Car Insurance FAQ

What are the typical factors used for calculating the premium for my car?

The premium for car insurance is calculated as a percentage of the value of your car. If you have had any accidents, it would be factored in to the premium. If you have not had any accidents, we offer a no-claims bonus with the renewal of your policy

What is Policy Excess?

Also known as ‘Deductible’, the Policy Excess is the fixed amount of money that you have to pay for each and every claim you may have – the Policy Excess is there to offer you a lower overall premium for your car insurance

Is the premium higher for super-fast sports/exotic cars?

The premium for super-fast and exotic cars is a little higher and the policy excess (deductible) is higher too based on the fact that these cars are very expensive to repair and generally have a higher risk of accidents than normal cars

Does my basic insurance policy cover include Roadside Assistance for short trips to neighbouring GCC states?

Our Roadside Assistance cover gets you moving quickly. Apart from towing services, we also offer mechanical first aid, flat tyre, lock – out, fuel and battery services. This cover is applicable for non-accidental breakdowns only.
Roadside Assistance package comes in two versions, one that covers OMAN and the other that covers the UAE

Does my car insurance policy cover for sand dunes and similar terrains?

Many roads in Oman are still not paved and the standard comprehensive insurance does not cover your vehicle for accidents happening on non-paved roads such as dune driving, access roads to the beach, construction sites etc. With the Off-Road cover, you are covered on such roads

When does OQIC deem a car to be totaled (a total loss)?

If the estimated cost of repairing your damaged car is greater than 75% of the car’s insured value, it would be considered as a total loss

My car is seven years old. Can I get a Comprehensive insurance policy for it?

OQIC does not provide Comprehensive insurance policies for cars which are older than five years

My car is more than a year old. In the event of a claim, would my car be repaired at a workshop of the agency?

Repairs of your car will always be done at your car brand’s agency during the first year of its registration. Thereafter, OQIC may use a workshop of comparable quality
To ensure that your car is always repaired at a workshop of the agency, you can purchase our “Agency Repair” optional cover and add it to your comprehensive insurance

Travel Insurance FAQ

How long is a travel insurance policy valid?

The period of cover for a travel insurance ranges from one week to three months. The annual multiple cover is valid through one year (inclusive of maximum of 90 days stay per trip)

Does Travelcare Plus cover pre-existing medical treatments?

Pre-existing medical treatments are excluded from the scope of Travelcare Plus policy

What is the maximum age limit for Travelcare Plus policy?

Travelcare Plus covers for individuals up to the age of 70 years. A premium loading of 100% is applicable for applicants aging between 70 and 75 years. A medical certificate stating the fitness of the applicant needs to be submitted at the time of purchase of the policy

Are there any discounts for purchasing Travel insurance policies for children?

Children under the age of 18 are charged only 50% of the standard premium

Would Travelcare policies be issued to customers who are on visit or business visas?

To purchase a Travel care Plus policy, the customer must either be a permanent or a temporary resident of Oman and must have a residence or a regular place of business in Oman.

Is there a Policy Excess fee/Deductible for any Travelcare Plus Claim?

The first portion of each and every loss is USD 40 and will be borne by the insured.

Does my travel insurance cover for adventurous sports?

Involvement in any adventurous sport is typically not covered.

Can my Travel insurance provide cover for a one way trip?

OQIC’s Travel insurance provides cover for return trip arrangements only

Is the cover limit provided adequate for Embassy requirements?

Travelcare Plus offers medical cover ranging from USD 50,000 to USD 1,000,000, which makes it fully acceptable to the requirements of an Embassy.

Medical Insurance FAQ

What is the process if I want to include my Dependents?

Please request your HR Department to include your spouse and children. An eligible child will be covered until the end of the contract year in which he/she reaches age 18, or 23 if a full time student. There is no age limit for a dependant who is physically or mentally handicapped and is unable to live independently.

How will I upgrade my insurance coverage into a higher plan?

Upgrading your plan is only allowed if you as a principal member have been promoted from your current post and is eligible for a higher plan according to the new designation. All dependents will be in the same category of the principal insured.

Can I get individual insurance coverage?

At present, we are offering Health insurance solutions to corporate customers only.

What if I want to include Maternity Coverage into my existing plan?

Maternity coverage is an optional cover that is opted for on the level of the plan/Group. If the plan you are affiliated to is having that additional coverage, automatically maternity will be added to all married insured females aged between 15 to 50 years old. If the benefit is not available for your current plan, it cannot be added later on selection basis.

Can I add my parents to my health insurance policy?

Employee’s spouse and children are the only dependents that can be enrolled in the insurance policy.

Is there any age limit for Maternity age for Maternity Coverage?

Yes, from 15 to 50 years and the cover is applicable only for married females.

Is Caesarean Section covered?

Yes, if maternity benefit is included in your plan, Caesarean Section will be covered subject to the maternity sub-limit mentioned in the table of benefits.

Is Miscarriage covered?

Yes, if the maternity benefit is included in your plan, legal abortion will be covered subject to the maternity sub-limit mentioned in the Table of Benefits.

Are Maternity complications covered?

Yes, if the maternity benefit is included in your plan, maternity complications will be covered subject to the maternity sub-limit mentioned in the Table of Benefits.

If I want to deliver outside the plan’s geographical scope of cover, am I entitled to apply for re-imbursement of the incurred medical cost?

Delivery should be done only within the plan’s geographical scope of cover to be covered by the insurance policy.

Is pre-approval mandatory for availing medical treatment inside providers’ network?

Approval must be obtained for certain medical procedures/treatments. Healthcare provider bears the responsibility to obtain the pre-approval. The following are some examples for services that require pre-approval:

  • All hospital admissions and surgical procedures
  • Some outpatient procedures such as: MRI, CT, Endoscopies, physiotherapy.
  • Optional benefits (dental, maternity and optical)

Is pre-approval mandatory for availing medical treatment outside providers’ network?

Please ensure that any expenses for non-emergency “elective” inpatient treatment are agreed in writing i.e. either by fax/e-mail/letter before any planned treatment is undertaken. Planned inpatient treatment availed without pre-authorization may not be eligible for a full refund in accordance with the policy terms and conditions

How can I get a pre-approval?

  • Network Provider: Our service provider will arrange for the pre-approvals on your behalf.
  • Non-Network provider: Please contact TPA call centre and they will assist you with this.

If I plan to deliver outside Oman, what is the procedure and the necessary documents required?

If the country where you are planning the delivery is covered within the geographical scope of cover, the arrangement shall be as follows:

  • Inside Network Provider: The arrangement shall be on cashless basis and the preapproval shall be taken by the Network Provider.
  • Outside Network provider: The claim shall be processed on cash reimbursement basis on submission of the following:
  1. Copy of Medical card
  2. Original Itemised Invoice with dates of services availed
  3. Original Receipt or Payment Proof
  4. Detailed Medical Report / Discharge Summary duly filled, signed and stamped by the attending Medical Practitioner
  5. Copy of Investigations’ results (Laboratory / Radiology / Endoscopies, etc.)
  6. Copy of the Prescription
  7. Copy of birth certificate (Maternity)
  8. Proof of availed treatment (Physiotherapy)
  9. QLM preapproval

What is the mode of payment for cash-reimbursement claim?

Based on your preference, payments can be made either through a cheque or through a bank transfer.

What is the maximum time limit to submit my cash claims/invoices?

Claims should be submitted within 30 days from the date of treatment.

When can I receive the payment of the processed claims?

Payment for cash reimbursement of processed claim can be availed within 5 working days from the date of receiving complete claims documents.

In what currency do I get paid?

All cash reimbursements are made in Omani Rials.

What should I do in case of a medical emergency?

You can seek medical care immediately or speak to our TPA’s 24/7 call centre to assist you with any queries you may have. You would have to notify our TPA within 24 hours of admission to the hospital. Should you be on a trip outside Oman, you must immediately call the international call centre number printed at the back of your card.

Do I need a referral to see a specialist or consultant?

You can access a specialist or consultant directly.

What is covered under Dental Benefit?

Please visit our website and click on Dental “Sub-benefit” to view the Dental benefits.

How will I know if the treatment prescribed for me is covered or not?

You can always contact our TPA for any clarifications or assistance.

Can I get a discount for uncovered services from your network provider?

You may contact our TPA’s call centre and they will assist you accordingly.

Do I have to pay for any out-of-pocket expenses at the Provider?

The Insured will have to pay the deductible, co-payment and co-insurance (if any) as has been mentioned in the membership card. For more information, please refer to the Table of Benefits.

What is the difference between co-payment, deductible & co-insurance?

Deductible is the amount of a claim which has to be borne by the Insured before the relevant benefits are payable under the Policy apart from the optional benefits.

Co-payment is the percentage of costs the Insured must pay related to Dental, Optical & Maternity related treatments.

Co-insurance is the percentage of patient share applicable for Cash reimbursement claims or specific service provider. Kindly refer to the Table of Benefits for details.

What should I do if I lose my membership card?

You will need to notify your HR department to ask for a replacement. A replacement fee will be levied.

Does my policy cover preventive treatment/services?

The sole purpose of this policy is to treat and cure existing medical conditions; hence preventive measures are not covered.

If I do not utilise my policy limit this year, can I use it in the next policy year?

Policy limit of the previous policy year cannot be carried over for the next policy year.

Can I continue availing treatment from my existing doctor if he is not a part of your preferred network?

Yes you can. Please submit the claim for cash reimbursement.

How can I find the nearest hospital or specialists?

You can use “Find Provider” feature in TPA Mobile App.

Does my membership card provide guarantee of cover?

Your membership card is purely a way to identify you and the payment capability is subject to the coverage of the policy.