TRAVEL INSURANCE

CERTIFICATE
REFERENCE: SIJ-21-0004019 ISSUING DATE: 25/07/2021
DESTINATION FROM TO
COUNTRY OF RESIDENCE TELEPHONE NUMBER
Jordan 29-07-2021 04-
08-2021 Egypt

FULL NAME DATE OF BIRTH

PASSPORT NUMBER
ABDALRAOUF ABUHEWEILA 04/11/1965
4629436

Contrary to any stipulations stated in the General Conditions, the Plan

subscribed to, under this Letter of Confirmation, covers exclusively the below
mentioned Benefits,
Limitations & Excesses shown in the table hereafter.
The General Conditions form an integral part of this Letter of Confirmation.
For more info/modification regarding your policy, kindly do not hesitate to
contact your authorized agent or e-mail us on info@siassistance.com

BENEFITS
SUM INSURED EXCESS
‫ﻓﻮاﺋﺪ‬
Emergency Medical Expenses
$ 15,000 $ 500 ‫اﻟﻨﻔﻘﺎت اﻟﻄﺒﻴﺔ اﻟﻄﺎرﺋﺔ‬
Emergency Medical expenses due to COVID-19
Up to $ 35 000 72 hours COVID-19 ‫اﻟﻨﻔﻘﺎت اﻟﻄﺒﻴﺔ اﻟﻄﺎرﺋﺔ ﻣﻦ ﺟﺮاء ال‬
Repatriation of Mortal Remains
Real Cost $ 500 ‫إﻋﺎدة‬
‫اﻟﺮﻓﺎت‬
Emergency Dental Coverage
$ 500 $ 150 ‫اﻟﻌﻨﺎﻳﺔ اﻟﻄﺎرﺋﺔ ﺑﺎﻹﺳﻨﺎن‬
24 hours Assistance Services
Included ‫ ﻣﺪار‬24‫ ﺳﺎﻋﺔ‬‫ﺧﺪﻣﺔ اﻟﻤﺴﺎﻋﺪة ﻋﻠ‬
Delivery of Medicines abroad
Included ‫ اﻟﺨﺎرج‬‫ﺗﻮﺻﻴﻞ اﻷدوﻳﺔ اﻟ‬
Relay of Urgent Messages
Included ‫اﺑﻼغ وارﺳﺎل رﺳﺎﺋﻞ ﻃﺎرﺋﺔ‬
Connection Services
Included ‫ﺧﺪﻣﺎت‬
‫اﻟﻮﺻﻞ‬
Medical Referral/Appointment of local Medical Specialist
Included ‫ اﻟﺨﺎرج‬‫ ﻓ‬‫ ﻃﺒ‬‫ اﻻﺣﺎﻟﺔ اﻟﻄﺒﻴﺔ‬/‫ﺗﻌﻴﻴﻦ اﺧﺼﺎﺋ‬
Legal Expenses
$ 2,500 0 ‫اﻟﻨﻔﻘﺎت اﻟﻘﺎﻧﻮﻧﻴﺔ‬
Above sums insured are per person & per period of cover.

Important Notes::
- Upon calling the Alarm Center and claim being processed on direct billing
procedure, no deductible shall apply for Insured up to 70 years old
- In all cases,deductible shall apply for Insured above 70 years old.
Deductible shall be maintained for all Insured bracket of ages if claims are
accepted and processed on reimbursement basis.
(Please refer to Art. C-1 of the General Conditions for all deductibles details)
- In case claim is accepted on reimbursement, please refer to the General
Conditions.
 - This policy only covers sudden illness and accidents. All treatments related to
or resulting from pre-existing medical
conditions are excluded from cover (Please carefully read the general conditions)

Confirmation Code
FOR SWAN INTERNATIONAL ASSISTANCE S.A

For official use, scan the above code to validate this confirmation letter.

PLEASE KEEP THIS LETTER OF CONFIRMATION

In case of emergency or request of assistance,call us on:
WITH YOU AT ALL TIMES
+33 9 70 73 22 47 or +961 9 211 662 or

1-514-448-4417 or send an email to:

Claims must be reported within 48 hours from occurrence of the

request@swanassistance.com
event and all related original documents must be submitted to the

You will be asked to provide the reference of this letter and/or show
Company by the beneficiary within four (4) months maximum.
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this document. This purchase is non-refundable. Please refer to your

receipt.