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    Georgia SIA 24 0029900

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    jaberkhaled

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    © All Rights Reserved
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    Georgia SIA 24 0029900

    Uploaded by

    jaberkhaled
    1 views1 page

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    georgia-SIA-24-0029900

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    Georgia SIA 24 0029900

    Uploaded by

    jaberkhaled

    Copyright:

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

    TRAVEL INSURANCE CERTIFICATE

    REFERENCE: SIA-24-0029900 ISSUING DATE: 14/05/2024 PLAN: Going Advanced Cov AGENT: WIDE PLAINS INSURANCE
    BROKERS SAL

    DESTINATION FROM TO COUNTRY OF RESIDENCE TELEPHONE NUMBER


    Worldwide excluding LB, US, CA, AU, 19-05-2024 23-05-2024 Lebanon
    JP

    FULL NAME DATE OF BIRTH PASSPORT NUMBER PRICE


    Khaled Jaber 31/08/1966 LR2124226 20 USD

    Contrary to any stipulations stated in the General Conditions, the Plan subscribed to, under this Letter of Confirmation, covers exclusively the below mentioned Benefits,
    Limitations & Excesses shown in the table hereafter.
    The General Conditions form an integral part of this Letter of Confirmation.
    For more info/modification regarding your policy, kindly do not hesitate to contact your authorized agent or e-mail us on [email protected]

    BENEFITS SUM INSURED EXCESS


    Emergency Medical Expenses Up to $ 100,000 0
    Hospitalization expenses due to COVID-19 (excluding USA, Canada, Japan & Australia) Up to $ 35,000* 72 hours
    Emergency Medical Evacuation & repatriation Real Cost 0
    Repatriation of Mortal remains Real Cost 0
    Repatriation of Mortal remains due to COVID-19 (excluding USA, Canada, Japan & Australia) Up to $ 15,000* 0
    Emergency Dental Coverage Up to $ 600 $ 60
    Flight Cancelation Up to $ 200 6 hours
    Loss of baggage Up to $ 1,000 $ 25
    Delay of baggage Up to $ 300 12 hours
    Trip cancellation (up to 70 years of age) Up to $ 5,000 $ 75
    Trip curtailment (up to 70 years of age) Up to $ 500 $ 75
    Loss of Passport Up to $ 200 0
    Personal Accident – Death due to accident only (Common Carrier) Up to $ 10,000 0
    Personal Liability Up to $ 20,000 $ 200
    Winter Sports Up to $ 5,000 0
    Mugging - Loss of Credit Card Up to $ 200 each 0
    Above sums insured are per person & per period of cover.
    Important Notes:

    - This insurance coverage is underwritten by SIMA Ltd.


    - The Assistance Services are provided by Swan International Assistance.
    - Upon calling the Alarm Center and claim being processed on direct billing procedure, no deductible shall apply for Insured up to 70 years old In all cases,deductible shall apply for Insured above 70 years
    old. Deductible shall be maintained for all Insured bracket of ages if claims are accepted and processed on reimbursement basis. (Please refer to Art. C-1 of the General Conditions for all deductibles details)
    In case claim is accepted on reimbursement, please refer to the General Conditions
    * Coverage in the USA, Canada, Japan & Australia for Hospitalization Expenses due to Covid-19 is limited to US $ 20,000 & for Repatriation of Mortal remains due to Covid-19 is limited to US $ 10,000
    - This policy only covers sudden illness and accidents. All treatments related to or resulting from pre-existing medical conditions are excluded from cover. (Please carefully read the general conditions)
    - The insurance premium as stated in this certificate of coverage, must be paid exclusively in US Dollars, as it is due for the risk carrier

    Confirmation Code FOR SWAN INTERNATIONAL ASSISTANCE S.A.L

    For official use, scan the above code to validate this confirmation letter.

    PLEASE KEEP THIS LETTER OF CONFIRMATION WITH YOU In case of emergency or request of assistance, call us on:
    AT ALL TIMES. +33 9 70 73 22 47 or +961 9 211 662 or
    1-514-448-4417 or send an email to:
    Claims must be reported within 48 hours from occurrence of the event and [email protected]
    all related original documents must be submitted to the Company by the You will be asked to provide the reference of this letter and/or show this
    beneficiary within four (4) months maximum. document. This purchase is non-refundable. Please refer to your receipt. Page 1 / 1

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