Assistance Voucher

BMITZY3B66

GENERAL INFORMATION

VOUCHER NO. BMITZY3B66 STATUS Active

PURCHASE DATE Jul 04, 2022 NO. OF PASSENGERS 1

ORIGIN OF THE TRIP India DESTINATION North America

DEPARTURE DATE Jul 05, 2022 RETURN DATE Sep 29, 2022

PLAN Daily Plan COVERAGE Ultra

TOTAL PRICE View Receipt DAYS PURCHASED 87

BENEFICIARIES

NAME Vijaya LAST NAME Chheda

DATE OF BIRTH Aug 14, 1952 PASSPORT NO. / ID W1688509

TELEPHONE 7326689796 EMAIL dharmesh.chheda@gmail.com

ADDITIONAL BENEFITS NOT APPLIED

EMERGENCY CONTACT

NAME Dharmesh Chheda

TELEPHONE 7326689796
EMAIL ADDRESS dharmesh.chheda@gmail.com

COMMENTS

Jul 04, 2022 - Dharmesh Chheda

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BMITZY3B66

BENEFITS $ = USD / € = Euro **

Medical Assistance for Accident $/€ 30,000

Medical Assistance for Illness $/€ 30,000

Medical Assistance for Accident or Illness (Schengen) €30,000

Medical Assistance in Case of Pre-Existing Medical Condition $/€ 500

Medical Assistance for COVID-19 up to 75 years old INCLUDED

Prescription Drugs INCLUDED

Dental Emergency $/€ 300

Repatriation or Sanitary Transfer $/€ 30,000

Repatriation of Mortal Remains $/€ 30,000

Accidental Death $ 30,000

Transportation of Family Member due to Hospitalization INCLUDED

Convalescence Expense Hotel Expenses/Covid $/€ 800

Lost Documents and Personal Effects Assistance INCLUDED
Return due to Death of an Immediate Family Member ECONOMIC TICKET
Early Return Due to Serious Disaster at Home ECONOMIC TICKET
Minor Escort ECONOMIC TICKET

Trip Cancellation (up to 74 years old) $/€ 2,000

Substitution of an Executive INCLUDED

24 Hours’ Information Line INCLUDED
Emergency Message Transmission INCLUDED

Fee for Transfer of Funds $/€ 20,000

Fee for Transfer of Bail Bond $/€ 20,000

Legal Assistance for Traffic Accident $/€ 2,000

Expenses for Delay Luggage $/€ 800
Total and Definitive Loss of Baggage $/€ 1,200
Delayed or Cancelled Flight N/A
Coverage WORLDWIDE
Maximum Age Limit for Coverage 74 YEARS OLD / 75-85

Minimun Days per Trip 5

Maximum Travel Days per Trip 90

Amateur Sports Coverage $/€ 10,000

Theft or loss passport during a trip $/€ 70

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 Assistance Voucher
BMITZY3B66

BENEFITS $ = USD / € = Euro **

Late Arrival $/€ 300

Deductible N/A

Expectant mother - first 30 days up to 45 years old*** $/€ 5,000

Medical Assistance for COVID-19 - 76 years or older*** N/A

** Euros (€) only applies for Europe. Dollar ($) for other destinations.
*** These are optional benefits.

Requirements:
In the event that the customer presents symptoms of COVID -19 during their trip, they must present a negative PCR test maximum 72 hours before the
departure date of their trip and proof of vaccination. Only vaccines approved by (WHO) World Health Organization are accepted.

Request for assistance:

It is mandatory to obtain authorization from the Assistance Center before incurring any expense regarding the medical or non-medical benefits provided by
the plan. In the event of a real and verifiable emergency, you should go to the nearest hospital and have 24 hours to report.
Failure to notify any event leads to the automatic loss of any right to claim.

Please download and review the following important documents below:

Traveler Guide
General Conditions BMI TRAVEL

CONTACT TELEPHONE CONTACT TELEPHONE

Argentina (11)5077-1922 Australia (2) 8880-6474

Brasil (19)3253-2055 Costa Rica 4106-3300
United States (855) 241-8877 United States (786) 434-3760
Spain 910-48-2854 Mexico (229) 300-9034
USA Collect Call +1 (786) 628-8580 WhatsApp +506 7061-2439
Assistance Center asistencias@bmitravelassist.com Reimbursements reembolsos@bmitravelassist.com
Claims reclamos@bmitravelassist.com Extension Requests info@bmitravelassist.com
Inquiries info@bmitravelassist.com Verify your Plan www.bmitravelassist.com/Plans/VerifyPlan

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BMITZY3B66

Cut along the dashes and turn inguards the dots

BMITZY3B66

Vijaya Chheda
PASSPORT NO./ID: W1688509
DESTINATION: North America
Daily Plan-Ultra
EFFECTIVE: Jul 05, 2022 EXPIRE: Sep 29, 2022

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