Policy serial: 91151716

Sanhab Code: 30959480631

Insured details Premium

First Name HAMEDEHALSADAT Premium 15,464,000 IRR
Surname SOBHANI Discount 0 IRR
Passport NO W48065952 VAT 0 IRR
Birth Date 1989/9/21 Total 15,464,000 IRR
Visa Type Multi

Insurance details Signature

Agency Code 1103
THIS IS A COMPUTER-GENERATED DOCUMENT AND IT DOES NOT
Date Of Issue 2023/4/19
REQUIRE A SIGNATURE. THIS DOCUMENT SHALL NOT BE
Policy NO 1402/1103-1103/415/91151716
INVALIDATED SOLELY ON THE GROUND THAT IT IS NOT SIGNED.
Zone Schengen
‫ﺍﯾﻦ ﺑﯿﻤﻪ ﻧﺎﻣﻪ ﺑﻪ ﺻﻮﺭﺕ ﺍﻟﮑﺘﺮﻭﻧﯿﮑﯽ ﺻﺎﺩﺭ ﮔﺮﺩﯾﺪﻩ ﺍﺳﺖ ﻭ ﺑﺪﻭﻥ ﻣﻬﺮ ﻭ ﺍﻣﻀﺎ ﺩﺍﺭﺍﯼ‬
Duration Of Covers 186
‫ﺍﻋﺘﺒﺎﺭ ﻣﯽ ﺑﺎﺷﺪ‬
Plan Type: (with covid 19 coverage)30.000Euro Plan-World wide Exp
USA&CAN

.‫ 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
Email [email protected] 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.

In case of medical emergency, and need for any covered ‫ ﻭﻣﻬﻠﺖ ﺧﺮﻭﺝ ﺍﺯ ﻣﺮﺯﻫﺎﯼ‬.‫ﺗﺎﺭﯾﺦ ﺷﺮﻭﻉ ﺑﯿﻤﻪ ﻧﺎﻣﻪ ﻫﻤﺰﻣﺎﻥ ﺑﺎ ﺧﺮﻭﺝ ﺑﯿﻤﻪ ﺷﺪﻩ ﺍﺯ ﻣﺮﺯﻫﺎﯼ ﻗﺎﻧﻮﻧﯽ ﻣﯽ ﺑﺎﺷﺪ‬
services, the insured or one of his/her companies shall call or ‫ ﻣﺎﻩ ﭘﺲ ﺍﺯ ﺗﺎﺭﯾﺦ ﺻﺪﻭﺭﺑﯿﻤﻪ ﻧﺎﻣﻪ ﻣﯽ ﺑﺎﺷﺪ‬6 ‫ﻗﺎﻧﻮﻧﯽ‬
send email to “Assistance Provider” and declare the following ‫ ﻧﻬﺎﯾﺖ ﻣﺪﺕ ﺍﻋﺘﺒﺎﺭ ﻭ ﭘﻮﺷﺶ ﺩﻫﯽ ﺩﺭ ﺧﺎﺭﺝ ﺍﺯ ﮐﺸﻮﺭ‬.‫ﻣﺎﻩ ﺑﺎﺷﺪ‬3 ‫ﺑﺮﺍﯼ ﺑﯿﻤﻪ ﻧﺎﻣﻪ ﻫﺎﯾﯽ ﮐﻪ ﻣﺪﺕ ﺑﯿﻤﻪ ﻧﺎﻣﻪ ﺑﺎﻻﯼ‬
information: .‫ ﺭﻭﺯ ﻣﺘﻮﺍﻟﯽ ﺩﺭ ﻫﺮ ﺳﻔﺮ ﻣﯿﺒﺎﺷﺪ‬92
⦁ Insured’s name, policy number (indicated above), telephone ‫ ﻣﺎﻫﻪ ﻭ ﯾﮑﺴﺎﻟﻪ‬6 ‫ ﻣﺎﻩ ﻭ ﺑﯿﻤﻪ ﻧﺎﻣﻪ ﻫﺎﯼ‬6 ‫ ﻣﺎﻩ ﺣﺪﺍﮐﺜﺮ ﺗﺎ‬6 ‫ﺩﺭ ﺻﻮﺭﺕ ﻋﺪﻡ ﺩﺭﯾﺎﻓﺖ ﻭﯾﺰﺍ ﺑﺎﺑﺖ ﺑﯿﻤﻪ ﻫﺎﯼ ﮐﻤﺘﺮ ﺍﺯ‬
number and contact details
.‫ﺗﺎ ﯾﮑﺴﺎﻝ ﻣﯽ ﺗﻮﺍﻧﻨﺪ ﺻﺮﻓﺎ ﺑﺎ ﻣﺮﺍﺟﻌﻪ ﺑﻪ ﻭﺍﺣﺪ ﺻﺎﺩﺭ ﮐﻨﻨﺪﻩ ﻧﺴﺒﺖ ﺑﻪ ﻓﺴﺦ ﺑﯿﻤﻪ ﺍﻗﺪﺍﻡ ﻧﻤﺎﯾﻨﺪ‬
⦁ Brief description of the problem encountered, and the kind of
assistance required
‫ ﺷﻤﺎﺭﻩ ﺑﯿﻤﻪ ﻧﺎﻣﻪ ﻭ ﺷﻤﺎﺭﻩ ﺗﻠﻔﻦ ﺗﻤﺎﺱ‬،‫ﻧﺎﻡ ﺑﯿﻤﻪ ﺷﺪﻩ‬
⦁ If the insured is not able to contact or get services from
‫ﻧﻮﻉ ﮐﻤﮏ ﻣﻮﺭﺩ ﺩﺭﺧﻮﺍﺳﺖ ﻭ ﯾﺎ ﻣﺸﮑﻠﯽ ﮐﻪ ﺑﺎ ﺁﻥ ﻣﻮﺍﺟﻪ ﺍﺳﺖ‬
assistance provider, he/she should collect all relevant documents
and present them to the head office of Saman Insurance ‫ﺩﺭ ﺻﻮﺭﺗﯽ ﮐﻪ ﺑﯿﻤﻪ ﺷﺪﻩ ﺑﻪ ﻫﺮ ﺩﻟﯿﻞ ﻣﻮﻓﻖ ﺑﻪ ﺑﺮﻗﺮﺍﺭﯼ ﺗﻤﺎﺱ ﯾﺎ ﺩﺭﯾﺎﻓﺖ ﺧﺪﻣﺎﺕ ﺍﺯ ﺷﺮﮐﺖ ﮐﻤﮏ ﺭﺳﺎﻥ‬
Company in Tehran, Iran ‫ ﻣﯽ ﺑﺎﯾﺴﺖ ﮐﻠﯿﻪ ﻣﺪﺍﺭﮎ ﻣﺮﺑﻮﻃﻪ ﺑﻪ ﭘﺮﻭﻧﺪﻩ ﺧﻮﺩ ﺭﺍ ﺩﺭﯾﺎﻓﺖ ﻧﻤﻮﺩﻩ ﻭ ﺑﻪ ﻣﻨﻈﻮﺭ ﺭﺳﯿﺪﮔﯽ ﺑﻪ ﺩﻓﺘﺮ ﻣﺮﮐﺰﯼ‬،‫ﻧﮕﺮﺩﺩ‬
(below-mentioned address) for any further verification. .‫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)

Saman Insurance Co. address: NO 28, Ninth alley, Khaled Eslamboli Ave, Tehran, Iran
Tel: +98 (21) 8943 Fax: +98 (21) 88700204
Email: [email protected]
88700204 : ‫ ﻧﻤﺎﺑﺮ‬8943 : ‫ ﺗﻠﻔﻦ‬28 ‫ ﺧﯿﺎﺑﺎﻥ ﺧﺎﻟﺪ ﺍﺳﻼﻣﺒﻮﻟﯽ ) ﻭﺯﺭﺍ( ﮐﻮﭼﻪ ﯼ ﻧﻬﻢ ﭘﻼﮎ‬- ‫ ﺗﻬﺮﺍﻥ‬: ‫ﻧﺸﺎﻧﯽ ﺷﺮﮐﺖ ﺑﯿﻤﻪ ﺳﺎﻣﺎﻥ‬

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 850 EUR

850 EUR

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
30 ‫ﻭﺍﺣﺪ‬-5 ‫ﻃﺒﻘﻪ‬-‫ﺳﺎﺧﺘﻤﺎﻥ ﭘﺮﻭﺷﺎﺕ‬-‫ﺭﻭﺑﺮﻭﻱ ﺗﺮﮐﻤﻨﺴﺘﺎﻥ‬-‫ ﻣﻄﻬﺮﻱ‬-‫ﺗﻬﺮﺍﻥ‬ [email protected] 88437252

Saman Insurance Co. address: NO 28, Ninth alley, Khaled Eslamboli Ave, Tehran, Iran
Tel: +98 (21) 8943 Fax: +98 (21) 88700204
Email: [email protected]
88700204 : ‫ ﻧﻤﺎﺑﺮ‬8943 : ‫ ﺗﻠﻔﻦ‬28 ‫ ﺧﯿﺎﺑﺎﻥ ﺧﺎﻟﺪ ﺍﺳﻼﻣﺒﻮﻟﯽ ) ﻭﺯﺭﺍ( ﮐﻮﭼﻪ ﯼ ﻧﻬﻢ ﭘﻼﮎ‬- ‫ ﺗﻬﺮﺍﻥ‬: ‫ﻧﺸﺎﻧﯽ ﺷﺮﮐﺖ ﺑﯿﻤﻪ ﺳﺎﻣﺎﻥ‬

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