e-document issued: 23.07.

2021 05:51

Policyholder Correspondence address Email vinijaka@hotmail.com

Vinicius COSTA DA SILVA Vinicius COSTA DA SILVA Phone number +41789442384
st alban-rheinweg 162 st alban-rheinweg 162
4052 Basel 4052 Basel
(Switzerland) (Switzerland)

Insured person
Vinicius COSTA DA SILVA | Male | 20.09.1995 | (Brazil)

International student health insurance Switzerland

Policy SPSS-341979

Benefits summary

Plan level Standard

Hospitalisation / inpatient treatments KVG-LAMal benefits

Hospital room General ward

Maternity KVG-LAMal benefits

Outpatient treatments KVG-LAMal benefits

General practitioners & specialists KVG-LAMal benefits

Prescription medicine KVG-LAMal benefits

Ambulance & transport 50% max. 500

Assistance 24 / 7 Included

If the content of the policy or the addenda thereto do not conform with the agreements, the policyholder must request the revision of the
certificate within four weeks if its receipt; otherwise its content shall be considered as accepted by him. 

Start date Renewal Payment rate Annual premium Annual deductible GIC’s

17.06.2021 01.01. Monthly CHF 1188.00 CHF 300 SPSS-GIC-072019

Emergency Assistance (24/7) : +41 44 655 12 59

The risk carrier is Helvetia Swiss Insurance Company Ltd, Dufourstrasse 40, CH-9001 St. Gallen. The insurance lies with: European Travel Insurance (entitled ERV in the GIC), a branch of Helvetia Swiss
Insurance Company Ltd, headquartered at St. Alban-Anlage 56, P.O, CH-4002 Basel.

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