8c647189
DESCRIPTION
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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