Hey Jogunooru Samson Raju,
Your travel policy is ready for a take off.
Travel Details
Policy Number ACKTR86380 Policy Issue Date 23-06-2025
Travel Start Date 10-07-2025 Travel End Date 20-07-2025
Geography Covered Schengen region Visiting Country Norway
Coverages Selected Standard Medical Sum Insured $50,000 per person
Mobile Number (Primary 6309541501
Insured)
Travellers Covered
Name DOB Gender Passport Number Nominee GST
Number
Jogunooru Samson Raju 29-03- Male R2069674 Jogunooru Samson Raju Not
1988 Provided
Premium Breakup
Total Package Premium ₹499
IGST(18%) ₹90
Total Premium ₹589
When things go south, this plan
puts you back on track
You are covered for
Hospitalisation due to illness
Sum Insured Upto$50,000
If you fall sick, you can either get your medical bills reimbursed or avail cashless treatment in our
network hospitals (where we settle your bill directly with the hospital). To avail cashless treatment,
give us a missed call on:
Toll-free number (for United States):1833-813-8772
Call (for all countries, except the US):022-69635374
Please note:
1. Pre-existing diseases are not covered
2. Hospitalisation due to covid-19 is also covered
3. The coverage amount is common with other medical benefits where this condition is specified.
This does not cover treatment of any pre-existing disease
Hospitalisation due to accident
Sum Insured Upto$50,000
If you get injured, you can either get all your medical bills reimbursed or avail cashless treatment in
our network hospitals (where we settle your bill directly with the hospital). To avail cashless
treatment, give us a missed call on:
Toll-free number (for United States):1833-813-8772
Call (for all countries, except the US):022-69635374
Please note:
1. Injuries incurred during adventure sports activity like skiing, skydiving, etc. are not covered (unless
you opt for the adventure sports cover separately)
2. The coverage amount is common with other medical benefits where this condition is specified.
Missed flight
Sum Insured $150
If you miss your international flight, we will pay $150 to cover the cost of your new booking.
Please note:
1. The claim can be paid only if you book a new flight that departs within 48 hours of the scheduled
departure time of the original flight
2. Flight cancellation and rescheduling by the airline will not be covered under this benefit.
Trip cancellation
Sum Insured Upto$500
We will cover the cost of your flight cancellation charges of upto $500 if you cancel your flight due
to-
1. Hospitalisation of any of the travellers for 48 hours or more, or
2. Death of an immediate relative (within 20 days of your take off date), or
3. Any natural catastrophe.
Delay of checked-in baggage
Sum Insured $100
If your baggage is delayed for more than 3 hours, we will pay $100 to cover for your discomfort.
Please note:
1. This cover is not applicable for flights arriving in India.
Total loss of checked-in baggage
Sum Insured $500
If your airline confirms complete loss of your checked-in baggage, we will pay $500 to compensate
for your loss.
Loss of passport
Sum Insured Upto$250
If you lose your passport, we will cover the expenses incurred upto $250 to obtain a new passport
or emergency certificate.
Please note:
1. Any loss after your arrival in India will not be covered under this benefit.
Death due to accident
Sum Insured $10,000
In case of your untimely death due to any accident or injury during the trip, we will pay $10,000 to
your immediate relative or nominee.
Note:
1. The coverage amount is common with other medical benefits where this condition is specified.
Total disability
Sum Insured $10,000
We will pay $10,000 in case you are left with any permanent disabilities due to any injury during the
trip.
Note:
1. The coverage amount is common with other medical benefits where this condition is specified.
Missed connecting flight
Sum Insured Upto$500
In case you miss your connecting flight due to a delay of more than 6 hours of your original flight, we
will pay upto $500 to cover for your next booking (excluding refunds by the flight operator).
Please note:
1. This benefit is not applicable if you miss your connecting flight due to cancellation or rescheduling
of the first flight.
2. The gap between the two flights should be atleast 6 hours
Emergency evacuation
Sum Insured Upto$50,000
If, due to an extreme situation (medical condition or a catastrophe in your place of travel), you need
air/water/surface transportation to any place, your costs incurred will be reimbursed upto $50,000.
Note:
1. The coverage amount is common with other medical benefits where this condition is specified.
Travel expenses of immediate relative
Sum Insured Upto$2,500
If you are hospitalized for more than 48 hours during your travel period, we will reimburse upto
$2,500 for direct route economy class two-way tickets for your immediate relative.
Repatriation of mortal remains in case of death
Sum Insured Upto$50,000
If any injury or illness during the travel period leads to your unfortunate death, we will pay upto
$50,000 for the expenses incurred on the transportation of mortal remains.
Note:
1. The coverage amount is common with other medical benefits where this condition is specified.
If you're ever in a difficult spot (we hope not),
Acko makes it easy to raise a claim.
Get cashless treatment (if medical cover is Claim for other covers
applicable)
Login to the Acko app with your
Select this travel policy from the 'Your policies' registered mobile number and
section on your Acko app to get the list of select your travel policy from the
cashless network hospitals around you or call us ‘Your Policiesʼ section
on 18338138772 (for US) and on 022-69635374
(for other regions) In the ‘claimsʼ section of your
policy, select what you need to
We will immediately send a list of claim for, share details about what
cashless hospitals near you. happened and upload your
supporting documents
Show this policy document at the
hospital desk and proceed with Track the progress of your claim
the treatment. We will settle the directly from the Acko app
bill with the hospital directly.
This is to certify that Acko International Travel Insurance has been issued to the Proposer as mentioned in the ‘policy holder detailsʼ
section for the policy period as indicated. It is to be noted that the insurance accorded by the Policy described herein is subject to all the
terms, exclusions and conditions contained within the Policy wordings. The Policy provides for the sum insured to the insured in the
unfortunate event of having faced loss or damage by any insured perils in the coverage period. The summary of benefits of the same is
mentioned under the “You are covered for” section
For Acko General Insurance
Company Authorised Representative Signature
Consolidated Stamp Duty is paid with the Department of Stamps, Bengaluru – Karnataka
For further details, refer to the detailed policy wordings
Acko General Insurance Limited
Somasandra Palya, 36/5, Haralukunte village, adjacent 27th main road,sector 2 HSR Layout, Bangalore, Karnataka,560102
CIN: U66000KA2016PLC138288
GSTIN: 29AAOCA9055C1ZF
If you need any assistance
travelinsurance@[Link]
Within India Outside India
1800-266- 18338138772 (for US) and 022-69635374 (for other
2256 regions)
Premium receipt
Received with thanks from Jogunooru Samson Raju a sum of ₹589 towards premium on International Travel
Insurance Policy
INSURED DETAILS
Name of Insured: Jogunooru Samson Raju
GST: Not Provided
Policy Number: ACKTR86380
Payment Date: 23-06-2025
PREMIUM DETAILS (₹)
Total Package Premium ₹499
IGST(18%) ₹90
Total Premium ₹589
TERMS & CONDITIONS
Issuance of this receipt does not amount to acceptance of the risk by Acko General Insurance Limited. The insurance
cover for the risk shall be as per the terms and conditions of the Insurance Policy if and when issued.
Proposal Form
Dear Jogunooru Samson Raju,
We wish to inform you that the Insurance policy number ACKTR86380 has been issued on the basis of the information
and declaration given by you, the transcript whereof is mentioned below.
Please be informed that this Policy shall be construed to be void ab initio/invalid in the event we find that you have not
disclosed material or correct information required for the purpose of providing the below insurance cover and in case
of any claim arising under the policy in such a scenario, we shall be under no obligation whatsoever to settle such claim
to you and the premium paid by you under this policy shall stand fully forfeited.
Travel Details
Policy Number ACKTR86380 Policy Issue Date 23-06-2025
Travel Start Date 10-07-2025 Travel End Date 20-07-2025
Geography Covered Schengen region Visiting Country Norway
Coverages Selected Standard Medical Sum Insured $50,000 per person
Mobile Number (Primary 6309541501
Insured)
Travellers Covered
Name DOB Gender Passport Number Nominee GST
Number
Jogunooru Samson Raju 29-03- Male R2069674 Jogunooru Samson Raju Not
1988 Provided
Premium Breakup
Total Package Premium ₹499
IGST(18%) ₹90
Total Premium ₹589
Acko General Insurance Limited
International Travel Insurance
CUSTOMER INFORMATION SHEET
(Description is illustrative and not exhaustive)
Policy
Sr.
Title Description Clause
No
Number
Name of the
1 Acko International Travel Insurance
Product
Policy
2 ACKTR86380
Number
Type of
3 Insurance Both Indemnity and Benefit
Product/Policy
Sum
Cover
insured
Hospitalisation due to illness $50,000
Hospitalisation due to accident $50,000
Missed flight $150
Trip cancellation $500
Delay of checked-in baggage $100
Sum Insured
4 (Individual Total loss of checked-in baggage $500
Basis)
Loss of passport $250
Death due to accident $10,000
Total disability $10,000
Missed connecting flight $500
Emergency evacuation $50,000
Travel expenses of immediate relative $2,500
Repatriation of mortal remains in case of death $50,000
All the below mentioned benefits are covered up to sum insured & conditions as
specified in the policy schedule unless specified otherwise
Section
Accidental and Medical Benefits
3.1
Section
Illness during the Travel Period that leads to Hospitalisation
3.1.2
Injury due to an Accident that occurs during the Travel Period that Section
leads to Hospitalisation or Day Care Treatment 3.1.1
Accidental Death within 365 days because of Injury due to an Section
Accident during Travel Period 3.1.12
Injury due to an Accident that occurs during the Travel Period that Section
leads to Permanent Total Disability 3.1.13
Air or surface transportation of the Insured Person during the Travel
Section
Period including costs incurred for medical care during a situation
3.1.11
which requires Evacuation
Direct route two-way tickets up to Economy Class for an Immediate Section
Relative of the Insured Person for Compassionate Visit 3.1.8
Policy
5
Coverage Transportation of mortal remains from the place of death of the
Section
Insured Person during the Travel Period to the residence of the
3.1.15
Insured Person
Section
Flight Related Benefits
3.2
Missed Flight due to failure to reach the original departure point of Section
the booked journey 3.2.4
Delayed Delivery of the Insured Person’s accompanying Checked-in Section
Baggage for more than 3 Hours by the Flight operator 3.2.9
Permanent and Total loss of the Insured Person’s Checked-in Section
Baggage, by the Flight Operator 3.2.7
Additional Travel and Accommodation Expenses due to a Missed Section
Connection 3.2.5
Section
Other Trip Benefits
3.3
Section
Unavoidable Cancellation of Insured Person’s Common Carrier
3.3.3
Section
Loss of original passport during the Travel Period
3.3.5
Section
Suicide, Self-Inflicted Injury etc.
4(a)
Section
Any Pre-Existing Disease unless disclosed to us in advance
4(b)
Section
Abuse of any Substance, Intoxicant, Drug, Alcohol or Hallucinogen
4(c)
Section
Any breach of law
4(d)
Certification of disability by a Medical Practitioner who shares the Section
same residence as the Insured Person 4(e)
Section
Childbirth or Pregnancy
4(f)
Participation of the Insured Person in any flying activity, except as a Section
bona fide passenger on a public aircraft 4(g)
Section
Any change of profession after inception of the Policy
4(h)
Section
Engaging in any Hazardous Activities
4(i)
Section
Any act of foreign invasion
4(j)
Ionizing radiation or contamination by radioactivity from any Section
nuclear fuel 4(k)
6 Exclusions
Section
Nuclear, chemical or biological attack
4(l)
Any physical or medical condition, or treatment, or service that is
Section
specifically excluded in the Policy Schedule under special
4(m)
conditions.
Section
Any form of non-allopathic treatment.
4(n)
Any loss of eye-glasses or power lenses in respect of any Insured Section
Person. 4(o)
Section
Any loss of Valuables, Money, any kinds of securities or tickets.
4(p)
Any journey where the Insured Person is travelling as a commercial Section
driver, operator or crew member etc. 4(q)
Section
Any intentional illegal or unlawful act
4(r)
Section
Any failure to take reasonable precautions to avoid a claim
4(s)
Any journey commenced with the Insured Person:
1. Not being fit to travel or traveling against the advice of a
Medical Practitioner; or
2. Receiving, or is supposed to receive, medical treatment; or
Section
3. Having received terminal prognosis for a medical condition; or
4(t)
4. Travelling for the purpose of obtaining medical care, treatment
or advice of any kind whether this is the sole purpose of the
journey or not; or
5. Traveling to any country for which his/her visa is not allotted.
Initial waiting Period: NA
Waiting
7 Specific Illness (Standard list) waiting period: NA
Period
Pre-Existing Diseases exclusion / waiting period: NA
Financial
limits of
coverage
i. Sub-limit
This product has no copay or sub-limits applicable on any
ii. Co-
8 reasonable costs for treatments covered.
payment
Deductible : NA
iii. Deductible
iv. Any other
limit (as
applicable)
Cashless claim facility can be availed in all network hospitals. The
list of network hospitals are available on our website or can be
checked at the customer care centre.
For reimbursement of a claim, please submit all necessary
documents on our App or email to us. We may ask for original hard
Claims/Claims copy of the documents in some cases. Section
9
Procedure 5
Please find the important links/numbers below :-
i. Network Hospital Details: Acko App or [Link]
ii. Helpline Number: 1800 266 2256
iii. Hospitals which are blacklisted or from where no claims will be
accepted by the insurer: Acko App or [Link]
iv. Downloading getting the claim form: Acko App or [Link]
Company Officials: Acko General Insurance Limited, 2nd floor,
Policy #36/5, Hustlehub One East, 27th Main Rd, Sector 2, HSR
Servicing Layout, Bengaluru, Karnataka - 560102 Section
10
/Grievances Our website: [Link] 7
/Complaints Email: grievance@[Link]
Toll Free: 1800 266 2256
You may terminate this Policy at any time before the travel start
date by giving Us written notice.
Section
If no claim has been made under the Policy, then We will refund
6(6)
premium after deducting ₹100 (Including applicable taxes) per
Things to
11 member in the policy.
Remember
No change or alteration will be effective or valid unless approved in
Section
writing which will be evidenced by a written endorsement, signed
6(4)
and stamped by the company
If any of the facts provided to us to purchase this Policy are found to
Section
Your be incorrect, incomplete, suppressed or not disclosed, the policy
12 6 (1),
Obligations shall be canceled without refund of premium after 30 days’ notice.
(2), (3)
Any claim made under such Policy, shall be rejected.
Legal Disclaimer Note: The information must be read in conjunction with the product brochure
andpolicy document. In case of any conflict between the CIS and the policy document, the terms and
conditions mentioned in the policy document shall prevail.
Declaration by the Policy Holder:
I have read the above and confirm having noted the details.
Place: __________________
Date: Signature of the Policy Holder
Acko General Insurance Limited
36/5, Hustlehub One East, Somasandrapalya, 27th Main Rd, Sector 2, HSR Layout, Bengaluru, 560102
IRDAI Reg No: 157 | CIN: U66000KA2016PLC138288 | UIN: ACKTIOP25036V022425
[Link] | Toll-free: 1800 266 2256 | Mail: travel@[Link]
