Certificate-MISS MARY CLAIRE PAYWAN

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To Whom It may concern, 18 December 2021

AXA Sawasdee Thailand Insurance Certificate

This is to certify that MISS MARY CLAIRE PAYWAN


ID no./Passport no. P5550293B is covered for
outpatient and inpatient medical expense from sickness and accident including any
sickness caused by COVID-19(2) while travelling in Thailand under AXA Travel Insurance
Policy No. 2021-Q6202766-AT1 - Individual Inbound Travel Insurance Policy
plan starting from 18 January 2022 to 22 January 2022 (single trip) (1) with
benefit as below:
No Benefits Baht
1 Personal Accident Loss of Life, Dismemberment, Loss of Sight or Total Permanent
1,000,000
Disability
2 Medical Expense due to Accident or Sickness 1,750,000
3 Personal Liability 850,000
*The coverage meets the minimum requirement of 50,000 USD for Certificate of Entry (COE) and Thailand
pass application
Please refer to the Insurance Policy for full details of insurance conditions, coverage and
exclusions.
Remark:
1. This is a single trip policy. This Insurance Policy terminates upon departure from Thailand or the above stated
expiry date, whichever is earlier
2. Definition of COVID-19 follows criteria from the Ministry of Public Health of Thailand and/or WHO
3. A combined limit of 1,750,000 THB applies to Outpatient and Inpatient benefits

Claude Seigne Cecilia Chow


Chief Executive Officer Chief Retail Officer

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