Ambulance Evacuation Cover Please enable JavaScript in your browser to complete this form.Name: *FirstLastPhone Address: *Email: *Location: *Dependants: *Type Of Cover *Mercury 2,000Venus 2,500Mars 3,000Hospitals Of Choice: (Within 30 Kms radius ) *TERMS: This cover is only for emergency evacuation. It doesnt cover terminal ailment evacuations. This cover is renewable yearly. Evacuation beyond 30 kms radius will have special arrangement. Paybill Details: NCBA PAYBILL- 880100 ACCOUNT NUMBER – 274574 *Enter MPESA CODESubmit