Z-Travel International Lite

Policy Schedule
Agent Code : Premium : RM 128.00
D17405-000
Rebate : RM 32.00
Policy No.
: Tax (0.00%) : RM 0.00
222200122695-00
Policyholder : MOHD IZZAT FAREEZ BIN KAMARUDIN Stamp Duty : RM 0.00
: Total : RM 96.00
Policyholder NRIC/Passport/BRNo. 900605-14-6613
Policyholder Correspondence Address : NO 32,JALAN TK5/14 TAMAN MAWAR
PUCHONG,MALAYSIA,47100

Issuance date :
21 OCT 2022
Period of Insurance :
13 NOV 2022 To 22 NOV 2022
Travel Duration (Both dates inclusive) :
10 day(s)
Cover Types
Type of Trip :
Return Trip
Type of Cover :
Individual
Type of Plan : VIP Plan
Area of Travel :
Area 3
Add on Covid-19 Coverage : Yes

Insured Person(s)
Name of Insured Person(s) NRIC No./Passport No. Age Relationship with Policyholder
MOHD IZZAT FAREEZ BIN KAMARUDIN 900605-14-6613 33 SELF

Nomination
Full Name NRIC % of Shares Date of Birth Relationship

Date of Issue: 21 OCT 2022

Signed for and on behalf of ZURICH GENERAL INSURANCE MALAYSIA BERHAD

Junior Cho
Chief Executive Officer
Coverage under this Policy Schedule is subject to the full description of benefits, terms, conditions and exclusions of the Policy Wording.
The Policy Wording, Schedule of Benefit, Policy Schedule must be read together.
 INVOICE ORIGINAL COPY
SST REG. NO : W10-1808-31020434
INVOICE NO : EPT2200769261
CLIENT CODE :
ACCOUNT CODE : D17405-000
DATE : 21 Oct 2022

MOHD IZZAT FAREEZ BIN KAMARUDIN

NO 32,JALAN TK5/14 TAMAN MAWAR
PUCHONG,MALAYSIA

PARTICULARS

CLASS : TRAVEL PA
POLICY NO : 222200122695-00
PERIOD OF INSURANCE : 13 Nov 2022 TO 22 Nov 2022

No. Description Amount SST rate SST Amount Total(RM)

1 Premium 96.00 SST 0% 0 96.00

Total Before Disbursement 96.00 0.00 96.00

Stamp Duty (Disbursement) 0.00 0.00 0.00

Total After Disbursement 96.00 0.00 96.00

Total Amount Payable 96.00

A Cashier's Receipt will be given on payment of this account.

E. & O. E.
THIS IS A COMPUTER GENERATED FORM AND DOES NOT REQUIRE A SIGNATURE
 Z-Travel Insurance (International) Lite

SCHEDULE OF BENEFITS

with Section C - Covid-19 Benefits (optional)

Basic Plan VIP Plan
Benefit Benefit Description Maximum Sum Insured (RM)
Section A – Personal Accident and Medical Related Covers
1 Accidental Death and Permanent Disablement
(i) 30 days to 17 years old 25,000 75,000
(ii) 18 years old to 85 years old 100,000 300,000
2 Medical Expenses
2A Overseas Medical Expenses 100,000 300,000
2B Overseas Dental Expenses Included in 2A Included in 2A
2C Follow up Treatment in Malaysia 15,000 50,000
2D Outpatient Treatment in Malaysia Included in 2C Included in 2C
3 Overseas Hospital Income (RM150 per day) 9,000 9,000
4 Emergency Medical Evacuation
5 Medical Repatriation 1,000,000 1,000,000
6 Repatriation of Mortal Remains
Section B – Travel Inconvenience Covers
7 Travel Cancellation
7A Travel Cancellation NA 20,000
7B Travel Alteration NA 20,000
8 Travel Curtailment NA 20,000
9 Travel Interruption NA 1,000
Travel Delay – more than 6 consecutive hours Overseas 3,600 Overseas 7,200
10
(RM150 for every 6 consecutive hours) within Malaysia 450 within Malaysia 900
Baggage Delay – more than 6 consecutive hours Overseas 800 Overseas 1,600
11
(RM200 for every 6 consecutive hours) within Malaysia 200 within Malaysia 400
12 Baggage & Personal Effects 1,000 3,000
Sub-limit for Benefit 12:
(i) Any one (1) items or Pair or Set of Items 100 300
(ii) Portable Personal Computers 200 600
(iii) Baggage 50 150
13 Personal Money and Travel Documents 1,000 3,000
14 Personal Credit Card Theft 1,000 3,000
15 Home Care Benefits NA 3,000
16 Rental Car Excess
16A Car Excess NA 3,000
16B Car Return NA Included in 16A
17 Special Coverage
(i) 30 days to 17 years old 25,000 75,000
(ii) 18 years old to 85 years old 100,000 300,000
18 Travel Assist Included Included
Section C – Covid-19 Benefits (optional)
19 Travel Cancellation due to Covid-19 NA 20,000
20 Overseas Medical Expenses due to Covid-19 50,000 100,000
21 Death due to Covid-19 10,000 10,000

INTERNAL USE ONLY

 21 OCT 2022

Dear MOHD IZZAT FAREEZ BIN KAMARUDIN

900605-14-6613

Re: Z-Travel International Lite Covid-19 Add-On

Thank you for choosing Zurich as your preferred insurance provider! This is to confirm that You
have purchased an additional Covid-19 cover which provides the following benefits while
travelling from 13 Nov 2022 To 22 Nov 2022, subject to compliance of the Terms and Conditions
as stated in the policy contract.

Policy No: 222200122695-00

Coverage Type: TwoWay- VIP Plan ,Area 3

No. Benefits Sum Insured (RM)

1 Travel Cancellation due to Covid-19 20,000
2 Overseas Medical Expenses due to Covid-19 100,000
3 Death due to Covid-19 10,000
*Please refer to the Policy Wording for full details, terms and conditions of these benefits and coverage.

If you have any enquiries, please feel free to contact our customer support team for further
assistance. You may call us at +603 2109 6000 (Monday – Friday: 830am – 530pm) or email us at
callcentre@zurich.com.my

From the team here at Zurich, we would like to wish you a pleasant and safe journey!

Thank you.

Best Wishes,
Zurich General Insurance Malaysia Berhad

INTERNAL USE ONLY