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CHAPTER I: GENERAL CONDITIONS
A) DEFINITIONS
1- Insured : The person under 80 years of age , domiciled or having his / her permanent residence in IRAN and covered undera valid Travel insurance Policy issued by BIMEH IRAN( IRAN INSURANCE Co.)
2- Medical Team : medical structure appropriate to every Claim and defined by INTER PARTNER ASSISTANCE ( AXA ) chief medical officer and the treating physician.
3- Bodily Injury : wherever used therein means bodily injury caused solely and directly by violent .accidental,external and visible means, excluding illness or disease,and occuring afterthe beginning of the journey abroad undertaken by the insured during which such bodily injury gives rise to a request for assistance by the Insured or his representatives.
4- Illness : wherever used therein means sudden and unforeseen sickness or
disease contracted, commencing or originating after the beginning of the journey abroad undertaken by the insured during which such sickness or disease gives rise to a request for assistance by the insured or his representatives.
5- Claim : any event which may give rise to INTER PARTNER ASSISTANCE's(AXA's) interventions.
6- Relative : Insured's father, mother, child, spouse or concubine, brother, sister.
7- Serious Medical Reason : Bodily injury or illness of such gravity that it endangers the person's life.
8-Euros: shall mean the lawful currency of the European Union.
9- Deductible : part of the expenses borne directly by the insure.
B) TERRITORIALLY
The benefits mentioned in chapter II apply worldwide outside IRAN , except in the countries at either civil or foreign war, whether declared or not.
C ) PERIOD OF COVER
1) Assistance will only be granted for travels outside Iran which do not exceed 92 consecutive days .
2) Multiple-Travel Policies are valid for unlimited number of travels , which do not Exceed 92 days each.
D ) PRESCRIPTION
Every claim in respect of a covered event shall be time barred within one year from the date of occurrence of such event.
E ) SUBROGATION
INTER PARTNER ASSISTANCE shall take the place of the insured , to the extend of the cost incurred or indemnity paid , in the rights and actions of the Insured against anyone responsible for an accident causing a claim for one of the hereinlisted benefits. When the services provided by INTER PARTNER ASSISTANCE are covered in whole or in part by another scheme, INTER
PARTNERASSISTANCEshallbesubrogated to the rights and causes of action of the insured against said schemes .
F ) LIABILITY OF INTER PARTNER ASSISTANCE
INTER PARTNER ASSISTANCE shall not be held responsible for delays or failures to provide the assistance in case of strike, war, invasion , act of foreign enemies , hostilitiesiwhether war be declaredor not), civil war.rebellion ,insurrection,terrorism or military or usurped power, riot and civil commotion,radioactivity or any other event of force majeure .
CHAPTER II : BENEFITS
A ) Medical transportation
Should the Insured suffer accidental Bodily Injury or sudden illness ( and/or compulsory quarantine ), during the period of cover, INTER PARTNER ASSISTANCE will organize and pay for:
(i) The admission of the Insured into the nearest hospital .
(ii)lf necessary on medical grounds , the transfer of the Insured by any means (including but not limited toairambulance , scheduled flight, road ambulance...) To a more appropriate hospital according to the nature of the injuries or of the illness, and the repatriation to IRAN when after local treatment the condition of the insured will not prevent his repatriation to domicile as a regular passenger .according to the medical opinion of the treating physician and INTER PARTNER ASSISTANCE'S Medical team .
This repatriation will be carried out by scheduled airline or other adequate means, should his original return ticket not be valid for that purpose . Or,
(iii)Repatriation of the Insured by any means to a hospital near to his home in IRAN,if his condition does not prevent such a repatriation .
B ) Payment of medical expenses
Subject to a limit of Euros 50000 per each claim and per period of cover; A Euros 25(TwentyFive) deductible shall apply in all cases on each Claim, except in case of Bodily Injury and/or hospitalization for at least 24 hours .
INTER PARTNER ASSISTANCE guarantees the payment of the emergency medical, surgical, pharmaceutical and hospital expenses incurred by the Insured or any person acting on his behalf , on medical prescription , in urgent cases arising as a result of a Bodily Injury or a sudden illness , with the exclusion of any kind of prosthesis .
In any case, the medical expenses are covered uptothetimethelnsured meets the medical conditions fora repatriation in Iran, conditions which are assessed by INTER PARTNER ASSISTANCE medical team and the treating physician. Should the Insured refuse the repatriation to Iran.the medical expenses shall then be covered up to the amount of the costs of the repatriation , should this latter have been performed .
C ) Medical Referral
In an emergency situation, INTER PARTNER ASSISTANCE will provide the Insured with basic information such as:name of doctors,specialists,dentists or paramedical staff nearby location of hospitals , medical centers , drugstores , ambulances ... and give simple advice as to the action to be taken with the exclusion of any medical diagnosis .
D ) Payment of emergency dental express
Subject to a limit of Euros 150 (one hundred and fifty ) per Insured and per period of cover,
A Euros 20 (twenty ) deductible shall apply in all cases on each Claim. INTER PARTNER ASSISTANCE guarantees payment of emergency dental expenses incurred by the Insured or any person acting on his behalf in emergency cases , arising as a result of a bodily Injury or of an illness, with the exclusion of any kind of prosthesis and or definitive filling .
E ) Repartratioin in case of death
In the event of the death of the Insured INTER PARTNER ASSISTANCE will -take all the necessary measures to organize the repatriation of the body and will pay for the post mortem treatment and the basic coffin required for international transportation, and the transportation of the remains to
the airport nearest to the place of burial
in IRAN .
Funeral or burial expenses are not covered.
F ) Legal assistance
INTER PARTNER ASSISTANCE undertakes to organize and pay up to the equivalent amount in local currency of Euros 1000 ( one thousand ) for the legal defense of the Insured , should he be prosecuted for civil liability according to the Civil Code in force in the country further to accidental damage caused to a third party or involuntary violation or no respect of the laws and local settlements of administrative nature in a private life situation , as simple citizen, with exclusion Ofthe claims arising out of the use , possession or safe_ keeping of a motor vehicle .
G ) Emergency visit from IRAN
If the Insured should be hospitalized as a result of a bodily injury or illness for more than 10 (ten ) consecutive days , INTER PARTNER ASSISTANCE will, at the Insured's request, provide and pay for one round_trip ticket (on scheduled flight economy class or on train first class, originating in IRAN ) for any one person designed by the Insured residing in IRAN coming to his bedside .
H ) Enquire in case of a problem
In case of loss or theft of essential travel documents such as passport , visa , airline ticket ... INTER PARTNER ASSISTANCE will provide the Insured with the necessary information regarding the formalities to be fulfilled with the appropriate local authorities or entities in orderto obtain the replacement of such lost or stolen documents.
l ) Return of child(ren)left unattended
When an Insured has been evacuated and/or repatriated as per the assistance services A )" medical Transportation" or E ) " Repatriation in case of Death" ,and is no longer able to attend to any child under the age of fifteen ,who may have be Travelling with him at the time of
occurrence of the Assistance Event,INTER PARTNER ASSISTANCE will organize and pay for the return of such child to IRAN, under the supervision of an adult person .
J ) Transmission of urgent Message.
Upon Request of the Beneficiary.lNTER PARTNER ASSISTANCE will transmit to any one person named by the Beneficiary any urgent message related to any Assistance Event.
K) Unexpected return to Country of Residence.
INTER PARTNER ASSISTANCE will organise and pay for the reasonable supplementary costs resulting from the unexpected return on scheduled flight (economy class ) or train (1st class ) of the Beneficiary to his country of permanent Residence in case of Serious Medical Reason or decease of a relative in the country of his Permanent Residence, if the original ticket held by the Beneficiary cannot be used for such anticipated return.
L ) Dispatch of Medicines
In case of medical necessity duly ascertained by INTER PARTNER ASSISTANCE^ medical team, INTER PARTNER ASSISTANCE will dispatch
Esential medicines duly prescribed to the beneficiary and locally.unavailable or will determine, prescribe, obtain, and dispatch an equivalent medicine available locally. In any case, the cost of such medicine will be borne by the Beneficiary. The transportation of the medicines remains subject in any case to the regulations at the time imposed by the airline companies or any other transporation company.
M ) Retrieval of Luggage
In the event of loss misrouting of the Benetlciary.s luggage by a common carrier, INTER PARTNER-ASSISTANCE will liaise with the relevant entity, such as an airline company, and will organise the dispatch of such luggage, if recovered, to a place where the Beneficiary is staying.
N) Luggage Delay
If the Beneficiarys accompanied checked - in luggage is not delivered to him within twelve (12) hours of the beneficiary arrival at the scheduled destination point of his flight INTER PARTNER ASSISTANCE will indemnify the Beneficiary for charges incurred at such scheduled destination in respect of the emergency purchanse of essential clothing and toiletries up to two hundred
O) Loss of Registered luggage
if the Beneficiary.s accompanied checked-in luggage has not been delivered to him within fourty eight (48) hours of the beneficiary,s arrival at the scheduled destination of his flight. INTER PARTNER ASSISTANCE will indemnity the Beneficiary up to eight hundered dollars (Euros800) based on an indemnification of twenty Dollars (Euros20) per kilo and for a maximum of forty kilos (40 Kgs). For charges incurred within a further forty eight (48) Hours in respect of the emergency purchase of essential clothing and toiletries.
P) Emergency visit from IRAN & Accommodation expenses
If the insured is hospitalized as a result of a Bodily injury or illness for more than 10(ten) consecutive days, INTER PARTNER ASSISTANCE will, at the insured,s request, provide and pay for one round -trip ticket (on scheduled flight economy class or on train 1st class, orginating in IRAN) for any one
person designed by the insured residing in IRAN coming to his bedside, and pay for his accommo -dation expenses within the limits of Euros 60 per day for a maximum of 15 consecutive days. For benefits 5 and 6 written declaration and /or certificate from the Airline carrier and /or the relevant police station shall be requested by INTER PARTNER ASSISTANCE before any compensation.
CHAPTER III : GENERAL EXCLUSION
A ) Assistance will only be granted for travels no longer than 92 consecutive days,except for professional truckdrivers who shall be entitled to a coverage up to six month travels or stays .
B ) The Insured will not be entitled to the reimbursement of the expenses directly paid by him or by any person on Insured" s behalf without the previous declaration to and the authorization of INTER PARTNER ASSISTANCE Alarm center as listed in chap . IV
C ) Furthermore are excluded the claims:
a) Resulting from travels with a therapeutic objective
b) Resulting from treatments provided in the country of residence
to call the appropriate INTER PARTNER ASSISTANCE Alarm Center to provide the appropriate information as soon as practicable .
Hospitalization prior to notice INTER PARTNER ASSISTANCE:
In any case of illness or Bodily Injury requiring hospitalization, the Insured or any person acting on his behalf must inform INTER PARTNER ASSISTANCE within 120 hours from the time of occurrence . Failure to do so may entitle INTER PARTNER ASSISTANCE to invoice the supplementary cost to be borne by INTER PARTNER ASSISTANCE which would not have been incurred had this 120 hours delay been respected by the Insured .
B) MEDICAL TRANSFER
If the Insured claims for a medical transfer or repatriation , the following conditions
have to be observed :
i) In order to enable INTER PARTNER ASSISTANCE to take action as quickly as possible the Insured or any person acting on his 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.
ii) INTER PARTNER ASSISTANCE'S Medical Team or agents 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 .
iii)ln any case, INTER PARTNER ASSISTANCE , upon ag reement 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.
iv) Should INTER PARTNER ASSISTANCE pay for the transportation of the Insured , the latter will be asked to hand over to INTER PARTNER ASSISTANCE the unused portion of his original ticket or its counter-value .
C ) GENERAL PROVISIONS
- Limitation
As soon as a Claim occurs the Insured must make every endeavor to limit or stops its consequences .
- Recovery
The Insured will provide INTER PARTNER ASSISTANCE with all documents and all necessary formalities so as to enable INTER PARTNER ASSISTANCE to recover from relevant sources , if applicable .
Attention: The insured will not be entitled to the reimbursement of the expenses directly paid by him or by any person on insured's behalf without the pervious declaration by Telephone and Fax Inbetween120 Hours to one of the AXA Assistance Alarm Center .The Notification of claim must be sent by mail or Fax to -.Inter Partner Assistance .Garmischer Str10.D-80339 Munchen.Germany, Fax:+49-89-500 70-394,6 All declarations made after this delay shall be deemed as nil and therefore be rejected by AXA.
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