CONFIRMATION OF
TRAVEL INSURANCE COVERAGE
We are pleased to conkrm travel medical coverage under Visitor Secure®, insured by Lloyd’s Syndicate 4141 and administered by WorldTrips, a member of
the Tokio Marine HCC group of companies. WorldTrips has authority to enter into contracts of insurance on behalf of the Lloyd’s underwriting members of
Lloyd’s Syndicate 4141, which is managed by HCC Underwriting Agency Ltd. Lloyd’s is authorized as an insurer in Spain by the Spanish insurance regulatory
authority (Dirección General de Segurosy Fondos de Pensiones) under reference L0017.
This coverage is valid worldwide, except for the member’s Home Country and countries restricted by U.S. economic sanctionsand embargo programs.
Effective Date: 2024-09-14
Termination Date: 2024-10-04
Home Country: Bangladesh
Destination Country (ies): VIETNAM
Name Policy No. Date of Birth Passport Citizenship
RASHEDUL ISLAM VS124924 02/05/2005 A02933139 Bangladesh
VisitorSecure®
Overall Maxim um Limit
One Hundred Thirty Thousand US Dollars
$130,000 (€109902.0000*)
Deductible $ 50 ( € 42 .2 7 00* ) Fifty US Dollars
Medical Expenses (including hospitalization) (includes COVID‐19) See Schedule of Benekts
Emergency Medical Evacuation** $50,000 (€42270.0000*) Fifty Thousand US Dollars
Repatriation of Remains $25,000 (€21135.0000*) Twenty‐Five Thousand US Dollars
Personal Liability $0
Paid in full by AMEX
This coverage is extendable for up to 364 days. VisitorSecure ® is a scheduled benekt plan. Other limitations and exclusions do apply. Please see policy
documents for further details, or feel free to contact us with any questions or concerns.
COVID 19: Covered same as any other illness to the above mentioned medical maximum.
Sincerely,
Mark Carney WorldTrips
Plan Administrator for Lloyd’s, Fitzwilliam House, 10 St. Mary Axe, London, England EC3 A 8BF
* Plan pays in US Dollars only. Amounts in Euros are provided for convenience and are based on conversion rate as of July 7, 2021
** Except as provided under Acute Onset of Pre‐existing Condition
WorldTrips
251 North Illinois Street, Suite 600, Indianapolis, IN, 46204 USA • Tel: 317‐262‐2132 • Fax: 317‐262‐2140 • Toll Free: 800‐605‐2282 • worldtrips.com
