Policy serial: 92228037

Sanhab Code: 0

Insured details Premium

First Name GILDAA Premium 1,376,000 IRR
Surname DEYGAAN Discount 0 IRR
Birth Date 1982/1/20 VAT 0 IRR
Passport NO Z97519630 Total 1,376,000 IRR
Visa Type Single

Insurance details Signature

Agency Code 1103
Date Of Issue 2024/2/2
THIS IS A COMPUTER-GENERATED DOCUMENT AND IT DOES NOT
Policy NO 1402/1103-1103/415/92228037 REQUIRE A SIGNATURE. THIS DOCUMENT SHALL NOT BE
INVALIDATED SOLELY ON THE GROUND THAT IT IS NOT SIGNED.
Zone WORLDWIDE EXCEPT USA & CND ‫ﺍﯾﻦ ﺑﯿﻤﻪ ﻧﺎﻣﻪ ﺑﻪ ﺻﻮﺭﺕ ﺍﻟﮑﺘﺮﻭﻧﯿﮑﯽ ﺻﺎﺩﺭ ﮔﺮﺩﯾﺪﻩ ﺍﺳﺖ ﻭ ﺑﺪﻭﻥ ﻣﻬﺮ ﻭ ﺍﻣﻀﺎ ﺩﺍﺭﺍﯼ‬
Duration Of Covers 8 ‫ﺍﻋﺘﺒﺎﺭ ﻣﯽ ﺑﺎﺷﺪ‬

Plan Type: (with covid 19 coverage)30.000Euro Plan

.‫ ﺳﺎﻋﺖ ( ﺑﻪ ﺷﺮﮐﺖ ﮐﻤﮏ ﺭﺳﺎﻥ ﺍﻟﺰﺍﻣﯽ ﻣﯽ ﺑﺎﺷﺪ‬240 ) ‫ ﺭﻭﺯ‬10 ‫ﺩﺭ ﮐﻠﯿﻪ ﺷﺮﺍﯾﻂ ﺍﻋﻼﻡ ﺑﺮﻭﺯ ﺧﺴﺎﺭﺕ ﺣﺪﺍﮐﺜﺮ ﻇﺮﻑ ﻣﺪﺕ‬
.‫ﻗﺒﻞ ﺍﺯ ﻫﺮﮔﻮﻧﻪ ﺍﻗﺪﺍﻡ ﺑﺮﺍﯼ ﺩﺭﯾﺎﻓﺖ ﺧﺪﻣﺎﺕ ﺩﺭﻣﺎﻧﯽ ﺗﻤﺎﺱ ﺑﺎ ﺷﺮﮐﺖ ﮐﻤﮏ ﺭﺳﺎﻥ ﺍﻟﺰﺍﻣﯽ ﻣﯽ ﺑﺎﺷﺪ‬
.‫ ﺑﻪ ﺻﻮﺭﺕ ﺭﯾﺎﻟﯽ ﻭ ﺑﺮ ﻣﺒﻨﺎﯼ ﻧﺮﺥ ﺗﺴﻌﯿﺮ ﺳﺎﻣﺎﻧﻪ ﺳﻨﺎ ﺩﺭ ﺭﻭﺯ ﺣﺎﺩﺛﻪ ﻣﯽ ﺑﺎﺷﺪ‬،‫ﭘﺮﺩﺍﺧﺖ ﺧﺴﺎﺭﺕ ﺩﺭ ﺍﯾﺮﺍﻥ‬،‫ﺩﺭ ﺻﻮﺭﺕ ﻋﺪﻡ ﺩﺭﯾﺎﻓﺖ ﺧﺪﻣﺎﺕ ﮐﻤﮏ ﺭﺳﺎﻥ ﺩﺭ ﮐﺸﻮﺭ ﻣﻘﺼﺪ‬
Email Saman@Mideast-Assistance.com Call Center 24hour +9614548356 or +420234622725

⦁ The terms and conditions of this policy are according to the insurance policy general conditions.
⦁ Please read the general conditions of your policy. According to the regulations, the general conditions booklet should be given to you by
your agent.
⦁ You could also download the electronic version of general conditions from www.si24.ir

The policy will be started from the date of official exit from origin, and its maximum validity is
92 consecutive days.

The insurance policy starts simultaneously with the insured's

‫ ﻭﻣﻬﻠﺖ ﺧﺮﻭﺝ ﺍﺯ ﻣﺮﺯﻫﺎﯼ‬.‫ﺗﺎﺭﯾﺦ ﺷﺮﻭﻉ ﺑﯿﻤﻪ ﻧﺎﻣﻪ ﻫﻤﺰﻣﺎﻥ ﺑﺎ ﺧﺮﻭﺝ ﺑﯿﻤﻪ ﺷﺪﻩ ﺍﺯ ﻣﺮﺯﻫﺎﯼ ﻗﺎﻧﻮﻧﯽ ﻣﯽ ﺑﺎﺷﺪ‬
departure from legal borders. The deadline for leaving legal borders .‫ ﻣﺎﻩ ﭘﺲ ﺍﺯ ﺗﺎﺭﯾﺦ ﺻﺪﻭﺭﺑﯿﻤﻪ ﻧﺎﻣﻪ ﻣﯽ ﺑﺎﺷﺪ‬6 ‫ﻗﺎﻧﻮﻧﯽ‬
is 6 months after the issuance date of the insurance policy.
In case of medical emergency, and need for any covered services, ‫ ﻧﻬﺎﯾﺖ ﻣﺪﺕ ﺍﻋﺘﺒﺎﺭ ﻭ‬.‫ﻣﺎﻩ ﺑﺎﺷﺪ‬3 ‫ﺑﺮﺍﯼ ﺑﯿﻤﻪ ﻧﺎﻣﻪ ﻫﺎﯾﯽ ﮐﻪ ﻣﺪﺕ ﺑﯿﻤﻪ ﻧﺎﻣﻪ ﺑﺎﻻﯼ‬
the insured or one of his/her companies shall call or send email to
“Assistance Provider” and declare the following information:
.‫ ﺭﻭﺯ ﻣﺘﻮﺍﻟﯽ ﺩﺭ ﻫﺮ ﺳﻔﺮ ﻣﯿﺒﺎﺷﺪ‬92 ‫ﭘﻮﺷﺶ ﺩﻫﯽ ﺩﺭ ﺧﺎﺭﺝ ﺍﺯ ﮐﺸﻮﺭ‬
⦁ Insured’s name, policy number (indicated above), telephone ‫ ﻣﺎﻩ ﻭ ﺑﯿﻤﻪ‬6 ‫ ﻣﺎﻩ ﺣﺪﺍﮐﺜﺮ ﺗﺎ‬6 ‫ﺩﺭ ﺻﻮﺭﺕ ﻋﺪﻡ ﺩﺭﯾﺎﻓﺖ ﻭﯾﺰﺍ ﺑﺎﺑﺖ ﺑﯿﻤﻪ ﻫﺎﯼ ﮐﻤﺘﺮ ﺍﺯ‬
number and contact details
⦁ Brief description of the problem encountered, and the kind of ‫ ﻣﺎﻫﻪ ﻭ ﯾﮑﺴﺎﻟﻪ ﺗﺎ ﯾﮑﺴﺎﻝ ﻣﯽ ﺗﻮﺍﻧﻨﺪ ﺻﺮﻓﺎ ﺑﺎ ﻣﺮﺍﺟﻌﻪ ﺑﻪ ﻭﺍﺣﺪ ﺻﺎﺩﺭ ﮐﻨﻨﺪﻩ ﻧﺴﺒﺖ ﺑﻪ ﻓﺴﺦ‬6 ‫ﻧﺎﻣﻪ ﻫﺎﯼ‬
assistance required .‫ﺑﯿﻤﻪ ﺍﻗﺪﺍﻡ ﻧﻤﺎﯾﻨﺪ‬
⦁ If the insured is not able to contact or get services from assistance
provider, he/she should collect all relevant documents and present ‫ ﺷﻤﺎﺭﻩ ﺑﯿﻤﻪ ﻧﺎﻣﻪ ﻭ ﺷﻤﺎﺭﻩ ﺗﻠﻔﻦ ﺗﻤﺎﺱ‬،‫» ﻧﺎﻡ ﺑﯿﻤﻪ ﺷﺪﻩ‬
‫» ﻧﻮﻉ ﮐﻤﮏ ﻣﻮﺭﺩ ﺩﺭﺧﻮﺍﺳﺖ ﻭ ﯾﺎ ﻣﺸﮑﻠﯽ ﮐﻪ ﺑﺎ ﺁﻥ ﻣﻮﺍﺟﻪ ﺍﺳﺖ‬
them to the head office of Saman Insurance Company in Tehran, Iran
(below-mentioned address) for any further verification.
‫» ﺩﺭ ﺻﻮﺭﺗﯽ ﮐﻪ ﺑﯿﻤﻪ ﺷﺪﻩ ﺑﻪ ﻫﺮ ﺩﻟﯿﻞ ﻣﻮﻓﻖ ﺑﻪ ﺑﺮﻗﺮﺍﺭﯼ ﺗﻤﺎﺱ ﯾﺎ ﺩﺭﯾﺎﻓﺖ ﺧﺪﻣﺎﺕ‬
‫ ﻣﯽ ﺑﺎﯾﺴﺖ ﮐﻠﯿﻪ ﻣﺪﺍﺭﮎ ﻣﺮﺑﻮﻃﻪ ﺑﻪ ﭘﺮﻭﻧﺪﻩ ﺧﻮﺩ ﺭﺍ ﺩﺭﯾﺎﻓﺖ ﻧﻤﻮﺩﻩ ﻭ ﺑﻪ‬،‫ﺍﺯ ﺷﺮﮐﺖ ﮐﻤﮏ ﺭﺳﺎﻥ ﻧﮕﺮﺩﺩ‬
.‫ﻣﻨﻈﻮﺭ ﺭﺳﯿﺪﮔﯽ ﺑﻪ ﺩﻓﺘﺮ ﻣﺮﮐﺰﯼ ﺷﺮﮐﺖ ﺑﯿﻤﻪ ﺳﺎﻣﺎﻥ ﺩﺭ ﺗﻬﺮﺍﻥ )ﮐﺸﻮﺭ ﺍﯾﺮﺍﻥ( ﺑﻪ ﻧﺸﺎﻧﯽ ﺫﯾﻞ ﺍﺭﺍﺋﻪ ﻧﻤﺎﯾﺪ‬

THE VALIDITY OF THIS POLICY COULD BE CONTROLED THROUGH THE OFFICIAL TRAVEL INSURANCE PORTAL OF SAMAN INSURANE COMPANY WITH THE
FOLLOWING ADDRESS:
‫ﮐﻨﺘﺮﻝ ﺍﻋﺘﺒﺎﺭ ﺍﯾﻦ ﺑﯿﻤﻪ ﻧﺎﻣﻪ ﺍﺯ ﻃﺮﯾﻖ ﺳﺎﯾﺖ ﺭﺳﻤﯽ ﺻﺪﻭﺭ ﺑﯿﻤﻪ ﻧﺎﻣﻪ ﻣﺴﺎﻓﺮﺗﯽ ﺳﺎﻣﺎﻥ ﺑﻪ ﻧﺸﺎﻧﯽ ﺯﯾﺮ ﺍﻣﮑﺎﻥ ﭘﺬﯾﺮ ﻣﯽ ﺑﺎﺷﺪ‬
https://saman.travis.ir

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Covers Cover amount ‫ﭘﻮﺷﺶ ﻫﺎ‬

30000 EUR

Actual expenses

200 EUR

Actual expenses

Actual expenses

85EUR per day

(10consecutive day)

1500 EUR

200 EUR

Actual expenses

Actual expenses

Actual expenses

Actual expenses

100 EUR

200 EUR

Actual expenses

50EUR per 6hours (Up to

24 hours)

850 EUR

850 EUR

Saman Insurance Co. address: 6th Floor,No 9,2nd Deadend, Kooh Noor St, Motahari Ave, Tehran, Iran
Tel: +98 (21) 8943 Fax: +98 (21) 88700204
Email: travel@samaninsurance.ir
6 ‫ ﻃﺒﻘﻪ‬- 9 ‫ ﭘﻼﮎ‬- ‫ ﺑﻦ ﺑﺴﺖ ﺩﻭﻡ‬- ‫ ﺧﯿﺎﺑﺎﻥ ﮐﻮﻩ ﻧﻮﺭ‬- ‫ ﺧﯿﺎﺑﺎﻥ ﻣﻄﻬﺮﯼ‬- ‫ ﺗﻬﺮﺍﻥ‬: ‫ﻧﺸﺎﻧﯽ ﺷﺮﮐﺖ ﺑﯿﻤﻪ ﺳﺎﻣﺎﻥ‬

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 3000 EUR

750 EUR

This policy is subject to the following terms and conditions and attached provisions. It covers the expenses of the
insured in the countries Outside Iran.
.‫ ﺟﺒﺮﺍﻥ ﻣﯽ ﻧﻤﺎﯾﺪ‬،‫ﺍﯾﻦ ﺑﯿﻤﻪ ﻧﺎﻣﻪ ﺑﺮ ﺍﺳﺎﺱ ﺷﺮﺍﯾﻂ ﻭ ﻣﻘﺮﺭﺍﺕ ﭘﯿﻮﺳﺖ ﺻﺎﺩﺭﻩ ﮔﺮﺩﯾﺪﻩ ﻭ ﻫﺰﯾﻨﻪ ﻫﺎﯼ ﺑﯿﻤﻪ ﺷﺪﻩ ﺭﺍ ﮐﻪ ﺩﺭ ﺧﺎﺭﺝ ﺍﺯ ﮐﺸﻮﺭ ﺑﻪ ﻭﻗﻮﻉ ﭘﯿﻮﺳﺘﻪ ﺍﺳﺖ‬
Kasrachavoshi92@gmail.com

Saman Insurance Co. address: 6th Floor,No 9,2nd Deadend, Kooh Noor St, Motahari Ave, Tehran, Iran
Tel: +98 (21) 8943 Fax: +98 (21) 88700204
Email: travel@samaninsurance.ir
6 ‫ ﻃﺒﻘﻪ‬- 9 ‫ ﭘﻼﮎ‬- ‫ ﺑﻦ ﺑﺴﺖ ﺩﻭﻡ‬- ‫ ﺧﯿﺎﺑﺎﻥ ﮐﻮﻩ ﻧﻮﺭ‬- ‫ ﺧﯿﺎﺑﺎﻥ ﻣﻄﻬﺮﯼ‬- ‫ ﺗﻬﺮﺍﻥ‬: ‫ﻧﺸﺎﻧﯽ ﺷﺮﮐﺖ ﺑﯿﻤﻪ ﺳﺎﻣﺎﻥ‬

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