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  5. Summary
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  7. Policy
    Issuance
Date Of Birth:
Travel Country:

Second Traveling Country:

Trip Type:
Travel Duration:
Departure Date:
Expiry Date:
Note: Date Validation should be 18 to 85. Double Premium Will be Charged if Customer Age is More than 65 Years Date Validation On Family Plan Should Be 18 to 85.

Family Details

Relationship Gender Date Of Birth Action
Calculated Age: 0Years 0Months Oyears
Min Spouse Age: 18Years 0Months Oyears Max Spouse Age: 65Years 0Months Oyears Min Child Age: 0Years 6Months Oyears Max Child Age: 18Years 0Months Oyears
Relationship
Gender
Date Of Birth Calculated Age: 0Years 0Months Oyears
Action
Min Spouse Age: 18Years 0Months Oyears Max Spouse Age: 65Years 0Months Oyears Min Child Age: 0Years 6Months Oyears Max Child Age: 18Years 0Months Oyears

Date Of Birth

Trip Type:
Travel Duration:
Departure Date:
Expiry Date:

Family Details

Relationship Gender Date Of Birth Action
Calculated Age: 0Years 0Months Oyears
Min Spouse Age: 18Years 0Months Oyears Max Spouse Age: 65Years 0Months Oyears Min Child Age: 0Years 6Months Oyears Max Child Age: 18Years 0Months Oyears
Relationship
Gender
Date Of Birth Calculated Age: 0Years 0Months Oyears
Action
Min Spouse Age: 18Years 0Months Oyears Max Spouse Age: 65Years 0Months Oyears Min Child Age: 0Years 6Months Oyears Max Child Age: 18Years 0Months Oyears

Date Of Birth

Travel Country:
Trip Type:
Travel Duration:
Departure Date:
Expiry Date:
Date Of Birth:
Travel Country:

Second Traveling Country:

Trip Type:
Travel Duration:
Departure Date:
Expiry Date:

Family Details

Relationship Gender Date Of Birth Action
Calculated Age: 0Years 0Months Oyears
Min Spouse Age: 18Years 0Months Oyears Max Spouse Age: 65Years 0Months Oyears Min Child Age: 0Years 6Months Oyears Max Child Age: 18Years 0Months Oyears
Relationship
Gender
Date Of Birth Calculated Age: 0Years 0Months Oyears
Action
Min Spouse Age: 18Years 0Months Oyears Max Spouse Age: 65Years 0Months Oyears Min Child Age: 0Years 6Months Oyears Max Child Age: 18Years 0Months Oyears

Coverage Days: 10days

International travel Insurance - Care

International

Total Premium: PKR 5,100

Coverage Days: 10days

International travel Insurance - Care

International

Total Premium: PKR 5,100

Coverage Days: 10days

International travel Insurance - Care

International

Total Premium: PKR 5,100

Coverage Days: 10days

International travel Insurance - Care

International

Total Premium: PKR 5,100

Coverage Days: 10days

International travel Insurance - Care

International

Total Premium: PKR 5,100

Coverage Days: 10days

International travel Insurance - Care

International

Total Premium: PKR 5,100

is Foreign National

CNIC:
Passport Number:
CNIC Isuuance Date :

LifeTime CNIC

CNIC Expiry Date :
Customer Name:
Father/Husband Name:
Gender:
Country of Birth:

City of Birth

Nationality:
Source of Income:
Contact #:
Email:
Purpose of Visit:
Address:
City:
Country:

Remarks

Beneficiary Details

Name:
Ralationship:
CNIC:
Address:

Documents

Uploaded Image

CNIC Front

Uploaded Image

CNIC Back

Uploaded Image

Passport

Insured Details

Insured Name

Abdullah

Mobile Number

+92 123456789

Insured Name

example@gmail.com

Address

example address

Beneficiary Details

Name

Abdullah

Relationship

Brother

CNIC

42101-5632557-2

Address

example address

Product Detail

Product Name

International Travel Insurance

Plan

Secure Delight

Premium Details

Net Premium

PKR 3,400

Choose Do:

Choose Agent

Select Payment Method

Amount:

Bank Name:

Cheque Number:

Cheque Date:

Amount:

Uploaded Image

Payment Document:

Bank Name:

Payment Reference No:

Payment Receiving Date:

Amount:

Uploaded Image

Payment Document:

I agree to the terms & conditions

Thanks For Submitting