Aljazira Takaful - Visit Visa Extension Insurance

Policy Details

Dear Customer please note,

• Insurance Policy will be issued for visitors in KSA seeking for their visit visa extension.
• Enter correct passport number, Visa and border number details for successful upload of insurance policy in CCHI.

Enter the text you see above

I agree to grant Aljazira Takaful the right to inquire about my data with any relevant authorities.

I declare that all the information entered is correct and I also acknowledge that I do not have any valid insurance policy for the visit visa extension period and in the event of false declaration and/or any incorrect and misleading information provided by me, Aljazira Takaful company reserves the full rights to reject approvals and claims due to providing any incorrect and misleading information.

Policyholder Details

Health Conditions

1. Any hospital admission during the last 12 months

2. Have you been diagnosed with any of the following chronic disease limited to: Autism - Benign Tumor - Cancer - Heart Diseases - Chronic Hepatitis C - Gallstones - Kidney failure - Urinary tract stones - thyroid goiter - Cysts – fibroid uterus - Hernias – autoimmune diseases or Multiple sclerosis.

3. Have you been diagnosed with any of the following congenital disorder or hereditary diseases limited to: Cerebral - palsy - sickle cell disorder - Thalassemia -hemophilia - metabolic diseases - Hydrocephalus - spinal - muscle atrophy - gential - malformations - Chromosomal abnormalities - Gauchers disease - G6PD Deficiency - cystic fibosis - hemochromatosis – Wilson disease - polycystic Kidney Disease.

4. Have you been diagnosed with any of the following eye disease limited to Cataract - Glaucoma - Corneal diseases or Retinal diseases

5. Have you been diagnosed with any of the following bone disease limited to Vertebral disc prolapse-Scoliosis - Arthritis or Ligament tears

Pregnant Females only