Policyholder Information

Policy Holder

Declaration:

I hereby apply for a Bon Voyage Travel Insurance Policy to be based on the above statements, and warrant that to the best of my knowledge and belief that no Insured Person is travelling contrary to the advice of a medical practitioner or for the purpose of obtaining medical treatment and that I understand treatment of any pre-existing, existing, recurne or congental medical conditions is not insured. I further warrant that I am not aware of any condition, cause or circumstances that may necessitate the cancellation or curtailment of the joumey as planned. I further authorize the Company to provide my personal data including but not limited to health and details of the claims incurred to reinsurance companies with whom the Company has or proposes to have dealings or to any agent, contractor or third party service provider who provides services to the Company in connection with the operation of its business.

Insurance Plan : Premium

Country Of Origin:

Indonesia

Country(ies) To Be Visited:

Indonesia

Period Of Insurance:

10-10-2020 - 11-11-2020

Number of Days:

- days

Premium Type:

- days

Summary and Billing Statement

TRAVEL DETAILS

Country Of Origin
Hongkong,Philippines,Thailand,Vietnam
Countr(ies) To Be Visited
Indonesia,Aland Islands,Albania,Algeria
Period Of Insurance
09/27/2024 - 09/27/2024
Number of Day
1
Coverage Selected
Bon Voyage
Premium Type
individual
Plan / Type
Plan B

POLICYHOLDER INFORMATION

Origin
Hongkong, Philippines, Thailand, Vietnam
Destination
Indonesia, Aland Islands, Albania, Algeria
Departure Date
09/27/2024 - 09/27/2024
Number of Day
1 Day(s)
Your Plan
Bon Voyage
Travelers Type
Individual
Plan / Type
Plan B

INSURED INFORMATION

Total Premium:
$0
Download File Quotation

More than just insurance, Pacific Cross provides peace of mind.

Pacific Cross Insurance Team

customerservice@pacificcross.com https://www.pacificcross.com
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