Policy Serial: 3053377

Saman Travel Insurance

_{Policy No: 1395/602-499/415/2713 Date of Issue: Agency Code: 602}

First Name:

Surname:

Passport No:

DOB:

Country of Residency: Duration of Cover: 15 days (Single Entry) ^{Plan Type: Comprehensive insurance plan-} EUR10000-Golden type

Premium	Signature
• Premium: - • Discounts: - • VAT: - • Total: -

24 hours Call Center	+98 (21) 89302302
Email Address	travel@samaninsurance.ir
• 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 entry of Iran, and its maximum validity is 92 consecutive days.
In case of medical emergency, and need for any covered services, the insured or one of his/her companies shall call or send email to “Assistance Provider” and declare the following information: • Insured’s name, policy number (indicated above), telephone number and contact details • Brief description of the problem encountered, and the kind of assistance required. • If the insured is not able to contact or get services from assistance provider, he/she should collect all relevant documents and present them to the head office of Saman Insurance Company in Tehran, Iran (below-mentioned address) for any further verification.

THE VALIDITY OF THIS POLICY COULD BE CONTROLED THROUGH THE OFFICIAL TRAVEL INSURANCE PORTAL OF SAMAN INSURANE COMPANY WITH THE FOLLOWING ADDRESS: http://travis.ir/customers/defaultEn.aspx

Type of cover	Limits(EUR)
Medical expenses & Hospitalization abroad, Except aesthetic treatments, chronic ailments or illnesses existed prior to the inception date of the policy Deductible EUR 25 ( except emergency cases, and hospitalization more than 24 Hours)	EUR 10000
Emergency dental care It is restricted to treatment of pain, infection and removal of the tooth affected Deductible: EUR 25	EUR 200
Emergency return home following death of a close family member or serious illnesses	Actual Expenses
Transport or repatriation in case of illness or accident	EUR5500
Repatriation of mortal remains	Actual Expenses
Legal Assistance	EUR 250
Repatriation of family member traveling with the insured	Actual Expenses
Loss of passport, driving license, national identity card abroad	EUR200
Loss of registered luggage Benefits of this clause and previous one cannot be accumulated.	EUR150

This policy is subject to the following terms and conditions and attached provisions. It covers the expenses of the insured inside boundries of I.R.Iran.

Saman Insurance Co. address: 123 Khaled Eslamboli Ave. 15138 13119 Tehran, Iran Tel: +98 (21) 8943 Ext. 3317, 3319 Fax: +98 (21) 88700204

Email: travel@samaninsurance.ir