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    This document provides an insurance certificate for involuntary loss of employment coverage. The certificate covers Saju Pathampadiyil Sebastian Sebastian, an employee of Master Systems L.L.C, for a period of 12 months from March 1, 2023. The certificate provides 60% of the insured's average basic salary over the past 6 months, for a maximum of 3 months per claim. The maximum monthly benefit is AED 10,000 for Category A insureds. The certificate was issued by Dubai Insurance Company on behalf of the Insurance Pool.

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    WWW - ILOE.ae WWW - ILOE.ae

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    SajuSebastion
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    This document provides an insurance certificate for involuntary loss of employment coverage. The certificate covers Saju Pathampadiyil Sebastian Sebastian, an employee of Master Systems L.L.C, for a period of 12 months from March 1, 2023. The certificate provides 60% of the insured's average basic salary over the past 6 months, for a maximum of 3 months per claim. The maximum monthly benefit is AED 10,000 for Category A insureds. The certificate was issued by Dubai Insurance Company on behalf of the Insurance Pool.

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    C_01_2023_000782862

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    This document provides an insurance certificate for involuntary loss of employment coverage. The certificate covers Saju Pathampadiyil Sebastian Sebastian, an employee of Master Systems L.L.C, for a period of 12 months from March 1, 2023. The certificate provides 60% of the insured's average basic salary over the past 6 months, for a maximum of 3 months per claim. The maximum monthly benefit is AED 10,000 for Category A insureds. The certificate was issued by Dubai Insurance Company on behalf of the Insurance Pool.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    773 views2 pages

    WWW - ILOE.ae WWW - ILOE.ae

    Uploaded by

    SajuSebastion
    This document provides an insurance certificate for involuntary loss of employment coverage. The certificate covers Saju Pathampadiyil Sebastian Sebastian, an employee of Master Systems L.L.C, for a period of 12 months from March 1, 2023. The certificate provides 60% of the insured's average basic salary over the past 6 months, for a maximum of 3 months per claim. The maximum monthly benefit is AED 10,000 for Category A insureds. The certificate was issued by Dubai Insurance Company on behalf of the Insurance Pool.

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    Insurance Certificate ‫ﺷﻬﺎﺩﺓ ﺍﻟﺘﺄﻣﻴﻦ‬


    Involuntary Loss of Employment ‫ﺿﺪ ﺍﻟﺘﻌﻄﻞ ﻋﻦ ﺍﻟﻌﻤﻞ‬
    Insurance Certificate Number C/01/2023/000782862 C/01/2023/000782862 ‫ﺭﻗﻢ ﺷﻬﺎﺩﺓ ﺍﻟﺘﺄﻣﻴﻦ‬
    Coverage Period ‫ﻣﺪﺓ ﺍﻟﺘﻐﻄﻴﺔ‬
    Inception Date 01-03-2023 01-03-2023 ‫ﺗﺎﺭﻳﺦ ﺍﻟﺴﺮﻳﺎﻥ‬
    Expiry Date 12 months as of inception ‫ ﺷﻬﺮﺍً ﺑﻌﺪ ﺗﺎﺭﻳﺦ ﺑﺪﺍﻳﺔ ﺍﻟﺘﺄﻣﻴﻦ‬12 ‫ﺗﺎﺭﻳﺦ ﺍﻻﻧﺘﻬﺎﺀ‬
    date
    Details of the Insured Employee/ Worker ‫ﺑﻴﺎﻧﺎﺕ ﺍﻟﻤُﺆﻣَﻦ ﻟﻪ‬
    Name of the Insured Worker SAJU PATHAMPADIYIL ‫ﺳﺎﺟﻮ ﺑﺎﺗﺎﻳﻤﺒﺎﺩﻳﻴﻞ ﺳﻴﺒﺎﺳﺘﻴﺎﻥ ﺳﻴﺒﺎﺳﺘﻴﺎﻥ‬ ‫ﺍﺳﻢ ﺍﻟﻌﺎﻣﻞ ﺍﻟﻤُﺆﻣَﻦ ﻟﻪ‬
    SEBASTIAN SEBASTIAN
    Emirates ID No./UID number 784197860837687 784197860837687 ‫ﺍﻟﺮﻗﻢ ﺍﻟﻤﻮﺣﺪ‬
    Category Category A ‫ﺍﻟﻔﺌﺔ ﺃ‬ ‫ﻟﻔﺌﺔ‬
    Premium (AED) 60.00 60.00 (‫ﺍﻟﻘﺴﻂ ﺍﻟﺘﺄﻣﻴﻨﻲ )ﺑﺎﻟﺪﺭﻫﻢ‬
    Premium Paid upon purchase 60.00 60.00 ‫ﺩﻭﺭﻳﺔ ﺍﻟﺴﺪﺍﺩ ﻋﻨﺪ ﺍﻟﺸﺮﺍﺀ‬
    Establishment Details ‫ﺑﻴﺎﻧﺎﺕ ﻣﻨﺸﺄﺓ ﺍﻟﻌﻤﻞ‬
    at the date of issuing the Certificate of Insurance ‫ﻋﻨﺪ ﺇﺻﺪﺍﺭ ﺷﻬﺎﺩﺓ ﺍﻟﺘﺄﻣﻴﻦ‬
    Establishment Name MASTER SYSTEMS ‫ﻓﺮﻉ‬/‫ﺍﻻﺳﺘﺎﺫ ﻟﻼﻧﻈﻤﻪ ﺫ ﻡ ﻡ‬ ‫ﺍﺳﻢ ﺻﺎﺣﺐ ﺍﻟﻌﻤﻞ‬
    L.L.C/BR
    Establishment No. 555780 555780 ‫ﺭﻗﻢ ﺍﻟﻤﻨﺸﺄﺓ‬
    Insurance Coverage ‫ﺍﻟﺘﻐﻄﻴﺔ ﺍﻟﺘﺄﻣﻴﻨﻴﺔ‬
    60% of Basic Salary/Wage Wage calculated based on ‫ ﺍﻟﺮﺍﺗﺐ ﺍﻷﺳﺎﺳﻲ‬/ ‫ ﻣﻦ ﺍﻷﺟﺮ‬%60 ‫ﻳﻜﻮﻥ ﺍﻟﺘﻌﻮﻳﺾ ﻋﻠﻰ ﺃﺳﺎﺱ ﺷﻬﺮﻱ ﺑﻨﺴﺒﺔ‬
    average Basic Salary/Wage of the last 6 months prior to (‫ ﺃﺷﻬﺮ ﺍﻟﺴﺎﺑﻘﺔ ﻟﻠﺘﻌﻄﻞ ﻋﻦ ﺍﻟﻌﻤﻞ‬6 ‫)ﺗﺤﺴﺐ ﻋﻠﻰ ﺃﺳﺎﺱ ﻣﺘﻮﺳﻂ ﺍﻷﺟﺮ ﺍﻷﺳﺎﺳﻲ ﺁﺧﺮ‬
    Unemployment for a maximum of three (3) months per ،‫( ﺛﻼﺛﺔ ﺃﺷﻬﺮ ﺑﺤﺪ ﺃﻗﺼﻰ ﻟﻜﻞ ﻣﻄﺎﻟﺒﺔ ﻣﻦ ﺗﺎﺭﻳﺦ ﺍﻟﺘﻌﻄﻞ ﻋﻦ ﺍﻟﻌﻤﻞ‬3) ‫ﻭﻟﻤﺪﺓ‬
    Claim from the date of Unemployment, not exceeding: :‫ﻋﻠﻰ ﺃﻻ ﺗﺰﻳﺪ ﻋﻦ‬
    Maximum Monthly Limit :‫ﺍﻟﺤﺪ ﺍﻷﻗﺼﻰ ﻟﻠﺘﻐﻄﻴﺔ ﺍﻟﺘﺄﻣﻴﻨﻴﺔ ﺍﻟﺸﻬﺮﻳﺔ‬
    AED 10,000 and AED 20,000 for the first and second (20,000) ‫ ﻭﻻ ﺗﺰﻳﺪ ﻋﻦ‬،‫( ﻋﺸﺮﺓ ﺁﻻﻑ ﺩﺭﻫﻢ ﺍﻣﺎﺭﺗﻲ ﻟﻠﻔﺌﺔ ﺍﻷﻭﻟﻰ‬10,000)
    categories respectively as specified in the Policy .‫ﻋﺸﺮﻳﻦ ﺃﻟﻒ ﺩﺭﻫﻢ ﺍﻣﺎﺭﺗﻲ ﻟﻠﻔﺌﺔ ﺍﻟﺜﺎﻧﻴﺔ ﻛﻤﺎ ﻫﻮ ﻣﺒﻴﻦ ﻓﻲ ﺟﺪﻭﻝ ﺍﻟﻮﺛﻴﻘﺔ‬
    Maximum Claim Limit/Maximum Aggregate Limit
    The maximum compensation for any one Claim is three ‫ ﺍﻟﺤﺪ ﺍﻷﻗﺼﻰ ﻟﻠﺘﻐﻄﻴﺔ‬/‫ﺍﻟﺤﺪ ﺍﻷﻗﺼﻰ ﻟﻠﺘﻐﻄﻴﺔ ﺍﻟﺘﺄﻣﻴﻨﻴَّﺔ ﻋﻦ ﻛﻞ ﻣﻄﺎﻟﺒﺔ‬
    (3) consecutive months. :‫ﺍﻟﺘﺄﻣﻴﻨﻴَّﺔ ﺍﻹﺟﻤﺎﻟﻴﺔ‬
    The aggregate Claim shall not exceed the equivalent of .‫( ﺛﻼﺛﺔ ﺃﺷﻬﺮ ﻋﻦ ﻛﻞ ﻣﻄﺎﻟﺒﺔ‬3) :‫ﺍﻟﻤﺪﺓ ﺍﻟﻘﺼﻮﻯ ﻟﻠﺘﻌﻮﻳﺾ‬
    12 monthly benefits over the entire service period of ‫( ﺍﺛﻨﻲ ﻋﺸﺮ ﺷﻬﺮﺍً ﺧﻼﻝ ﻛﺎﻣﻞ ﻣﺪﺓ ﺧﺪﻣﺔ‬12) ‫ﻋﻠﻰ ﺃﻻ ﺗﺰﻳﺪ ﻣﺪﺓ ﺍﻟﺘﻌﻮﻳﺾ ﻋﻦ‬
    Insured in the Country. .‫ﺍﻟﻤُﺆﻣﻦ ﻋﻠﻴﻪ ﻓﻲ ﺳﻮﻕ ﺍﻟﻌﻤﻞ ﻓﻲ ﺍﻟﺪﻭﻟﺔ‬
    This Insurance Certificate is subject to the terms and ‫ ﻳﻤﻜﻦ ﺍﻻﻃﻼﻉ ﻋﻠﻰ ﻭﺛﻴﻘﺔ ﺍﻟﺘﺄﻣﻴﻦ ﻋﺒﺮ‬. ‫ﺗﺨﻀﻊ ﻫﺬﻩ ﺍﻟﺸﻬﺎﺩﺓ ﻟﺸﺮﻭﻁ ﻭﺍﺣﻜﺎﻡ ﻭﺛﻴﻘﺔ ﺍﻟﺘﺄﻣﻴﻦ‬
    conditions of the Insurance Policy. The insurance policy can be :‫ (؛ ﺃﻭ ﻣﻦ ﺧﻼﻝ ﻣﺴﺢ ﺍﻟﺮﻣﺰ ﺍﻟﺘﺎﻟﻲ‬www.ILOE.ae ) ‫ﺭﺍﺑﻂ ﺍﻟﻤﻮﻗﻊ ﺍﻻﻟﻜﺘﺮﻭﻧﻲ‬
    viewed via the website link (www.ILOE.ae), or scan the QR:

    This certificate was issued by Dubai Insurance Company ‫ﺑﺼﻔﺘﻬﺎ ﻋﻀﻮ‬، ‫ﻉ‬.‫ﻡ‬.‫ﺻﺪﺭﺕ ﻫﺬﻩ ﺍﻟﺸﻬﺎﺩﺓ ﻋﻦ ﺷﺮﻛﺔ ﺩﺑﻲ ﻟﻠﺘﺄﻣﻴﻦ ﺵ‬
    PJSC, in its capacity as a member and manager of the ‫ﻭﻣﺪﻳﺮ ﺍﻟﻤﺠﻤﻊ ﺍﻟﺘﺄﻣﻴﻨﻲ ﻭﺑﺎﻟﻨﻴﺎﺑﺔ ﻋﻦ ﺃﻋﻀﺎﺀ ﺍﻟﻤﺠﻤﻊ ﺍﻟﺘﺄﻣﻴﻨﻲ‬
    Insurance Pool and on behalf of the members of the
    Insurance Pool
    Dubai Insurance Company Psc, Head Office, Al Rigga Road, PO Box 3027, Dubai, UAE
    TRN: 100032059600003

    TAX INVOICE ‫ﻓﺎﺗﻮﺭﺓ ﺿﺮﻳﺒﻴّﺔ‬

    Tax Invoice Number 0000782861 ‫ﺭﻗﻢ ﺍﻟﻔﺎﺗﻮﺭﺓ ﺍﻟﻀﺮﻳﺒﻴّﺔ‬


    Date(same as payment date) 01-03-2023 ‫ﺗﺎﺭﻳﺦ ﺍﻟﻔﺎﺗﻮﺭﺓ‬
    The Insured Worker’s Name SAJU PATHAMPADIYIL SEBASTIAN ‫ﺍﺳﻢ ﺍﻟﻌﺎﻣﻞ ﺍﻟﻤﺆﻣﻦ ﻋﻠﻴﻪ‬
    SEBASTIAN
    Emirates ID or UID number 784197860837687 ‫ﺭﻗﻢ ﺍﻟﻬﻮﻳﺔ ﺍﻹﻣﺎﺭﺍﺗﻴّﺔ‬
    Certificate of Insurance No. C/01/2023/000782862 ‫ﺭﻗﻢ ﺷﻬﺎﺩﺓ ﺍﻟﺘﺄﻣﻴﻦ‬
    Coverage Period 01-03-2023 to 29-02-2024 ‫ﻓﺘﺮﺓ ﺍﻟﺘﻐﻄﻴﺔ‬
    Payment Plan (monthly/quarterly/yearly) Full/Annual ‫ﺩﻭﺭﻳّﺔ ﺍﻟﺴﺪﺍﺩ‬

    Due Date of last installment 01-03-2023 ّ‫ﺗﺎﺭﻳﺦ ﺍﺳﺘﺤﻘﺎﻕ ﺍﻟﺪﻓﻌﺔ ﺍﻷﺧﻴﺮﺓ ﻣﻦ ﺍﻟﻘﺴﻂ ﺍﻟﺘﺄﻣﻴﻨﻲ‬

    Premium in AED 60.00 (‫ﺍﻟﻘﺴﻂ ﺍﻟﺘﺄﻣﻴﻨﻲّ )ﺑﺎﻟﺪﺭﻫﻢ‬


    VAT 5% on premium 3.00 (%5)ّ‫ﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ ﻋﻠﻰ ﺍﻟﻘﺴﻂ ﺍﻟﺘﺄﻣﻴﻨﻲ‬

    Total consideration payable 63.00 ‫ﺇﺟﻤﺎﻟﻲ ﺍﻟﻤﺒﻠﻎ ﻣﺴﺘﺤﻖ ﺍﻟﺴﺪﺍﺩ‬


    Payment Reference Number PR0000801838 ‫ﺭﻗﻢ ﻣﻌﺎﻣﻠﺔ ﺍﻟﺴﺪﺍﺩ‬
    Payment made through Worker ‫ﺁﻟﻴﺔ ﺍﻟﺴﺪﺍﺩ‬

    First installment received with VAT (AED) 63.00 ‫ ﻣﺘﻀﻤﻨﺔ‬- ‫ﺍﻟﺪﻓﻌﺔ ﺍﻷﻭﻟﻰ ﻣﻦ ﺍﻟﻘﺴﻂ ﺍﻟﺘﺄﻣﻴﻨﻲّ ﺍﻟﻤﺴﺘﺤﻘﺔ‬
    (‫ﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ )ﺑﺎﻟﺪﺭﻫﻢ‬

    Balance to be received in agreed 0.00 (‫ﺑﺎﻗﻲ ﺩﻓﻌﺎﺕ ﺍﻟﻘﺴﻂ ﺍﻟﺘﺄﻣﻴﻨﻲّ ﺍﻟﻤﺴﺘﺤﻘﺔ )ﺑﺎﻟﺪﺭﻫﻢ‬
    instalments (AED)

    This is a system generated document ‫ﺗﺼﺪﺭ ﻫﺬﻩ ﺍﻟﻔﺎﺗﻮﺭﺓ ﻣﻦ ﺧﻼﻝ ﻧﻈﺎﻡ ﺇﻟﻜﺘﺮﻭﻧﻲّ ﻭﻻ‬
    does not need any signature or stamp ‫ﺣﺎﺟﺔ ﻟﺨﺘﻤﻬﺎ ﺃﻭ ﺗﻮﻗﻴﻌﻬﺎ‬

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