COVID-19 INCLUDED

Your product includes medical coverage in case you test positive for Covid-19, up to the
maximum benefit limit of the product purchased. For more information please review the
attached general terms and conditions and the schedule of benefits.

11/23/2022
AGENCY Nº 1779
Your ASSIST CARD
Please double-check your personal info is correct

GEORGE ASSIST CARD N° PRODUCT

620 7678550 06C ACR 150
ANTHONY
CORREA SERVICE VALIDITY
12/15/2022 01/16/2023 inclusive.
CAMPOS
PASSPORT / ID COVERAGE
118845659 USD 150.000

BEFORE YOUR TRAVEL BEGINS

IMPORTANT 1. Download our APP here:
2. Login

IF YOU NEED MEDICAL ASSISTANCE DURING YOUR TRIP

It is simple! You can request it through our mobile app, in 3 simple steps
1. Fill in your personal information and location
2. Let us know your symptoms
3. Select:
SCHEDULE AN APPOINTMENT WITH A DOCTOR
We will contact you shortly to make necessary arrangements.

OTHER CONTACT OPTIONS:

For Toll Free phone numbers, visit www.assistcard.com/phonelist

Latin America North America

+54 (11) 5555-1500 +1 800-874-2223

Europe Asia
+34 (91) 788-3333 +82 (2) 2023-5858
Save the contact information on your phone

RECOMMENDATIONS
Please have the following documents at hand as it may be required when requesting
Assistances Services:
- Passport with exit stamps from your country of residence.
- Air Tickets /Boarding pass

- Confirm your personal information and access the general terms and conditions at my.assistcard.com
- Download and print the attached schedule of benefits of your product.
- If you are going to the US, it is vital to contact us before checking in at an emergency room.
CORREA CAMPOS GEORGE ANTHONY ASSIST CARD Nº: Product:
Modality:Long Stay Daily 620 7678550 06C ACR 150
Nº ID: Validity Period:
118845659 15 DEC 2022 4 16 JAN 2023 inclusive

Particular conditions
PLEASE VERIFY IN THE GENERAL CONDITIONS THE CLAUSES CORRESPONDING TO THE LIMITS AND/OR AMOUNTS INDICATED BELOW. IMPORTANT: IF YOU NEED ASSISTANCE,
PLEASE CONTACT ASSIST CARD AND REMEMBER THAT YOU MUST OBTAIN AUTHORIZATION FROM ASSIST CARD BEFORE TAKING ANY ACTION, AS SET FORTH IN THE GENERAL
CONDITIONS.

Summary of Benefits
C.4 MAXIMUM GLOBAL AMOUNT (INCLUDES ALL SERVICES WITHIN THIS PRODUCT WITH THEIR LIMITS): USD 150.000
SPECIFIC FOR EACH SERVICE:
C.4.1.10.1 MEDICAL ASSISTANCE IN CASE OF ACCIDENT: USD 150.000
C.4.1.10.2 MEDICAL ASSISTANCE IN CASE OF NON PRE-EXISTING ILLNESS (COVID-19 INCLUDED): USD 150.000
C.4.2.2 FIRST MEDICAL CARE FOR PREEXISTING AND CHRONIC ILLNESSES USD 500
C.4.1.2 ATTENTION BY SPECIALISTS: INCLUDES PEDIATRICIAN CONTACT
C.4.1.5.1 MEDICATIONS AT AMBULATORY ASSISTANCES: USD 2.000
C.4.1.5.2 MEDICATIONS AT ASSISTANCES DURING HOSPITALIZATION: INCLUDED IN C.4
C.4.1.6.1 EMERGENCY DENTISTRY: USD 700 (USD 300 PER PIECE)
C.4.1.9 PROTHETICS AND ORTHOTICS USD 3.500
C.4.21 SPORTS PRACTICE: USD 10.000
C.4.22 PREGNANCY: USD 10.000 (INCLUDED UP TO WEEK 26)
C.4.3 MEDICAL TRANSFERS: INCLUDED IN C.4
C.4.4 MEDICAL REPATRIATIONS: USD 100.000
C.4.5 MINORS OR ELDERLY PEOPLE ESCORT: INCLUDED IN C.4
C.4.6 TRANSFER OF A RELATIVE: INCLUDED IN C.4
C.4.7.1 STAY OF A CARD HOLDER'S RELATIVE/DAILY LIMIT: USD 100
C.4.7.2 STAY OF A CARD HOLDER'S RELATIVE/TOTAL LIMIT: USD 500
C.4.8 DIFFERENCE IN AIRFARE DUE TO DELAYED OR EARLY RETURN: INCLUDED IN C.4
C.4.9.1 HOTEL EXPENSES DUE TO FORCED RESTING AFTER HOSPITALIZATION/DAILY LIMIT: USD 180
C.4.9.2 HOTEL EXPENSES DUE TO FORCED RESTING AFTER HOSPITALIZATION/TOTAL MAXIMUM: USD 1.100
C.4.13 ASSISTANCE IN THE EVENT OF LOST OR STOLEN DOCUMENTS: INCLUDED IN C.4
C.4.14 EARLY RETURN DUE TO SERIOUS DISASTER AT HOME: INCLUDED IN C.4
C.4.15 FUNERARY REPATRIATION OR TRANSFERS: USD 100.000
C.4.16 LUGGAGE LOCATION: INCLUDED IN C.4
C.4.17.1 LEGAL ASSISTANCE/ADVANCE AS A LOAN: USD 8.000
C.4.18 CASH ADVANCE FOR BAIL BONDS: USD 8.000
C.4.19 LEGAL ASSISTANCE TO FILE CLAIMS IN CASE OF AN ACCIDENT: INCLUDED IN C.4
C.5.2.1 TERRITORAIL VALIDITY: INTERNATIONAL INBOUND
C.5.4.1 CONSECUTIVE DAYS PER JOURNEY: UP TO 365 DAYS
C.5.13 SPECIAL LIMITATIONS AND EXCLUSIONS DUE TO AGE: PRODUCT VALID ONLY FOR CARD HOLDERS 69
YEARS OLD OR YOUNGER
D.1.3.1(1) INDEMNIFICATION FOR DELAY IN DELIVERY OF THE BAGGAGE (MORE THAN 8 HOURS): USD 50 EVERY 8 HOURS (UP TO USD 200)*
D.1.3.2 INDEMNITY DUE TO LOSS OF LUGGAGE: USD 1.200 - USD 40 PER KG*
D.1.3.3 GENERAL PROVISIONS FOR COMPENSATION / INDEMNITY: SUPPLEMENTARY
D.2.2.1 INSURED RISKS (ACCIDENTAL DEATH IN PUBLIC TRANSPORTATION): USD 100.000*
D.2.5 MAXIMUM AMOUNT RESPONSIBILITY IN CASE OF DISASTER INVOLVING MORE THAN 1 CARD HOLDER: USD 2.500.000*
D.3.3 PERSONAL ACCIDENT COVERAGE (TOTAL AND PERMANENT DISABILITY): USD 40.000*
PEREF LOST OF PERSONAL BELONGINGS: USD 300
THIS PRODUCT DOES NOT COVER PRE-EXISTENT ILLNESSES. ASSIST CARD HAS OTHER PRODUCTS AVAILABLE
WHICH INCLUDE THIS COVERAGE. ASK YOUR TRAVEL AGENT PRIOR TO YOUR DEPARTURE.
6. IN THE PREVIOUS BENEFITS WHERE THE WORD “ INCLUDED” IS MENTIONED, ASSIST CARD WILL TAKE CHARGES
FOR THE COSTS AND / OR SERVICES THAT APPLY, UNTIL THE MAXIMUM AMOUNT INDICATED IN THE CLAUSE.
* The indicated insurances are covered by Chubb Insurance and the exclusions of habitual and/or legal use for this type of coverage
apply and are approved by the Insurance Control Agency of the country in which the ASSIST CARD card is issued.

IMPORTANT: The use of assistance services included in the ASSIST CARD product you have chosen and purchased , implies full knowledge of the Special
Conditions and the General Terms and Conditions , thereof and in texts accompanying attachments and it is necessary for you to read. You may also return to our
website to Access the specific General Terms and Conditions associated with the product you have purchased , also the general and particular conditions of the
insurances.