TRAVEL INSURANCE CERTIFICATE

REFERENCE: DIC-22-1168945     ISSUING DATE: 17/03/2022     PLAN: Inbound UAE Compulsory     AGENT: 336

DESTINATION VALIDITY PERIOD COUNTRY OF RESIDENCE TELEPHONE NUMBER

United Arab Emirates 30 days from the date of entry into the Worldwide including US, CA, AU, JP 97100000000
UAE (excluding residence)

FULL NAME DATE OF BIRTH PASSPORT NUMBER

RAHUL OM PRAKASH NISHAD 11/02/1996 V0794937

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 support@siassistance.com

BENEFITS SUM INSURED EXCESS

COVID-19 Emergency Medical Expenses and Hospitalization until stabilization only Up to USD 5,000 25% co-insurance

Above sums insured are per person & per period of cover.

Important Notes:

* Excess is changeable depending on the Age of the insured. Please refer to the deductibles table in the General Conditions document.
-If your date of entry to UAE changes from the dates shown on your certificate of insurance, your cover dates will be automatically amended to start from the date you entered the UAE (as stamped on
your passport) or after 60 days from visa start date whichever comes first and run for the same duration as the original policy period. Issued policies are in all cases not refundable.
-This policy covers the multiple entries to the UAE within your policy period.

Confirmation Code AUTHORIZED SIGNATORY AND STAMP

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

For inquiries or claims covered under this policy, please call us on: 800 382467 In case of emergency or request of assistance,
call us on: +33 9 70 73 22 47 or +961 9 211 662 or 1-514-448-4417 or send an email to: request@swanassistance.com.
You will be asked to provide the reference of this letter and/or show this document.