Additional Cover

Personal Accident Insurance Oman

S.No. Benefits Coverage
1 Emergency Medical and Associated Expenses (due to accident) Actual expenses up to OMR 5000
2 Ambulance Transportation Cover (due to accident) Actual expenses up to OMR1000
3 Accident Death Benefit OMR 100,000
4 Permanent Total Disability (accident)– any occupation with 6 month deferment OMR 50,000
5 Repatriation of Mortal Remains Actual expenses up to OMR 10,000
Days/ Month Premium (OMR)
1 to 30 days OMR 8/- per day
1 Month to 6 months OMR 180/- per month
6 Months & above OMR 150/- per month

Insurer

Reinsurer

Disclaimer : The above particulars and this document are provided by Orient Insurance PJSC and is for information purpose only. The insurance benefits and this policy is issued by Orient Insurance PJSC ("Orient"), a Oman based Insurer with part of the risk cover being reinsured by HDFC International Life and Re Company Limited, a DIFC bas ed life reinsurer, regulated by the DFSA.

Eligibility

  • The minimum entry age is 18 years and the expiry age is attainment of 65 years
  • Voluntary participation while renting a car from Pinewoods Technology Services FZE
  • Should hold a valid driving license
  • Should be either a legal resident or visitor with a valid visa

Service & Claims

Please email to OrientLife.Claims@alfuttaim.com (mention policy number# & your SelfDrive.ae registered email id)

All the claim documentation for the relevant benefit should be supported by:

  • A letter signed by the Policyholder intimating the claim.
  • Duly completed claim form.

No claims shall be payable if they are notified to the insurer after 90 days from the date of claim event date

Documents Needed for Claims

Emergency Medical & Associated Expenses (Due to accident)
  • Claim Form, duly filled, signed by the claimant
  • Original invoices for Emergency Medical & Associated Expenses
  • Original copy of police report of the accident
  • Any other documents pertaining to the claim which the insurer may require
Ambulance Transportation Cover (due to accident)
  • Claim Form, duly filled, signed by the claimant
  • Original invoice from Ambulance transportation
  • Original copy of police report of the accident
  • Any other documents pertaining to the claim which the insurer may require
Accidental Death Benefit
  • Claim Form, duly filled, signed by the claimant
  • Original copy of the police report
  • Death Claim Form, duly filled, signed and stamped by the claimant
  • Original or true copy of the death certificate,
  • Passport copy of deceased with valid visa page at the time of death
  • Wherever legally possible, a post mortem report will be required, along with a police report if death was due to an accident
  • Any other documents pertaining to the claim which the insurer may require
Permanent Total Disability
  • Claim Form, duly filled, signed by the claimant
  • Original copy of the police report
  • Copy of full and complete medical report showing diagnosis, prognosis and specifying any percentage of disability from treating doctor or hospital.
  • Copy of discharge summary from the treating doctor or hospital if treatment involved hospitalization.
  • Copy of all diagnostic, pathological examinations if conducted.
  • Copy of Disability Certificate issued by Government agencies.
  • Any other documents pertaining to the claim which the insurer may require
Repatriation of Mortal Expenses
  • Airway bill & payment receipt of freight charges.
  • Receipts for embalming charges / collection of body from the morgue / coffin charges etc.
  • Copy of ticket of person accompanying the body.
  • Receipt for cost of the ticket issued for accompanying person.
  • Any other charges pertaining to the repatriation of the body to native or home country.
  • Any other documents pertaining to the claim which the insurer may require

Claims Settlement

No claims shall be payable if they are notified to the insurer after the notification period as mentioned in the table given below
S.No. Benefits Maximum notification period from claim event date
1 Emergency Medical and Associated Expenses (due to accident) 30 days
2 Ambulance Transportation Cover (due to accident) 30 days
3 Accident Death Benefit 90 days
4 Permanent Total Disability (accident) 90 days
5 Repatriation of Mortal Expenses 90 days

Geographical Scope of Coverage

The personal accident insurance cover under this policy is Valid in Oman, Oman and KSA

Definitions

ACCIDENTAL DEATH BENEFIT

It is hereby declared that if the death of a Member occurs as the result of an accident, the company shall pay the sum insured as stipulated under the policy for that Member, provided that

  • The Policy is in force on the date of the accident and the deceased is a Member on that date
  • The accident occurs prior to the attainment by the Member of the benefits’ expiry age and after the age of 18 years
  • Death results solely, directly and independently of all other causes from bodily injury affected through external, violent, visible and accidental means or from a surgical operation necessarily consequent thereto, within 90 days of such accident

PERMANENT TOTAL DISABILITY(ACCIDENT) BENEFITS

It is hereby declared that in the event of a Member being totally and permanently disabled as a result of an accident, to the extent of being unable ever again to follow any occupation, following 12 months' of such continuous disability as herein defined, the company shall pay the Sum Insured equivalent to the basic life Sum Insured under the Policy, provided that

  • The Policy is in force and the disabled person is a Member on the date of the event resulting in the claim
  • The accident occurs prior to the attainment by the Member of the benefits’ expiry age and after the age of 18 years
  • The disability results solely, directly and independently of all other causes from bodily injury affected through external, violent, visible and accidental means or from a surgical operation necessarily consequent thereto, within 90 days of such accident
  • Acceptance by the company of a claim under this endorsement will automatically terminate the life cover under the Policy and all benefits applying under any other endorsement thereto in respect of the Member
  • If the Member qualifies for payment under this endorsement, the total payment shall not exceed the greater sum insured under the endorsements
  • In the event of a claim for Permanent Total Disability the monthly salary, where applicable, prevailing at the date of the event giving rise to the claim shall be used to determine the sum insured potentially payable (rather than the monthly salary applicable at the end of the deferment period)

REPATRIATION EXPENSES OF MORTAL REMAINS

  • Notwithstanding anything contained herein to the contrary it is agreed and declared that in case of the death of a Member herein, the repatriation of the mortal remains shall be reimbursed up to a maximum of the amount mentioned in the table of benefits Notwithstanding the above this Endorsement shall be subject to the special conditions in the Schedule of Exclusions applying to Annexure A which forms part of this Policy

EMERGENCY MEDICAL EXPENSES ( BENEFITS)

It is hereby declared that in the event of a Member requiring medical attention or treatment as the result of an accident the Insurer shall pay all reasonable and customary charges in respect of such attention or treatment provided it is administered by a properly qualified medical practitioner and, also provided that

  • The Policy is in force and the affected life is a Member on the date of the event resulting in the claim
  • The accident occurs prior to the attainment of the maximum expiry age by the Member
  • The medical expenses arise from bodily injury occurring solely, directly and independently of all other causes as a result of external, violent, visible and accidental means
  • In any event the total amount payable under this Endorsement shall be limited to maximum amount mentioned in the table of benefits per Member per annum, as more specifically stated in the Schedule of the Policy
  • The payments of medical expenses are not restricted to government hospitals/clinics
  • All expenses relating to prostheses additional or artificial devices either external or implanted which substitutes for supplements a missing or defective part of the body Patient treatment supplies (including all types of bandages, elastic stockings, ace bandages, gauzes, rips and like products non prescription drugs and treatments and all other external fittings /co payments are excluded

AMBULANCE TRANSPORTATION COVER (due to accident)

Ambulance service cover is provided for sudden medical emergency occurred due to accident of the leased car, where insured’s condition is so severe that no other method of transport other than ambulance would be recommendable Absence of immediate medical condition could result in placing the patient's health in serious jeopardy, impairment to bodily functions or serious dysfunction to any bodily organ or part The emergency conditions are listed below:

  • Severe bleeding/hemorrhage with a risk of heavy blood loss e g intracranial bleeding
  • Medically restrained or immobile due to or to prevent injury e g fracture
  • Requires oxygen and/or skilled emergency medical treatment during transportation
  • Burns requiring treatment
  • Bed confined/unable to ambulate not even in wheel chair or could be moved only by stretcher
  • Multiple severe injuries or life threatening trauma If the above listed conditions are not present documentation should be provided to justify the service Note Not having alternative transport does not justify the coverage as emergency ambulance service

Transportation using ambulance only from site of accident to hospital would be allowed . The amount of cover is as per actual expenses subject to the maximum amount as mentioned under benefits table and policy schedule.

Conditions

Personal accident insurance benefits will be provided on enrollment to the member/ insured

  • Applicable only to accident related to the leased car
  • The cover is applicable only to the enrolled member of the Master Policy Holder and does not extend to passengers of the leased car
  • Pay out is limited to a maximum of the sum assured for each benefit per insured member for opted coverage period.
  • The cover is applicable only for non commercial vehicles
  • Death due to accident occurs within 30 days from the date of accident
  • Customers should have a valid booking for car drive at the inception of the policy
  • The insured member should hold a valid driving license as per Oman laws
  • The insured member is above 18 years or has attained age 65 years on last birthday
  • The number of passengers (including driver) should not be more than the seating capacity of the vehicle
  • The member should be a legal resident or a visitor with a valid Oman visa
  • Claim for personal accident insurance benefit will not be paid for more than one enrollment if there are multiple enrollments held by the member
  • No refund of premium will be made to the member upon cancellation of lease of vehicle

Schedule of Exclusions

General Exclusions

  • Co passengers of enrolled customer of SelfDrive ae (Pinewoods Technology services FZE) who have actively subscribed to this Policy on Voluntary basis Customers should have a valid booking for a car ride at the inception of the policy
  • The insured member does not hold a valid driving license
  • The insured member is below 18 years or has attained age 65 years on the last birthday
  • Accident has occurred in any car which has not been leased from and insurance not facilitated by Pinewoods Technology Services FZE
  • The number of passengers (including driver) should not be more than the seating capacity of the vehicle
  • The claim will not be permissible in case of Wilful Act, Self inflicted injury, Mental Illness, Drug or Alcohol abuse which leads to injury to self
  • The policy does not cover any contractual and consequential liability, except as covered in the Policy
  • Any journey commenced to obtain medical care, treatment or advice of any kind whether this is the sole purpose of customer’s journey or not
  • Any event arising from or caused due to use, abuse or a consequence or influence of an abuse of any substance, intoxicant, drug, alcohol or hallucinogen
  • Only registered member is eligible to receive the in ride insurance benefit
  • Insurance policy is not valid for 2 wheelers and commercial vehicles or vehicles used for commercial purposes
  • Suicide, illegal or criminal acts, atomic, biological or chemical contamination
  • Taking part in any strike, industrial dispute, riot etc
  • Mountaineering or rock climbing that uses ropes or guides, bungee jumping, scuba diving, pot holing or organized team sports
  • Competing in or practicing for speed or time trials, sprints or racing of any kind
  • Losses sustained or contracted in consequence of a named insured being intoxicated or under the influence of any narcotic or drug unless administered on the advice of a physician

Terrorism Exclusion:

  • Notwithstanding any other provision in this Agreement the insurer shall not be liable for claims directly or indirectly caused by, resulting from, or in connection with acts of terrorism by making use of nuclear, biological or chemical weapons or material, or action taken in controlling, preventing, suppressing or in any way relating to any such act of terrorism, regardless of any other cause or event contributing concurrently or in any other sequence of the loss. An act of terrorism means an act whether involving violence or the use of force or not or the threat or the preparation thereof, of any person or group(s) of persons whether acting alone or on behalf of or in connection with any organization(s) or government (s) which appears to be intended to intimidate or influence a de jure or de facto government or the public or a section of the public, or disrupt any segment of the economy and from its nature or context is done in connection with political, social, religious, ideological or similar causes or objectives. In any case, active participation of the insured in any acts of terrorism whether making use of nuclear, biological or chemical weapons or material or not shall be excluded.

War Exclusion:

  • Incident occurs in Iraq, Afghanistan, Libya, Palestine, Israel, Iran, Syria, Sudan, Yemen and any other country where war or war like operation takes place
  • Where a member remains in a country for more than 28 days following an outbreak of war in that country
  • War, civil commotion, invasion, terrorism, hostilities (whether war be declared or not)
  • Where a member is travelling to or visiting a country after war has been declared in that country or after it has been recognized as a war zone by the United Nations or US or EU or any other competent international agencies or if foreign offices advice against “all travel” in that country or where there are war likes operations