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CERTIFICATE

THE SCHENGEN TRAVEL INSURANCE

This document is provided 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: Mack Alexter Lustre


Last name: Domingo
Date of Birth: 06/06/2012
Nationality: Philippines
Passport nº: P9899387B

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: SCHEU2024-49591-A


Date of subscription: 06/05/2024
Period covered from 06/07/2024 to 22/07/2024
Drawn up in Brussels on 06/05/2024

No deductible to pay. Medical fees related to COVID-19 are covered in the limits, conditions & exclusions established in the
insurance policy.

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: Domingo

Policy nº: SCHEU2024-49591

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
Boulevard du Régent 7 - 1000 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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