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Country of Cover
Purpose of Travel	Occupation
Usual Country of Residence
Policy Start Date	Policy End Date
Benefits
Personal Accident Benefit payable for Accidental Death, Dismemberment and Permanent Total Disablement.	Medical & Evacuation Benefit payable for Medical and Medical Evacuation. (USD 250 excess / deductible)
Over 65 years of age Minimum age 18, maximum age 75.
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