Asuransi Perjalanan (Travel)
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Draft Quotation Slip Ttravela Telkomsel
SLIP PENAWARAN / QUOTATION SLIP
ASURANSI PERJALANAN / TRAVEL INSURANCE
T TRAVELLA
NEW BUSINESS
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Nama Tertanggung Name of Insured |
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Bapak/Ibu |
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Alamat Tertanggung Address of Insured |
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Tempat/Tanggal Lahir Place/Date of Birth |
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Tanda Pengenal Identification |
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Pekerjaan Occupation |
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Ahli Waris / Hubungan Beneficiary Name / Relation |
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- |
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Periode Pertanggungan Period of Insurance |
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Mulai dari s.d Start from to |
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Mata Uang Currency |
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Indonesian Rupiah (IDR) |
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Batas Ganti Rugi Limit of Indemnity |
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Negara Tujuan Destination |
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Moda Angkutan Transportation |
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Premi : IDR
Premium
Biaya Admin dan Materai : - IDR
Adm & Materai fee
Diskon : IDR
Discount
Premi Neto : IDR
Net Premium
TABEL MANFAAT PRODUK STANDAR / STANDARD PRODUCT BENEFIT TABLE
ASURANSI ASURANSI PERJALANAN / TRAVEL INSURANCE
T TRAVELLA - INTERNASIONAL STANDAR
| Opsi 1 | |||
| Period of cover : 30 days (as per Telkomsel Package) | |||
| Premium : Rp. 436.000 | |||
| Administration cost : Rp. 12.500 | |||
| LUAS JAMINAN / COVERAGE | MANFAAT / BENEFIT | BATASAN GANTI RUGI / LIMIT OF LIABILITY | |
| A | Biaya Pengobatan & Layanan Darurat / Emergency Service Expenses | Biaya Pengobatan dan Rawat Inap / Medical and hospitalization expenses | Rp 500.000.000 |
| Biaya Transportasi atau Repatriasi Ketika Sakit atau Kecelakaan / Transport or repatriation in the event of illness or accident expenses | Rp 500.000.000 | ||
| Biaya Repatriasi Jenazah / Repatriation of Mortal Remain expenses | Rp 500.000.000 | ||
| Biaya Perjalanan Salah Satu Anggota Keluarga Dekat / Travel of one immediate family member expenses | Rp 25.000.000 | ||
| Biaya penjagaan/pedampingan anak / Child Guard expenses | Rp 1.500.000 | ||
| B | Biaya Pembatalan atau Pengurangan Perjalanan / Travel Cancellation or Curtailment Expenses | Biaya pembatalan atau pengurangan perjalanan / Travel cancellation or curtailment expenses | Rp 10.000.000 |
| C | Manfaat Atas Kehilangan dan Penundaan / Benefits for Losses dan Delay | Gangguan perjalanan / Travel disruption | Rp 5.000.000 |
| Penundaan perjalanan / Travel postponement | Rp 5.000.000 | ||
| Tertinggal perjalanan lanjutan / Travel misconnection | Rp 2.500.000 | ||
| Keterlambatan keberangkatan / Delayed Departure | Rp 2.500.000 | ||
| D | Manfaat Untuk Barang Bawaan / Benefits For Luggage | Kompensasi kehilangan di dalam pesawat, perampokan atau perusakan bagasi / Compensation for in-flight loss, robbery or destruction of baggage checked-in | Rp 5.000.000 (max. Rp 1.000.000 per item) |
| Keterlambatan kedatangan bagasi / Delay in the arrival of luggage | Rp 2.500.000 | ||
| Kehilangan paspor, SIM atau KTP / Loss of passport, driving license or ID Card | Rp 2.500.000 | ||
| Penemuan dan pengiriman bagasi dan barang pribadi / Discovery & delivery of luggage and personal effects | Rp 1.000.000 | ||
| E | Manfaat Tambahan / Additional Benefit | Pengiriman obat-obatan / Drugs delivery | Rp 1.000.000 |
| Pembajakan pesawat terbang / Aircraft Hijacking | Rp 500.000 per hari (max. Rp 5.000.000) | ||
| Biaya telepon darurat / Emergency phone call | Rp 1.000.000 | ||
| Perpanjangan periode pertanggungan otomatis / Automatic of extension period | Ya / Yes | ||
| F | Manfaat Kecelakaan Diri dan Cacat Tetap / Benefits For Personal Accident and Disability | Santunan Kematian dan Cacat Tetap Akibat Kecelakaan / Death & Permanent Disablement due to accident | Rp 500.000.000 |
| Cacat Tetap Sebagian / Partial Permanent Disablement | Sesuai tabel skala benefit | ||
| G | Manfaat Tanggung Gugat Pribadi / Benefits For Personal Liability | Tanggung gugat pribadi / Personal Liability | Rp 500.000.000 |
| Opsi 2 | |||
| Period of cover : 7 days (as per Telkomsel Package) | |||
| Premium : Rp. 101.000 | |||
| Administration cost : Rp. 12.500 | |||
| LUAS JAMINAN / COVERAGE | MANFAAT / BENEFIT | BATASAN GANTI RUGI / LIMIT OF LIABILITY | |
| A | Biaya Pengobatan & Layanan Darurat / Emergency Service Expenses | Biaya Pengobatan dan Rawat Inap / Medical and hospitalization expenses | Rp 500.000.000 |
| Biaya Transportasi atau Repatriasi Ketika Sakit atau Kecelakaan / Transport or repatriation in the event of illness or accident expenses | Rp 500.000.000 | ||
| Biaya Repatriasi Jenazah / Repatriation of Mortal Remain expenses | Rp 500.000.000 | ||
| Biaya Perjalanan Salah Satu Anggota Keluarga Dekat / Travel of one immediate family member expenses | Rp 25.000.000 | ||
| Biaya penjagaan/pedampingan anak / Child Guard expenses | Rp 1.500.000 | ||
| B | Biaya Pembatalan atau Pengurangan Perjalanan / Travel Cancellation or Curtailment Expenses | Biaya pembatalan atau pengurangan perjalanan / Travel cancellation or curtailment expenses | Rp 10.000.000 |
| C | Manfaat Atas Kehilangan dan Penundaan / Benefits for Losses dan Delay | Gangguan perjalanan / Travel disruption | Rp 5.000.000 |
| Penundaan perjalanan / Travel postponement | Rp 5.000.000 | ||
| Tertinggal perjalanan lanjutan / Travel misconnection | Rp 2.500.000 | ||
| Keterlambatan keberangkatan / Delayed Departure | Rp 2.500.000 | ||
| D | Manfaat Untuk Barang Bawaan / Benefits For Luggage | Kompensasi kehilangan di dalam pesawat, perampokan atau perusakan bagasi / Compensation for in-flight loss, robbery or destruction of baggage checked-in | Rp 5.000.000 (max. Rp 1.000.000 per item) |
| Keterlambatan kedatangan bagasi / Delay in the arrival of luggage | Rp 2.500.000 | ||
| Kehilangan paspor, SIM atau KTP / Loss of passport, driving license or ID Card | Rp 2.500.000 | ||
| Penemuan dan pengiriman bagasi dan barang pribadi / Discovery & delivery of luggage and personal effects | Rp 1.000.000 | ||
| E | Manfaat Tambahan / Additional Benefit | Pengiriman obat-obatan / Drugs delivery | Rp 1.000.000 |
| Pembajakan pesawat terbang / Aircraft Hijacking | Rp 500.000 per hari (max. Rp 5.000.000) | ||
| Biaya telepon darurat / Emergency phone call | Rp 1.000.000 | ||
| Perpanjangan periode pertanggungan otomatis / Automatic of extension period | Ya / Yes | ||
| F | Manfaat Kecelakaan Diri dan Cacat Tetap / Benefits For Personal Accident and Disability | Santunan Kematian dan Cacat Tetap Akibat Kecelakaan / Death & Permanent Disablement due to accident | Rp 500.000.000 |
| Cacat Tetap Sebagian / Partial Permanent Disablement | Sesuai tabel skala benefit | ||
| G | Manfaat Tanggung Gugat Pribadi / Benefits For Personal Liability | Tanggung gugat pribadi / Personal Liability | Rp 500.000.000 |
