Agent | Kingfisher | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | TBA | ||||||||
Effective Date | 12/18/2017 | ||||||||
Expiry Date | 01/31/2018 | ||||||||
Plan | Plan B (World Wide Including USA & Canada) | ||||||||
Cover | Medical Only A-C | ||||||||
Name of Policy Holder | Elena Stavros Yiannakis | ||||||||
Policy Number | T/KF168 | ||||||||
Country of Origin | Malawi | ||||||||
Destination Area | USA | ||||||||
Address | Private Bag 154 | ||||||||
Number of Passengers | 1 | ||||||||
List of persons insured |
| ||||||||
Net Premium (Before Tax) | 367,777.60 | ||||||||
Service Fees | 0.00 | ||||||||
Total Premium (After Tax) | 422,635.90 | ||||||||
Signed by |