AVIAREPS_Taiwan_COI_Exp._11.8.26.pdf

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Attached to
Master Agreement AZ|CTR079292
Contract number
CTR079292
Issued by
Arizona

About this file

This document is a Certificate of Insurance issued by Cathay Life Insurance Co., Ltd. from the Republic of China, Taiwan. The insurance policy is for AVIAREPS, with policy number G500086713, and covers an individual named TSAI, PI-JU. The effective period of the insurance is from November 8, 2025, to November 8, 2026, with an exchange rate of USD 1 to NTD 31.010.

The insurance coverage includes several key benefits: Accidental Death and Dismemberment (AD&D) with a benefit of NT$3,000,000, Specific Accidental Death and Dismemberment at NT$3,000,000, and Aviation Accidental Death and Dismemberment also at NT$3,000,000. Additional benefits include a Daily Benefit for Hospitalization and Non-Hospitalized Allowance for Fracture (Accident Only) of NT$2,000, Medical Reimbursement (Accident Only) of NT$50,000, and a Daily Benefit for ICU (Accident Only) of NT$2,000. The certificate notes that in case of any conflict between the Chinese policy and the certificate, the Chinese policy shall prevail.

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Text version

NAME OF INSURANCE CO.:

COUNTRY:

INSURANCE APPLICANT:

POLICY NUMBER:

EFFECTIVE PERIOD: FROM Nov 08, 2025 TO

NAME OF INSURED:

ID / PASSPORT NUMBER:

EXCHANGE RATE: USD 1 / NTD 31.010

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

NT$

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES. IF THERE IS ANY CONFLICT BETWEEN

THE CHINESE POLICY AND THE CERTIFICATE, THE CHINESE POLICY SHALL PREVAIL.

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ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D) 3,000,000

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SPECIFIC ACCIDENTAL DEATH AND DISMEMBERMENT 3,000,000

AVIATION ACCIDENTAL DEATH AND DISMEMBERMENT 3,000,000

DAILY BENEFIT FOR HOSPITALIZATION AND NON-HOSPITALIZED

ALLOWANCE FOR FRACTURE - ACCIDENT ONLY

2,000

MEDICAL REIMBURSEMENT - ACCIDENT ONLY 50,000

DAILY BENEFIT FOR ICU - ACCIDENT ONLY 2,000

DATE: 2025/11/12

Nov 08, 2026

COVERAGE BENEFIT

CATHAY LIFE INSURANCE CO., LTD.

REPUBLIC OF CHINA, TAIWAN

AVIAREPS

G500086713

TSAI, PI-JU

G221331134 / 369518199

#N/A 0

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CATHAY LIFE BUILDING: No. 296, Sec. 4, Ren-Ai Road, Taipei City 106, Taiwan, R.O.C.

URL: https://www.cathaylife.com.tw/cathaylife/

TEL: 886-2-55595110 #2

SHAN-CHI LIU

President

Cathay Life Insurance Co., Ltd.

File details come from the government source that posted it. Updated .