Travel Insurance Policy

Policy No. HO-00816 Issue Date: 05-06-2024 15:36:22 Issued At: AIL Head Office, Lahore.

Net Premium: (PKR) 8,811 /- Eight thousand, Eight hundred and Eleven

Insured's Detail
Name of Insured : Sana Rafi
Address : House No. 09, Street No.12, Mohallah Mali Pura, Ka

Passport No. : BS9597143 CNIC No. : 3520224547144

Date of Birth : 18-06-1989 CNIC Issu. Date : 16-09-2024
Contact No. : 03261859942

Travel Detail
Travel Destination : Abu Dhabi -UAE Purpose of Visit : Business
Period of Insurance : From: 06-06-2024 To: 04-07-2024 Maximum stay : 31 Days

Detail of Beneficiary
Name : MS. Kausar Haroon Relationship : Sister
Contact No : 03174457441 CNIC No : 3520227252234

Product : Atlas Gold

Benefit : As per schedule attached

Jurisdiction : Pakistan

Authorized Signature

The Insured is requested to read this policy. If any error or misdescription be found the Policy should be returned to the issuing
Branch Office or Agency or Head Office for correction.

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Atlas Insurance Ltd

Head Office, 63/A. Block-XX, Phase-III (commercial), Khayaban-e-Iqbal,Defence Housing Authority, Lahore, Pakistan.
Tel: 042-37132611-18 Fax: 042-37132622, www.ail.atlas.pk
 Schedule of Benefits (US $)

Coverage / Benefits Gold

Emergency Medical, Hospitalization, Pharmaceutical and Surgical Expenses Abroad, Due to Accident/ Sudden Illness US$ 25,000 with
the excess of US$
100
Stay of one immediate family member with the insured in case of accident / sudden illness Per day US$ 100,
Max up to US$ 500
Dispatched of Specialized Physician Abroad Covered Assistance
Only 24/7
Medical Referral / Appointment of Local Medical Specialist Abroad Covered Assistance
Only 24/7
Escort of Minor Child in case of Accident / Sudden Illness of the Insured US$ 2,500
Location and Forwarding of Delayed Checked-In Luggage and Personal Effects Assistance Only
Transport to a Properly Equipped Medical Facility/ Repatriation in Case of Accident/ Sudden Illness (Medical Evacuation and Repatriation) Up to Actual Expenses
Included Under
Medical Expenses
Emergency Dental Care US$ 600 with the
excess of US$ 50
Repatriation of Family Member Travelling with the Insured Cost of return Economy
Ticket up to US$
300
Loss of credit card US$ 1,000
Relay of Urgent Messages Covered Assistance
only 24/7
Accidental Death US$ 5,000
Repatriation of Mortal Remains Up to Actual Expenses
Included Under
Medical Expenses
In-flight Loss of Checked-in Baggage Per bag US$150
Max up to US$ 500
Delayed Departure Abroad US$ 50 Per each
completed 6 hours,
Max Upto US$ 500
Excess: 6 Hours
Trip Cancellation US$ 500
Travel and stay over of one Immediate Family Member in case of Accident / Sudden Illness Cost of return economy
ticket up to US$
300
Permanent Total Disability 100% of Sum Insured
Loss of Passport US$ 300
Connection Services Covered Assistance
only 24/7
Delivery of Medicine Covered Assistance
only 24/7
Permanent Partial Disability % of Sum Insured
as per wording scale
Emergency Return Home to the country of residence following death of close family member Economy Ticket
up to US$ 350

Above Age Medical Deductibles

From 66 Years to 70 From 71 Years to 75 From 76 Years to 80
years Old years Old years Old
USD 250 USD 500 USD 750

By receiving this policy the insured person(s) declare to agree to the terms and conditions, exclusions and limitations of
this Travel Insurance Policy. For policy terms and conditions and detailed benefits, please visit
www.ail.atlas.pk/travel
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Atlas Insurance Ltd

Head Office, 63/A. Block-XX, Phase-III (commercial), Khayaban-e-Iqbal,Defence Housing Authority, Lahore, Pakistan.
Tel: 042-37132611-18 Fax: 042-37132622, www.ail.atlas.pk
 Available 24 Hrs / 7 days
Country Contact Number
International +961 9 211 662
USA / Canada +1 514 448 4417
France / Europe +33 9 70 73 22 47
Pakistan +92 300 0344488
Email: request@swanassistance.com, atlas.travel@ail.atlas.pk

How to request assistance or intimate claim?

1. As soon as possible contact Swan International Assistance at above mentioned contact numbers to notify the
claim stating the benefits required.
2. Take all reasonable steps to minimize the loss.
3. Freely provide all relevant information.
4. Make "NO" admission of liability or offer promise or payment of any kind.
5. In the cases where the insured, only due to force majeure or any reason beyond his control cannot contact
Swan International Assistance directly to request the services or benefits covered by the policy, the insured
can seek for expenses reimbursement in writing as follows;

a. Contact Swan International Assistance to obtain a "CASE NUMBER".

b. Send an explanation letter of the circumstances of why the "Services or Benefits" for which expenses are being
claimed were not requested or obtained from Swan International Assistance directly.

c. Send the official documents (such as Medical Report, Police Report or Notification of Loss or Theft, Airline Report of Delay,
Cancellation, Lost Luggage, etc.) and original receipts of the expenses incurred.

Swan International Assistance is NOT liable in respect of any Benefit, which would otherwise be payable under this Policy,
should there be another insurance in force Covering the same contingencies. Swan International Assistance,
at its discretion will consider reimbursing any expenses, totally or partially, after an internal assessment
and case study is done.

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Atlas Insurance Ltd

Head Office, 63/A. Block-XX, Phase-III (commercial), Khayaban-e-Iqbal,Defence Housing Authority, Lahore, Pakistan.
Tel: 042-37132611-18 Fax: 042-37132622, www.ail.atlas.pk