GENERAL CONDITIONS
In a meeting held on Nov. 20, 2012, in execution of the article 17 of Law of Establishment of Central Iranian Insurance and Insurers and the guideline of the article 13 of Executive Bylaw of the article 91 of Law of the Fourth Plan of Economic, Social and Cultural Development of Islamic Republic of Iran, Insurance High Council enacted the “General Conditions of Travel Insurance Policy for the Aliens who Apply to Enter into Islamic Republic of Iran ” including 7 articles as follows:
CHAPTER 1- Generalities
a. Definitions
- Insurer Any insurance company, who holds a license of operation in such a field issued by Central Insurance Company, whose specifications and particular are mentioned in the present insurance policy, in return for receiving insurance dues, compensation of medical and non-medical expenses and other services covered, in accordance with the conditions specified in the present insurance policy.
- Insured Aliens who have entered into Iran on a legal basis, and the probability of occurrence of dangers and services subject to the present insurance policy have caused them to enter into the present insurance policy and their particulars are mentioned herein, shall be responsible to pay the insurance dues.
- Insurance Dues Amount which should be paid by the Insured in return for the obligations of the Insurer and the fulfillment of the obligations of the insurer shall be subject to payment of the insurance dues which is agreed in the present insurance policy.
- Insurance Subject Compensation of medical and non-medical expenses, and rendering other kinds of services to aliens during the term of their residence in Iran, according to the insurance policy conditions
- Accident Any sudden accident arising from an external factor, which has occurred without will and volition of the insured, and has caused physical injury to the insured
- Physical Injury Physical injury which is caused as a result of a compulsory and sudden factor which is out of the control and volition of the insured, during the term of insurance.
- Acute Injury or Disease Injuries or diseases which prevent the insured to travel during the term of insurance or cause the death danger for the insured at the discretion of his attending physician
- Disease and Illness Sudden and unpredictable complication to which affliction or its beginning or origin shall be after the entrance of the insured to Iran, and will cause request of help on the part of the insured or their representative
- Compulsory Medical Quarantine Fulfillment of insulated operations and compulsory limitation for prevention of prevalence of a disease
- Relatives Father, mother, children, spouse, brothers, sisters and any other person who is introduced by the insured
- Franchise Share of the insured from non-hospitalization medical expenses, of which amount in the present insurance policy is equal to 10% of the amount of medical expenses
b. Present contract shall be valid in accordance with the regulations of Islamic Republic of Iran.
c. Term of Insurance
Covering period of the present insurance policy on the basis of the term specified in the insurance policy is at most 92 consecutive days, of which enhancement date shall be the date of entrance of the insured to Islamic Republic of Iran. Present insurance policy shall become null and void after termination of the term of travel of the insured or exit of the insured from the legal boundaries of the country (anyone happens sooner). In case the insured proceeds to purchase insurance policy after entering to Iran, the insurance coverage shall start as of the date specified in the insurance policy.
CHAPTER 2 - Insurer’s Obligations
If, during the valid term of the present insurance policy, the Insured suffers from any disease or physical injury arising from an accident or compulsory medical quarantine, the Insurer shall be responsible to organize and render the following services and pay the related expenses.
a-Transfer
- Reception and transfer of the insured to the nearest hospital or equipped medical center in the shortest period
- Transfer of the insured, in case of need, at the discretion of the attending physician to the more equipped medical centers, as soon as possible
- Sending back the insured to their respective country at the opinion of the attending physician and at the discretion of the physician of trust, if after treatment at the center, the physical conditions of the insured prevent him to come back a an ordinary passenger
- Taking the necessary action in case of death of the insured, for the purpose of transfer of the body to the nearest airport of his place of residence in the respective country
- Taking the required action in order to come back the accompanying persons with the insured who are under 15 years old, and one of the relatives of the insured to the respective country, if the insured is not able to continue his travel with his personal vehicle or the vehicle which is used at the beginning of the travel
- Taking the necessary action for transfer of one of the relatives of the insured from the country of residence to Iran, if the insured is hospitalized due to an accident or a disease which is subject to the present insurance policy, and if he needs an accompanying person at the discretion of the attending physician
b-Payment of Expenses
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Medical and hospitalization expense below €10,000 or its equal amount in Rial, on the basis of the foreign currency exchange rate specified in the insurance policy on the basis of the medical certificate to the effect of the urgent need to medical treatment during the term of covering (after deduction of franchise of non-hospitalization medical expenses) shall be paid as follows:
- Medical expenses, such as the primary checkup fees, photography and laboratory services, medical expenses, outpatients surgery, physiotherapy, transfer of the injured persons and the patients to the relevant medical centers arising from the accident
- Medical expenses arising from hospitalization and surgery at the hospital and day care centers (with more than 6 hours of hospitalization)
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Non-medical expenses shall be paid as follows:
I. Known expenses related to preparation of coffin and transfer of the corpse of the deceased insured to the nearest international airport of the place of residence at the country of origin or place of residence (expenses of holding funeral procession or burial ceremonies shall not be the responsibility of the insured)
II. If the insured is hospitalized at the hospital due to accident or disease subject matter of the reasons of the present insurance policy, and at the discretion of the attending physician and physician of trust the insured needs an accompanying person, the recognized expenses of return trip of one of the relatives of the insured from the country of residence of the insured to the place of hospitalization and also his residence expenses in Iran at most for 20 days, shall be paid.
III. Ordinary expenses of unexpected return of the insured, because of acute medical injuries or diseases if he could not use the return ticket
IV. Common expenses for returning the accompanying persons of the insured who are under 15 years old, and one of his relatives to the country of origin or place of residence, if the insured is not able to travel with his motor vehicle or a vehicle which is used at the beginning of the travel
V. Emergency dental expenses up to €200. Such expenses are limited to the cure of toothache, treatment of infection and pooling tooth
VI. Necessary expenses for preparation of the important travel documents, such as passport, driving license or consular documents, in case of losing the relevant documents, up to €200
VII. Expenses related to judicial assistance up to €250 in the petitions, which are filed against the insured during the term of residence in Iran
c-Medical Guidance
Insurer shall be responsible to furnish the information required by the insured, for instance the addresses of hospitals, limited surgery charity centers (day care centers), pharmacies and other specialized centers for the patients and injuries, and present the other necessary information and guidance in two languages of Persian
d-Payment of Compensations
Insurer shall be responsible to pay the compensation to the beneficiary, at most within 5 days as of the date of obtaining the necessary documents
e-Directing the Insured in case of Losing the Documents
In case of losing the important travel documents, such as passport and visa, the Insurer shall be held accountable to help the insured
CHAPTER 3- Exceptions
Expenses and compensations arising from the following cases shall not be subject to the obligations of the Insurer.
- Disease of long standing, further affliction of the chronic or continued disease, or the complications of which the Insured have been informed before enhancement of insurance covering for the same, or have been under treatment. Convalescence shall be considered as a part of the disease period.
- War, military aggression, action of foreign enemy, terroristic and hostile action (whether informed or not informed)
- Suicide, premeditated injury to himself, assistance, complicity or help in a crime
- Participation in horse-race, bicycle race and any other race or showing with motorized vehicles, participation in professional sport practices and races such as mountain climbing (professional climb), piloting and any kind of flight, spelunking, diving, winter sports or practice for participation in solemn races, and/or show and any other sports and recreation, which are considered as dangerous sports
- Pollution arising from nuclear radiations
- Delivery during the three months period to the date of delivery and volitional abortion
- Slight and great effects arising from usage of narcotic substances, alcoholic beverages, psychedelic drugs, except for the medicines which are used at the prescription of the competent physician
- Professional risks of the insured which are considered as job and labor accidents in accordance with the rules
- Innateness disorders and the diseases arising from the same
- Prevention or vaccination
- Complications arising from physiotherapy
- Energy-therapy, heliotherapy and treatments for beauty, cure through mineral springs
- Problems arising from mental illnesses and madness
CHAPTER 4- Duties of Insured
For any assistance request, the insured undertakes:
- Contact obligatorily and immediately after the ASSISTANCE EVENT following 24 hours a day alarm centers:
| Tel.No |
Email Address |
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+98-09945799680
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info.travel@kins.ir
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Before taking any personal action and:
-state his/her full name.
-state his/her policy No and validity dates of his travel insurance policy.
-state the place and telephone number where he/she can be reached.
-Give a brief description of the problem encountered and nature of the help required. Life threatening situation: Any other of this Appendix or of this Agreement notwithstanding, in a life-threatening situation, the insured or his/her representative should always try to arrange for emergency transfer to a hospital near the place of occurrence such situation through the most appropriate means, and to call the ASSISTANCE PROVIDER alarm center to provide the appropriate information as soon as practicable. Claim Declaration Time: Any declaration of any hospitalization cases shall be made immediately, within maximum 168 hours (7days) further to the very beginning of the hospitalization or to the date and time of the medical consulting. All declaration made after this delay shall be deemed as nil, and might therefore be rejected by the ASSISTANCE PROVIDER. If the insured claims for medical transfer or repatriation, the following conditions have to be observed:1) In order to enable the ASSISTANCE PROVIDER to take action as quickly as possible, the insured or any person acting on his/her behalf must give:
– the name, address and phone number of the hospital where the insured has been taken.
– the name, address and phone number of the treating physician and if necessary the family doctor.
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The ASSISTANCE PROVIDER'S medical team or agent shall have free access to the insured in order to ascertain his condition. If this obligation is not fulfilled and except justified opposition, the insured will no longer be entitled to medical assistance.
- In any case the ASSISTANCE PROVIDER upon agreement with the treating physician will choose the date and means of transportation. Medical transfer or repatriation by air ambulance shall be limited to continental transportation.
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Should the ASSISTANCE PROVIDER pay for the transportation of the insured, the latter will be asked to hand over to the ASSISTANCE PROVIDER the unused portion of his original ticket or its counter-value.
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Take all reasonable precautions to minimize the loss.
- limitation: As soon as a claim occurs, the insured must make every endeavor to limit or stop its consequence
CHAPTER 5- Reference to Arbitration
Parties to the contract should settle their disputes through amicable negotiation as much as possible. If the dispute is not settled through amicable negotiation, they may settle the matter through arbitration or reference to the court. In case of non- agreement for appointment of a mutually-agreed arbitrator, any party may introduce their appointed arbitrator in writing to the other party. The appointed arbitrators may appoint a third arbitrator, and after settlement of the matter of dispute, they may issue a judgment of arbitration by the unanimity of votes. If the appointed arbitrators do not agree to appoint the third arbitrator, any party may request the competent court to appoint the third arbitrator. Any party may pay the fee for his appointed arbitrator and the fees for the 3rd arbitrator shall be shared by the parties.
CHAPTER 6- Deadline for Lawsuit
Any claim arising from the present insurance policy should be filed at most within the period of 2 years as of the date of annulment, termination or expiry of the valid term of the insurance policy, and in case of occurrence of the accidents which are under covering, the action should be filed as of the date of occurrence of the accident, and after two mentioned years, the claim arising from the present insurance policy shall not be heard. Passage of time may be cut for once by any party through an official declaration. In case of disconnection of the statute of limitation, the remaining term of the passage of time shall be added for one more year.
CHAPTER 7- Other Conditions
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In case of failure in issuance of the visa at the request of the insured, upon deduction of one euro out of the amount of insurance dues, the Insurer shall be responsible to annul the insurance policy and repay the balance of insurance dues.
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In case of issuance of visa and failure in going on a journey, at the request of the insured, after termination of the term of visa, upon deduction of one euro out of the entire amount of insurance dues, the Insurer shall be responsible to annul the insurance policy and repay the balance of the insurance dues.
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Deadline for request of annulment of the insurance policy shall be at most 6 months as of the date of issue.