TRAVEL ASSISTANCE - POLICY SCHEDULE

POLICY HOLDER: BELAL AHMAD SHARAF POLICY NO: 1073YQI

P.O.BOX AND ADDRESS : SYRIAN ARAB REPUBLIC POLICY ISSUE DATE: 28/12/2022

MOBILE NUMBER: 776843008

NATIONALITY : SYRIAN ARAB REPUBLIC

PASSPORT : 013990318 COVERAGE PERIOD: 365 days

DATE OF BIRTH : 10-01-2000

EFFECTIVE FROM: 01/01/2023

AGENCY CODE PREMIUM: 18.610 USD
EXPIRY ON: 01/01/2024

DESTINATION AREA: WORLDWIDE - WORLDWIDE EXCEPT THE COUNTRY OF RESIDENCE

Details of Insured Persons

Name Gender Nationality PASSPORT Date Of Birth
BELAL AHMAD SHARAF MALE SYRIAN ARAB REPUBLIC 013990318 10-01-2000

Cover Table/Schedual of Covers

SUMMARY OF COVERES LIMITS IN USD
MEDICAL EXPENSES AND HOSPITALIZATION ABROAD $ 50 000 - DEDUCTIBLE APPLIES
TRANSPORT OR REPATRIATION TO THE COUNTRY OF RESIDENCE IN CASE OF ILLNESS OR ACCIDENT ACTUAL EXPENSES
REPATRIATION OF FAMILY MEMBER TRAVELLING WITH THE INSURED ACTUAL EXPENSES
REPATRIATION OF MORTAL REMAINS US$ 20,000
TRAVEL OF ONE IMMEDIATE FAMILY MEMBER TO STAY WITH THE INSURED IN CASE OF ILLNESS OR ACCIDENT 100$/DAY – MAX 1 000 $
EMERGENCY RETURN HOME TO THE COUNTRY OF RESIDENCE FOLLOWING DEATH OF A CLOSE FAMILY MEMBER ACTUAL EXPENSES
LOSS OF PASSPORT, DRIVING LICENSE, NATIONAL IDENTITY CARD ABROAD $ 500
TRIP CANCELLATION US$ 1,000 - DEDUCTIBLE APPLIES
DELAYED DEPARTURE $ 250

In the case of a claim, immediatly contact Gulf Assist on:

International: +962 6 5008111
Fax:+962 6 5627981
EMAIL:TRAVELA@mapfre.com
INSURED PERSON SIGNATURE
AUTHORIZED SIGNATORY AND STAMP