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  • Domestic TravInsure - Specially designed for SpiceJet PassengersSchedule of Travel Insurance

    Issued at Mumbai

    Schedule Number:Policy Validity Dates:

    (Max covered period 30 days from the first departure date of the insured schedule flight unless insured returns to the station of origin earlier.)From 13/04/2008 to 13/04/20088C647189

    Applicant/Insured Name: VIKRAM VARMAApplicant/Insured Address: A S/4 Paraiso De Goa Alto Porvorim

    Goa 403521Benefits subject to terms and conditions for the policy

    Benefits Maximum Coverage DeductibleAccidental Death and Dismemberment (24 Hrs)Emergency Accidental Medical ReimbursementEmergency Medical Evacuation andRepatriation of Remains24-hr Emergency Assistance ServiceTrip CancellationBaggage Loss-Checked

    Flight Delay

    Common Carrier Delay

    Trip Interruption

    Rs 750,000Rs 100,000*INCLUDED

    *INCLUDEDUp to the Original Cost of FlightRs 7,500

    Rs 1,500 per 6 Hrs delay periodup to RS 10,500Rs 1,500 per 6 Hrs delay periodup to Rs 10,500Up to the Original Cost of Flight

    10% / 50% (Per Article /

    * Included under overall limit of Accident & Sickness

    Per Bag Limit)

    PREMIUMTax (12.36%)Total Premium

    INRINR

    INR 14

    129

    115

    Assistance Contact0091-11-41898858(International SOS)Email:[email protected]

    Address for submission of claim documentsClaims Department

    Ahura Centre, 4th Floor, 82, Mahakali Cave Road,Andheri (East), Mumbai, India-400093

    Important: Any Pre-Existing Medical condition willbe excluded from the policyThe stamp duty of RS.1/- paid by demand draft,

    Signed for & on Behalf of TATA AIG General Insurance Company Ltd.

    TATA AIG General Insurance Company Ltd

    Authorized SignatoryDate Issued:

    vide Receipt/Challan no. 148356 dated 22nd August 2006

    10/04/2008

    Declaration: The full terms & conditions of your TATA AIG Policy can be viewed or downloaded online at www.spicejet.com.It is important to read the terms & condition of the Insurance policy & Carry a copy of this certificate for ready reference.

    Ahura Centre, 4th Floor, 82, Mahakali Caves Road, Andheri (East), Mumbai 400093, Maharastra, India. TEL +91-22-66930000 FAX +91-22-28305888. Registered Office: Peninsula Corporate Park, Nicholas Piramal Tower, 9th Floor, Ganpatrao Kadam Marg, Lower Parel, Mumbai 400013, Maharastra, India.

    TEL +91-22-66699696 FAX +91-22-56546464.

    RECPPCertificate of Endorsement - Spice Jet IndiaPage 1