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    Ce - Scheu2019 371716 A

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    marta helena sinaga
    This document provides a Schengen travel insurance certificate for Jos Iswadi Sitompul from Indonesia. The insurance covers emergency medical care, hospitalization, surgery, transportation, repatriation, and medications up to €100,000 in the Schengen area and EU from December 6-17, 2019. In case of a medical incident, the insured should contact AXA Assistance at +32 2 552 53 98 or [email protected]. The certificate is valid for verification by embassies and consulates online at http://subscribe.axa-schengen.com/embassy/.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Ce - Scheu2019 371716 A

    Uploaded by

    marta helena sinaga
    1K views1 page
    This document provides a Schengen travel insurance certificate for Jos Iswadi Sitompul from Indonesia. The insurance covers emergency medical care, hospitalization, surgery, transportation, repatriation, and medications up to €100,000 in the Schengen area and EU from December 6-17, 2019. In case of a medical incident, the insured should contact AXA Assistance at +32 2 552 53 98 or [email protected]. The certificate is valid for verification by embassies and consulates online at http://subscribe.axa-schengen.com/embassy/.

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    CE

    Original Title

    CE_SCHEU2019-371716-A (1)

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    This document provides a Schengen travel insurance certificate for Jos Iswadi Sitompul from Indonesia. The insurance covers emergency medical care, hospitalization, surgery, transportation, repatriation, and medications up to €100,000 in the Schengen area and EU from December 6-17, 2019. In case of a medical incident, the insured should contact AXA Assistance at +32 2 552 53 98 or [email protected]. The certificate is valid for verification by embassies and consulates online at http://subscribe.axa-schengen.com/embassy/.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    1K views1 page

    Ce - Scheu2019 371716 A

    Uploaded by

    marta helena sinaga
    This document provides a Schengen travel insurance certificate for Jos Iswadi Sitompul from Indonesia. The insurance covers emergency medical care, hospitalization, surgery, transportation, repatriation, and medications up to €100,000 in the Schengen area and EU from December 6-17, 2019. In case of a medical incident, the insured should contact AXA Assistance at +32 2 552 53 98 or [email protected]. The certificate is valid for verification by embassies and consulates online at http://subscribe.axa-schengen.com/embassy/.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    CERTIFICATE

    THE SCHENGEN TRAVEL INSURANCE

    This document is povided by Inter Partner Assistance, part of AXA Assistance Group and was generated from http://www.axa-
    schengen.com

    With the present document, Inter Partner Assistance covers the following traveller:

    First name: Jos Iswadi


    Last name: Sitompul
    Date of Birth: 26/05/1987
    Nationality: Indonesia
    Passport nº: C4858121

    In case of a medical incident, this insurance covers the traveller in all countries of the Schengen Area and of the European Union, for
    the following:

    Emergency medical care, emergency hospital care, surgical fees, transportation, repatriation for medical reasons, repatriation
    in case of death and medications.
    Total cover is up to EUR 100 000 (one hundred thousand Euros) in the Schengen area and in the European Union and its
    equivalent in Swiss Francs, US Dollars and Pounds Sterling (at the official rate of exchange at the date of the occurrence of the
    incident) for all medical incidents occurring and treated in Switzerland, the United Kingdom or involving an insured whose
    country of residence is the United States of America for the period insured.

    Reference of the policy Schengen Europe Travel

    Policy Number: SCHEU2019-371716-A


    Date of subscription: 08/11/2019
    Period covered from 06/12/2019 to 17/12/2019
    Drawn up in Brussels on 08/11/2019

    No deductible to pay

    FOR THE ATTENTION OF EMBASSIES AND CONSULATES - ONLINE VERIFICATION


    In order to strengthen the security, Embassies and Consulates can check the validity of the present certificate by entering the
    following information on the Internet site:

    http://subscribe.axa-schengen.com/embassy/

    Beneficiary Name: Sitompul

    Policy nº: SCHEU2019-371716

    AXA Schengen follows strictly the Regulation (EC) No 810/2009 of the European Parliament and of the Council of July 13th of 2009,
    implemented on April 5th of 2010. In all cases, the covered period refers to this insurance policy only and its validity. It can't be used as
    an argument when applying for visa.

    In case of a medical incident, contact AXA Assistance 24/7

    via telephone: +32 2 552 53 98 or

    Email: [email protected]

    AXA Partners – Inter Partner Assistance SA/NV


    Public limited company with registered capital of EUR 31.702.613
    Avenue Louise 166 B1 - 1050 Brussels -Belgium
    BIC : BBRUBEBB - IBAN : BE49 3100 7270 0071 Tel : +32 2 550 04 00
    Insurance company authorised under no. CBFA 0487, registered in Belgium at the Brussels Chamber of
    Commerce under no. 0415.591.055.

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