SPECIAL CONDITIONS FOR THE

'SCHENGEN INSURANCE' POLICY

REFERENCE OF THE POLICY POLICY HOLDER
Policy no.: SCHLC2023-1620 Last name/First name: Beltran, Alvaro
Date of subscription: 04/01/2023 Country of residence: Colombia
Period covered: from 25/01/2023 to 25/02/2023 INSURED PARTY/PARTIES
Cost of policy: €72.00 Last name/First name: Beltran, Alvaro
Country of residence: Colombia
Policy no.: SCHLC2023-1620

COVER:

Telephone assistance 24/7

Cover for medical expenses and emergency hospitalization
Medical repatriation
Repatriation of the mortal remains and burial
For Low Cost Insurance: limit Euro 30,000 in the Schengen zone. For Europ Travel Insurance: limit Euro 100,000. For Multi Trip
Insurance: limit Euro 100,000.

Medical fees related to Covid-19 are covered in the limits, conditions, and exclusions established in the insurance policy.

THE PROTECTION OF PRIVATE LIFE WITH RESPECT TO PERSONAL DATA PROCESSING RELATING TO HEALTH:

Personal information relating to the client which is provided to the insurer in the context of this policy is processed for the purposes of
administering the insurance, client base management, antifraud procedures and dispute management by::

AXA Partners – Inter Partner Assistance SA/NV, Avenue Louise 166/1, in 1050 Brussels
AXA Business Services Private Limited, Residency Road 16/2, 560025 Bangalore, India

The client explicitly accepts and declares that they agree to the processing of personal information relating to their health in so far as
this is necessary and/or useful for the management and/or execution of the insurance policy entered into between them and the
insurer.

In case of a medical incident, contact AXA Assistance 24/7

via telephone: +32 2 552 53 98 or

Email: be.med@ip-assistance.com

AXA Partners – Inter Partner Assistance SA/NV

Public limited company with registered capital of EUR 31.702.613
Avenue Louise 166 B1 - 1050 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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