Uttar Pradesh JeevanBhavan, Phase 2, 6th floor, 2201188,
and Nawal Kishore Road, Hazaratganj, 2231330, 0522- ioblko@sancharnet.i
Uttaranchal LUCKNOW-226001 2231331 2231310 n
022-
26106889,
3rd Floor, JeevanSevaAnnexe EPBX 022-
Maharashtra (above MTNL), S V Road, Santacruz 022- 26106052, ombudsman.i@hclinf
and Goa (W), Mumbai-400 054 26106889 26106980 inetcom
Assam,
Megha!aya,
Manipur,
Mizoram, 0361-
Arunachal 2413525
Pradesh, EPBX
Nagaland and Aquarius Bhaskar Nagar, R G 0361- 0361-
Tripura Baruah Road, GUWAHATI 781 021 2415430 2414051

The details of Insurance Ombudsman are available on !RDA website :www.irda.gov.in. on the website
of General Insurance Council : www.generalinsurancecouncil.org.in,the Company's website
www.reljancegeneral.co.in or from any of the Company's offices.
Address and contac"t number of Governing Body of Insurance Council -
Secretary General
Governing Body of Insurance Council
JeevanSevaAnnexe, 3rd Floor (Above MTNT)

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S. V. Road, Santacruz (W)

Mumbai - 400 054
Tel: 022-6106889
Fax:022-6106980,6106052
Email: inscoun@vsnl.ne0074

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