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Personal Information


Please provide the personal information of the person who will travel.


Itinerary


Please specify the countries you will travel to and the duration of your trip. Note: Please don't include stopovers.


For more information about our packages. Click here.
  (min 125km away from usual place of residence)



For more information about our COVID-19 Assist Coverage. Click here.
 

Quote Summary


Premium Computation
Net Premium Php
Plus
Documentary Stamps
Premium Tax
Local Government Tax
Total Amount Due
Less % -
Final Amount Due Php
Promo
Please note the percent discount from the promo code is applied against the Net Premium US dollar amount .Only one promo code is allowed per transaction.
Documentary Stamps Tax
Due to BIR implementation of EDST(Electronic Documentary Stamp Tax) system effective July 1, 2010, policy holder are mandated to pay the DST portion of the premium once the policy is issued. Refund on DST for cancelled policies is not allowed.
Coverage
Mode of Transpo:
Package:
I. Accidental Death / Disablement Php
II. Accidental Medical Reimbursement
III. Accidental Burial Benefit
IV. Unprovoked Murder and Assault
Travel Assistance
Medical expenses (with Sabotage and Terrorism) and hospitalization Php
Transport of repatriation in case of illness or accident Actual Expense
Repatriation of mortal remains Actual Expense
Pre-existing Condition within the Look Back Period
Trip Cancellation
Trip Curtailment
Delayed departure up to Php 10,000.00
Baggage Delay up to Php 5,000.00
Compensation for in-flight loss and damage (checked-in baggage) up to Php 10,000.00 (subject to Php 1,000.00/item)
Long distance medical information services Actual Expense
Medical referral/appointment of local medical specialists Actual Expense
Connection Services Actual Expense
Covid Coverage
OPTIONAL COVER-COVID-19 COVERAGE(Via Air or Via Non-Air) Packet Pro Prime Platinum
Trip Cancellation due to Covid-19 Php 25,000.00 Php 25,000.00 Php 25,000.00 Php 25,000.00
Daily Hospital Benefits due to Covid-19 (maximum of 15 days) Php 250.00/day Php 500.00/day Php 750.00/day Php 1,000.00/day
Travel Information
Province:
Purpose of Travel Leisure: Leisure / Vacation
Type of Coverage: Individual
Start Date:
End Date: (both dates inclusive)
Insured Information
Name:
Birthday:
Telephone No.:
Mobile No.:
Email Address:

Personal Information











Contact Information







 




Final Quote


Premium Computation
Net Premium Php
Plus
Documentary Stamps
Premium Tax
Local Government Tax
Total Amount Due
Less % -
Total Premium Php

Personal Information
Name:
Birthday:
Telephone No.:
Mobile No.:
Email Address:
Travel Information
Province:
Purpose of Travel Leisure: Leisure / Vacation
Type of Coverage: Individual
Start Date:
End Date: (both dates inclusive)
Emergency Contacts
No. Name Contact No. Relation Bday Status
Beneficiaries
No. Name Relation
Coverage
Mode of Transpo:
Package:
I. Accidental Death / Disablement Php
II. Accidental Medical Reimbursement
III. Accidental Burial Benefit
IV. Unprovoked Murder and Assault

Travel Assistance
Medical expenses (with Sabotage and Terrorism) and hospitalization Php
Transport of repatriation in case of illness or accident Actual Expense
Repatriation of mortal remains Actual Expense
Pre-existing Condition within the Look Back Period
Trip Cancellation
Trip Curtailment
Delayed departure up to Php 10,000.00
Baggage Delay up to Php 5,000.00
Compensation for in-flight loss and damage (checked-in baggage) up to Php 10,000.00 (subject to Php 1,000.00/item)
Long distance medical information services Actual Expense
Medical referral/appointment of local medical specialists Actual Expense
Connection Services Actual Expense
Covid Coverage
OPTIONAL COVER-COVID-19 COVERAGE(Via Air or Via Non-Air) Packet Pro Prime Platinum
Trip Cancellation due to Covid-19 Php 25,000.00 Php 25,000.00 Php 25,000.00 Php 25,000.00
Daily Hospital Benefits due to Covid-19 (maximum of 15 days) Php 250.00/day Php 500.00/day Php 750.00/day Php 1,000.00/day
Subjectivities
Warranted that the covered person/s should have two (2) shots of Covid-19 vaccine (one for J&J shots) at inception of policy.
Insured is not confirmed positive (asymptomatic or symptomatic), suspected, or probable cases of COVID-19 at the time of the application.
Infectious Disease Exclusion Clause.
Sabotage and Terrorism Inclusion.
Beneficiary Endorsement.
Standard Cocogen Domestic Travel Policy Wordings
Domestic Covid-19 Coverage Endorsement Wordings