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‫ﺗﺮﺍﻓﻞ ﺳﻤﺎﺭﺕ‬
TRAVEL SMART ‫ﺍﺮﻓﻘﺎﺕ ﺟﺪﻭﻝ ﺍﻟﺒﻮﻟﻴﺼﻴﻪ ﻭﺍﻻﻳﺼﺎﻝ‬
Policy schedule and receipt ‫ﻭﻓﺎﺗﻮﺭﺓ ﺍﻟﻀﺮﻳﺒﺔ ﻣﻨﻔﺼﻞ‬
and separate Tax Invoice as attached
Summary of Plan ‫ﻣﻠﺨﺺ ﺍﻟﺘﻐﻄﻴﺔ‬
Product Travel Inbound Plus ‫ﺍﻟﻤﻨﺘﺞ‬ Issuing Date 05/ JULY /2023 ‫ﺗﺎﺭﻳﺦ ﺍﻻﺻﺪﺍﺭ‬
Policy Type Multi Trip ‫ﻧﻮﻉ ﺍﻟﻮﺛﻴﻘﺔ‬ Period 05/Jul/2023 To 03/Oct/2023 ‫ ﺇﻟﻰ‬- ‫ﺍﻟﺼﻼﺣﻴﺔ ﻣﻦ‬
Duration upto 90 days ‫ﺍﻟﻤﺪﺓ‬ Premium 60 AED ‫ﺻﺎﻓﻲ‬
Area of Travel Uzbekistan ‫ﺍﻟﺤﺪﻭﺩ ﺍﻟﺠﻐﺮﺍﻓﻴﺔ‬
Group Policy Size None ‫ﺣﺠﻢ ﺍﻟﻤﺠﻤﻮﻋﺔ‬ VAT @ 5% 3.00 AED @ ‫ﺍﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ‬
%5
Policy Number 1-ZT-22005-201178-0 ‫ﺭﻗﻢ ﺍﻟﻮﺛﻴﻘﺔ‬ Premium Including 63.00 AED ‫ﻗﺴﻂ ﺍﻟﺘﺄﻣﻴﻦ ﺷﺎﻣﻠﺔ ﺿﺮﻳﺒﺔ‬
VAT ‫ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ‬
Deleted Cover None ‫ﺍﻟﺘﻐﻄﻴﺎﺕ ﺍﻟﻤﺰﺍﻟﺔ‬ Policy Fees 0.00 AED ‫ﺭﺳﻮﻡ ﺍﻟﻮﺛﻴﻘﺔ‬
Adventure Sports Yes ‫ﺗﻐﻄﻴﺔ ﺍﻟﺮﻳﺎﺿﺔ‬ Total Premium 63.00 AED ‫ﻗﺴﻂ ﺍﻟﺘﺄﻣﻴﻦ‬
‫ﺍﻟﺨﻄﺮﺓ‬
Reference Policy Generated via ‫ﺍﻟﻤﺮﺟﻊ‬
OLSTravelV2

Payment Details (online payment) (‫ﺗﻔﺎﺻﻴﻞ ﺍﻟﺪﻓﻊ )ﻋﺒﺮ ﺍﻻﻧﺘﺮﻧﺖ‬

Amount ‫ﺍﻟﻤﺒﻠﻎ‬ Date ‫ﺍﻟﺘﺎﺭﻳﺦ‬ Payment Receipt ‫ﺍﻟﻮﺻﻞ‬
63 AED 05/07/2023 7:05:38 PM H0013ZTT4181122070201

Primary Insured ‫ﺍﻟﻤﺆﻣﻦ ﻟﻪ‬

Name ‫ﺍﻷﺳﻢ‬ Gender ‫ﺍﻟﺠﻨﺲ‬ YOB ‫ﺗﺎﺭﻳﺦ ﺍﻟﻤﻴﻼﺩ‬ Nationality ‫ﺍﻟﺠﻨﺴﻴﺔ‬
Fouad Aoudia M 09/Aug/1994 ALG

Policy Benefits and Limits (in AED/QAR) (‫ ﺭﻳﺎﻝ ﻗﻄﺮﻱ‬/ ‫ﻣﻨﺎﻓﻊ ﻭ ﺣﺪﻭﺩ ﺍﻟﻮﺛﻴﻘﺔ )ﺩﺭﻫﻢ ﺇﻣﺎﺭﺍﺗﻲ‬
The following benefits apply to each of the Insured Persons mentioned ‫ ﺗﺄﻣﻴﻦ ﺍﻟﺴﻔﺮ ﻟﺘﺄﺷﻴﺮﺓ ﺍﻟﺰﻳﺎﺭﺓ ﺻﺎﻟﺤﺔ ﻓﻘﻂ ﻓﻲ ﺩﻭﻝ‬.‫ﺍﻟﻤﻨﺎﻓﻊ ﺍﻟﺘﺎﻟﻴﺔ ﺗﻄﺒﻖ ﻟﻜﻞ ﻓﺮﺩ ﻣﺆﻣﻦ ﻟﻪ ﻣﺬﻛﻮﺭ ﺃﻋﻼﻩ‬
‫ﻣﺠﻠﺲ ﺍﻟﺘﻌﺎﻭﻥ ﺍﻟﺨﻠﻴﺠﻲ‬
Benefits Limits ‫ﺍﻟﺤﺪ ﺍﻷﻗﺼﻰ‬ ‫ﺍﻟﻤﻨﺎﻓﻊ‬
A Emergency Medical expenses 150,000.00, Excess: 400.00 ‫ﻣﺼﺎﺭﻳﻒ ﺍﻟﻌﻼﺝ ﻓﻲ ﺍﻟﺤﺎﻻﺕ ﺍﻟﻄﺎﺭﺋﺔ‬ ‫ﺃ‬
C Emergency Medical transportation 50,000.00 ‫ﻧﻘﻞ ﺍﻟﺤﺎﻻﺕ ﺍﻟﻄﺎﺭﺋﺔ ﻟﻠﻌﻼﺝ‬ ‫ﺝ‬
E Repatriation of mortal remains 15,000.00 ‫ﺗﻐﻄﻴﺔ ﻣﺼﺎﺭﻳﻒ ﺇﻋﺎﺩﺓ ﺍﻟﺮﻓﺎﺕ‬ ‫ﻩ‬
L Cancellation or curtailment up to 5,000.00 ‫ﺇﻟﻐﺎﺀ ﺃﻭ ﺍﺧﺘﺼﺎﺭ ﺍﻟﺮﺣﻠﺔ‬ ‫ﻝ‬
M Delayed departure 50.00 up to 750.00 ‫ﺗﺄﺧﺮ ﺍﻟﻤﻐﺎﺩﺭﺓ‬ ‫ﻡ‬
N Delayed baggage up to 750.00 ‫ﺗﺄﺧﺮ ﺍﻷﻣﺘﻌﺔ‬ ‫ﻥ‬
O Loss of personal baggage and personal money up to 10,000.00, Excess: 400.00 ‫ﺍﻷﻣﺘﻌﺔ ﻭ ﺍﻷﻣﻮﺍﻝ ﺍﻟﺸﺨﺼﻴﺔ‬ ‫ﺱ‬
P Loss of passport up to 1,500.00, Excess: 400.00 ‫ﻓﻘﺪﺍﻥ ﺟﻮﺍﺯ ﺍﻟﺴﻔﺮ‬ ‫ﻉ‬

VAT registration No: 100291881900003

AXA ASSISTANCE - Morocco - Tel 0021 2522464630
MEDICAL EMERGENCY Tel - 00971 4 4294003
Gulf Insurance Group (Gulf) B.S.C. (c), www.giggulf.ae
UAE - P.O. Box 290 - Tel: 800 292
 Scan to validate

TRAVEL SMART
Policy schedule and receipt
and separate Tax Invoice as attached
Important Notice: This Policy Schedule contains a summary of cover only.
For full Terms, Conditions and Exclusions please refer to the Policy
Wording.
Cover is valid for visitor traveling to GCC countries only.
All material facts must be disclosed and failure to do so will invalidate this
policy.
The scope of cover under the subject policy excludes losses or claims due
to incidents occurred within the geographical area of any country declared
by the United Nations as a war zone.
In case of illness due to infectious disease (epidemic/ pandemic including
Covid-19) in any country apart from the country the Trip originated, we
shall pay for the Emergency Medical Expenses as per Terms and
Conditions mentioned in the Policy Booklet.
For medical emergencies, please call
+971 4 429 4003
For complete details please refer to details terms and conditions at
www.gig-gulf.com
‫ﺗﺮﺍﻓﻞ ﺳﻤﺎﺭﺕ‬
‫ﺍﺮﻓﻘﺎﺕ ﺟﺪﻭﻝ ﺍﻟﺒﻮﻟﻴﺼﻴﻪ ﻭﺍﻻﻳﺼﺎﻝ‬
‫ﻭﻓﺎﺗﻮﺭﺓ ﺍﻟﻀﺮﻳﺒﺔ ﻣﻨﻔﺼﻞ‬
.‫ ﺟﺪﻭﻝ ﻫﺬﻩ ﺍﻟﻮﺛﻴﻘﺔ ﻳﺤﺘﻮﻱ ﻋﻠﻰ ﻣﻠﺨﺺ ﻟﻠﺘﻐﻄﻴﺔ ﻓﻘﻂ‬:‫ﻣﻼﺣﻈﺔ ﻫﺎﻣﺔ‬
‫ﻳﺮﺟﻰ ﺍﻟﺮﺟﻮﻉ ﺇﻟﻰ ﻛﺘﻴﺐ ﺍﻟﻮﺛﻴﻘﺔ ﻟﻠﺸﺮﻭﻁ ﻭ ﺍﻻﺳﺘﺜﻨﺎﺀﺍﺕ ﺍﻟﻜﺎﻣﻠﺔ‬
‫ﺍﻟﺘﻐﻄﻴﺔ ﻣﺘﺎﺣﺔ ﻓﻘﻂ ﻟﻠﻤﺴﺎﻓﺮﻳﻦ ﺍﻟﻰ ﺩﻭﻝ ﻣﺠﻠﺲ ﺍﻟﺘﻌﺎﻭﻥ ﺍﻟﺨﻠﻴﺠﻲ‬
‫ﻳﺠﺐ ﺍﻟﻜﺸﻒ ﻋﻦ ﻛﻞ ﺍﻟﺤﻘﺎﺋﻖ ﺍﻟﺠﻮﻫﺮﻳﺔ ﻭﻋﺪﻡ ﺍﻟﻘﻴﺎﻡ ﺑﺬﻟﻚ ﺳﻴﺆﺩﻱ ﻹﺑﻄﺎﻝ ﻫﺬﻩ ﺍﻟﻮﺛﻴﻘﺔ‬
‫ﻳﺴﺘﺜﻨﻲ ﻧﻄﺎﻕ ﺍﻟﺘﻐﻄﻴﺔ ﺿﻤﻦ ﻫﺬﻩ ﺍﻟﻮﺛﻴﻘﺔ ﺍﻟﺨﺴﺎﺋﺮ ﺃﻭ ﺍﻟﻤﻄﺎﻟﺒﺎﺕ ﺍﻟﻨﺎﺗﺠﺔ ﻋﻦ ﺍﻟﺤﻮﺍﺩﺙ ﺍﻟﺘﻲ ﻭﻗﻌﺖ ﺩﺍﺧﻞ ﺃﻱ‬
‫ﻣﻨﻄﻘﺔ ﺟﻐﺮﺍﻓﻴﺔ ﻣﻦ ﺃﻱ ﺑﻠﺪ ﺃﻋﻠﻨﺘﻪ ﺍﻷﻣﻢ ﺍﻟﻤﺘﺤﺪﺓ ﻛﻤﻨﻄﻘﺔ ﺣﺮﺏ‬
‫ ﺍﻟﻤﺴﺘﺠﺪ ( ﻓﻲ ﺍﻱ ﺑﻠﺪ‬19- ‫ﺟﺎﺋﺤﺔ ﺑﻤﺎ ﻓﻴﻬﺎ ﻓﻴﺮﻭﺱ ﻛﻮﺭﻭﻧﺎ‬/‫ﻓﻲ ﺣﺎﻟﺔ ﺍﻻﺻﺎﺑﺔ ﺑﺎﻱ ﻣﺮﺽ ﻣﻌﺪﻱ )ﻭﺑﺎﺀ‬
‫ ﺗﺨﻀﻊ ﻟﺸﺮﻭﻁ ﻭ ﺍﺣﻜﺎﻡ‬،‫ ﺳﻮﻑ ﻧﻘﻮﻡ ﺑﺪﻓﻊ ﻣﺼﺎﺭﻳﻒ ﺍﻟﻄﻮﺍﺭﺉ ﺍﻟﻄﺒﻴﺔ‬, ‫ﺧﻼﻓﺎ ﻟﺒﻠﺪ ﺍﻟﺬﻱ ﻧﺸﺄﺕ ﻣﻨﻪ ﺍﻟﺮﺣﻠﺔ‬
.‫ﻛﺘﻴﺐ ﻭﺛﻴﻘﺔ ﺍﻟﺘﺄﻣﻴﻦ‬
:‫ﻟﺤﺎﻻﺕ ﺍﻟﻄﻮﺍﺭﺉ ﺍﻟﻄﺒﻴﺔ ﻳﺮﺟﻰ ﺍﻹﺗﺼﺎﻝ ﻋﻠﻰ‬
+971 4 429 4003
‫ﻟﻠﺤﺼﻮﻝ ﻋﻠﻰ ﺍﻟﺘﻔﺎﺻﻴﻞ ﺍﻟﻜﺎﻣﻠﺔ ﻳﺮﺟﻰ ﺍﻟﺮﺟﻮﻉ ﺇﻟﻰ ﻛﺘﻴﺐ ﺍﻟﺸﺮﻭﻁ ﻭﺍﻷﺣﻜﺎﻡ ﻋﺒﺮ‬
www.gig-gulf.com

Sanctions and Limitations Exclusion: :‫ﺍﻟﻌﻘﻮﺑﺎﺕ ﻭﻗﻴﻮﺩ ﺍﻻﺳﺘﺒﻌﺎﺩ‬

We shall not be deemed to provide cover and we shall not be liable to pay ‫ﺍﻧﻨﺎ ﻧﻌﺘﺒﺮ ﺍﻧﻨﺎ ﻟﻢ ﻧﻮﻓﺮ ﺃﻱ ﻏﻄﺎﺀ ﻭﻟﻦ ﻧﻜﻮﻥ ﻣﺴﺌﻮﻟﻴﻦ ﻋﻦ ﺗﺴﻮﻳﺔ ﺃﻱ ﻣﻄﺎﻟﺒﺔ ﺃﻭ ﺗﻘﺪﻳﻢ ﻣﻨﻔﻌﺔ ﺇﺫﺍ ﻛﺎﻥ ﺫﻟﻚ ﻳﺆﺩﻱ‬
any claim or provide any benefit hereunder to the extent that the provision ‫ﺇﻟﻰ ﺗﻌﺮﺿﻨﺎ ﻷﻱ ﻋﻘﻮﺑﺔ ﺃﻭ ﺣﻈﺮ ﺃﻭ ﻗﻴﻮﺩ ﺑﻤﻮﺟﺐ ﻗﺮﺍﺭﺍﺕ ﺍﻷﻣﻢ ﺍﻟﻤﺘﺤﺪﺓ ﺃﻭ ﺍﻟﻌﻘﻮﺑﺎﺕ ﺍﻟﺘﺠﺎﺭﻳﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ‬
of such cover, payment of such claim or provision of such benefit would .‫ ﺍﻟﻤﻤﻠﻜﺔ ﺍﻟﻤﺘﺤﺪﺓ ﺃﻭ ﺍﻟﻮﻻﻳﺎﺕ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻷﻣﺮﻳﻜﻴﺔ‬، ‫ﺃﻭ ﺍﻟﻘﻮﺍﻧﻴﻦ ﻭﺍﻷﻧﻈﻤﺔ ﺍﻟﻤﻌﻤﻮﻝ ﺑﻬﺎ ﻓﻲ ﺍﻻﺗﺤﺎﺩ ﺍﻷﻭﺭﺑﻲ‬
expose Us to any sanction, prohibition or restriction under United Nations
resolutions or the trade or economic sanctions, laws or regulations of the
European Union, United Kingdom or United States of America.

Applicable Taxes: :‫ﺍﻟﻀﺮﺍﺋﺐ ﺍﻟﻤﻄﺒّﻘﺔ‬

You accept and agree to pay any taxes on this Policy, in compliance with
the laws and regulations applicable in the territory of sale, including but
not limited to value added tax (“VAT”), which are due on Your Policy,
within fifteen working days from the date of request to pay by GIG Gulf.
GIG Gulf will contact You in the event that VAT is applicable to Your Policy.
Failure by You to pay any applicable taxes may result in Your Policy being
rendered null and void or cancelled at GIG Gulf's discretion.
‫ ﻭﻓﻘﺎ ﻟﻠﻘﻮﺍﻧﻴﻦ ﻭﺍﻟﻠﻮﺍﺋﺢ ﺍﻟﻤﻌﻤﻮﻝ ﺑﻬﺎ ﻓﻲ‬،‫ﺃﻧﻚ ﺗﻘﺒﻞ ﻭﺗﻮﺍﻓﻖ ﻋﻠﻰ ﺩﻓﻊ ﺃﻱ ﺿﺮﺍﺋﺐ ﻣﻔﺮﻭﺿﺔ ﻋﻠﻰ ﻫﺬﻩ ﺍﻟﻮﺛﻴﻘﺔ‬
‫ ﻓﻲ‬،‫ ﺑﻤﺎ ﻓﻲ ﺫﻟﻚ ﻭﻟﻜﻦ ﻻ ﺗﻘﺘﺼﺮ ﻋﻠﻰ ﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ ﺍﻟﻤﺴﺘﺤﻘﺔ ﻋﻠﻰ ﻭﺛﻴﻘﺘﻚ ﺍﻟﺨﺎﺻﺔ‬،‫ﺇﻗﻠﻴﻢ ﺍﻟﺒﻴﻊ‬
‫ ﺳﻮﻑ ﻳﺘﺼﻞ ﺑﻚ ﻣﻮﻇﻔﻲ‬..‫ﺟﻲ‬.‫ﺁﻱ‬.‫( ﻳﻮﻡ ﻋﻤﻞ ﻣﻦ ﺗﺎﺭﻳﺦ ﻃﻠﺐ ﺍﻟﺪﻓﻊ ﻣﻦ ﻗﺒﻞ ﺟﻲ‬15) ‫ﻏﻀﻮﻥ ﺧﻤﺴﺔ ﻋﺸﺮ‬
‫ ﻗﺪ ﻳﺆﺩﻱ ﺇﺧﻔﺎﻗﻚ ﻓﻲ ﺩﻓﻊ ﺃﻱ ﺿﺮﺍﺋﺐ‬.‫ ﻓﻲ ﺣﺎﻟﺔ ﺗﻄﺒﻴﻖ ﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ ﻋﻠﻰ ﺍﻟﻮﺛﻴﻘﺔ‬.‫ﺟﻲ‬.‫ﺁﻱ‬.‫ﺟﻲ‬
.‫ﺟﻲ‬.‫ﺁﻱ‬.‫ﺳﺎﺭﻳﺔ ﺇﻟﻰ ﺟﻌﻞ ﻭﺛﻴﻘﺘﻚ ﺑﺎﻃﻠﺔ ﺃﻭ ﻣﻠﻐﺎﺓ ﻭﻓﻘﺎ ﻟﺘﻘﺪﻳﺮ ﺟﻲ‬

This insurance is ‫ﺗﻢ ﺇﺻﺪﺍﺭ ﺍﻟﻮﺛﻴﻘﺔ‬

marketed by GIG UAE ONLINE ‫ﻳﺘﻢ ﺗﺴﻮﻳﻖ ﻫﺬﻩ ﺍﻟﻮﺛﻴﻘﺔ ﻋﺒﺮ‬ Issued by Online Services
‫ﻣﻦ ﻗﺒﻞ‬
and underwritten by GIG Gulf Insurance. ‫ ﻟﻠﺘﺄﻣﻴﻦ ﻭ ﻳﺘﻌﻴﻦ‬.‫ﺟﻲ‬.‫ﺁﻱ‬.‫ﻭ ﺗﺘﻢ ﻋﻤﻠﻴﺔ ﺍﻻﻛﺘﺘﺎﺏ ﻣﻦ ﻗﺒﻞ ﺟﻲ‬ In Dubai, ‫ﻓﻲ‬
All claims under the policy should be ‫ ﻟﻠﺘﺄﻣﻴﻦ‬.‫ﺟﻲ‬.‫ﺁﻱ‬.‫ﺗﻮﺟﻴﻪ ﺟﻤﻴﻊ ﺍﻟﻤﻄﺎﻟﺒﺎﺕ ﺇﻟﻰ ﺟﻲ‬ On 18/Nov/2022 ‫ﺑﺘﺎﺭﻳﺦ‬
directed to and will be handled by GIG
Gulf Insurance.

For the Company ‫ﻧﻴﺎﺑﺔ ﻋﻦ ﺍﻟﺸﺮﻛﺔ‬ Stamp ‫ﺍﻟﺨﺘﻢ‬

VAT registration No: 100291881900003

AXA ASSISTANCE - Morocco - Tel 0021 2522464630
MEDICAL EMERGENCY Tel - 00971 4 4294003
Gulf Insurance Group (Gulf) B.S.C. (c), www.giggulf.ae
UAE - P.O. Box 290 - Tel: 800 292