Claims

Registering claims with OQIC

Having an accident – and a claim to register – is always a hassle; we know this. We have therefore done our utmost to make registering and managing claims with us as easy and fast as possible Click one of the images below to learn how to easily register a claim with us – if in doubt, or you need our assistance, you can always call 8006 7421

Travel Insurance Claims Management

Upon submission of all documents (as mentioned below) we will open a claim file

      • A duly filled Travel care Plus Claims form within 30 days of your return – please find the travel claims form here
      • Copies of Oman ID and travel booking / itinerary
      • All original invoices and bills
      • All property irregularity reports or official written confirmations of a loss
      • All claims must be substantiated with receipts, valuations, medical, police or other report(s) as applicable

In the event of an Inpatient Medical and Curtailment claim, please contact our 24 Hour Claims Assistance  Company Neuron at +971 4382 3600 before OQIC’s approval

Motor Insurance Claims Management

To register a motor claim, you need only five documents

If you have an accident with your car, all you need to do is visit any of our branches along with below documents.

      • Approved police report (in case of property damage / body injury & / major accident).
If there is no property damage or body injury, all involved parties would have to meet our motor
claims department along with the below documents.
    • Copy of Insurance certificate or Insurance policy for the insured vehicle.
    • Copy of valid driving license & ID (both sides) for all parties.
    • Copy of ownership book (Mulkiya) for all parties.
    • MRTA (Minor Road Traffic Accident) form for minor accident.

After accident if the vehicle is still drivable then it has to be brought to the designated OQIC office location for survey. If the vehicle is not drivable, it has to be delivered to our approved workshop.
We will then proceed for survey and approval for repair as per Unified motor policy terms and condition.

How to open a Claim:

With these five documents, you can now easily register the claim with us – this can be done in four different ways – if you’re in doubt or have any questions, we’re always more than happy to assist you; all you have to do is call 8006 7421  and we’ll do whatever we can to make it easy for you.

You can also visit any of our Branches (Al Khoudh, CBD, Ghubra & Sohar) with the required documents and open a claim file.

Things to be aware of with your motor insurance policy

An insurance policy is a financial agreement between OQIC and you. To protect your rights and to secure compliance of OQIC as a financial organisation, the Sultanate of Oman has mandated how comprehensive and third partly liability insurances works in terms of covers

For Comprehensive Insurances

The owner of the vehicle has to pay a small part of the spare parts used for repairing the car once the car is older than one year. However, this can be waived by purchasing the ‘No Depreciation of Spare Parts’ (Agency Repair) Optional cover.
Claims repairs will always be done at the car brand’s agency during the first year of registration. Thereafter, OQIC can choose to use another workshop of comparable quality. If you wish to ensure your car be repaired at the workshop of the agency even after a year, then you can buy the ‘Agency Repair’ Optional cover.

 

Important to Know: There are times when your motor insurance does not cover you

There are very few exceptions to the cover of your motor insurance, but they are very important to be aware of – for an exhaustive explanation of the below exceptions, please refer to the policy wordings

The motor insurance does not cover you and the damages you cause if:

  • Driver of the vehicle (Insured or anyone in his position) was driving under the influence of drugs or alcohol.
  • If the vehicle is driven by a person who is not legally authorized to drive.
  • The use of vehicle is for purposes other than those specified in the policy.
  • Consequential loss suffered by the Insured or decrease in the value due to usage, wear & tear, obsolescence or any failure, defect or mechanical or electrical break down, failure or breakage.
  • Damage to vehicle as a result of overloading or carrying passengers in excess of licensed number of seats.
  • Damage to tyres unless the vehicle is damaged at the same time.
  • You drive off road without the Off-Road cover

Motor Claims

Mr. Mohamed. Abdel Sabour
OQIC – Head of Motor claims
Direct tel:+968 24765270 Ext. 214
Customer care Mobile no:+968 93270764
Email:mohammed.abdelsabour@oqic.com

We will do our best to ease your frustration by making your engagement with us as simple and hassle-free as possible. Please arrange the following documents to register a claim.

  • A completed Claim form
  • A Police Report detailing the nature, extent and cause of loss/or damage.
  • High resolution photographs of incurred loss/or damage.
  • An inventory of damaged/lost items with proof of its cumulative value.
  • A scope and cost estimate for repairing damaged items (for prior approval).
  • Contact details for arranging a survey.
  • A copy of your claim letter sent to third parties (if any), who may be responsible for the damage, thus protecting rights of recovery.

How to register a Claim?

Please follow any one of the following procedures:

  • Present relevant documents at our Non Motor Claims department in our Corporate Office at P.O Box 3660, Ruwi 112, Sultanate of Oman to:
    Mrs. M. Lakshmi Rajesh
    Technical Claims
    Tell: +968 24765315
    Fax:+968 24700815
    Email: lakshmi@oqic.com
  • You can contact our Call Center at 80067421 for further assistance:-

Terms & Conditions (Basic & All Risk Cover)

  • The minimum Gross Premium per policy is OMR 50/-
  • A maximum limit of 5% of the Total Sum Insured for home contents will be assigned for the value of any single lost/damaged item (e.g. antique furniture, artifact, household appliance, radio/television set or piano), unless specifically declared and accepted by OQIC as a separate item of the listed Personal Contents.
  • A maximum limit of 20% of the Total Sum Insured for home contents will be assigned for lost/damaged Platinum/Gold/ Silver jewellery or fur, unless specifically declared and accepted by OQIC.
  • Any single item valued at or exceeding OMR 250 needs to be declared from the Total Personal Contents value and will be subject to acceptance by QIC (Terms & Conditions Apply).

The Insured should have a clear understanding of the Policy/ plan of cover and the benefits included prior to submitting a claim.

When treatments are taken outside the designated Network Provider or when the insured has paid all expenses in full at the service provider, the claim should be submitted to OQIC by visiting or sending the documentation to OQIC office at Al Burj Street (Rex Road), Way No.2101, Villa No.4 or P.O Box 3660, PC 112 Ruwi, Oman.

Claim Documents required to process your claim:
When filing a claim, please provide all relevant documents including but not limited to the following:

  • Copy of OQIC Medical card
  • Original Itemized Invoice with date
  • Original Receipt or Payment
  • Detailed Medical Report / Discharge Summary duly filled in, signed and stamped by the attending Medical Practitioner
  • Copy of result of investigations (Laboratory / Radiology / Endoscopies, etc.)
  • Copy of the Prescription
  • Copy of birth certificate (Maternity)

 

All claims must be submitted within 30 days from the date of service wherein the above mentioned documents are appropriately filled. The insured shall be reimbursed subject to the insured’s policy plan, terms and conditions.

The insured shall be liable for any deductible / co-payment / co-insurance and / or excess that is mentioned in the Benefits of your Policy.

Failure to fully substantiate your claim will result in delayed processing and settlement or may invalidate your claim.

Compassionate Visit Claims Reimbursement

  • Your policy may extend to include the costs of a return economy class ticket fare to and from the home country of an insured employee in the event of critical illness or death of an immediate family member (father, mother, spouse, daughter or son).
  • This option is not operative when the insured is travelling to the home country on holiday or business trip.
  • The additional benefit provided by this extension shall be limited to the amount per employee as set forth in the schedule and shall form part of the maximum benefit stated in the schedule.

The following documents are required to make a claim for Air Fare Reimbursement:

  • Copy of OQIC Medical card
  • Original ticket / print out
  • Original invoice / receipt
  • Original Boarding Pass
  • Death Certificate copy / Medical certificate copy (in case of Critical illness)
  • Proof of age of the deceased / sick person
  • Proof of relation of the deceased / sick person to the insured employee
  • Copy of exit & entry stamped page of the passport as well as the front page of the passport.

Reimbursement Settlements are made in the following way

  • Payment Cheque issued in the local currency under name of the insured employee / policyholder’s name (as per the request) along with a detailed breakdown summary of the submitted claim.
  • Bank Transfer in local currency to the insured employee’s local Bank Account and a detailed breakdown summary shall be emailed to the employee’s mail address.

Outside Oman:

  • Please ensure that any expenses for non-emergency inpatient and day-patient treatment are agreed by local/ international call center in writing i.e. fax/ e-mail/ letter before any planned treatment is undertaken.
  • Pre-authorization of any Elective Treatment or non-emergency treatment should be submitted in writing to local/ international call center as soon as reasonable and at least 48 hours prior to admission.
  • Planned Treatment undertaken without pre-authorization from TPA may not be eligible for a full refund in accordance with the policy terms and conditions, unless the Help Line response was delayed beyond a reasonable time.
  • Verbal confirmation does not constitute pre-authorization. If in doubt, please contact the medical helpline, as shown on your membership card.
  • TPA medical helpline is available 24 hours a day and is staffed by multi-lingual operators.
  • We have arranged a direct settlement network with certain Medical Providers in certain countries where you can receive treatment for eligible medical conditions on a direct billing basis. Please note you will still be responsible for payment of any co-Insurance or excess at the time of your appointment.

Contact our Claims Department

OQIC Call Center: 8006 7421 – open Sunday through Thursday from 9am-6pm

Travel Claims