TRAVEL INSURANCE SPECIAL PACKAGE EXPO MILANO 2015 What is covered? Personal Accident: This includes losses resulting from an accident sustained by the insured (you) when it results in death, loss of limb(s), loss of sight or permanent total disablement. Emergency Medical and Evacuation Services: Emergency medical and evacuation services up to the amount shown in the schedule of benefits necessary as a result of the insured (you) sustaining accidental bodily injury or becoming ill. Hospital Benefits: Policy covers up to the amount shown in the schedule of benefits for which the insured (you) is an inpatient in a hospital, as a result of an accidental injury or illness which is covered under policy. Loss of Checked Baggage: The insured (you) will be reimbursed for the cost of purchase of essential items, up to the maximum as shown in the schedule of benefits, should baggage be delayed in transit on the outward journey for more than 12 hours. Delay of Checked Baggage: We will pay up to the amount shown in the schedule of benefits in the event of the insured person suffering a total loss of/or damage to baggage that has been checked-in. SCHEDULE OF BENEFITS SECTION A Personal accident LIMIT (US$) DEDUCTIBLE (US$) Death: $25,000 Loss of limb: $25,000 Permanent total disability: $25,000 Nil over 70 yrs: $5,000 B Emergency medical expenses C $100,000 $100 $10 for each day (24 hrs) of hospitalization up to maximum for $ 100 Nil D Loss of checked Baggage $1000 $100 E Delay of checked Baggage $50 for each 12 hour period delay up to a maximum of $150 12 hours F Loss of Passport $150 Nil G Personal Liability $200,000 $200 in respect of third party property Damage Claims Only. PACKAGE Loss of Passport: We shall be responsible for the reimbursement of actual expenses up to the limit shown in the schedule of benefits which are necessarily and reasonably incurred by the insured person in connection with obtaining permits to travel in the event that the insured person loses their passports. Personal Liability: We will indemnify the insured up to the amount as shown in the schedule of benefits for the legal liability of the insured for accidental injury to third parties or accidental damage to their property. COVER NO.OF DAYS PREMIUM (US$) 50 DAYS 33 Documents required to apply The following documents have to be presented with; • • Proposal Form Passport Copy TRAVEL INSURANCE PROPOSAL FORM EXPO MILANO 2015 Applicant’s Name: Date of Birth: D D ID No. M M Y Y Y Y Permanent Address (as in ID card): Male Female Nationality: Contact Name: Contact No: House/Building name: Road: District: Email: Postal Code: Atoll,Island: Fax: Period of Insurance: Travelling to: Fair Name: DecIaration: I/We desire to effect with the Company an insurance, in the terms of the Policy used for this class of business and I/We warrant that the above statements and particulars are correct and complete. I/We agree that this proposal shall be the basis of the contract and part of the insurance between myself/ourselves and the Company. Signature: Date:
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