Agent | Libertas Lilongwe | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | LL001 | ||||||||
Effective Date | 04/24/2018 | ||||||||
Expiry Date | 05/13/2018 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Medical Only A-C | ||||||||
Name of Policy Holder | Vitumbiko Chinoko | ||||||||
Policy Number | T/LL392 | ||||||||
Country of Origin | Malawi | ||||||||
Destination Area | Germany | ||||||||
Address | Private Bag A89 | ||||||||
Number of Passengers | 1 | ||||||||
List of persons insured |
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Net Premium (Before Tax) | 41,314.20 | ||||||||
Service Fees | 0.00 | ||||||||
Total Premium (After Tax) | 49,131.04 | ||||||||
Signed by |