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AIG MEA Limited (Kuwait Branch)
TRAVEL PROTECTION
Scope of Cover
Cover:
Travel Insurance
Insured:
All of the Service Provider’s customers aged between 18 years and 69 years who have
requested for enrollment in policy via the Service Provider’s Travel Insurance cover provided
premium has been paid in full.
Operative Time:
24 Hours / Worldwide while on International Travel (excluding Iraq, Afghanistan, Cuba and
Democratic Republic of Congo), outside Kuwait
Individual Policy Period:
Monthly Premium: 30 days starting from the Premium Charge Date (not later than the
day prior to the next Premium Charge Date)
Rate:
Individual
Rate
Monthly Premium
KWD 2
Conditions:
-
As per AIG MEA Limited (Kuwait
Branch) Travel Insurance Policy Wording
Insured age between 18 years and 69 years
War and Terrorism exclusion
Premium will be charged on a monthly basis
Premium adjustment on a monthly basis
“Premium Charged Date” is the date on which the Policyholder charges the Premium due to the
Telecom Company customer
Maximum limit of indemnity “Principal Sum Insured” per Insured is irrespective of the number of
Travel Insurance policies purchased
Insured must be permanent resident of country where the policy is issued
Private Aircraft of the Policyholder excluded
Pre-existing conditions excluded
Table of Benefits:
Insured Event
Sum Insured
Emergency Medical Expenses (Accident & Sickness)
Deductible
$20,000
$100
Baggage Loss (Common Carrier)
Per Bag
Per Item
$1,000
$500
$50
Baggage Delay
In Excess
$50 per hour up to $500
6 Hours
Trip Delay
In Excess
$50 per hour up to $500
6 Hours
Loss of Passport
$300
Assistance Department (24 Hours / Worldwide Services)
Covered
© AIG, all rights reserved (V 1.0 – June 20, 2013)
This Policy is a contract made between the Insured Person and AIG MEA LTD – Kuwait Branch and its successors and assigns, the
Company. The Company agrees to provide insurance on the basis set out in this Policy based on information offered by the Insured Person
and provided the Premium is paid when due and the Company agrees to accept it.
This document together with the Policy Confirmation or Policy Schedule and Endorsements, if any, complete the Policy.
1. Introductory clauses
PERIOD OF COVERAGE
This Policy’s coverage will commence on the Start Date of Cover appearing on the Policy Schedule.
This Policy will provide cover for Insured Journeys that are:
1 Booked after; or
2 Commenced after; the Start Date of Cover appearing on the Policy Schedule
until the earlier of the date the Insured Person returns from his Insured Journey or the expiration date shown on the Policy Schedule.
This Policy will run until cancelation or the expiration date shown on the Policy Schedule, or if earlier the date the Insured Person returns
from his Insured Journey.
For annual multi-trip plan, cover will terminate on the Insured Person’s return to the Point of Departure and recommence on his next
Insured Journey.
The maximum period for any Insured Journey is restricted to 90 days for single trip policies and annual multi-trip plan.
This Policy cannot be cancelled following the Start Date of Cover.
PREMIUM PAYMENTS
The Insured Person is liable for the Premium; the Premium is payable in advance and the Company shall not be liable for any claim arising
under this Policy that occurs prior to receipt of the premium. The Company shall not be obliged to accept premium tendered to it or to any
intermediary after such date, but may do so upon such terms as it in its sole discretion may determine. The Company reserves the right to
ask for proof of payment of premium at any time. Such proof must be to the Company’s satisfaction.
MAXIMUM AMOUNT PAYABLE
1 No Insured Person shall be entitled to recover a benefit exceeding 100% of the sum for an Insured Event as reflected in the Table of
Benefits.
2 If two or more travel policies issued by the Company or any other member company of AIG MEA LIMITED (Kuwait Branch) apply to the
same claim, the maximum amount payable by AIG member companies under all such policies shall not exceed the limit of liability of
whichever of such policies has the highest applicable limit of liability. Nothing contained herein shall be construed to increase the limit of
liability of this Policy.
CANCELLATION/TERMINATION
Cancellation
The Company may cancel the Policy at any time by written notice delivered to the Insured Person and cancellation shall be effective
thereafter. Such cancellation shall be without prejudice to any valid claim-originating prior thereto.
In the event the individual insurance offered to an Insured Person under the Policy for which the Premium has been paid in advance is
cancelled by written notice delivered to the Company and by returning the original copy of the Policy (if applicable) prior to the Insured
Journey commencements, 100% of the Premium shall be refunded.
In the event of termination of coverage of the Insured, Spouse and/or Child due to payment of the Principal Sum, the Company will not
refund any Premium.
Termination
This Policy will terminate on the earliest of the following dates:
1 The date of the Insured Person’s return to the Point of Departure in his Country of Residence. For Annual Multi Trip Plan, cover will
terminate on the Insured Person’s return to the Point of Departure and recommence on his next Insured Journey; or
2 The date that the Insured Person reaches the maximum age for the cover selected.
3
4
5
6
The
The
The
The
expiry date appearing on the Policy Schedule.
date the Premium is due and not paid.
date the Insured person is no longer eligible within the classification of Insured Persons.
date the benefits are paid to the extent of the Sum Insured in respect of any Insured.
© AIG, all rights reserved (V 1.0 – June 20, 2013)
2. DEFINITIONS
In this Policy the following definitions apply:
Accident means a sudden unexpected and specific event caused solely and directly by violent, external and visible means which occurs at
an identifiable time and place, resulting in Injury.
AIDS mean an opportunistic infection or a malignant neoplasm. For the purpose of this definition, the term "Acquired Immune Deficiency
Syndrome" shall have the meaning assigned to it by the World Health Organization “Acquired Immune Deficiency Syndrome” shall include
H.I.V. (Human Immune Deficiency Virus), encephala (dementia) or H.I.V. wasting syndrome.
Beneficiary means the person or persons nominated by the Insured Person as stated on the Policy Schedule, if not mentioned then the
Beneficiary will be the legal heirs of the Insured Person. If Family Plan is selected then the beneficiary in case of death of the spouse or the
child is the Insured Person.
Children means the Insured Person’s dependant children who are not in full-time employment and who are between the ages of 3 months
and 18 years (or under the age of 23 years provided they are in full-time education), unmarried, not pregnant, without children and
primarily dependent on the Insured Person for support.
Common Carrier means any land, water or air conveyance operated under a valid license for the transportation of passengers for hire.
Contact Sport means any sport in which physical contact between players is an accepted part of play.
Country of Residence means the country of which the Insured Person is currently residing and holds a valid residency visa or is born
there
Day means a period of 24 consecutive hours including the day of admission but excluding the day of discharge.
Effective Date of Coverage means the Start Date of Cover as shown on the Policy Schedule. Cover cannot start after an Insured
Journey has begun.
Emergency Evacuation means: (a) the Insured Person medical condition warrants immediate transportation from the place where he is
injured or sick to the nearest Hospital where appropriate medical treatment can be obtained; (b) after being treated at a local Hospital, his
medical condition warrants transportation to the country where the trip commenced to obtain further medical treatment or to recover; or
(c) both (a) and (b) above.
Excess or Deductible means the first amount, or period, of each and every loss payable by the Insured Person.
Hazardous Sports means skiing, land-skiing, mono-skiing, cross-country skiing, heli-skiing, off-piste skiing (only when accompanied by an
official guide), ice skating (no speed skating), snow boarding, ski boarding, sledging, tobogganing, fishing, sail boarding, sailing, surfing,
water skiing, wind surfing.
Hospital means a place that: (a) holds a valid license (if required by law); (b) operates primarily for the care and treatment of sick or
injured persons; (c) has a staff of one or more physicians available at all times; (d) provides 24-hour nursing service and has at least one
registered professional nurse on duty at all times; (e) has organized diagnostic and surgical facilities, either on premises or in facilities
available to the hospital on a pre-arranged basis; and (f) is not, except incidentally, a clinic, nursing home, rest home, or convalescent
home for the aged, or a facility operated as a drug and/or alcohol treatment centre.
Illness or Sickness means any fortuitous sickness or disease contracted, commencing or first manifesting itself during an Insured
Journey.
Injury means bodily injury caused solely and directly by violent, accidental, external and visible means occurring during the Insured Period.
Insured Event means an event stated in the purchased plan’s Table of Benefits in Section 2.
Insured Journey means a journey commencing at the time when the Insured Person leaves his home address in his Country of Residence
to travel outside the territorial limits of the Country of Residence in a direct, uninterrupted manner, including the return journey to his home
address in his Country of Residence. The Insured Journey should start and end in the Insured Person’s Country of Residence and within the
time frame of the period of coverage.
Insured Person means the person whose name appears on the Policy, aged between 18 years and 69 years and with respect to whom
premium has been paid and who is a permanent resident of the Country of Policy Issuance.
Insurer means the entity underwriting this Policy, AIG MEA LTD . – Kuwait Branch
Manual Labor means physical labor involving the use of hands or the use or operation of mechanical or non-mechanical machinery or
equipment.
Medical Expenses means all Reasonable and Customary Charges for Illness or Injury on an Insured Journey resulting in hospitalization,
surgical or other diagnostic or remedial treatment given or prescribed by a Medical Practitioner.
Medical Practitioner means a person registered with a current, legal license to practice medicine, but excludes an Insured Person or
Insured Person’s Relative.
Medical Treatment means a Medical Practitioner's medical advice, treatment, consultations and prescribed or repeat maintenance
medication.
Period of Coverage: means the period chosen by the Insured Person as per the Policy Schedule, for which premium has been paid,
starting on the Start Date of Cover as shown on the Policy Schedule and expiring at the end of the chosen period.
Permanent Total Disablement means total and absolute disablement which entirely prevents the Insured Person from engaging in or
giving attention to any occupation and which will in all probability be lasting and continuous for his lifetime.
Personal Effects means spectacles, dentures, purses, wallets, cosmetics, mobile phone and other personal effects normally worn or
© AIG, all rights reserved (V 1.0 – June 20, 2013)
carried on the person.
Point of Departure means the point from which an Insured Person commences an Insured Journey, from within the territorial limits of his
Country of Residence.
Policy means this document and Policy Schedule.
Policy Schedule or Policy Confirmation means the document which gives details such as, but not limited to, benefits, Premiums,
conditions, limits and cover the Insured Person has.
Pre-Existing Medical Conditions a condition for which medical care, treatment, or advice was recommended by or received from a
Physician within a two year period preceding the Effective Date of Coverage, or a condition for which hospitalization or surgery was
required within a five year period preceding the Effective Date of Coverage.
Professional Player means an Insured Person who earns in excess of 50% of his income from playing sport or who participates in a sport
that remunerates him as a means of livelihood.
Public Conveyance means any scheduled or chartered conveyance legally licensed to carry passengers for hire operating commercially in
accordance with all locally applicable laws and regulations and in which the Insured Person is traveling only as a fare-paying passenger,
including taxis and hired motor vehicles but excluding minibuses, non-standard motor vehicles and non-pressurized single engine piston
aircraft.
Reasonable and Customary Charges means the charges which: (a) are medically required for the treatment, supplies or medical
service to treat an Insured Person's condition; (b) do not exceed the usual level of charges for similar treatment, supplies or medical
services in the locality where the expenses are incurred, and (c) do not exceed the charges for treatment that would have been made if no
insurance existed.
Related Expenses means additional accommodation and traveling expenses, excluding telephone costs, meals and beverages of necessity
incurred by any one person, who on the advice of a Medical Practitioner appointed by the Company remains with or escorts the Insured
Person until completion of his Insured Journey or until he resumes the Insured Journey or returns to the Point of Departure, whichever
occurs first.
Relative means a Spouse, parent, parent-in-law, grandparent, step-parent, Children, grandchild, brother, brother-in-law, sister, sister-inlaw, daughter-in-law, son-in-law, fiancée, fiancé, half-brother, half-sister, aunt, uncle, niece or nephew of the Insured Person.
Ski equipment means skis, poles, boots and bindings, snow boards or ice skates.
Spouse wherever used in the policy shall mean the Insured Person’s legally married husband or wife between the ages of 18 years and 69.
Terrorist Act means any actual or threatened use of force or violence directed at or causing damage, Injury, harm or disruption, or
commission of an act dangerous to human life or property, against any individual, property or government, with the stated or unstated
objective of pursuing economic, ethnic, nationalistic, political, racial or religious interests, whether such interests are declared or not.
Robberies or other criminal acts, primarily committed for personal gain and acts arising primarily from prior personal relationships between
perpetrator/s and victim/s shall not be considered Terrorist Acts. ‘Terrorist Act’ shall also include any act which is verified or recognized as
an act of terrorism by the (relevant) government of the country where the act occurs.
Third Party means any person other than the Insured Person, his spouse or common-law partner, child, parent, friend or relative.
Transportation means any land, water or air conveyance required to transport the Insured Person during an Emergency Evacuation.
Transportation includes, but is not limited to, air ambulances, land ambulances and private motor vehicles.
War means war, whether declared or not, or any warlike activities (including use of military force) by any sovereign nation to achieve
economic, geographic, nationalistic, political, racial, religious or other ends.
3. BENEFITS
3.1 MEDICAL AND RELATED EXPENSES BENEFITS
3.1.1 EMERGENCY MEDICAL EXPENSES (ACCIDENT & SICKNESS)
If an Insured Person whilst traveling on an Insured Journey incurs Medical Expenses as a result of Illness or Injury, the Company will pay
for those expenses up to the amount as stated in the Table of Benefits.
3.1.1.1 SPECIFIC CONDITIONS
Medical and Related Expenses shall only be paid until such time as a Medical Practitioner appointed by the Company decides that an
Insured Person is capable of being repatriated. If the Insured Person is capable of being repatriated and elects not to return to the Point of
Departure, all expenses incurred in respect of the occurrence including those prior to the date of possible repatriation will be from the
Insured Person's own account.
3.1.1.2 SPECIFIC EXCLUSIONS
The Company will not pay for any medical expenses:
1 incurred for continuing treatment, including any medication commenced prior to the commencement date of the Insured Journey, which
the Insured Person has been advised to continue whilst on an Insured Journey; or
2 incurred due to investigatory treatment that is not specified by a Medical Practitioner as immediately necessary; or
© AIG, all rights reserved (V 1.0 – June 20, 2013)
3
4
5
6
for fillings or crowns of precious metal; or
for any procedures relating to dental or oral hygiene; or
for specialist Medical Treatment without referral from a Medical Practitioner; or
relating to contraceptive devices, prosthetic devices, medical appliances or artificial aids; or
7 for preventative treatment, including but not limited to any vaccination and/or immunization;
8 Incurred in Country of Residence
3.2 TRAVEL INCONVENIENCE BENEFITS
3.2.1 BAGGAGE LOSS (COMMON CARRIER)
The Company will pay benefits if the Insured Person baggage, which is in the care, custody and control of a Common Carrier, is lost due to
theft or due to misdirection by a Common Carrier while the insured is a ticketed passenger on the Common Carrier during the trip. The
Company will reimburse up to the maximum shown in the Table of Benefits, for the cost of replacement of the baggage and its contents.
All claims must be verified by the Common Carrier.
The maximum amount to be reimbursed per bag is 50% and the maximum amount to be reimbursed per article contained in any bag
is 10% of the amount stated in the Table of Benefits. There is also a combined maximum limit of 10% of the Baggage Loss amount
stated in the Table of Benefits for the following: jewelry, watches, articles consisting in whole or in part of silver, gold or platinum, furs,
articles trimmed with or made mostly of fur, and cameras, including related camera equipment, computers and electronic equipment.
Loss of a Pair/Set
In case of loss to a pair or set, the Company may elect to:
(A) Repair or replace any part, to restore the pair or set to its value before the loss; or
(B) Pay the difference between the cash value of the property before and after the loss.
3.2.1.1 SPECIFIC CONDITION
Benefits for baggage and personal effects will be in excess of any amount paid or payable by the Common Carrier responsible for the loss.
Benefits for baggage and personal effects will be in excess of all other valid and collectible insurance. If at the time of the occurrence of
any loss there is other valid and collectible insurance in place, the Company will be liable only for the excess of the amount of loss, over the
amount of such other insurance, and any applicable deductible.
3.2.1.2 SPECIFIC EXCLUSIONS
Benefits will not be provided for any loss of:
1. Animals, birds, or fish;
2. Automobiles or automobile equipment, boats, motors, trailers, motorcycles, or other conveyances or their appurtenances (except bicycles
while checked as baggage with a Common Carrier);
3. Household furniture;
4. Eyeglasses or contact lenses;
5. Artificial teeth or dental bridges;
6. Hearing aids;
7. Prosthetic limbs;
8. Musical instruments;
9. Money or securities;
10. Tickets or documents;
11. Perishables and consumable.
12. Mobile
13. Laptops
Benefits will not be provided for any loss resulting (in whole or in part) from:
1. Wear and tear or gradual deterioration;
2. Insects or vermin;
3. Inherent vice or damage;
4. Confiscation or expropriation by order of any government or public authority;
5. Seizure or destruction under quarantine or custom regulation;
6. Radioactive contamination;
7. Usurped power or action taken by governmental authority in hindering combating or defending against such an occurrence;
8. Transporting contraband or illegal trade;
9. Mysterious disappearance; or
10.Breakage of brittle or fragile articles, cameras, musical instruments, radios, and similar property.
© AIG, all rights reserved (V 1.0 – June 20, 2013)
3.2.2 BAGGAGE DELAY
The Company will reimburse the Insured Person for reasonable essential expenses incurred (original receipts required) following the Excess
period and up to the amount stated in the Table of Benefits, for the emergency purchase of essential items if his baggage is delayed,
misdirected or temporarily misplaced by a carrier.
3.2.2.1 SPECIFIC CONDITIONS
1 Written proof of delay from the transport provider must be submitted with any claim and the Company’s liability is subject to it receiving
original receipts for the essential expenses incurred.
2 The baggage delay must exceed the Excess.
3 Confiscation or requisition by customs or other government authority cannot form the basis of a claim for loss or expenses.
4 Claims in respect of essential clothing or requisites purchased as a result of delayed baggage will only be considered if items have been
purchased within 4 days after the actual arrival time at the intended destination.
5 If baggage appears to be delayed at the destination airport (except returning to the country of residence) the Insured Person must
formally notify the relevant carrier airline immediately. Evidence of notification should be provided
3.2.3 TRAVEL DELAY
The Company will reimburse the Insured Person for reasonable essential expenses incurred (original receipts required) caused by
unforeseen travel delay and following the Excess period, up to the amount stated in the Table of Benefits resulting from:
1 Loss or theft of travel documents (travel tickets, passports and visas).
2 An accident or mechanical/electrical breakdown involving the transport in which he arranged to travel or was traveling for the purpose of
reaching the Point of Departure and/or departure point from which he had intended commencing an onward journey.
3. Delay of a scheduled departure of a Public Conveyance due to: a) industrial dispute, strike or action; or b) adverse weather conditions
including cyclones, tornados, floods, typhoons, blizzards, or natural disasters in the country to or through which he is traveling; or c)
mechanical/electrical breakdown; or d) public transport services failure.
3.2.3.1 SPECIFIC EXCLUSIONS
The Company will not pay for expenses incurred:
1 where comparable alternative onward transportation has been made available to the Insured Person within the Excess after the
scheduled departure time of a booked flight or within the Excess after an actual flight arrival (in the case of a connecting flight); or
2 where the Insured Person fails to check in according to the itinerary supplied, unless such failure was due to a strike or industrial action;
or
3 where the delay is due to industrial dispute, strike or action which existed or for which advance notice had been given on or before the
date on which the Insured Journey commenced; or
4 where the delay is due to the withdrawal from service temporarily or permanently of any Public Conveyance on the orders or
recommendation of any port authority or the civil aviation authority or any similar body in any country in which advance notice had been
given on or before the date on which the Insured Journey commenced; or
5 for carrier caused delays where the cost of expenses is recoverable from the carrier.
3.2.4 LOSS OF PASSPORT
The Company will pay costs incurred by the Insured Person limited to fees, penalties and courier charges towards replacement of travel
documents in lieu of lost passport as per amount stated in the Table of Benefits, under plan opted for and subject to letter intimating loss
of passport acknowledged by appropriate authorities.
3.2.4.1 SPECIFIC EXCLUSIONS
1. Impounding of Passport by any authorities
2. If the loss is recoverable under other insurance or recoverable from other source.
© AIG, all rights reserved (V 1.0 – June 20, 2013)
3.2.5 ASSISTANCE DEPARTMENT
Assistance Department provides Emergency Assistance Services, including medical, technical and general services as listed below. Insured
Persons may contact Assistance Department at Phone number: +1 817 826 7276 twenty four (24) hours a day.
3.2.5.1 Medical Services:
Medical Reference: Assistance Department shall provide the Insured Person(s) with the name, address, telephone number, office hours
and English language translation assistance for medical and health care professionals in any worldwide location reasonably requested
by the Insured Person(s): physicians, hospitals, ambulance, and other emergency medical service (collectively, Medical Service
Providers). Whenever Assistance Department has sufficient information to do so, it shall refer the Insured Person(s) to two or more
such Medical Service Providers, set appointments, translate if needed, and coordinate with the Insured Person(s)s' primary medical
insurer. Assistance Department shall use its reasonable best efforts to ensure that its medical referrals are to Medical Service Providers
who meet the professional standards of the country and city in which they are located. Assistance Department will make its reasonable
best efforts to pre-negotiate fees for services with Medical Service Providers, steer Insured Person(s) of AIG MEA LTD to Medical
Service Providers in-network, and to arrange direct billing with its Medical Service Providers whenever possible for expenses incurred
by the Insured Person(s) of AIG MEA LTD. Assistance Department will use every effort to supply a qualified Medical Reference within
24 hours of the initial request, however when this is not possible, Assistance Department cannot be held responsible for circumstances
beyond its control. In all instances, Assistance Department will notify the Insured Person(s) of the status of the request within this
time frame.
Advance Payment of Medical Expenses: When it is deemed medically appropriate, Assistance Department will advance up to the amount
allowed in the Policies issued to the Insured Person(s) for the payment of medical expenses. Any determination by Assistance Department to
advance such amounts will be based on advise and approval from AIG MEA LTD. If there is no coverage, or if coverage is insufficient under
the Insured Person’s Policy, any uncovered expense associated with the Insured Person’s medical expenses will be the sole responsibility of
the Insured Person or of the person (s) acting on the Insured Person’s behalf.
Guarantee of Hospitalization Fee: When it is deemed medically appropriate, Assistance Department will guarantee payment of hospitalization
fees up to the amount allowed in the Insured Person’s Policy for hospitalization benefits. Any determination by Assistance Department to
guarantee such amounts will be subject to approval of the same advance from AIG MEA LTD in accordance with this Policy. If there is
coverage under the Policy issued to the Insured Person by AIG MEA LTD, then Assistance Department will pay up to the maximum amount
available under the Policy for hospitalization fees. If there is no coverage, or if coverage is insufficient under the Policy, any uncovered
expense associated with an Insured Person’s hospitalization will be the sole responsibility of the Insured Person or of the person(s) acting on
the Insured Person’s behalf.
Medical Evacuation: Assistance Department shall arrange and coordinate the medical evacuation by means of air transportation,
including but not limited to commercial air transportation with or without medical escort, air ambulance transport and /or, if
appropriate, other forms of transportation of an Insured Person from a foreign hospital or health care facility to another foreign
hospital or health care facility, or to a hospital or health care facility in the Insured Person’s Country of Residence, when a physician
designated by Assistance Department to monitor the Insured Person's condition and treatment deems such an evacuation or
transportation necessary in his/her professional judgment. Assistance Department shall use its best efforts to ensure that all services
so arranged are with Medical Service Providers that meet the professional standards of the country and city in which the evacuation
will originate. Assistance Department will pay reasonable costs on Insured Person’s behalf up to the policy limits issued by AIG MEA
LTD.
Medical Case Monitoring: Following all medical referrals or other assistance to an Insured Person in connection with a medical
emergency, Assistance Department shall monitor the Insured Person's medical condition and treatment until the Insured Person is
released from treatment or returns home.
Repatriation of Remains: When Assistance Department is notified that an Insured Person has died while traveling, Assistance Department
will verify that insurance applicable to repatriation of remains is in force. Subject to any governmental regulations, Assistance Department
will also assist in making all necessary arrangements for the return of the Insured Person’s remains to the place designated by the Insured
Person’s next-of-kin. Assistance Department will pay on Insured Person’s behalf reasonable costs up to the policy limits issued by AIG MEA
LTD. Any expense associated with the repatriation of the Insured Person’s remains over the amount available through Insurance will be the
sole responsibility of person(s) acting on the deceased Insured Person’s behalf.
Insurance/Claims Coordination: In a medical emergency, communication and filing issues between a Insured Person’s insurance
carriers and providers to settle billing medical expenses will be handled.
© AIG, all rights reserved (V 1.0 – June 20, 2013)
3.2.5.2 Technical Services:
Lost/Stolen Luggage and Personal Effects: Insured Person whose luggage or personal effects are lost or stolen can expect help with
local authorities and agencies. Assistance Department shall coordinate with common carriers to locate and recover lost or stolen
luggage which shall involve the use of all available tracking systems and establishing, on the Insured Person's behalf and, as
appropriate, liaison with transportation carriers, airports, hotels, government authorities and others. Assistance Department will also
coordinate arrangements to assist the Insured Person with processing of insurance claims resulting from the lost luggage.
Lost/Stolen Travel Documents/Tickets: In the event a traveler’s personal travel documents are lost or stolen, Insured Person(s)s can expect help
with obtaining replacement and canceling original documents, including making alternate reservations and arranging for replacement airline/rail
tickets when needed. Assistance Department shall use its best effort to assist the Insured Person in locating lost documents (including, but not
limited to lost passports and visas), and upon request, to replace such documents by identifying and contacting appropriate governmental
authorities, gathering necessary information, and otherwise taking all reasonable steps necessary to facilitate the replacement of the lost
documents in a prompt and timely manner.
3.2.5.3 General Services:
Travel Documentation: Advice on procuring travel documents, passport/visa requirements, and customs entry/exit restrictions and
regulations.
Immunizations: Advice on the immunizations required for the trip, information on local medical advisories, epidemics, and available
preventive measures.
Currency and ATM Locations: Currency exchange rates are available, as well as information on local bank/government holidays.
Global Weather: General climate and up-to-date weather forecasting for domestic and international destinations.
Telephone Translation for medical emergencies: For travelers in an emergency medical situation who do not speak the local language,
multilingual counselors are available 24 hours a day, seven days a week, for translations via telephone.
4. UNIFORM EXCLUSIONS
The Company will not cover loss, injury, damage or legal liability caused by, sustained, or arising directly or indirectly from:
1.
War, invasion, act of foreign enemy, hostilities, civil war, rebellion, revolution, insurrection or military or usurped power, labor
disturbances, riot, strike or lock-out. However, the Insured Person will continue to be entitled to be covered for 7 calendar days from
the start of the hostilities in case he is surprised by such events abroad insofar as he does not actively participate in them.; nor
2.
the intentional use of military force to intercept, prevent, or mitigate any known or suspected Terrorist Act; nor
3.
4.
any Terrorist Act or bomb incident or threat thereof; nor
the use, release or escape of nuclear materials that directly or indirectly results in ionizing, radiation or contamination by radioactivity
from any nuclear fuel or from nuclear weapons materials. For the purpose of this exclusion, combustion shall include any selfsustaining process of nuclear fission; nor
the release, the dispersal or application of pathogenic or poisonous biological or chemical materials; or
being in service or on duty with or undergoing training with any military or police force, or militia or paramilitary organization; nor
5.
6.
7.
8.
engaging in occupational activities underground or requiring the use of explosives; nor
willful or deliberate exposure to danger (except in an attempt to save human life), intentional self inflicted injury, suicide or attempt
thereat; nor
9. deliberate violation of criminal law; nor
10. traveling by air on a legally licensed aircraft and where the Insured Person is acting as pilot or part of the aircraft crew; nor
11. mental disorders including, but not limited to anxiety disorders, eating disorders, psychotic disorders, affective disorders, personality
disorders, substance use disorders, somatoform disorders, dissociate disorders, psychosexual disorders, adjustment disorders, organic
mental disorders, mental retardation and autism; nor
12. pregnancy and all related conditions, including services and supplies related to the diagnosis or treatment of infertility or other
problems related to inability to conceive a child; birth control, including surgical procedures and devices; nor
13. sexually transmitted diseases and the conditions commonly known as AIDS or HIV and/or any related illness or condition including
derivatives or variations thereof, howsoever, acquired or caused; nor
14. chronic fatigue syndrome or myalgic encephalomyelitis (M.E.) (anticardiolipin antibody positively) or the Illness commonly referred to
as yuppie flu; nor
© AIG, all rights reserved (V 1.0 – June 20, 2013)
15. a) an Insured Person being under the influence of alcohol with more than the legal limit of alcohol in his blood or breath; or
b) an Insured Person being under the influence of drugs or narcotics unless such drugs or narcotics were administered by a Medical
Practitioner or unless prescribed by and taken in accordance with the directions of a Medical Practitioner; or c) an Accident occurring
whilst an Insured Person was driving a motor vehicle with more than the legal limit of alcohol in his blood or breath; or d) alcohol
abuse, alcoholism, substance abuse, solvent abuse, drug abuse or addictive conditions of any kind; nor
16. (a) any Pre-existing Medical Condition; or (b) any cardiac or cardio vascular or vascular or cerebral vascular illness or conditions or
sequelae thereof or complications that, in the opinion of a Medical Practitioner appointed by the Company, can reasonably be related
thereto, if the Insured Person has received medical advice or treatment (including medication) for hypertension 2 years prior to the
commencement of the Insured Journey; nor
17. congenital anomalies and conditions arising out of or resulting there from, and hernia; nor
18. flying in any aircraft owned, leased or operated by or on behalf of an Insured Person or any member of an Insured Person's
household; nor
19. an Insured Person traveling against medical advice or to seek medical attention or advice or with a terminal condition which was
diagnosed prior to the Insured Journey or when he is unfit to do so; nor
20. a) employment involving Manual Labor, other than off duty; or b) undertaking employment on a permanent or contract basis which is
not casual, other than whilst on a leisure trip; nor
21. a) participating in any sport as a Professional Player; or b) school sports (unless an Endorsement has been issued and additional
premium charged and authorized by the Company and paid by the Insured Person); nor
22. any hazardous pursuits, sports or activities which introduce or increase the possibility of a loss including but not limited to engaging in
motor cycling (where the engine capacity exceeds 200cc or the cycle is under control of an unlicensed driver), steeple-chasing, polo or
horseback riding, hunting, bungee jumping, abseiling, white water rafting, hiking (unless accompanied by a recognized guide or on a
clearly marked route), mountaineering requiring the use of ropes or equipment, scuba diving (unless licensed or accompanied by a
qualified instructor), fighting (except in bona fide self defense), racing (other than on foot or under sail in inland waters), being a crew
member on a ship or boat traveling from one country to another, speed or endurance racing or practice thereof (other than athletics),
or training for or engaging in contact sports where physical contact between players is an accepted part of play. Skiing, land-skiing,
mono-skiing, cross-country skiing, heli-skiing, off-piste skiing (only when accompanied by an official guide), ice skating (no speed
skating), snow boarding, ski boarding, sledging, tobogganing or ice skating, fishing, sail boarding, sailing, surfing, water skiing, wind
surfing, unless an additional premium has been charged and authorized by the Company and paid by the Insured Person. This remains
23.
24.
25.
26.
27.
at the discretion of the Company; nor
consequential loss of any kind or financial loss and/or expense not otherwise specifically covered; nor
default or insolvency of the carrier; nor
the Insured Person’s intention to emigrate, unless agreed previously in writing by the Company.
travel in, to through Afghanistan, Iraq, Cuba or Democratic Republic of Congo.
any terrorist or member of a terrorist organization, narcotics trafficker, or purveyor of nuclear, chemical or biological weapons.
28. Heart attack or any heart related condition
29. Any condition arising from tumor or relating to cancer
5. GENERAL CONDITIONS
5.1 Age limits
This Policy covers Insured Events which happen to an Insured Person who is 18 years to 69 years of age at the date of such event.
5.2 Airlines
The Company will have no liability to pay any benefit in relation to any Insured Event for which the Insured Person may be able to seek
compensation from an airline. If the Insured Person proves that he has taken all reasonable and necessary steps to claim from the airline,
the Company will pay a pro-rata portion of the benefits. The Company’s liability will be calculated by reducing the benefits by the amount
for which the Company considers the airline to be liable.
5.3 Currency
All amounts are shown in United States Dollar. If expenses are incurred in a foreign currency the rate of exchange used will be the rate at
the time of incurring the expense or suffering a loss.
5.4 Endorsements
This Policy may be extended, amended or altered by the Company issuing an endorsement, provided that the application is made in writing
to the Company prior to the expiry of the existing Policy and there are neither existing nor initiated claims on the existing Policy.
5.5 Liability
The Company shall not be liable or responsible for: a) the negligence, wrongful acts and/or omissions of any legal and/or health care
professional or any other person or persons or legal entity that provide direct or indirect service to the Insured Person; b) The failure of any
agent or broker to explain adequately the terms, conditions, endorsements, terminations and exclusions of this Policy.
© AIG, all rights reserved (V 1.0 – June 20, 2013)
5.6 Language
The official version of this Policy is in English. Words in the singular include the plural and vice versa and words in the masculine gender
include the feminine gender.
5.7 Marketing
Should any discrepancies arise between the Policy and any literature received by the Insured Person, the Terms, Conditions, Endorsements,
Terminations and Exclusions in the Policy will govern in all cases.
5.8 Misrepresentation
This Policy shall be considered void (at the discretion of the Company) in the event of misrepresentation, mis-description or non-disclosure
by or on behalf of the Insured Person of any information material to this Policy.
5.9 Other financial products and services
The Company will accept no liability whatsoever for any of the insurance or other financial products or services which are sold in
conjunction with this Policy that are provided or underwritten by any other insurance or assurance companies and/or assistance companies
and/or financial providers.
5.10 Other insurance
If the Insured Person is able to claim under any other policies (including statutory insurance and/or automatic credit card travel insurance)
to be covered for the whole or any part of an Insured Event (“Other Claims”), the Company will only be liable to pay its pro rata portion of
the claim submitted in terms of this Policy.
- If in the Company’s discretion it decides to pay the claim in full, then it will not be obliged to make payment unless the Insured Person
cedes to the Company all of their rights in respect of the Other Claims.
- If the Company has already paid benefits in terms of this Policy, all of the Insured Person’s rights in respect of the Other Claims will be
ceded automatically to the Company.
- Without limiting any provision of this Policy or any legal obligation, the Insured Person must cooperate fully with the Company in relation
to the Other Claim or legal proceedings including: a) not doing anything to prejudice or limit the Company’s rights; b) giving the Company
whatever information and documents it may require; c) signing any document or affidavit that the Company may request to enable it to
exercise its rights.
5.11 Third Party
This Policy is between the Company and the Insured Person only and all of its provisions and conditions are for the sole and exclusive
benefit of those parties. Nothing in this Policy, expressed or implied, is intended to confer upon any other person any rights or remedies of
any nature whatsoever under this Policy or any of its provisions. Without limitation, no third party shall have any rights under this Policy or
any right to receive Policy benefits. Receipt of Benefits paid will be a valid discharge of the Company’s liability under this Policy.
This Policy cannot be ceded, assigned or in any way transferred to a third party. Benefits shall be payable only to the Insured Person or his
legal representative.
5.12 Public Conveyance tickets
The Company has the right to utilize the Insured Person’s Public Conveyance ticket to offset the Company’s expenses.
5.13 Country of Issuance Law
This Policy will be governed by the laws of country where the policy has been issued and its courts shall have exclusive jurisdiction to the
exclusion of the courts of any other country.
5.14 Subrogation
The Company has the right to commence or take over legal proceedings in the Insured Person's name for the defense or settlement of any
claim, or to sue or prosecute any other party to recover monies payable by them at law. The Insured Person must co-operate with the
Company and do nothing to hinder the Company’s rights.
5.15 Tax or Imposts
The onus will always be on the Insured Person to ensure, correctly admit and pay any tax liability in consideration of any benefit being paid
that may incur tax or imposts of any nature.
5.16 Data Disclosure
By entering into this contract of Insurance, the Insured consents to the Insurer processing data relating to the Insured for providing
insurance products and services, legal, administrative and management purposes and in particular to the processing of any sensitive
personal data relating to the Insured.
The Insured consent to the Insurer making such information available to third parties including but not limited to any Group Company,
those who provide products or services to the Insurer or any Group Company, and regulatory authorities, within and outside the Insured’s
country of domicile.
5.17 Economic Sanctions Exclusion
If, by virtue of any law or regulation which is applicable to an Insurer, its parent company or its ultimate controlling entity, at the inception
of this Policy or at any time thereafter, providing coverage to the Insured is or would be unlawful because it breaches an applicable
embargo or sanction, that Insurer shall provide no coverage and have no liability whatsoever nor provide any defense to the Insured or
make any payment of defense costs or provide any form of security on behalf of the Insured, to the extent that it would be in breach of
such embargo or sanction.
© AIG, all rights reserved (V 1.0 – June 20, 2013)
5.18 Privacy Policy
To review our privacy policy, go to:
http://www.AIG.ae
5.19 Complaints and Disputes:
If you have a complaint about your policy, please contact:
Customer Service Group
AIG MEA Limited (Kuwait Branch)
5th Floor, Al-Kharafi Tower, Osama Bin Monkiz St., Area 7
Al Qubla, Kuwait City, Kuwait
Tel: +965 2 247-4260, Fax: +965 2 247-4264
E-mail: servicecenter-me@AIG.com
6. CLAIMS CONDITIONS
6.1 Compliance
The Insured Person must follow the Company’s advice or instruction otherwise the Company may decline to pay the whole or any part of
the claim.
6.2 Legal action
If the Company denies liability for any claim and the Insured Person does not institute legal action and serve summons on the Company (or
initiate arbitration proceedings if the Company has agreed to submit to arbitration) within 36 months after such repudiation, all benefits of
such claim shall be forfeited.
6.3 Notice of claim and proof of loss
The Insured Person must give the Company notice in writing:
a) Within 60 days of an Accident which may give rise to a claim under this Policy Any benefit related to death will only be payable if the
Company receives written notification of the death within 30 days. The Company shall have the right to have a post mortem examination of
the body conducted.
b) Within 30 days of any other occurrence which may give rise to a claim under this Policy.
The Insured Person must, at his own cost, provide whatever certificates, information and documented evidence (“Evidence”) is required by
the Company regarding the Insured Event.
6.4 Recoveries
All recoveries net of the Company’s actual recovery costs will be distributed firstly to the Company for all amounts paid and any remainder
will be paid to the Insured Person.
6.5 Fraudulent Claims
If the Insured Person or anyone acting on his behalf uses any fraudulent means or devices to obtain any benefit, then any amount payable
in respect of such claim shall be forfeited, the Policy will be cancelled and no Premium will be refunded.
6.6 General
- The Insured Person shall submit to medical examination at the expense of the Company as often as shall be required in connection with
any claim. Any report generated as a result of such examination shall be the property of the Company and shall be deemed to be
confidential information of the Company.
- Medical Treatment shall be sought and followed promptly on the occurrence of an Injury or Illness and the Company shall not be liable for
that part of any claim which in the opinion of a Medical Practitioner arises from the unreasonable or willful neglect or failure of any Insured
Person to seek and remain under the care of a qualified Medical Practitioner.
- All claims arising from criminal incidents are to be supported and accompanied by a certified police report.
- The due observance and fulfillment of the Policy insofar as it relates to anything being done or complied with by the Insured Person, shall
be a condition precedent to liability to make any payment under this Policy.
- The Company shall have the right to access any current or prior medical records of the Insured Person in order to finalize and/or proceed
with the assessment of a claim and/or render medical assistance. By virtue of this clause, the Insured Person shall be deemed to have
given the Company written consent to access any of the Insured Person’s current or prior medical records.
- No amount payable in terms of this Policy shall bear any interest.
© AIG, all rights reserved (V 1.0 – June 20, 2013)
‫ﺇﻴﻪ ﺁﻱ ﺠﻲ ﻤﻴﺎ ﺍﻝﻤﺤﺩﻭﺩﺓ )ﻓﺭﻉ ﺍﻝﻜﻭﻴﺕ(‬
‫ﺤﻤﺎﻴﺔ ﺍﻝﺴﻔﺭ‬
‫ﺤﺩﻭﺩ ﺍﻝﺘﻐﻁﻴﺔ‬
‫ﺍﻝﺘﻐﻁﻴﺔ‪:‬‬
‫ﺘﺄﻤﻴﻥ ﺍﻝﺴﻔﺭ‬
‫ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪:‬‬
‫ﻜل ﻤﻥ ﻋﻤﻼﺀ ﻤﻘﺩﻡ ﺍﻝﺨﺩﻤﺔ ﺍﻝﺫﻴﻥ ﺘﺘﺭﺍﻭﺡ ﺃﻋﻤﺎﺭﻫﻡ ﺒﻴﻥ ‪ 18‬ﻋﺎﻤﺎ ‪ 69‬ﻋﺎﻤﺎ ﺍﻝﺫﻴﻥ ﻁﻠﺒﻭﺍ ﺍﻝﺘﺴﺠﻴل ﻓﻲ ﻭﺜﻴﻘﺔ ﺍﻝﺘﺄﻤﻴﻥ ﻋﺒﺭ ﻤﻘﺩﻡ ﺨﺩﻤـﺔ‬
‫ﺘﻐﻁﻴﺔ ﺘﺄﻤﻴﻥ ﺍﻝﺴﻔﺭ ﺸﺭﻁ ﺃﻥ ﻴﻜﻭﻥ ﺍﻝﻘﺴﻁ ﻗﺩ ﺩﻓﻊ ﺒﺎﻝﻜﺎﻤل‬
‫ﻓﺘﺭﺓ ﺍﻝﺘﺄﻤﻴﻥ‪:‬‬
‫‪ 24‬ﺴﺎﻋﺔ‪ /‬ﻓﻲ ﺠﻤﻴﻊ ﺃﻨﺤﺎﺀ ﺍﻝﻌﺎﻝﻡ ﺃﺜﻨﺎﺀ ﺍﻝﺴﻔﺭ ﺍﻝﺩﻭﻝﻲ )ﺒﺎﺴﺘﺜﻨﺎﺀ ﺍﻝﻌﺭﺍﻕ ﻭﺃﻓﻐﺎﻨﺴﺘﺎﻥ ﻭﻜﻭﺒﺎ ﻭﺠﻤﻬﻭﺭﻴﺔ ﺍﻝﻜﻭﻨﻐﻭ ﺍﻝﺩﻴﻤﻘﺭﺍﻁﻴـﺔ( ﺨـﺎﺭﺝ‬
‫ﺍﻝﻜﻭﻴﺕ‬
‫ﻤﺩﺓ ﺍﻝﺘﺄﻤﻴﻥ ﺍﻝﻔﺭﺩﻴﺔ‪:‬‬
‫ﻗﺴﻁ ﺍﻝﺘﺄﻤﻴﻥ‪:‬‬
‫ﺍﻝﺸﺭﻭﻁ ‪:‬‬
‫ﺍﻝﻘﺴﻁ ﺍﻝﺸﻬﺭﻱ ‪ 30 :‬ﻴﻭﻡ ﺒﺩﺀﹰﺍ ﻤﻥ ﺘﺎﺭﻴﺦ ﺩﻓﻊ ﺍﻝﻘﺴﻁ )ﻓﻲ ﻤﻭﻋﺩ ﻻ ﻴﺘﺠﺎﻭﺯ ﺍﻝﻴﻭﻡ ﺍﻝﺴﺎﺒﻕ ﻝﺘﺎﺭﻴﺦ ﺩﻓﻊ ﺍﻝﻘﺴﻁ ﺍﻝﻘﺎﺩﻡ(‬
‫ﻓﺭﺩﻱ‬
‫ﺍﻝﻘﺴﻁ‬
‫ﺍﻝﻘﺴﻁ ﺍﻝﺸﻬﺭﻱ‬
‫‪ 2‬ﺩ ‪.‬ﻙ‪.‬‬
‫ﻭﻓﻘﺎ ﻝﺼﻴﻐﺔ ﻭﺜﻴﻘﺔ ﺘﺄﻤﻴﻥ ﺍﻝﺴﻔﺭ ﺍﻝﺼﺎﺩﺭﺓ ﻋﻥ ﺇﻴﻪ ﺁﻱ ﺠﻲ ﻤﻴﺎ ﺍﻝﻤﺤﺩﻭﺩﺓ )ﻓﺭﻉ ﺍﻝﻜﻭﻴﺕ(‬
‫ﻴﺘﺭﺍﻭﺡ ﻋﻤﺭ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻤﻥ ‪ 18‬ﺇﻝﻰ ‪ 69‬ﺴﻨﺔ‪.‬‬
‫ﺍﺴﺘﺜﻨﺎﺀ ﺍﻝﺤﺭﺏ ﻭﺍﻹﺭﻫﺎﺏ‬
‫ﻴﺘﻡ ﻓﺭﺽ ﺍﻝﻘﺴﻁ ﻋﻠﻰ ﺃﺴﺎﺱ ﺸﻬﺭﻱ‬
‫ﺘﻌﺩﻴل ﺍﻝﻘﺴﻁ ﺸﻬﺭﻴﺎ‬
‫"ﺘﺎﺭﻴﺦ ﻗﺴﻁ ﺍﻝﺘﺄﻤﻴﻥ" ﻫﻭ ﺍﻝﺘﺎﺭﻴﺦ ﺍﻝﺫﻱ ﻴﻘﻭﻡ ﻓﻴﻪ ﺤﺎﻤل ﺍﻝﻭﺜﻴﻘﺔ ﺒﺩﻓﻊ ﺍﻝﻘﺴﻁ ﺍﻝﻤﺴﺘﺤﻕ ﻋﻠﻴﻪ ﺍﻝﻰ ﺸﺭﻜﺔ ﺍﻻﺘﺼﺎﻻﺕ‬
‫ﺍﻝﺤﺩ ﺍﻷﻗﺼﻰ ﻝﻠﺘﻌﻭﻴﺽ "ﻤﺒﻠﻎ ﺍﻝﺘﺄﻤﻴﻥ ﺍﻷﺴﺎﺴﻲ" ﻝﻜل ﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻻﻴﺘﻌﻠﻕ ﺒﻌﺩﺩ ﻭﺜﺎﺌﻕ ﺍﻝﺘﺄﻤﻴﻥ ﺍﻝﻤﺸﺘﺭﺍﺕ‬
‫ﺃﻥ ﻴﻜﻭﻥ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻤﻘﻴﻡ ﺩﺍﺌﻡ ﻓﻲ ﺍﻝﺩﻭﻝﺔ ﺍﻝﺘﻲ ﺘﻡ ﺇﺼﺩﺍﺭ ﺍﻝﻭﺜﻴﻘﺔ ﻓﻴﻬﺎ‪.‬‬
‫ﺍﻝﻁﺎﺌﺭﺓ ﺍﻝﺨﺎﺼﺔ ﻝﺤﺎﻤل ﺍﻝﻭﺜﻴﻘﺔ ﻤﺴﺘﺒﻌﺩﺓ‪.‬‬
‫ﺍﻝﺤﺎﻻﺕ ﺍﻝﻘﺎﺌﻤﺔ ﻤﺴﺒﻘﺎ ﻤﺴﺘﺒﻌﺩﺓ‬
‫ﺠﺩﻭل ﺍﻝﻤﻨﺎﻓﻊ‪:‬‬
‫ﺍﻝﺤﺩﺙ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‬
‫ﻤﺒﻠﻎ ﺍﻝﺘﺄﻤﻴﻥ‬
‫ﺍﻝﻤﺼﺎﺭﻴﻑ ﺍﻝﻁﺒﻴﺔ ﺍﻝﻁﺎﺭﺌﺔ )ﺍﻝﺤﻭﺍﺩﺙ ﻭﺍﻝﻤﺭﺽ(‬
‫‪$20.000‬‬
‫ﺘﺤﻤل‬
‫‪$100‬‬
‫ﻓﻘﺩﺍﻥ ﺍﻷﻤﺘﻌﺔ )ﺸﺭﻜﺔ ﺍﻝﻨﻘل ﺍﻝﻌﺎﻡ(‬
‫‪$1.000‬‬
‫ﻝﻠﺤﻘﻴﺒﺔ ﺍﻝﻭﺍﺤﺩﺓ‬
‫‪$500‬‬
‫ﻝﻠﻘﻁﻌﺔ‬
‫‪$50‬‬
‫ﺘﺄﺨﺭ ﺍﻷﻤﺘﻌﺔ‬
‫‪ $50‬ﻝﻠﺴﺎﻋﺔ ﺤﺘﻰ ‪$500‬‬
‫ﺘﺤﻤل‬
‫‪ 6‬ﺴﺎﻋﺎﺕ‬
‫ﺘﺄﺨﺭ ﺍﻝﺭﺤﻠﺔ‬
‫‪ $50‬ﻝﻠﺴﺎﻋﺔ ﺤﺘﻰ ‪$500‬‬
‫ﺘﺤﻤل‬
‫‪ 6‬ﺴﺎﻋﺎﺕ‬
‫ﻓﻘﺩﺍﻥ ﺠﻭﺍﺯ ﺍﻝﺴﻔﺭ‬
‫‪$300‬‬
‫ﺨﺩﻤﺔ ﺍﻝﻤﺴﺎﻋﺩﺓ )‪ 24‬ﺴﺎﻋﺔ‪ /‬ﺨﺩﻤﺎﺕ ﻓﻲ ﺠﻤﻴﻊ ﺍﻨﺤﺎﺀ ﺍﻝﻌﺎﻝﻡ(‬
‫ﻤﻐﻁﻰ‬
‫)‪© AIG, all rights reserved (V 1.0 – June 20, 2013‬‬
‫ﺇﻥ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﻫﻲ ﻋﻘﺩ ﺒﻴﻥ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻭ ﺃﻴﻪ ﺁﻱ ﺠﻲ ﻤﻴﺎ ﺍﻝﻤﺤﺩﻭﺩﺓ – ﻓﺭﻉ ﺍﻝﻜﻭﻴﺕ‪ ،‬ﻭﺨﻠﻔﺎﺀﻫﺎ ﻭﺍﻝﻤﺘﻨﺎﺯل ﺇﻝﻴﻬﻡ ﻝﺩﻴﻬﺎ‪ ،‬ﻭﻴﺸﺎﺭ ﺇﻝﻴﻬﺎ ﺒﺎﻝﺸﺭﻜﺔ‪ .‬ﺘﻭﺍﻓﻕ ﺍﻝﺸﺭﻜﺔ‬
‫ﻋﻠﻰ ﺘﻘﺩﻴﻡ ﺍﻝﺘﺄﻤﻴﻥ ﺍﺴﺘﻨﺎﺩﺍ ﺇﻝﻰ ﺍﻷﺴﺎﺱ ﺍﻝﻤﺤﺩﺩ ﻓﻲ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﻭﺒﻨﺎﺀ ﻋﻠﻰ ﺍﻝﻤﻌﻠﻭﻤﺎﺕ ﺍﻝﻤﻘﺩﻤﺔ ﻤﻥ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪ ،‬ﻭﺸﺭﻴﻁﺔ ﺩﻓﻊ ﻗـﺴﻁ ﺍﻝﺘـﺄﻤﻴﻥ ﻋﻨـﺩ‬
‫ﺍﺴﺘﺤﻘﺎﻗﻪ ﻭﻤﻭﺍﻓﻘﺔ ﺍﻝﺸﺭﻜﺔ ﻋﻠﻰ ﻗﺒﻭﻝﻪ‪.‬‬
‫ﺇﻥ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﻤﻊ ﺍﻝﺘﺄﻜﻴﺩ ﻋﻠﻰ ﺍﻝﻭﺜﻴﻘﺔ ﺃﻭ ﺠﺩﻭل ﻭﻤﻼﺤﻕ ﺍﻝﻭﺜﻴﻘﺔ‪ ،‬ﺇﻥ ﻭﺠﺩﺕ‪ ،‬ﺘﺴﺘﻜﻤل ﺍﻝﻭﺜﻴﻘﺔ‪.‬‬
‫‪.1‬ﺒﻨﻭﺩ ﺘﻤﻬﻴﺩﻴﺔ‬
‫ﻤﺩﺓ ﺍﻝﻐﻁﺎﺀ‬
‫ﻴﺒﺩﺃ ﻏﻁﺎﺀ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﻓﻲ ﺘﺎﺭﻴﺦ ﺒﺩﺀ ﺍﻝﻐﻁﺎﺀ ﺍﻝﺫﻱ ﻴﻅﻬﺭ ﻓﻲ ﺠﺩﻭل ﺍﻝﻭﺜﻴﻘﺔ‪.‬‬
‫ﺘﻘﺩﻡ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﺍﻝﻐﻁﺎﺀ ﻝﻠﺭﺤﻼﺕ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻬﺎ ﺍﻝﺘﻲ ‪:‬‬
‫ﻴﺘﻡ ﺤﺠﺯﻫﺎ ﺒﻌﺩ ﺃﻭ‬
‫ﺘﺒﺩﺃ ﺒﻌﺩ ﺘﺎﺭﻴﺦ ﺒﺩﺀ ﺍﻝﻐﻁﺎﺀ ﺍﻝﺫﻱ ﻴﻅﻬﺭ ﻓﻲ ﺠﺩﻭل ﺍﻝﻭﺜﻴﻘﺔ‬
‫ﻭﺤﺘﻰ ﺍﻝﺤﺩﻭﺙ ﺍﻷﻭل ﻝﺘﺎﺭﻴﺦ ﻋﻭﺩﺓ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻤﻥ ﺭﺤﻠﺘﻪ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻬﺎ ﺃﻭ ﺘﺎﺭﻴﺦ ﺍﻨﺘﻬﺎﺀ ﺍﻝﺼﻼﺤﻴﺔ ﺍﻝﻤﺒﻴﻥ ﻓﻲ ﺠﺩﻭل ﺍﻝﻭﺜﻴﻘﺔ‪.‬‬
‫ﻭﺴﻭﻑ ﺘﺴﺭﻱ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﺤﺘﻰ ﺘﺎﺭﻴﺦ ﺍﻹﻝﻐﺎﺀ ﺃﻭ ﺘﺎﺭﻴﺦ ﺍﻨﺘﻬﺎﺀ ﺍﻝﺼﻼﺤﻴﺔ ﺍﻝﻤﺒﻴﻥ ﻓﻲ ﺠﺩﻭل ﺍﻝﻭﺜﻴﻘﺔ‪ ،‬ﺃﻭ ﻗﺒل ﺫﻝﻙ ﻓﻲ ﺘﺎﺭﻴﺦ ﻋﻭﺩﺓ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻤـﻥ‬
‫ﺭﺤﻠﺘﻪ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻬﺎ‪.‬‬
‫ﺒﺎﻝﻨﺴﺒﺔ ﻝﺒﺭﻨﺎﻤﺞ ﺍﻝﺭﺤﻼﺕ ﺍﻝﻤﺘﻌﺩﺩﺓ ﺍﻝﺴﻨﻭﻱ‪ ،‬ﺴﻭﻑ ﻴﻨﺘﻬﻲ ﺍﻝﻐﻁﺎﺀ ﻋﻨﺩ ﻋﻭﺩﺓ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺇﻝﻰ ﻨﻘﻁﺔ ﺍﻝﻤﻐﺎﺩﺭﺓ ﻭﺇﻋﺎﺩﺓ ﺒﺩﺀ ﺭﺤﻠﺘﻪ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻬﺎ ﺍﻝﺘﺎﻝﻴﺔ‪.‬‬
‫ﺍﻝﺤﺩ ﺍﻷﻗﺼﻰ ﻝﻤﺩﺓ ﺃﻱ ﺭﺤﻠﺔ ﻤﺅﻤﻥ ﻋﻠﻴﻬﺎ ﻴﻘﺘﺼﺭ ﻋﻠﻰ ‪ 90‬ﻴﻭﻡ ﻝﻭﺜﺎﺌﻕ ﺍﻝﺭﺤﻼﺕ ﺍﻝﻭﺤﻴﺩﺓ ﻭﺒﺭﻨﺎﻤﺞ ﺍﻝﺭﺤﻼﺕ ﺍﻝﻤﺘﻌﺩﺩﺓ‪.‬‬
‫ﻻ ﻴﻤﻜﻥ ﺇﻝﻐﺎﺀ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﺒﻌﺩ ﺘﺎﺭﻴﺦ ﺒﺩﺀ ﺍﻝﻐﻁﺎﺀ‪.‬‬
‫ﻤﺩﻓﻭﻋﺎﺕ ﻗﺴﻁ ﺍﻝﺘﺄﻤﻴﻥ‬
‫ﻴﻠﺘﺯﻡ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺒﻘﺴﻁ ﺍﻝﺘﺄﻤﻴﻥ‪ ،‬ﻭﻴﺴﺘﺤﻕ ﺩﻓﻊ ﻗﺴﻁ ﺍﻝﺘﺄﻤﻴﻥ ﻤﻘﺩﻤﺎ ﻭﻝﻥ ﺘﻜﻭﻥ ﺍﻝﺸﺭﻜﺔ ﻤﻠﺯﻤﺔ ﺒﺄﻱ ﻤﻁﺎﻝﺒﺔ ﺘﻨﺸﺄ ﺒﻤﻭﺠﺏ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﻭﺘﺤـﺩﺙ ﻗﺒـل‬
‫ﺍﺴﺘﻼﻡ ﻗﺴﻁ ﺍﻝﺘﺄﻤﻴﻥ‪ .‬ﻭﻝﻥ ﺘﻜﻭﻥ ﺍﻝﺸﺭﻜﺔ ﻤﻠﺯﻤﺔ ﺒﻘﺒﻭل ﻗﺴﻁ ﺍﻝﺘﺄﻤﻴﻥ ﺍﻝﻤﻘﺩﻡ ﺇﻝﻴﻬﺎ ﺃﻭ ﺇﻝﻰ ﺃﻱ ﻭﺴﻴﻁ ﺒﻌﺩ ﻫﺫﺍ ﺍﻝﺘﺎﺭﻴﺦ‪ ،‬ﻭﻝﻜﻥ ﻴﻤﻜﻨﻬﺎ ﺍﻝﻘﻴﺎﻡ ﺒﺫﻝﻙ ﺒﻤﻭﺠﺏ ﺍﻝـﺸﺭﻭﻁ‬
‫ﺍﻝﺘﻲ ﺘﻘﺭﺭﻫﺎ ﻭﻓﻘﺎ ﻝﺘﻘﺩﻴﺭﻫﺎ ﻭﺤﺩﻫﺎ‪ .‬ﻭﺘﺤﺘﻔﻅ ﺍﻝﺸﺭﻜﺔ ﺒﺤﻕ ﻁﻠﺏ ﺇﺜﺒﺎﺕ ﺩﻓﻊ ﻗﺴﻁ ﺍﻝﺘﺄﻤﻴﻥ ﻓﻲ ﺃﻱ ﻭﻗﺕ‪ .‬ﻭﻴﺘﻌﻴﻥ ﺃﻥ ﻴﻜﻭﻥ ﺍﻹﺜﺒﺎﺕ ﺍﻝﻤﺫﻜﻭﺭ ﻭﻓﻘﺎ ﻝﺭﻀﻰ ﺍﻝﺸﺭﻜﺔ‪.‬‬
‫ﺍﻝﺤﺩ ﺍﻷﻗﺼﻰ ﻝﻠﻤﺒﻠﻎ ﺍﻝﻭﺍﺠﺏ ﺍﻝﺩﻓﻊ‪:‬‬
‫ﻝﻥ ﻴﺤﻕ ﻷﻱ ﺸﺨﺹ ﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺍﺴﺘﺭﺩﺍﺩ ﻤﻨﻔﻌﺔ ﺘﺘﺠﺎﻭﺯ ‪ %100‬ﻤﻥ ﻤﺒﻠﻎ ﺍﻝﺤﺎﺩﺙ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻜﻤﺎ ﻫﻭ ﻤﺫﻜﻭﺭ ﻓﻲ ﺠﺩﻭل ﺍﻝﻤﻨﺎﻓﻊ‪.‬‬
‫ﻓﻲ ﺤﺎﻝﺔ ﺴﺭﻴﺎﻥ ﻭﺜﻴﻘﺘﻲ ﺘﺄﻤﻴﻥ ﻋﻠﻰ ﺍﻝﺴﻔﺭ ﺃﻭ ﺃﻜﺜﺭ ﺼﺎﺩﺭﺓ ﻤﻥ ﻗﺒل ﺍﻝﺸﺭﻜﺔ ﺃﻭ ﺃﻱ ﺸﺭﻜﺔ ﺃﺨﺭﻯ ﻋﻀﻭ ﻓﻲ ﺃﻴﻪ ﺁﻱ ﺠﻲ ﻤﻴﺎ ﺍﻝﻤﺤﺩﻭﺩﺓ )ﻓﺭﻉ ﺍﻝﻜﻭﻴﺕ( ﻋﻠﻰ ﻨﻔﺱ‬
‫ﺍﻝﻤﻁﺎﻝﺒﺔ‪ ،‬ﻓﺈﻥ ﺍﻝﺤﺩ ﺍﻷﻗﺼﻰ ﻝﻠﻤﺒﻠﻎ ﺍﻝﻭﺍﺠﺏ ﺍﻝﺩﻓﻊ ﻤﻥ ﺍﻝﺸﺭﻜﺎﺕ ﺍﻷﻋﻀﺎﺀ ﻓﻲ ﺃﻴﻪ ﺁﻱ ﺠﻲ ﺒﻤﻭﺠﺏ ﻜﺎﻓﺔ ﺘﻠﻙ ﺍﻝﻭﺜﺎﺌﻕ ﻝﻥ ﻴﺘﺠﺎﻭﺯ ﺤﺩ ﺍﻝﻤـﺴﺌﻭﻝﻴﺔ ﺃﻱ ﻤـﻥ ﻫـﺫﻩ‬
‫ﺍﻝﻭﺜﺎﺌﻕ ﺍﻝﺘﻲ ﻴﻜﻭﻥ ﻝﻬﺎ ﺃﻋﻠﻰ ﺤﺩ ﻤﺴﺌﻭﻝﻴﺔ ﻭﺍﺠﺏ ﺍﻝﺘﻁﺒﻴﻕ‪ .‬ﻭﻝﻥ ﻴﺘﻡ ﺘﻔﺴﻴﺭ ﺃﻱ ﺸﻲﺀ ﻓﻲ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﻋﻠﻰ ﺇﻨﻪ ﻴﺯﻴﺩ ﻤﻥ ﺤﺩ ﺍﻝﻤﺴﺌﻭﻝﻴﺔ ﺒﻤﻭﺠﺏ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ‪.‬‬
‫ﺍﻹﻝﻐﺎﺀ ‪ /‬ﺍﻹﻨﻬﺎﺀ‬
‫ﺍﻹﻝﻐﺎﺀ‬
‫ﻴﺠﻭﺯ ﺃﻥ ﺘﻘﻭﻡ ﺍﻝﺸﺭﻜﺔ ﺒﺈﻝﻐﺎﺀ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﻓﻲ ﺃﻱ ﻭﻗﺕ ﺒﻤﻭﺠﺏ ﺃﺸﻌﺎﺭ ﺨﻁﻲ ﻴﺘﻡ ﺘﺴﻠﻴﻤﻪ ﺇﻝﻰ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻭﺴﻭﻑ ﻴﺴﺭﻱ ﻤﻔﻌﻭل ﺍﻹﻝﻐﺎﺀ ﺒﻌﺩ ﺫﻝـﻙ‪.‬‬
‫ﻭﺴﻭﻑ ﻴﻜﻭﻥ ﻫﺫﺍ ﺍﻹﻝﻐﺎﺀ ﺒﺩﻭﻥ ﺍﻝﻤﺴﺎﺱ ﺒﺄﻱ ﻤﻁﺎﻝﺒﺔ ﺴﺎﺭﻴﺔ ﺍﻝﻤﻔﻌﻭل ﺘﻨﺸﺄ ﻗﺒل ﺫﻝﻙ‪.‬‬
‫ﻭﻓﻲ ﺤﺎﻝﺔ ﺇﻝﻐﺎﺀ ﺍﻝﺘﺄﻤﻴﻥ ﺍﻝﻔﺭﺩﻱ ﺍﻝﻤﻘﺩﻡ ﺇﻝﻰ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺒﻤﻭﺠﺏ ﺍﻝﻭﺜﻴﻘﺔ ﻭﺍﻝﺘﻲ ﺘﻡ ﺩﻓﻊ ﻗﺴﻁ ﺘﺄﻤﻴﻥ ﻤﺴﺒﻘﺎ ﺒﻤﻭﺠﺏ ﺇﺸﻌﺎﺭ ﺨﻁﻲ ﺘﻡ ﺘﺴﻠﻴﻤﻪ ﺇﻝﻰ ﺍﻝـﺸﺭﻜﺔ ﻭﻤـﻥ‬
‫ﺨﻼل ﺇﻋﺎﺩﺓ ﺍﻝﻨﺴﺨﺔ ﺍﻷﺼﻠﻴﺔ ﻝﻠﻭﺜﻴﻘﺔ )ﻓﻲ ﺤﺎﻝﺔ ﻭﺠﻭﺏ ﺍﻝﺘﻁﺒﻴﻕ( ﻗﺒل ﺒﺩﺀ ﺍﻝﺭﺤﻠﺔ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻬﺎ‪ ،‬ﺴﻭﻑ ﻴﺘﻡ ﺭﺩ ‪ %100‬ﻤﻥ ﻗﺴﻁ ﺍﻝﺘﺄﻤﻴﻥ‪.‬‬
‫ﻭﻓﻲ ﺤﺎﻝﺔ ﺇﻨﻬﺎﺀ ﻏﻁﺎﺀ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪ ،‬ﺍﻝﺯﻭﺠﺔ‪/‬ﺍﻝﺯﻭﺝ ﻭ‪/‬ﺃﻭ ﺍﻝﻁﻔل ﺒﺴﺒﺏ ﺩﻓﻊ ﺍﻝﻤﺒﻠﻎ ﺍﻷﺴﺎﺴﻲ‪ ،‬ﻝﻥ ﺘﻘﻭﻡ ﺍﻝﺸﺭﻜﺔ ﺒﺭﺩ ﺃﻱ ﻗﺴﻁ ﺘﺄﻤﻴﻥ‪.‬‬
‫)‪© AIG, all rights reserved (V 1.0 – June 20, 2013‬‬
‫ﺍﻹﻨﻬﺎﺀ‪:‬‬
‫ﺘﻨﺘﻬﻲ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﻋﻨﺩ ﺃﻭل ﺤﺩﻭﺙ ﻷﻱ ﻤﻥ ﺍﻝﺘﻭﺍﺭﻴﺦ ﺍﻝﺘﺎﻝﻴﺔ‪:‬‬
‫ﺘﺎﺭﻴﺦ ﻋﻭﺩﺓ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺇﻝﻰ ﻨﻘﻁﺔ ﺍﻝﻤﻐﺎﺩﺭﺓ ﻓﻲ ﺩﻭﻝﺔ ﺇﻗﺎﻤﺘﻪ‪ .‬ﻭﺒﺎﻝﻨﺴﺒﺔ ﻝﺒﺭﻨﺎﻤﺞ ﺍﻝﺭﺤﻼﺕ ﺍﻝﻤﺘﻌﺩﺩﺓ ﺍﻝﺴﻨﻭﻱ‪ ،‬ﺴﻭﻑ ﻴﻨﺘﻬﻲ ﺍﻝﻐﻁﺎﺀ ﻋﻨﺩ ﻋﻭﺩﺓ ﺍﻝـﺸﺨﺹ‬
‫ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺇﻝﻰ ﻨﻘﻁﺔ ﺍﻝﻤﻐﺎﺩﺭﺓ ﻭﺇﻋﺎﺩﺓ ﺍﻝﺒﺩﺀ ﻓﻲ ﺭﺤﻠﺘﻪ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻬﺎ ﺍﻝﺘﺎﻝﻴﺔ ﺃﻭ‬
‫ﺘﺎﺭﻴﺦ ﺍﻨﺘﻬﺎﺀ ﺍﻝﺼﻼﺤﻴﺔ ﺍﻝﻤﺒﻴﻥ ﻓﻲ ﺠﺩﻭل ﺍﻝﻭﺜﻴﻘﺔ‪.‬‬
‫ﺘﺎﺭﻴﺦ ﺍﻨﺘﻬﺎﺀ ﺍﻝﺼﻼﺤﻴﺔ ﺍﻝﻤﺫﻜﻭﺭ ﻓﻲ ﺠﺩﻭل ﺍﻝﻭﺜﻴﻘﺔ‬
‫ﺘﺎﺭﻴﺦ ﺍﺴﺘﺤﻘﺎﻕ ﻗﺴﻁ ﺍﻝﺘﺄﻤﻴﻥ ﻭﻋﺩﻡ ﺩﻓﻌﻪ‬
‫ﺍﻝﺘﺎﺭﻴﺦ ﺍﻝﺫﻱ ﻴﺘﻭﻗﻑ ﻓﻴﻪ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻋﻥ ﺍﺴﺘﺤﻘﺎﻗﻪ ﻀﻤﻥ ﺘﺼﻨﻴﻑ ﺍﻷﺸﺨﺎﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻬﻡ‪.‬‬
‫ﺍﻝﺘﺎﺭﻴﺦ ﺍﻝﺫﻱ ﻴﺘﻡ ﻓﻴﻪ ﺩﻓﻊ ﺍﻝﻤﻨﺎﻓﻊ ﻭﻓﻘﺎ ﻝﺤﺩ ﻤﺒﻠﻎ ﺍﻝﺘﺄﻤﻴﻥ ﻓﻴﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺄﻱ ﺸﺨﺹ ﻤﺅﻤﻥ ﻋﻠﻴﻪ‪.‬‬
‫‪ .2‬ﺍﻝﺘﻌﺭﻴﻔﺎﺕ‪:‬‬
‫ﺘﻁﺒﻕ ﺍﻝﺘﻌﺎﺭﻴﻑ ﺍﻝﺘﺎﻝﻴﺔ ﻓﻲ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ‪:‬‬
‫ﺤﺎﺩﺙ ﻴﻌﻨﻲ ﺤﺩﺜﺎ ﻤﺤﺩﺩﺍ ﻏﻴﺭ ﻤﺘﻭﻗﻊ ﻭﻤﻔﺎﺠﺊ ﻴﺘﺴﺒﺏ ﻓﻘﻁ ﻭﺒﺸﻜل ﻤﺒﺎﺸﺭ ﻤﻥ ﻗﺒل ﻭﺴﺎﺌل ﻋﻨﻴﻔﺔ ﺨﺎﺭﺠﻴﺔ ﻭﻅﺎﻫﺭﺓ ﻭﺍﻝﺫﻱ ﻴﺤﺩﺙ ﻓﻲ ﻭﻗﺕ ﻭﻤﻜﺎﻥ ﻤﺤﺩﺩ‪ ،‬ﻤﻤﺎ ﻴﺅﺩﻯ‬
‫ﺇﻝﻰ ﺇﺼﺎﺒﺔ‪.‬‬
‫ﺍﻹﻴﺩﺯ ﻴﻌﻨﻲ ﻭﺠﻭﺩ ﻋﺩﻭﻯ ﺍﻨﺘﻬﺎﺯﻴﺔ ﺃﻭ ﺍﻷﻭﺭﺍﻡ ﺍﻝﺨﺒﻴﺜﺔ‪ .‬ﻭﻝﻐﺭﺽ ﻫﺫﺍ ﺍﻝﺘﻌﺭﻴﻑ‪ ،‬ﻓﺈﻥ ﻤﺼﻁﻠﺢ "ﻤﺘﻼﺯﻤﺔ ﻨﻘﺹ ﺍﻝﻤﻨﺎﻋﺔ ﺍﻝﻤﻜﺘﺴﺏ" ﺴﻭﻑ ﻴﻜـﻭﻥ ﻝﻬـﺎ ﺍﻝﻤﻌـﺎﻨﻲ‬
‫ﺍﻝﻤﺨﺼﺼﺔ ﻝﻬﺎ ﻤﻥ ﻗﺒل ﻤﻨﻅﻤﺔ ﺍﻝﺼﺤﺔ ﺍﻝﻌﺎﻝﻤﻴﺔ‪ ،‬ﻭﺘﺸﻤل " ﻤﺘﻼﺯﻤﺔ ﻨﻘﺹ ﺍﻝﻤﻨﺎﻋﺔ ﺍﻝﻤﻜﺘﺴﺏ ")‪) (H.I.V‬ﻓﻴﺭﻭﺱ ﻨﻘـﺹ ﺍﻝﻤﻨﺎﻋـﺔ ﺍﻝﺒـﺸﺭﻴﺔ( ‪encephala ،‬‬
‫)ﺍﻝﺨﺭﻑ( ﺃﻭ ﻤﺘﻼﺯﻤﺔ ﺍﻝﻬﺯﺍل ﺍﻝﻨﺎﺘﺞ ﻋﻥ ﻓﻴﺭﻭﺱ ﻨﻘﺹ ﺍﻝﻤﻨﺎﻋﺔ ﺍﻝﺒﺸﺭﻴﺔ‪.‬‬
‫ﺍﻝﻤﺴﺘﻔﻴﺩ ﻴﻌﻨﻲ ﺍﻝﺸﺨﺹ ﺃﻭ ﺍﻷﺸﺨﺎﺹ ﺍﻝﺫﻴﻥ ﺘﻡ ﺘﺭﺸﻴﺤﻬﻡ ﻤﻥ ﻗﺒل ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻜﻤﺎ ﺠﺎﺀ ﻓﻲ ﺠﺩﻭل ﺍﻝﻭﺜﻴﻘﺔ‪ ،‬ﻭﺇﺫﺍ ﻝﻡ ﻴﺭﺩ ﺫﻜﺭﻩ‪ ،‬ﺴﻭﻑ ﻴﻜﻭﻥ ﺍﻝﻤﺴﺘﻔﻴﺩ‬
‫ﺍﻝﻭﺭﺜﺔ ﺍﻝﻘﺎﻨﻭﻨﻴﻴﻥ ﻝﻠﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪ .‬ﻭﻓﻲ ﺤﺎﻝﺔ ﺍﺨﺘﻴﺎﺭ ﺒﺭﻨﺎﻤﺞ ﺍﻷﺴﺭﺓ‪ ،‬ﻋﻨﺩﺌﺫ ﺴﻭﻑ ﻴﻜﻭﻥ ﺍﻝﻤﺴﺘﻔﻴﺩ ﻓﻲ ﺤﺎﻝﺔ ﻭﻓﺎﺓ ﺍﻝﺯﻭﺝ‪/‬ﺍﻝﺯﻭﺠﺔ ﺃﻭ ﺍﻝﻁﻔل ﻫﻭ ﺍﻝـﺸﺨﺹ‬
‫ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪.‬‬
‫ﺍﻷﻁﻔﺎل ﻴﻘﺼﺩ ﺒﻬﻡ ﺃﻁﻔﺎل ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺍﻝﺫﻴﻥ ﻴﻘﻭﻡ ﺒﺈﻋﺎﻝﺘﻬﻡ ﻭﻝﻴﺱ ﻝﺩﻴﻬﻡ ﻭﻅﻴﻔﺔ ﺩﻭﺍﻡ ﻜﺎﻤل ﻭﺍﻝﺫﻴﻥ ﺘﺘﺭﺍﻭﺡ ﺃﻋﻤﺎﺭﻫﻡ ﺒﻴﻥ ‪ 3‬ﺃﺸﻬﺭ ﻭ ‪ 18‬ﺴﻨﺔ )ﺃﻭ ﺘﺤﺕ‬
‫ﺴﻥ ‪ 23‬ﺴﻨﺔ ﺸﺭﻁ ﺃﻥ ﻴﻜﻭﻨﻭﺍ ﻤﻘﻴﺩﻴﻥ ﻓﻲ ﺍﻝﺘﻌﻠﻴﻡ ﺩﻭﺍﻡ ﻜﺎﻤل(‪ ،‬ﻏﻴﺭ ﻤﺘﺯﻭﺠﻴﻥ‪ ،‬ﻭﻝﻴﺴﻭ ﺤﻭﺍﻤل‪ ،‬ﻭﻝﻴﺱ ﻝﺩﻴﻬﻡ ﺃﻁﻔﺎل‪ ،‬ﻭﻴﻌﺘﻤﺩﻭﻥ ﻓﻲ ﺍﻝﻤﻘﺎﻡ ﺍﻷﻭل ﻋﻠـﻰ ﺍﻝـﺸﺨﺹ‬
‫ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻝﻠﺤﺼﻭل ﻋﻠﻰ ﺍﻝﺩﻋﻡ‪.‬‬
‫ﺍﻝﻨﺎﻗل ﺍﻝﻌﺎﻡ ﻴﻌﻨﻲ ﺃﻱ ﻭﺴﻴﻠﺔ ﻨﻘل ﺒﺭﻴﺔ‪ ،‬ﺒﺤﺭﻴﺔ ﺃﻭ ﺠﻭﻴﺔ ﺘﻌﻤل ﺘﺤﺕ ﺘﺭﺨﻴﺹ ﺼﺎﻝﺢ ﻝﻨﻘل ﺍﻝﺭﻜﺎﺏ ﻤﻘﺎﺒل ﺃﺠﺭ‪.‬‬
‫ﺭﻴﺎﻀﺔ ﺍﻝﺘﻼﻤﺱ ﺘﻌﻨﻲ ﺃﻱ ﺍﻝﺭﻴﺎﻀﺔ ﻴﻜﻭﻥ ﺨﻼﻝﻬﺎ ﺍﻻﺘﺼﺎل ﺍﻝﺠﺴﺩﻱ ﺒﻴﻥ ﺍﻝﻼﻋﺒﻴﻥ ﺠﺯﺀ ﻤﻘﺒﻭﻻ ﻤﻥ ﺍﻝﻠﻌﺏ‪.‬‬
‫ﺒﻠﺩ ﺍﻹﻗﺎﻤﺔ ﺘﻌﻨﻲ ﺍﻝﺒﻠﺩ ﺍﻝﺘﻲ ﻴﻜﻭﻥ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻤﻘﻴﻡ ﻓﻴﻬﺎ ﺤﺎﻝﻴﺎ ﻭﺤﺎﺼل ﻋﻠﻰ ﺘﺄﺸﻴﺭﺓ ﺇﻗﺎﻤﺔ ﺴﺎﺭﻴﺔ ﺍﻝﻤﻔﻌﻭل ﺃﻭ ﺘﻤﺕ ﻭﻻﺩﺘﻪ ﻓﻴﻬﺎ‪.‬‬
‫ﺍﻝﻴﻭﻡ ﻴﻌﻨﻲ ﻓﺘﺭﺓ ﻤﻥ ‪ 24‬ﺴﺎﻋﺔ ﻤﺘﺘﺎﻝﻴﺔ ﺒﻤﺎ ﻓﻴﻬﺎ ﻴﻭﻡ ﺍﻝﺩﺨﻭل ﻝﻜﻥ ﺒﺎﺴﺘﺜﻨﺎﺀ ﻴﻭﻡ ﺍﻝﺨﺭﻭﺝ‪.‬‬
‫ﺍﻝﺘﺎﺭﻴﺦ ﺍﻝﻔﻌﻠﻲ ﻝﻠﺘﻐﻁﻴﺔ ﻴﻌﻨﻲ ﺘﺎﺭﻴﺦ ﺒﺩﺀ ﺍﻝﻐﻁﺎﺀ ﻜﻤﺎ ﻫﻭ ﻤﺒﻴﻥ ﻓﻲ ﺠﺩﻭل ﺍﻝﻭﺜﻴﻘﺔ‪ .‬ﻻ ﻴﻤﻜﻥ ﺍﻥ ﻴﺒﺩﺃ ﺍﻝﻐﻁﺎﺀ ﺒﻌﺩ ﺒﺩﺍﻴﺔ ﺭﺤﻠﺔ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪.‬‬
‫ﺍﻹﺨﻼﺀ ﻓﻲ ﺤﺎﻻﺕ ﺍﻝﻁﻭﺍﺭﺉ ﻴﻌﻨﻲ‪) :‬ﺃ( ﺘﺒﺭﺭ ﺍﻝﺤﺎﻝﺔ ﺍﻝﻁﺒﻴﺔ ﻝﻠﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻨﻘﻠﻪ ﻓﻭﺭﺍ ﻤﻥ ﺍﻝﻤﻜﺎﻥ ﺍﻝﺫﻱ ﻴﺘﻭﺍﺠﺩ ﻓﻴﻪ ﺒﺴﺒﺏ ﺍﻹﺼﺎﺒﺔ ﺃﻭ ﺍﻝﻤﺭﺽ ﺇﻝﻰ ﺍﻗـﺭﺏ‬
‫ﻤﺴﺘﺸﻔﻰ ﺤﻴﺙ ﻴﻤﻜﻥ ﺍﻝﺤﺼﻭل ﻋﻠﻰ ﻋﻼﺝ ﻁﺒﻲ ﻤﻨﺎﺴﺏ )ﺏ( ﺒﻌﺩ ﺍﻝﻌﻼﺝ ﺒﺎﻝﻤﺴﺘﺸﻔﻰ ﺍﻝﻤﺤﻠﻲ‪ ،‬ﺘﺒﺭﺭ ﺤﺎﻝﺘﻪ ﺍﻝﻁﺒﻴﺔ ﻨﻘﻠﻪ ﺇﻝﻰ ﺍﻝﺩﻭﻝﺔ ﺤﻴﺙ ﺒـﺩﺃﺕ ﺍﻝﺭﺤﻠـﺔ ﻓﻴﻬـﺎ‬
‫ﻝﻠﺤﺼﻭل ﻋﻠﻰ ﻋﻼﺝ ﻁﺒﻲ ﺇﻀﺎﻓﻲ ﺃﻭ ﻝﻼﺴﺘﺸﻔﺎﺀ‪ ،‬ﺃﻭ )ﺝ( ﻜل ﻤﻥ )ﺃ( ﻭ )ﺏ( ﺃﻋﻼﻩ‪.‬‬
‫ﻓﺎﺌﺽ ﺃﻭ ﺨﺼﻡ ﻴﻌﻨﻲ ﺍﻝﻤﺒﻠﻎ ﺍﻷﻭل‪ ،‬ﺃﻭ ﺍﻝﻔﺘﺭﺓ‪ ،‬ﻤﻥ ﻜل ﺨﺴﺎﺭﺓ ﻤﺴﺘﺤﻘﺔ ﺍﻝﺩﻓﻊ ﻤﻥ ﻗﺒل ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪.‬‬
‫ﺍﻝﺭﻴﺎﻀﺔ ﺍﻝﺨﻁﺭﺓ ﺘﻌﻨﻲ ﺍﻝﺘﺯﻝﺞ ﻭﺍﻝﺘﺯﺤﻠﻕ ﻋﻠﻰ ﺍﻷﺭﺽ‪ ،‬ﺍﻝﺘﺯﻝﺞ ﺍﻷﺤﺎﺩﻱ‪ ،‬ﺍﻝﺘﺯﻝﺞ ﻋﺒﺭ ﻁﺎﺌﺭﺍﺕ ﺍﻝﻬﻠﻴﻜﻭﺒﺘﺭ‪ ،‬ﺍﻝﺘﺯﻝﺞ ﺨﺎﺭﺝ ﺍﻝﺯﺤﻠﻘﺔ )ﻓﻘﻁ ﻋﻨﺩﻤﺎ ﻴﻜـﻭﻥ ﺒـﺼﺤﺒﺔ‬
‫ﻤﺭﺸﺩ ﺭﺴﻤﻲ(‪ ،‬ﻭﺍﻝﺘﺯﺤﻠﻕ ﻋﻠﻰ ﺍﻝﺠﻠﻴﺩ )ﻝﻴﺱ ﺘﺯﻝﺞ ﺍﻝﺴﺭﻋﺔ(‪ ،‬ﺼﻌﻭﺩ ﺍﻝﺜﻠﻭﺝ‪ ،‬ﺍﻝﺘﺯﻝﺞ ﺒﺎﻻﻝﻭﺍﺡ‪ ،‬ﺴﻠﻴﺩﺠﻴﻨﺞ‪ ،‬ﺍﻝﺘﺯﺤﻠﻕ‪ ،‬ﺍﻝﺼﻴﺩ‪ ،‬ﺍﻝﺘﺯﻝﺞ ﺍﻝﺸﺭﺍﻋﻲ‪ ،‬ﻭﺍﻹﺒﺤﺎﺭ‪ ،‬ﺭﻜﻭﺏ‬
‫ﺍﻷﻤﻭﺍﺝ‪ ،‬ﺍﻝﺘﺯﻝﺞ ﻋﻠﻰ ﺍﻝﻤﺎﺀ‪ ،‬ﺭﻜﻭﺏ ﺍﻷﻤﻭﺍﺝ ﻭﺍﻝﺭﻴﺎﺡ‪.‬‬
‫ﻤﺴﺘﺸﻔﻰ ﻴﻌﻨﻲ ﻤﻜﺎﻥ )ﺃ( ﺤﺎﺌﺯ ﻋﻠﻰ ﺘﺭﺨﻴﺹ ﺴﺎﺭﻱ ﺍﻝﻤﻔﻌﻭل )ﻭﻓﻘﺎ ﻝﻤﺘﻁﻠﺒﺎﺕ ﺍﻝﻘﺎﻨﻭﻥ(‪) ،‬ﺏ( ﻴﻌﻤل ﺒﺸﻜل ﺃﺴﺎﺴﻲ ﻝﺘﻘﺩﻴﻡ ﺍﻝﺭﻋﺎﻴﺔ ﻭﺍﻝﻌﻼﺝ ﻝﻠﻤﺭﻀﻰ ﺍﻭ ﺍﻝﻤﺼﺎﺒﻴﻥ‬
‫)ﺝ( ﻤﺠﻬﺯ ﺒﻁﺒﻴﺏ ﺒﺸﺭﻱ ﻭﺍﺤﺩ ﺍﻭ ﺍﻜﺜﺭ ﻤﺘﺎﺡ ﻓﻲ ﻜﺎﻓﺔ ﺍﻷﻭﻗﺎﺕ )ﺩ( ﻴﻘﺩﻡ ﺨﺩﻤﺔ ﺘﻤﺭﻴﺽ ﻋﻠﻰ ﻤﺩﺍﺭ ﺍﻝـ ‪ 24‬ﺴﺎﻋﺔ ﻭﻤﺠﻬﺯ ﺒﻤﺎ ﻻ ﻴﻘل ﻋـﻥ ﻤﻤﺭﻀـﺔ ﻤﻬﻨﻴـﺔ‬
‫ﻤﺴﺠﻠﺔ ﻭﺍﺤﺩﺓ ﺘﻌﻤل ﻓﻲ ﻜﺎﻓﺔ ﺍﻷﻭﻗﺎﺕ )ﻫـ( ﻝﺩﻴﻪ ﻤﺭﺍﻓﻕ ﺘﺸﺨﻴﺼﻴﺔ ﻭﺠﺭﺍﺤﻴﺔ ﻤﻨﻅﻤﺔ‪ ،‬ﺇﻤﺎ ﺒﺎﻝﻤﺒﻨﻰ ﺃﻭ ﻓﻲ ﻤﺭﺍﻓﻕ ﻤﺘﺎﺤﺔ ﻝﻠﻤﺴﺘﺸﻔﻰ ﻋﻠﻰ ﺃﺴﺎﺱ ﺍﻝﺘﺭﺘﻴﺏ ﺍﻝﻤـﺴﺒﻕ‬
‫ﻭ)ﻭ( ﻝﻴﺴﺕ – ﺇﻻ ﻋﺭﻀﻴﺎ – ﻋﻴﺎﺩﺓ‪ ،‬ﺒﻴﺕ ﺘﻤﺭﻴﺽ‪ ،‬ﺒﻴﺕ ﺭﺍﺤﺔ ﺃﻭ ﺒﻴﺕ ﺸﻔﺎﺀ ﻝﻠﻤﺴﻨﻴﻥ‪ ،‬ﺃﻭ ﻤﺭﻓﻕ ﻴﺘﻡ ﺘﺸﻐﻴﻠﻪ ﻜﻤﺭﻜﺯ ﻝﻠﻌﻼﺝ ﻤﻥ ﺍﻝﻤﺨﺩﺭﺍﺕ ﻭ‪/‬ﺍﻭ ﺍﻝﻜﺤﻭل‪.‬‬
‫ﺍﻝﻤﺭﺽ ﺃﻭ ﺍﻹﺼﺎﺒﺔ ﺘﻌﻨﻲ ﺃﻱ ﻤﺭﺽ ﻏﻴﺭ ﻤﺘﻭﻗﻊ ﺃﻭ ﻤﺭﺽ ﻴﺘﻡ ﺍﻹﺼﺎﺒﺔ ﺒﻪ‪ ،‬ﻴﺒﺩﺃ ﺃﻭ ﻴﻅﻬﺭ ﻝﻠﻤﺭﺓ ﺍﻷﻭﻝﻰ ﺃﺜﻨﺎﺀ ﺭﺤﻠﺔ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪.‬‬
‫ﺍﻹﺼﺎﺒﺔ ﺘﻌﻨﻲ ﺍﻹﺼﺎﺒﺔ ﺍﻝﺠﺴﻤﺎﻨﻴﺔ ﺍﻝﺘﻲ ﻨﺘﺠﺕ ﻓﻘﻁ ﺒﺸﻜل ﻤﺒﺎﺸﺭ ﺒﺴﺒﺏ ﻭﺴﺎﺌل ﻋﻨﻴﻔﺔ‪ ،‬ﻋﺎﺭﻀﺔ‪ ،‬ﺨﺎﺭﺠﻴﺔ ﻭﻤﺭﺌﻴﺔ ﺘﺤﺩﺙ ﺃﺜﻨﺎﺀ ﻤﺩﺓ ﺍﻝﺘﺄﻤﻴﻥ‪.‬‬
‫)‪© AIG, all rights reserved (V 1.0 – June 20, 2013‬‬
‫ﺤﺎﺩﺙ ﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻴﻌﻨﻲ ﺍﻝﺤﺎﺩﺙ ﺍﻝﻤﺫﻜﻭﺭ ﻓﻲ ﺠﺩﻭل ﻤﻨﺎﻓﻊ ﺍﻝﺒﺭﻨﺎﻤﺞ ﺍﻝﺫﻱ ﺘﻡ ﺸﺭﺍﺀﻩ ﻓﻲ ﺍﻝﺠﺯﺀ ﺍﻝﺜﺎﻨﻲ‪.‬‬
‫ﺍﻝﺭﺤﻠﺔ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻬﺎ ﺘﻌﻨﻲ ﺍﻝﺭﺤﻠﺔ ﺍﻝﺘﻲ ﺘﺒﺩﺃ ﻓﻲ ﺍﻝﻭﻗﺕ ﺍﻝﺫﻱ ﻴﻐﺎﺩﺭ ﻓﻴﻪ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻋﻨﻭﺍﻨﻪ ﺍﻝﻤﻨﺯﻝﻲ ﻓﻲ ﺩﻭﻝﺔ ﺇﻗﺎﻤﺘﻪ ﻝﻠـﺴﻔﺭ ﺇﻝـﻰ ﺨـﺎﺭﺝ ﺍﻝﺤـﺩﻭﺩ‬
‫ﺍﻹﻗﻠﻴﻤﻴﺔ ﻝﺩﻭﻝﺔ ﺍﻹﻗﺎﻤﺔ ﺒﺄﺴﻠﻭﺏ ﻤﺒﺎﺸﺭ ﻭﻏﻴﺭ ﻤﻨﻘﻁﻊ ﻭﻴﺸﻤل ﺫﻝﻙ ﺭﺤﻠﺔ ﺍﻝﻌﻭﺩﺓ ﺇﻝﻰ ﻋﻨﻭﺍﻨﻪ ﺍﻝﻤﻨﺯﻝﻲ ﻓﻲ ﺩﻭﻝﺔ ﺇﻗﺎﻤﺘﻪ‪ .‬ﻭﻴﺠﺏ ﺃﻥ ﺘﺒﺩﺃ ﺍﻝﺭﺤﻠـﺔ ﺍﻝﻤـﺅﻤﻥ ﻋﻠﻴﻬـﺎ‬
‫ﻭﺘﻨﺘﻬﻲ ﻓﻲ ﺩﻭﻝﺔ ﺇﻗﺎﻤﺔ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻭﻀﻤﻥ ﺇﻁﺎﺭ ﺍﻝﻤﺩﺓ ﺍﻝﺯﻤﻨﻴﺔ ﻝﻠﻐﻁﺎﺀ‪.‬‬
‫ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻴﻌﻨﻲ ﺍﻝﺸﺨﺹ ﺍﻝﺫﻱ ﻴﻅﻬﺭ ﺍﺴﻤﻪ ﻓﻲ ﺍﻝﻭﺜﻴﻘﺔ‪ ،‬ﻭﻴﺘﺭﺍﻭﺡ ﻋﻤﺭﻩ ﻤﻥ ‪ 18‬ﺴﻨﺔ ﺇﻝﻰ ‪ 69‬ﺴﻨﺔ ﻭﺘﻡ ﺩﻓﻊ ﻗﺴﻁ ﺍﻝﺘﺄﻤﻴﻥ ﺒﺸﺄﻨﻪ ﻭﻴﻜﻭﻥ ﻤﻘﻴﻡ ﺩﺍﺌﻡ ﻓﻲ ﺍﻝﺩﻭﻝـﺔ‬
‫ﺤﻴﺙ ﺘﻡ ﺇﺼﺩﺍﺭ ﺍﻝﻭﺜﻴﻘﺔ‪.‬‬
‫ﺸﺭﻜﺔ ﺍﻝﺘﺄﻤﻴﻥ ﺘﻌﻨﻲ ﺍﻝﺠﻬﺔ ﺍﻝﻤﺼﺩﺭﺓ ﻝﻬﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﻭﻫﻲ ﺃﻴﻪ ﺁﻱ ﺠﻲ ﻤﻴﺎ ﺍﻝﻤﺤﺩﻭﺩﺓ – ﻓﺭﻉ ﺍﻝﻜﻭﻴﺕ‬
‫ﺍﻝﻌﻤل ﺍﻝﻴﺩﻭﻱ ﻴﻌﻨﻲ ﺍﻝﻌﻤل ﺍﻝﺒﺩﻨﻲ ﻭﺍﻝﺫﻱ ﻴﺘﻁﻠﺏ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻝﻴﺩﻴﻥ ﺃﻭ ﺍﺴﺘﺨﺩﺍﻡ ﺃﻭ ﺘﺸﻐﻴل ﺁﻻﺕ ﺃﻭ ﻤﻌﺩﺍﺕ ﻤﻴﻜﺎﻨﻴﻜﻴﺔ ﺃﻭ ﻏﻴﺭ ﻤﻴﻜﺎﻨﻴﻜﻴﺔ‪.‬‬
‫ﺍﻝﻤﺼﺎﺭﻴﻑ ﺍﻝﻁﺒﻴﺔ ﺘﻌﻨﻲ ﻜﺎﻓﺔ ﺍﻝﺭﺴﻭﻡ ﺍﻝﻤﻌﻘﻭﻝﺔ ﻭﺍﻹﻋﺘﻴﺎﺩﻴﺔ ﺒﺨﺼﻭﺹ ﺍﻝﻤﺭﺽ ﺃﻭ ﺍﻹﺼﺎﺒﺔ ﺃﺜﻨﺎﺀ ﺍﻝﺭﺤﻠﺔ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻬﺎ ﻭﺍﻝﻨﺎﺘﺠﺔ ﻋـﻥ ﺩﺨـﻭل ﺍﻝﻤﺴﺘـﺸﻔﻰ ﺃﻭ‬
‫ﺍﻝﻌﻼﺝ ﺍﻝﺠﺭﺍﺤﻲ ﺃﻭ ﺍﻝﺴﺭﻴﺭﻱ ﺃﻭ ﺍﻻﺴﺘﺸﻔﺎﺌﻲ ﺍﻝﻤﻌﻁﻰ ﺃﻭ ﺍﻝﻤﻭﺼﻭﻑ ﻤﻥ ﻗﺒل ﻁﺒﻴﺏ‪.‬‬
‫ﻁﺒﻴﺏ ﻴﻌﻨﻲ ﺃﻱ ﺸﺨﺹ ﻤﺴﺠل ﻝﻤﻤﺎﺭﺴﺔ ﺍﻝﻁﺏ ﺒﻤﻭﺠﺏ ﺭﺨﺼﺔ ﺴﺎﺭﻴﺔ ﻭﻗﺎﻨﻭﻨﻴﺔ ﺒﺎﺴﺘﺜﻨﺎﺀ ﺃﻱ ﺸﺨﺹ ﻤﺅﻤﻥ ﻝﻪ ﺃﻭ ﺃﻱ ﻓﺭﺩ ﻤﻥ ﺃﻗﺎﺭﺒﻪ‪.‬‬
‫ﻋﻼﺝ ﻁﺒﻲ ﻴﻌﻨﻲ ﺍﻻﺴﺘﺸﺎﺭﺓ ﺍﻝﻁﺒﻴﺔ ﺃﻭ ﺍﻝﻌﻼﺝ ﺃﻭ ﺍﻝﻭﺼﻔﺎﺕ ﺃﻭ ﺍﻝﻤﺩﺍﻭﺍﺓ ﺍﻝﻤﺘﻜﺭﺭﺓ ﻤﻥ ﻗﺒل ﺍﻝﻁﺒﻴﺏ‪.‬‬
‫ﻓﺘﺭﺓ ﺍﻝﺘﻐﻁﻴﺔ ﺘﻌﻨﻲ ﺍﻝﻤﺩﺓ ﺍﻝﺘﻲ ﻴﻘﻭﻡ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺒﺎﺨﺘﻴﺎﺭﻫﺎ ﻭﻓﻘﺎ ﻝﺠﺩﻭل ﺍﻝﻭﺜﻴﻘﺔ‪ ،‬ﻭﺍﻝﺘﻲ ﺘﻡ ﺩﻓﻊ ﻗﺴﻁ ﺍﻝﺘﺄﻤﻴﻥ ﻋﻨﻬﺎ‪ ،‬ﻭﺘﺒﺩﺃ ﻓﻲ ﺘﺎﺭﻴﺦ ﺒﺩﺀ ﺍﻝﺘﻐﻁﻴﺔ ﻜﻤـﺎ‬
‫ﻫﻭ ﻤﺒﻴﻥ ﻓﻲ ﺠﺩﻭل ﺍﻝﻭﺜﻴﻘﺔ ﻭﺘﻨﺘﻬﻲ ﺒﻨﻬﺎﻴﺔ ﺍﻝﻤﺩﺓ ﺍﻝﻤﺤﺩﺩﺓ‪.‬‬
‫ﻼ ﻝﻤﻤﺎﺭﺴـﺘﻬﺎ ﺃﻭ‬
‫ﺍﻝﻌﺠﺯ ﺍﻝﻜﻠﻲ ﺍﻝﺩﺍﺌﻡ ﻴﻌﻨﻲ ﻋﺠﺯ ﺘﺎﻡ ﻭﻤﻁﻠﻕ ﻴﻤﻨﻊ ﺍﻝﻤﺅﻤﻥ ﻝﻪ ﺒﺸﻜل ﺘﺎﻡ ﻤﻥ ﻤﻤﺎﺭﺴﺔ ﺃﻭ ﺍﻻﻨﺘﺒﺎﻩ ﺇﻝﻰ ﺃﻴﺔ ﻭﻅﻴﻔﺔ ﺍﻋﺘﻴﺎﺩﻴﺔ ﺃﻭ ﻏﻴﺭﻫﺎ ﻴﻜﻭﻥ ﻤـﺅﻫ ﹰ‬
‫ﻴﻜﻭﻥ ﻗﺩ ﺘﻠﻘﻰ ﺘﺩﺭﻴﺒﹰﺎ ﺨﺎﺼﹰﺎ ﺒﻬﺎ ﻭﺍﻝﺫﻱ ﺴﻴﻜﻭﻥ ﺒﻜﺎﻓﺔ ﺍﻻﺤﺘﻤﺎﻻﺕ ﺩﺍﺌﻤﹰﺎ ﻭﻤﺴﺘﻤﺭﹰﺍ ﻁﻭﺍل ﺤﻴﺎﺘﻪ‪.‬‬
‫ﺍﻝﻤﻘﺘﻨﻴﺎﺕ ﺍﻝﺸﺨﺼﻴﺔ ﺘﻌﻨﻲ ﺍﻝﻨﻅﺎﺭﺍﺕ ﻭﺍﻷﺴﻨﺎﻥ ﺍﻻﺼﻁﻨﺎﻋﻴﺔ ﻭﺃﻜﻴﺎﺱ ﻭﻤﺤﺎﻓﻅ ﺍﻝﻨﻘﻭﺩ ﻭﺃﺩﻭﺍﺕ ﺍﻝﺘﺠﻤﻴل ﻭﺠﻬﺎﺯ ﺍﻝﻬﺎﺘﻑ ﺍﻝﻨﻘﺎل ﻭﺍﻝﻤﻘﺘﻨﻴﺎﺕ ﺍﻝﺸﺨﺼﻴﺔ ﺍﻷﺨﺭﻯ ﺍﻝﺘـﻲ‬
‫ﻴﺭﺘﺩﻴﻬﺎ ﺍﻝﻤﺅﻤﻥ ﻝﻪ ﺃﻭ ﻴﺤﻤﻠﻬﺎ ﻋﺎﺩﺓ‪.‬‬
‫ﻨﻘﻁﺔ ﺍﻝﻤﻐﺎﺩﺭﺓ ﺘﻌﻨﻲ ﺍﻝﻨﻘﻁﺔ ﺍﻝﺘﻲ ﻴﺒﺩﺃ ﻤﻨﻬﺎ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺍﻝﺭﺤﻠﺔ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻬﺎ‪ ،‬ﻤﻥ ﺩﺍﺨل ﺍﻝﺤﺩﻭﺩ ﺍﻹﻗﻠﻴﻤﻴﺔ ﻝﺩﻭﻝﺔ ﺍﻹﻗﺎﻤﺔ‪.‬‬
‫ﻭﺜﻴﻘﺔ ﺍﻝﺘﺎﻤﻴﻥ ﺘﻌﻨﻲ ﻫﺫﺍ ﺍﻝﻤﺴﺘﻨﺩ ﻭﺠﺩﻭل ﺍﻝﻭﺜﻴﻘﺔ‬
‫ﺠﺩﻭل ﺍﻝﻭﺜﻴﻘﺔ ﻴﻌﻨﻲ ﺍﻝﻤﺴﺘﻨﺩ ﺍﻝﺫﻱ ﻴﺘﻀﻤﻥ ﺘﻔﺎﺼﻴل ﺍﻝﻤﻨﺎﻓﻊ‪ ،‬ﺍﻷﻗﺴﺎﻁ‪ ،‬ﺍﻝﺸﺭﻭﻁ‪،‬ﺍﻝﺤﺩﻭﺩ ﻭﺍﻝﺘﻐﻁﻴﺔ ﺍﻝﺘﺄﻤﻴﻨﻴﺔ ﺍﻝﺨﺎﺼﺔ ﺒﺎﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪.‬‬
‫ﺤﺎﻻﺕ ﻁﺒﻴﺔ ﻗﺎﺌﻤﺔ ﻤﺴﺒﻘﺎ ﻫﻲ ﺃﻴﺔ ﺤﺎﻝﺔ ﺃﻭﺼﻰ ﺃﻱ ﻁﺒﻴﺏ ﺒﺭﻋﺎﻴﺘﻬﺎ ﻁﺒﻴﹰﺎ ﻭﻋﻼﺠﻬﺎ ﺃﻭ ﻗﺩﻡ ﻨﺼﻴﺤﺔ ﺒﺨﺼﻭﺼﻬﺎ ﺃﻭ ﻗﺎﻡ ﻫﻭ ﺒﺘﻠﻙ ﺍﻝﺭﻋﺎﻴﺔ ﺃﻭ ﺍﻝﻌﻼﺝ ﺨـﻼل ﻤـﺩﺓ‬
‫ﺴﻨﺘﻴﻥ ﻗﺒل ﺘﺎﺭﻴﺦ ﻨﻔﺎﺫ ﺍﻝﺘﻐﻁﻴﺔ ﺍﻝﺘﺄﻤﻴﻨﻴﺔ‪ ،‬ﺃﻭ ﺃﻴﺔ ﺤﺎﻝﺔ ﺘﻁﻠﺒﺕ ﺩﺨﻭل ﺍﻝﻤﺴﺘﺸﻔﻰ ﺃﻭ ﺇﺠﺭﺍﺀ ﻋﻤل ﺠﺭﺍﺤﻲ ﺨﻼل ﺨﻤﺴﺔ ﺴﻨﻭﺍﺕ ﻗﺒل ﺘﺎﺭﻴﺦ ﻨﻔﺎﺫ ﺍﻝﺘﻐﻁﻴﺔ ﺍﻝﺘﺄﻤﻴﻨﻴﺔ‪.‬‬
‫ﻻﻋﺏ ﻤﺤﺘﺭﻑ ﻴﻌﻨﻲ ﺃﻱ ﺸﺨﺹ ﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻴﻜﺴﺏ ﻤﺎ ﻴﺯﻴﺩ ﻋﻥ ‪ %50‬ﻤﻥ ﺩﺨﻠﻪ ﻤﻥ ﻝﻌﺏ ﺭﻴﺎﻀﺔ ﺃﻭ ﻴﺸﺎﺭﻙ ﻓﻲ ﺭﻴﺎﻀﺔ ﺘﻘﻭﻡ ﺒﺘﻌﻭﻴﻀﻪ ﻜﻭﺴﻴﻠﺔ ﻝﻜﺴﺏ ﺍﻝﻌﻴﺵ‪.‬‬
‫ﻭﺴﻴﻠﺔ ﻨﻘل ﻋﺎﻤﺔ ﺘﻌﻨﻲ ﺃﻱ ﻭﺴﻴﻠﺔ ﻨﻘل ﻤﺤﺠﻭﺯﺓ ﺃﻭ ﻤﺴﺘﺄﺠﺭﺓ ﻤﺭﺨﺼﺔ ﻗﺎﻨﻭﻨﺎ ﻝﻨﻘل ﺍﻝﺭﻜﺎﺏ ﻤﻘﺎﺒل ﺃﺠﺭﺓ ﻭﺘﻌﻤل ﺒﺸﻜل ﺘﺠﺎﺭﻱ ﻭﻓﻘـﺎ ﻝﻜﺎﻓـﺔ ﺍﻝﻘـﻭﺍﻨﻴﻥ ﻭﺍﻝﻠـﻭﺍﺌﺢ‬
‫ﺍﻝﻤﻌﻤﻭل ﺒﻬﺎ ﻤﺤﻠﻴﺎ ﻭﺍﻝﺘﻲ ﻴﺘﻨﻘل ﻤﻥ ﺨﻼﻝﻬﺎ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻓﻘﻁ ﻜﺭﺍﻜﺏ ﺩﺍﻓﻊ ﻝﻸﺠﺭﺓ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻝﻙ ﺴﻴﺎﺭﺍﺕ ﺍﻻﺠﺭﺓ ﻭﺍﻝﺴﻴﺎﺭﺍﺕ ﺍﻝﻤﺴﺘﺄﺠﺭﺓ ﻭﻝﻜـﻥ ﻏﻴـﺭ‬
‫ﺸﺎﻤل ﺍﻝﺤﺎﻓﻼﺕ ﺍﻝﺼﻐﻴﺭﺓ ﻭﺍﻝﺴﻴﺎﺭﺍﺕ ﺍﻝﺘﻲ ﻻ ﺘﺘﻤﺘﻊ ﺒﻤﻭﺍﺼﻔﺎﺕ ﻗﻴﺎﺴﻴﺔ ﻭﺍﻝﻁﺎﺌﺭﺍﺕ ﺍﻝﺘﻲ ﺘﻌﻤل ﺒﻤﺤﺭﻙ ﻤﻜﺒﺴﻲ ﻭﺍﺤﺩ ﻭﻏﻴﺭ ﻤﻜﻴﻔﺔ ﺍﻝﻀﻐﻁ‪.‬‬
‫ﺍﻷﺠﺭﺓ ﺍﻝﻤﻌﻘﻭﻝﺔ ﻭﺍﻹﻋﺘﻴﺎﺩﻴﺔ ﺘﻌﻨﻲ ﺍﻝﺭﺴﻭﻡ ﺍﻝﺘﻲ )ﺃ( ﺘﻜﻭﻥ ﻤﻁﻠﻭﺒﺔ ﻁﺒﻴﺎ ﻤﻥ ﺃﺠل ﺍﻝﻌﻼﺝ ﺃﻭ ﺍﻝﺘﺠﻬﻴﺯﺍﺕ ﺃﻭ ﺍﻝﺨﺩﻤﺔ ﻝﻌﻼﺝ ﺤﺎﻝﺔ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴـﻪ )ﺏ( ﻻ‬
‫ﺘﺘﺠﺎﻭﺯ ﺍﻝﻤﺴﺘﻭﻯ ﺍﻝﻤﻌﺘﺎﺩ ﻝﻠﺭﺴﻭﻡ ﻤﻘﺎﺒل ﺍﻝﻌﻼﺝ ﻭﺍﻝﺘﺠﻬﻴﺯﺍﺕ ﺃﻭ ﺍﻝﺨﺩﻤﺎﺕ ﺍﻝﻁﺒﻴﺔ ﺍﻝﻤﻤﺎﺜﻠﺔ ﻓﻲ ﺍﻝﻤﻜﺎﻥ ﺍﻝﺫﻱ ﻴﺘﻡ ﻓﻴﻪ ﺘﺤﻤل ﻫﺫﻩ ﺍﻝﻤﺼﺎﺭﻴﻑ ﻭ)ﺝ( ﻻ ﺘﺘﺠﺎﻭﺯ ﺭﺴﻭﻡ‬
‫ﺍﻝﻌﻼﺝ ﺍﻝﺫﻱ ﻜﺎﻥ ﺴﻴﺘﻡ ﺩﻓﻌﻬﺎ ﻓﻲ ﺤﺎﻝﺔ ﻋﺩﻡ ﻭﺠﻭﺩ ﺍﻝﺘﺄﻤﻴﻥ‪.‬‬
‫ﺍﻝﻤﺼﺎﺭﻴﻑ ﺍﻝﻤﺭﺘﺒﻁﺔ ﺘﻌﻨﻲ ﻨﻔﻘﺎﺕ ﺍﻹﻗﺎﻤﺔ ﻭﺍﻝﺴﻔﺭ ﺍﻹﻀﺎﻓﻴﺔ‪ ،‬ﻏﻴﺭ ﺸﺎﻤل ﻨﻔﻘﺎﺕ ﺍﻝﻬﺎﺘﻑ ﻭﺍﻝﻭﺠﺒﺎﺕ ﻭﺍﻝﻤﺸﺭﻭﺒﺎﺕ ﺍﻝﻀﺭﻭﺭﻴﺔ ﺍﻝﺘﻲ ﻴﺘﺤﻤﻠﻬﺎ ﺃﻱ ﺸﺨﺹ ﻭﺍﺤﺩ ﻭﻓـﻕ‬
‫ﻨﺼﻴﺤﺔ ﻁﺒﻴﺏ ﺘﻌﻴﻨﻪ ﺍﻝﺸﺭﻜﺔ ﻤﻊ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺃﻭ ﻴﺭﺍﻓﻘﻪ ﺤﺘﻰ ﺍﻨﺘﻬﺎﺀ ﺭﺤﻠﺘﻪ ﺃﻭ ﺤﺘﻰ ﻤﺘﺎﺒﻌﺘﻪ ﺍﻝﺭﺤﻠﺔ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻬﺎ ﺃﻭ ﻴﻌﻭﺩ ﺇﻝﻰ ﻨﻘﻁﺔ ﺍﻝﻤﻐﺎﺩﺭﺓ‪ ،‬ﺇﻴﻬﻤـﺎ‬
‫ﻻ‪.‬‬
‫ﻴﺤﺩﺙ ﺃﻭ ﹰ‬
‫ﺍﻝﻘﺭﻴﺏ ﻴﻌﻨﻲ ﺍﻝﺯﻭﺝ‪/‬ﺍﻝﺯﻭﺠﺔ‪ ،‬ﺍﻷﺏ‪/‬ﺍﻷﻡ‪ ،‬ﻭﺍﻝﺩ‪/‬ﻭﺍﻝﺩﺓ ﺍﻝﺯﻭﺝ‪/‬ﺍﻝﺯﻭﺠﺔ‪ ،‬ﺍﻝﺠﺩ‪/‬ﺍﻝﺠﺩﺓ‪ ،‬ﺯﻭﺝ‪/‬ﺯﻭﺠﺔ ﺍﻻﺏ‪/‬ﺍﻷﻡ‪ ،‬ﺍﻷﻁﻔﺎل‪ ،‬ﺍﻷﺤﻔﺎﺩ‪ ،‬ﺍﻝﺸﻘﻴﻕ‪ ،‬ﺸﻘﻴﻕ ﺍﻝـﺯﻭﺝ‪/‬ﺍﻝﺯﻭﺠـﺔ‪،‬‬
‫ﺍﻝﺸﻘﻴﻘﺔ‪ ،‬ﺸﻘﻴﻘﺔ ﺍﻝﺯﻭﺝ‪/‬ﺍﻝﺯﻭﺠﺔ‪ ،‬ﺯﻭﺠﺔ ﺍﻻﺒﻥ‪ ،‬ﺯﻭﺝ ﺍﻻﺒﻨﺔ‪ ،‬ﺍﻝﺨﻁﻴﺏ‪ ،‬ﺍﻝﻤﺨﻁﻭﺒﺔ‪ ،‬ﺃﺥ ﻏﻴﺭ ﺸﻘﻴﻕ‪ ،‬ﺨﺎﻝﺔ‪/‬ﻋﻤﺔ‪ ،‬ﺨﺎل‪/‬ﻋﻡ‪ ،‬ﺍﺒﻥ‪/‬ﺍﺒﻨﺔ ﺸﻘﻴﻕ‪/‬ﺸﻘﻴﻘﺔ ﺍﻝﺸﺨﺹ ﺍﻝﻤـﺅﻤﻥ‬
‫ﻋﻠﻴﻪ‪.‬‬
‫ﻤﻌﺩﺍﺕ ﺍﻝﺘﺯﻝﺞ ﺘﻌﻨﻲ ﺍﻝﺯﻻﺠﺎﺕ‪ ،‬ﻭﺍﻝﻌﺼﻲ‪ ،‬ﻭﺍﻷﺤﺫﻴﺔ‪ ،‬ﻭﺍﻷﺭﺒﻁﺔ‪ ،‬ﻭﺃﻝﻭﺍﺡ ﺍﻝﺘﺯﻝﺞ ﻋﻠﻰ ﺍﻝﺜﻠﺞ ﺃﻭ ﺍﻝﺠﻠﻴﺩ‬
‫ﺃﺤﺩ ﺍﻝﺯﻭﺠﻴﻥ ﻋﻨﺩ ﺍﻻﺴﺘﺨﺩﺍﻡ ﻓﻲ ﺍﻝﻭﺜﻴﻘﺔ ﻴﻌﻨﻲ ﺍﻝﺯﻭﺝ ﺃﻭ ﺍﻝﺯﻭﺠﺔ ﺍﻝﻤﺘﺯﻭﺠﺔ ﻭﻓﻘﺎ ﻝﻠﻘﺎﻨﻭﻥ ﻤﻥ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪ ،‬ﻭﻴﺘﺭﺍﻭﺡ ﻋﻤﺭﻩ‪/‬ﻋﻤﺭﻫﺎ ﻤﻥ ‪ 18‬ﺴﻨﺔ ﺇﻝـﻰ‬
‫‪ 69‬ﺴﻨﺔ‪.‬‬
‫ﻋﻤل ﺇﺭﻫﺎﺒﻲ ﻴﻌﻨﻲ ﺃﻱ ﺍﺴﺘﺨﺩﺍﻡ ﻓﻌﻠﻲ ﺃﻭ ﻤﻬﺩﺩ ﺒﻪ ﻝﻠﻘﻭﺓ ﺃﻭ ﺍﻝﻌﻨﻑ ﺍﻝﻤﻭﺠﻪ ﻨﺤﻭ ﺃﻭ ﺍﻝﺫﻱ ﻴﺴﺒﺏ ﻓﻲ ﻀﺭﺭ‪ ،‬ﺇﺼﺎﺒﺔ‪ ،‬ﺃﺫﻯ ﺃﻭ ﺇﺯﻋﺎﺝ ﺃﻭ ﺍﺭﺘﻜﺎﺏ ﻓﻌل ﺨﻁـﺭ ﻋﻠـﻰ‬
‫ﺍﻝﺤﻴﺎﺓ ﺍﻝﺒﺸﺭﻴﺔ ﺃﻭ ﺍﻝﻤﻤﺘﻠﻜﺎﺕ ﻀﺩ ﺃﻱ ﻓﺭﺩ‪ ،‬ﻤﻤﺘﻠﻜﺎﺕ ﺃﻭ ﺤﻜﻭﻤﺔ‪ ،‬ﺒﻬﺩﻑ ﻤﻌﻠﻥ ﺃﻭ ﻏﻴﺭ ﻤﻌﻠﻥ ﻤﻥ ﺃﺠل ﺍﻝﺤﺼﻭل ﻋﻠﻰ ﻤﺼﺎﻝﺢ ﺍﻗﺘﺼﺎﺩﻴﺔ‪ ،‬ﻋﺭﻗﻴﺔ‪ ،‬ﻗﻭﻤﻴﺔ‪ ،‬ﺴﻴﺎﺴﻴﺔ‪،‬‬
‫ﻋﻨﺼﺭﻴﺔ ﺃﻭ ﺩﻴﻨﻴﺔ‪ ،‬ﺴﻭﺍﺀ ﻜﺎﻨﺕ ﻫﺫﻩ ﺍﻝﻤﺼﺎﻝﺢ ﻤﻌﻠﻨﺔ ﺃﻡ ﻻ‪ ،‬ﻭﺍﻝﺴﺭﻗﺎﺕ ﺃﻭ ﺃﻱ ﺃﻋﻤﺎل ﺇﺠﺭﺍﻤﻴﺔ‪ ،‬ﻴﺘﻡ ﺍﺭﺘﻜﺎﺒﻬﺎ ﺒﺸﻜل ﺭﺌﻴﺴﻲ ﻝﺘﺤﻘﻴﻕ ﻤﻜﺎﺴﺏ ﺸﺨﺼﻴﺔ ﻭﻝـﻥ ﺘﻌﺘﺒـﺭ‬
‫)‪© AIG, all rights reserved (V 1.0 – June 20, 2013‬‬
‫ﺍﻝﺘﺼﺭﻓﺎﺕ ﺍﻝﺘﻲ ﺘﻨﺸﺄ ﺒﺸﻜل ﺭﺌﻴﺴﻲ ﻋﻥ ﻋﻼﻗﺎﺕ ﺸﺨﺼﻴﺔ ﻤﺴﺒﻘﺔ ﺒﻴﻥ ﺍﻝﺠﺎﻨﻲ‪/‬ﺍﻝﺠﻨﺎﺓ ﻭﺍﻝﻀﺤﻴﺔ‪ /‬ﺍﻝﻀﺤﺎﻴﺎ ﺃﻋﻤﺎل ﺇﺭﻫﺎﺒﻴﺔ‪ .‬ﻭﺴﻭﻑ ﻴﺸﻤل "ﺍﻝﻌﻤل ﺍﻹﺭﻫﺎﺒﻲ" ﺍﻴـﻀﺎ‬
‫ﺃﻱ ﻋﻤل ﻴﺘﻡ ﺍﻝﺘﺤﻘﻕ ﻤﻨﻪ ﺃﻭ ﺍﻻﻋﺘﺭﺍﻑ ﺒﻪ ﻜﻔﻌل ﺍﺭﻫﺎﺒﻲ ﻤﻥ ﻗﺒل ﺍﻝﺤﻜﻭﻤﺔ )ﺫﺍﺕ ﺍﻝﺼﻠﺔ( ﺒﺎﻝﺩﻭﻝﺔ ﺍﻝﺘﻲ ﻴﻘﻊ ﻓﻴﻬﺎ ﺍﻝﻔﻌل‪.‬‬
‫ﺍﻝﻁﺭﻑ ﺍﻝﺜﺎﻝﺙ ﻴﻌﻨﻲ ﺃﻱ ﺸﺨﺹ ﺒﺨﻼﻑ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻭﺯﻭﺠﺘﻪ‪/‬ﺯﻭﺠﻬﺎ ﺃﻭ ﺍﻝﺸﺭﻴﻙ ﺍﻝﻘﺎﻨﻭﻨﻲ ﺍﻝﻤﺸﺘﺭﻙ‪ ،‬ﺍﻝﻁﻔل‪ ،‬ﺍﻷﺏ‪/‬ﺍﻷﻡ‪ ،‬ﺍﻝﺼﺩﻴﻕ ﺃﻭ ﺍﻝﻘﺭﻴﺏ‬
‫ﻭﺴﺎﺌل ﺍﻝﻨﻘل ﻴﻌﻨﻲ ﺃﻱ ﻭﺴﻴﻠﺔ ﻨﻘل ﺒﺭﻴﺔ ﻭﺒﺤﺭﻴﺔ ﺃﻭ ﺠﻭﻴﺔ ﻤﻁﻠﻭﺒﺔ ﻝﻨﻘل ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺍﺜﻨﺎﺀ ﺍﻹﺠﻼﺀ ﻓﻲ ﺤﺎﻝﺔ ﺍﻝﻁﻭﺍﺭﺉ‪ .‬ﻭﻴﺸﻤل ﺍﻝﻨﻘل‪ ،‬ﻋﻠﻰ ﺴﺒﻴل ﺍﻝﻤﺜﺎل‬
‫ﻻ ﺍﻝﺤﺼﺭ‪ ،‬ﻁﺎﺌﺭﺍﺕ ﺍﻹﺴﻌﺎﻑ‪ ،‬ﻤﺭﻜﺒﺎﺕ ﺍﻹﺴﻌﺎﻑ‪ ،‬ﻭﺍﻝﺴﻴﺎﺭﺍﺕ ﺍﻝﺨﺎﺼﺔ‪.‬‬
‫ﺍﻝﺤﺭﺏ ﺘﻌﻨﻲ ﺍﻝﺤﺭﺏ‪ ،‬ﺴﻭﺍﺀ ﻜﺎﻨﺕ ﻤﻌﻠﻨﺔ ﺍﻡ ﻻ‪ ،‬ﺃﻭ ﺃﻱ ﺃﻨﺸﻁﺔ ﺤﺭﺒﻴﺔ )ﻭﺘﺸﻤل ﺍﺴﺘﺨﺩﺍﻡ ﺍﻝﻘﻭﺓ ﺍﻝﻌﺴﻜﺭﻴﺔ( ﻤﻥ ﻗﺒل ﺃﻱ ﺩﻭﻝﺔ ﺫﺍﺕ ﺴﻴﺎﺩﺓ ﻝﺘﺤﻘﻴﻕ ﺃﻫﺩﺍﻑ ﺍﻗﺘـﺼﺎﺩﻴﺔ‪،‬‬
‫ﺠﻐﺭﺍﻓﻴﺔ‪ ،‬ﻗﻭﻤﻴﺔ‪ ،‬ﺴﻴﺎﺴﻴﺔ‪ ،‬ﻋﺭﻗﻴﺔ‪ ،‬ﺩﻴﻨﻴﺔ ﺃﻭ ﺃﻫﺩﺍﻑ ﺃﺨﺭﻯ‪.‬‬
‫‪ .3‬ﺍﻝﻤﻨﺎﻓﻊ‬
‫‪ 3.1‬ﻤﻨﺎﻓﻊ ﺍﻝﻤﺼﺎﺭﻴﻑ ﺍﻝﻁﺒﻴﺔ ﻭﺍﻝﻤﺭﺘﺒﻁﺔ‬
‫‪ 3.1.1‬ﺍﻝﻤﺼﺎﺭﻴﻑ ﺍﻝﻁﺒﻴﺔ ﺍﻝﻁﺎﺭﺌﺔ )ﺍﻝﺤﻭﺍﺩﺙ ﻭﺍﻝﻤﺭﺽ(‬
‫ﻓﻲ ﺤﺎﻝﺔ ﺘﺤﻤل ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺃﺜﻨﺎﺀ ﺍﻝﺴﻔﺭ ﻓﻲ ﺭﺤﻠﺔ ﻤﺅﻤﻥ ﻋﻠﻴﻬﺎ ﻝﻨﻔﻘﺎﺕ ﻁﺒﻴﺔ ﻨﺘﻴﺠﺔ ﻝﻠﻤﺭﺽ ﺃﻭ ﺍﻹﺼﺎﺒﺔ‪ ،‬ﺴﻭﻑ ﺘﺩﻓﻊ ﺍﻝﺸﺭﻜﺔ ﻤﻘﺎﺒل ﺘﻠﻙ ﺍﻝﻤـﺼﺎﺭﻴﻑ‬
‫ﻤﺎ ﻴﺼل ﺇﻝﻰ ﺍﻝﻤﺒﻠﻎ ﺍﻝﻤﺫﻜﻭﺭ ﻓﻲ ﺠﺩﻭل ﺍﻝﻤﻨﺎﻓﻊ‪.‬‬
‫ﺍﻝﺸﺭﻭﻁ ﺍﻝﺨﺎﺼﺔ‬
‫ﻴﺘﻡ ﺩﻓﻊ ﺍﻝﻤﺼﺎﺭﻴﻑ ﺍﻝﻁﺒﻴﺔ ﻭﺍﻝﻤﺭﺘﺒﻁﺔ ﻓﻘﻁ ﺤﺘﻰ ﺍﻝﻭﻗﺕ ﺍﻝﺫﻱ ﻴﻘﺭﺭ ﻓﻴﻪ ﺍﻝﻁﺒﻴﺏ ﺍﻝﻤﻌﻴﻥ ﻤﻥ ﺍﻝﺸﺭﻜﺔ ﺇﻥ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻗﺎﺩﺭ ﻋﻠﻰ ﺍﻝﻌﻭﺩﺓ ﺍﻝﻰ ﻭﻁﻨﻪ‪ .‬ﻭﻓﻲ‬
‫ﺤﺎﻝﺔ ﺃﻥ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺍﺨﺘﺎﺭﻋﺩﻡ ﺍﻝﻌﻭﺩﺓ ﺇﻝﻰ ﻨﻘﻁﺔ ﺍﻝﻤﻐﺎﺩﺭﺓ‪ ،‬ﻓﺈﻥ ﻜﺎﻓﺔ ﺍﻝﻤﺼﺎﺭﻴﻑ ﺍﻝﺘﻲ ﻴﺘﻡ ﺘﺤﻤﻠﻬﺎ ﻓﻴﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺎﻝﺤﺎﺩﺙ ﻭﺘﺸﻤل ﺘﻠﻙ ﺍﻝﺘﻲ ﺘﻡ ﺘﺤﻤﻠﻬﺎ ﻗﺒل‬
‫ﺘﺎﺭﻴﺦ ﺍﻝﻌﻌﻭﺩﺓ ﺍﻝﻰ ﺍﻝﻭﻁﻥ ﺍﻝﻤﺤﺘﻤل ﺴﻭﻑ ﺘﻜﻭﻥ ﻋﻠﻰ ﺤﺴﺎﺏ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺍﻝﺸﺨﺼﻲ‪.‬‬
‫ﺍﻻﺴﺘﺜﻨﺎﺀﺍﺕ ﺍﻝﺨﺎﺼﺔ‬
‫ﻝﻥ ﺘﺩﻓﻊ ﺍﻝﺸﺭﻜﺔ ﻤﻘﺎﺒل ﺃﻱ ﻤﺼﺎﺭﻴﻑ ﻁﺒﻴﺔ‪:‬‬
‫ﺘﻡ ﺘﺤﻤﻠﻬﺎ ﻤﻘﺎﺒل ﺍﻝﻌﻼﺝ ﺍﻝﻤﺴﺘﻤﺭ‪ ،‬ﻭﺘﺸﻤل ﺃﻱ ﺃﺩﻭﻴﺔ ﻴﺘﻡ ﺍﻝﺒﺩﺀ ﻓﻴﻬﺎ ﻗﺒل ﺘﺎﺭﻴﺦ ﺒﺩﺀ ﺍﻝﺭﺤﻠﺔ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻬﺎ‪ ،‬ﺘﻡ ﺘﻭﺼﻴﺔ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺒﺎﻻﺴـﺘﻤﺭﺍﺭ ﻓﻴﻬـﺎ‬
‫ﺃﺜﻨﺎﺀ ﺍﻝﺭﺤﻠﺔ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻬﺎ‪.‬‬
‫ﻴﺘﻡ ﺘﺤﻤﻠﻬﺎ ﺒﺴﺒﺏ ﺍﻝﻌﻼﺝ ﺍﻝﺘﺸﺨﻴﺼﻲ ﺍﻝﺫﻱ ﻝﻡ ﻴﺘﻡ ﺘﺤﺩﻴﺩﻩ ﻤﻥ ﻗﺒل ﺍﻝﻁﺒﻴﺏ ﺒﺄﻨﻪ ﻀﺭﻭﺭﻱ ﺒﺸﻜل ﻓﻭﺭﻱ ﺃﻭ‬
‫ﻤﻘﺎﺒل ﺤﺸﻭ ﺃﻭ ﺘﻴﺠﺎﻥ ﺍﻷﺴﻨﺎﻥ ﻤﻥ ﺍﻝﻤﻌﺎﺩﻥ ﺍﻝﺜﻤﻴﻨﺔ‪.‬‬
‫ﻤﻘﺎﺒل ﺃﻱ ﺇﺠﺭﺍﺀﺍﺕ ﺫﺍﺕ ﺼﻠﺔ ﺒﺼﺤﺔ ﺍﻷﺴﻨﺎﻥ ﺃﻭ ﺍﻝﻔﻡ‬
‫ﻤﻘﺎﺒل ﺃﻱ ﻋﻼﺝ ﻁﺒﻲ ﻤﺘﺨﺼﺹ ﺒﺩﻭﻥ ﺘﺤﻭﻴل ﻤﻥ ﺍﻝﻁﺒﻴﺏ‬
‫ﺘﺘﻌﻠﻕ ﺒﻭﺴﺎﺌل ﻤﻨﻊ ﺍﻝﺤﻤل‪ ،‬ﺍﻷﺠﻬﺯﺓ ﺍﻝﺘﻌﻭﻴﻀﻴﺔ‪ ،‬ﺍﻷﺠﻬﺯﺓ ﺍﻝﻁﺒﻴﺔ ﺃﻭ ﺍﻷﺠﻬﺯﺓ ﺍﻝﺼﻨﺎﻋﻴﺔ‪ ،‬ﺍ‬
‫ﺍﻝﻌﻼﺝ ﺍﻝﻭﻗﺎﺌﻲ ﻭﻴﺸﻤل ﻭﻻ ﻴﻘﺘﺼﺭ ﻋﻠﻰ ﺃﻱ ﺘﻁﻌﻴﻡ ﻭ‪/‬ﺃﻭ ﺘﺤﺼﻴﻥ‪،‬‬
‫ﻴﺘﻡ ﺘﺤﻤﻠﻬﺎ ﻓﻲ ﺩﻭﻝﺔ ﺍﻹﻗﺎﻤﺔ‪.‬‬
‫‪ 3.2‬ﻤﻨﺎﻓﻊ ﻤﻀﺎﻴﻘﺎﺕ ﺍﻝﺴﻔﺭ‬
‫ﻓﻘﺩﺍﻥ ﺍﻷﻤﺘﻌﺔ )ﺍﻝﻨﻘل ﺍﻝﻌﺎﻡ(‬
‫ﺴﻭﻑ ﺘﺩﻓﻊ ﺍﻝﺸﺭﻜﺔ ﺍﻝﻤﻨﺎﻓﻊ ﻓﻲ ﺤﺎﻝﺔ ﺃﻥ ﺤﻘﺎﺌﺏ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪ ،‬ﺍﻝﺘﻲ ﺘﻜﻭﻥ ﺘﺤﺕ ﺭﻋﺎﻴﺔ ﻭﺤﻴﺎﺯﺓ ﻭﺴﻴﻁﺭﺓ ﺍﻝﻨﺎﻗل ﺍﻝﻌﺎﻡ‪ ،‬ﺘﻡ ﻓﻘﺩﻫﺎ ﺒﺴﺒﺏ ﺍﻝﺴﺭﻗﺔ ﺃﻭ ﻨﺘﻴﺠﺔ‬
‫ﺍﻝﺨﻁﺄ ﻓﻲ ﺍﻝﺘﻭﺠﻴﻪ ﻤﻥ ﻗﺒل ﺍﻝﻨﺎﻗل ﺍﻝﻌﺎﻡ ﻓﻲ ﺍﻝﻭﻗﺕ ﺍﻝﺫﻱ ﻴﻜﻭﻥ ﻓﻴﻪ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺭﺍﻜﺏ ﺒﻤﻭﺠﺏ ﺘﺫﻜﺭﺓ ﻋﻠﻰ ﺍﻝﻨﺎﻗل ﺍﻝﻌﺎﻡ ﺃﺜﻨﺎﺀ ﺍﻝﺭﺤﻠﺔ‪ .‬ﻭﺴﻭﻑ ﺘﺴﺩﺩ ﺍﻝﺸﺭﻜﺔ ﻤـﺎ‬
‫ﻴﺼل ﺇﻝﻰ ﺍﻝﺤﺩ ﺍﻷﻗﺼﻰ ﺍﻝﻤﺒﻴﻥ ﻓﻲ ﺠﺩﻭل ﺍﻝﻤﻨﺎﻓﻊ‪ ،‬ﻤﻘﺎﺒل ﺘﻜﻠﻔﺔ ﺍﺴﺘﺒﺩﺍل ﺍﻝﺤﻘﺎﺌﺏ ﻭﻤﺤﺘﻭﻴﺎﺘﻬﺎ‪.‬‬
‫ﻭﻴﺠﺏ ﺍﻝﺘﺤﻘﻕ ﻤﻥ ﻜﺎﻓﺔ ﺍﻝﻤﻁﺎﻝﺒﺎﺕ ﺒﻭﺍﺴﻁﺔ ﺍﻝﻨﺎﻗل ﺍﻝﻌﺎﻡ‪.‬‬
‫ﺴﻴﺘﻡ ﺘﻌﻭﻴﺽ ﻤﺒﻠﻎ ﺃﻗﺼﺎﻩ ‪ %50‬ﻝﻜل ﺤﻘﻴﺒﺔ ﻭﺃﻗﺼﻰ ﻗﻴﻤﺔ ﻝﻜل ﺒﻨﺩ ﺘﺤﺘﻭﻴﻪ ﺃﻴﺔ ﺤﻘﻴﺒﺔ ﻫﻲ ‪ %10‬ﻤﻥ ﺍﻝﻤﺒﻠﻎ ﺍﻝﻤﺒﻴﻥ ﻓﻲ ﺠﺩﻭل ﺍﻝﻤﻨﺎﻓﻊ‪ .‬ﻜﻤﺎ ﻴﻭﺠﺩ ﺃﻴﻀﹰﺎ ﺤﺩ ﺃﻗﺼﻰ‬
‫ﻤﺭﻜﺏ ﻗﺩﺭﻩ ‪ %10‬ﻤﻥ ﺍﻝﻤﺒﻠﻎ ﺍﻝﻤﺒﻴﻥ ﻓﻲ ﺠﺩﻭل ﺍﻝﻤﻨﺎﻓﻊ ﺒﺨﺼﻭﺹ ﻤﺎ ﻴﻠﻲ‪ :‬ﺍﻝﻤﺠﻭﻫﺭﺍﺕ‪ ،‬ﺍﻝﺴﺎﻋﺎﺕ‪ ،‬ﺍﻷﺸﻴﺎﺀ ﺍﻝﺘﻲ ﺘﺘﺄﻝﻑ ﺒﺸﻜل ﻜﻠﻲ ﺃﻭ ﺠﺯﺌﻲ ﻤﻥ ﺍﻝﻔﻀﺔ‪ ،‬ﺍﻝﺫﻫﺏ‬
‫)‪© AIG, all rights reserved (V 1.0 – June 20, 2013‬‬
‫ﺃﻭ ﺍﻝﺒﻼﺘﻴﻨﻭﻡ‪ ،‬ﺍﻝﻔﺭﺍﺀ‪ ،‬ﺍﻷﺸﻴﺎﺀ ﺍﻝﻤﺯﻴﻨﺔ ﺒﻔﺭﺍﺀ ﺃﻭ ﺍﻝﻤﺼﻨﻭﻋﺔ ﺒﻤﻌﻅﻤﻬﺎ ﻤﻥ ﺍﻝﻔﺭﺍﺀ‪ ،‬ﻭﺍﻝﻜﺎﻤﻴﺭﺍﺕ‪ ،‬ﺒﻤﺎ ﻓﻴﻬﺎ ﻤﻌـﺩﺍﺕ ﺍﻝﻜـﺎﻤﻴﺭﺍﺕ ﺍﻝﻤﻌﻨﻴـﺔ‪ ،‬ﺍﻝﺤﻭﺍﺴـﻴﺏ ﻭﺍﻝﻤﻌـﺩﺍﺕ‬
‫ﺍﻹﻝﻜﺘﺭﻭﻨﻴﺔ‪.‬‬
‫ﻓﻘﺩ ﺯﻭﺝ‪ /‬ﺍﻝﻁﻘﻡ‬
‫ﻓﻲ ﺤﺎﻝﺔ ﻓﻘﺩ ﺯﻭﺝ ﺃﻭ ﻁﻘﻡ‪ ،‬ﻴﺠﻭﺯ ﻝﻠﺸﺭﻜﺔ ﺍﻥ ﺘﺨﺘﺎﺭ‪:‬‬
‫ﺇﺼﻼﺡ ﺃﻭ ﺍﺴﺘﺒﺩﺍل ﺃﻱ ﻗﻁﻌﺔ‪ ،‬ﻹﻋﺎﺩﺓ ﺍﻝﺯﻭﺝ ﺃﻭ ﺍﻝﻁﻘﻡ ﺇﻝﻰ ﻗﻴﻤﺘﻪ ﻗﺒل ﺍﻝﻔﻘﺩ‪،‬‬
‫ﺩﻓﻊ ﺍﻝﻔﺭﻕ ﺒﻴﻥ ﺍﻝﻘﻴﻤﺔ ﺍﻝﻨﻘﺩﻴﺔ ﻝﻠﻤﻤﺘﻠﻜﺎﺕ ﻗﺒل ﻭﺒﻌﺩ ﺍﻝﺨﺴﺎﺭﺓ‪.‬‬
‫‪ 3.2.1.1‬ﺍﻝﺸﺭﻁ ﺍﻝﺨﺎﺹ‬
‫ﺴﺘﻜﻭﻥ ﺘﻌﻭﻴﻀﺎﺕ ﺍﻷﻤﺘﻌﺔ ﻭﺍﻝﻤﻘﺘﻨﻴﺎﺕ ﺍﻝﺸﺨﺼﻴﺔ ﺯﺍﺌﺩﹰﺍ ﻋﻠﻰ ﺃﻱ ﻤﺒﻠﻎ ﻤﺩﻓﻭﻉ ﺃﻭ ﻤﺴﺘﺤﻕ ﺍﻝﺩﻓﻊ ﻤﻥ ﻗﺒل ﺍﻝﻨﺎﻗل ﺍﻝﻌﺎﻡ ﺍﻝﻤﺴﺅﻭل ﻋﻥ ﺍﻝﺨﺴﺎﺭﺓ‪.‬‬
‫ﺴﺘﻜﻭﻥ ﺘﻌﻭﻴﻀﺎﺕ ﺍﻷﻤﺘﻌﺔ ﻭﺍﻝﻤﻘﺘﻨﻴﺎﺕ ﺍﻝﺸﺨﺼﻴﺔ ﺯﺍﺌﺩﺓ ﻋﻠﻰ ﻜﺎﻓﺔ ﺍﻝﺘﺄﻤﻴﻨﺎﺕ ﺍﻷﺨﺭﻯ ﺍﻝﺴﺎﺭﻴﺔ ﻭﺍﻝﺘﻲ ﻴﻤﻜﻥ ﺘﺤﺼﻴﻠﻬﺎ‪ .‬ﻓﻲ ﺤﺎل ﻭﺠﻭﺩ ﺨﺴﺎﺭﺓ ﺘﺄﻤﻴﻥ ﺁﺨﺭ ﺴـﺎﺭﻱ‬
‫ﻭﻴﻤﻜﻥ ﺘﺤﺼﻴﻠﻪ ﻋﻨﺩ ﻭﻗﻭﻉ ﺃﻴﺔ ﺨﺴﺎﺭﺓ‪ ،‬ﺴﺘﻜﻭﻥ ﺍﻝﺸﺭﻜﺔ ﻤﺴﺅﻭﻝﺔ ﻓﻘﻁ ﻋﻥ ﺍﻝﺯﻴﺎﺩﺓ ﻓﻲ ﻤﺒﻠﻎ ﺍﻝﺨﺴﺎﺭﺓ‪ ،‬ﻋﻠﻰ ﻤﺒﻠﻎ ﺫﻝﻙ ﺍﻝﺘﺄﻤﻴﻥ ﺍﻵﺨﺭ‪ ،‬ﻭﺃﻴﺔ ﻤﺒﺎﻝﻎ ﺘﺤﻤل ﺴﺎﺭﻴﺔ‪.‬‬
‫ﺍﻻﺴﺘﺜﻨﺎﺀﺍﺕ ﺍﻝﺨﺎﺼﺔ‬
‫ﻝﻥ ﻴﺘﻡ ﺘﻘﺩﻴﻡ ﺍﻝﻤﻨﺎﻓﻊ ﻋﻥ ﺃﻱ ﻓﻘﺩ ﻝﻤﺎ ﻴﻠﻲ‪:‬‬
‫ﺍﻝﺤﻴﻭﺍﻨﺎﺕ ﻭﺍﻝﻁﻴﻭﺭ ﺃﻭ ﺍﻷﺴﻤﺎﻙ‬
‫ﺍﻝﺴﻴﺎﺭﺍﺕ ﺍﻭ ﻤﻌﺩﺍﺕ ﺍﻝﺴﻴﺎﺭﺍﺕ ﻭﺍﻝﻤﺭﺍﻜﺏ ﻭﺍﻝﻤﺤﺭﻜﺎﺕ ﻭﺍﻝﻤﻘﻁﻭﺭﺍﺕ ﻭﺍﻝﺩﺭﺍﺠﺎﺕ ﺍﻝﻨﺎﺭﻴﺔ ﺃﻭ ﺃﻱ ﻭﺴﺎﺌل ﻨﻘل ﺃﺨﺭﻯ ﺃﻭ ﺘﻭﺍﺒﻌﻬﺎ )ﺒﺎﺴﺘﺜﻨﺎﺀ ﺍﻝـﺩﺭﺍﺠﺎﺕ ﺍﻝﺘـﻲ ﻴـﺘﻡ‬
‫ﺘﺴﺠﻴﻠﻬﺎ ﻜﺄﻤﺘﻌﺔ ﻝﺩﻯ ﺍﻝﻨﺎﻗل ﺍﻝﻌﺎﻡ(‪.‬‬
‫‪ .3‬ﺍﻷﺜﺎﺙ ﺍﻝﻤﻨﺯﻝﻲ؛‬
‫‪ .4‬ﺍﻝﻨﻅﺎﺭﺍﺕ ﺃﻭ ﺍﻝﻌﺩﺴﺎﺕ ﺍﻝﻼﺼﻘﺔ؛‬
‫‪ .5‬ﺍﻷﺴﻨﺎﻥ ﺍﻻﺼﻁﻨﺎﻋﻴﺔ ﺃﻭ ﺠﺴﻭﺭ ﺍﻷﺴﻨﺎﻥ؛‬
‫‪ .6‬ﺃﺩﻭﺍﺕ ﺍﻝﺴﻤﻊ؛‬
‫‪ .7‬ﺍﻷﻁﺭﺍﻑ ﺍﻝﺼﻨﺎﻋﻴﺔ؛‬
‫‪ .8‬ﺍﻵﻻﺕ ﺍﻝﻤﻭﺴﻴﻘﻴﺔ؛‬
‫‪ .9‬ﺍﻷﻤﻭﺍل ﺃﻭ ﺍﻷﻭﺭﺍﻕ ﺍﻝﻤﺎﻝﻴﺔ؛‬
‫‪ .10‬ﺍﻝﺘﺫﺍﻜﺭ ﺃﻭ ﺍﻝﻭﺜﺎﺌﻕ؛‬
‫‪ .11‬ﺍﻝﻤﻭﺍﺩ ﺴﺭﻴﻌﺔ ﺍﻝﺘﻠﻑ ﻭﺍﻻﺴﺘﻬﻼﻜﻴﺔ‪.‬‬
‫‪ .12‬ﺍﻝﻬﺎﺘﻑ ﺍﻝﻤﺤﻤﻭل‬
‫‪ .13‬ﺃﺠﻬﺯﺓ ﺍﻝﻜﻤﺒﻴﻭﺘﺭ ﺍﻝﻤﺤﻤﻭﻝﺔ‬
‫ﻝﻥ ﻴﺘﻡ ﺘﻭﻓﻴﺭ ﻤﻨﺎﻓﻊ ﻷﻱ ﺨﺴﺎﺭﺓ ﻨﺎﺘﺠﺔ )ﻜﻠﻴﺎ ﺃﻭ ﺠﺯﺌﻴﺎ( ﻤﻥ‪:‬‬
‫‪ .1‬ﺍﻝﺒﻠﻲ ﻭﺍﻻﻫﺘﺭﺍﺀ ﺃﻭ ﺍﻝﺘﻠﻑ ﺍﻝﺘﺩﺭﻴﺠﻲ؛‬
‫‪ .2‬ﺍﻝﺤﺸﺭﺍﺕ ﺃﻭ ﺍﻝﻁﻔﻴﻠﻴﺎﺕ؛‬
‫‪ .3‬ﻋﻴﺏ ﻤﺘﺄﺼل ﺃﻭ ﻀﺭﺭ؛‬
‫‪ .4‬ﻤﺼﺎﺩﺭﺓ ﺃﻭ ﻨﺯﻉ ﺍﻝﻤﻠﻜﻴﺔ ﺒﺄﻤﺭ ﻤﻥ ﺃﻱ ﺤﻜﻭﻤﺔ ﺃﻭ ﺴﻠﻁﺔ ﻋﺎﻤﺔ؛‬
‫‪ .5‬ﻤﺼﺎﺩﺭﺓ ﺃﻭ ﺘﺩﻤﻴﺭ ﺒﻤﻭﺠﺏ ﻻﺌﺤﺔ ﺍﻝﺤﺠﺭ ﺍﻝﺼﺤﻲ ﺃﻭ ﺍﻝﺠﻤﺎﺭﻙ‬
‫‪ .6‬ﺍﻝﺘﻠﻭﺙ ﺍﻹﺸﻌﺎﻋﻲ؛‬
‫‪ .7‬ﺍﻝﺴﻠﻁﺔ ﺍﻝﻤﻐﺘﺼﺒﺔ ﺃﻭ ﺍﻹﺠﺭﺍﺀﺍﺕ ﺍﻝﺘﻲ ﺍﺘﺨﺫﺘﻬﺎ ﺍﻝﺴﻠﻁﺔ ﺍﻝﺤﻜﻭﻤﻴﺔ ﻓﻲ ﺇﻋﺎﻗﺔ ﻤﻜﺎﻓﺤﺔ ﺃﻭ ﺍﻝﺩﻓﺎﻉ ﻀﺩ ﺤﺩﻭﺙ ﺫﻝﻙ؛‬
‫‪ .8‬ﻨﻘل ﺍﻝﻤﻭﺍﺩ ﺍﻝﻤﻬﺭﺒﺔ ﺃﻭ ﺍﻝﺘﺠﺎﺭﺓ ﻏﻴﺭ ﺍﻝﻤﺸﺭﻭﻋﺔ؛‬
‫‪ .9‬ﺍﻻﺨﺘﻔﺎﺀ ﺍﻝﻐﺎﻤﺽ؛ ﺃﻭ‬
‫‪.10‬ﻜﺴﺭ ﺍﻝﻤﻭﺍﺩ ﺍﻝﻬﺸﺔ ﺃﻭ ﺍﻝﻘﺎﺒﻠﺔ ﻝﻠﻜﺴﺭ‪ ،‬ﻭﺍﻝﻜﺎﻤﻴﺭﺍﺕ‪ ،‬ﻭﺍﻵﻻﺕ ﺍﻝﻤﻭﺴﻴﻘﻴﺔ‪ ،‬ﻭﺃﺠﻬﺯﺓ ﺍﻝﺭﺍﺩﻴﻭ‪ ،‬ﻭﺍﻝﻤﻤﺘﻠﻜﺎﺕ ﺍﻝﻤﻤﺎﺜﻠﺔ‪.‬‬
‫)‪© AIG, all rights reserved (V 1.0 – June 20, 2013‬‬
‫ﺘﺄﺨﺭ ﻭﺼﻭل ﺍﻷﻤﺘﻌﺔ‬
‫ﺴﻭﻑ ﺘﺴﺩﺩ ﺍﻝﺸﺭﻜﺔ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻋﻥ ﺍﻝﻤﺼﺎﺭﻴﻑ ﺍﻷﺴﺎﺴﻴﺔ ﺍﻝﻤﻌﻘﻭﻝﺔ ﺍﻝﺘﻲ ﻴﺘﻡ ﺘﺤﻤﻠﻬﺎ )ﻤﻊ ﻁﻠﺏ ﺍﻹﻴﺼﺎﻻﺕ ﺍﻷﺼﻠﻴﺔ( ﺍﻝﻨﺎﺘﺠﺔ ﻋـﻥ ﺍﻝﺘـﺄﺨﻴﺭ ﻏﻴـﺭ‬
‫ﺍﻝﻤﻨﻅﻭﺭ ﻓﻲ ﺍﻝﺴﻔﺭ ﻭﺒﻌﺩ ﻓﺘﺭﺓ ﺍﻝﺘﺠﺎﻭﺯ‪ ،‬ﺤﺘﻰ ﺍﻝﻤﺒﻠﻎ ﺍﻝﻤﺫﻜﻭﺭ ﻓﻲ ﺠﺩﻭل ﺍﻝﻤﻨﺎﻓﻊ ﻋﻥ ﺍﻝﺸﺭﺍﺀ ﺍﻝﻁﺎﺭﺉ ﻷﻴﺔ ﺃﺸﻴﺎﺀ ﻀﺭﻭﺭﻴﺔ ﺇﺫﺍ ﺘﺄﺨﺭﺕ ﺃﻤﺘﻌﺘﻪ‪ ،‬ﺃﻭ ﺃﺭﺴـﻠﺕ ﺇﻝـﻰ‬
‫ﻭﺠﻬﺔ ﺨﺎﻁﺌﺔ ﺃﻭ ﻭﻀﻌﺕ ﻓﻲ ﻤﻜﺎﻥ ﺨﺎﻁﺊ ﻤﻥ ﻗﺒل ﻨﺎﻗل ﻋﺎﻡ‪.‬‬
‫ﺸﺭﻭﻁ ﺨﺎﺼﺔ‬
‫ﻴﺠﺏ ﺘﻘﺩﻴﻡ ﺇﺜﺒﺎﺕ ﺨﻁﻲ ﻤﻥ ﻤﻘﺩﻡ ﺨﺩﻤﺔ ﺍﻝﻨﻘل ﻤﻊ ﺃﻴﺔ ﻤﻁﺎﻝﺒﺔ ﻭﺘﺘﻭﻗﻑ ﻤﺴﺅﻭﻝﻴﺔ ﺍﻝﺸﺭﻜﺔ ﻋﻠﻰ ﺍﺴﺘﻼﻡ ﺍﻝﻔﻭﺍﺘﻴﺭ ﺍﻷﺼﻠﻴﺔ ﺒﺨﺼﻭﺹ ﺍﻝﻤﺼﺎﺭﻴﻑ ﺍﻝﻀﺭﻭﺭﻴﺔ ﺍﻝﺘﻲ ﺘﻡ‬
‫ﺘﻜﺒﺩﻫﺎ‪.‬‬
‫ﻴﺠﺏ ﺃﻥ ﻴﺘﺠﺎﻭﺯ ﺘﺄﺨﺭ ﺍﻷﻤﺘﻌﺔ ﻤﺩﺓ ﺍﻝﺘﺤﻤل‬
‫ﻻ ﻴﻤﻜﻥ ﺃﻥ ﺘﺸﻜل ﺍﻝﻤﺼﺎﺩﺭﺓ ﺃﻭ ﺍﻻﺴﺘﻴﻼﺀ ﻤﻥ ﻗﺒل ﺍﻝﺠﻤﺎﺭﻙ ﺃﻭ ﺃﻴﺔ ﺴﻠﻁﺔ ﺤﻜﻭﻤﻴﺔ ﺃﺨﺭﻯ ﺃﺴﺎﺴﹰﺎ ﻝﻠﻤﻁﺎﻝﺒﺔ ﺒﺨﺴﺎﺭﺓ ﺃﻭ ﻤﺼﺎﺭﻴﻑ‪.‬‬
‫ﺴﻴﺘﻡ ﺍﻝﻨﻅﺭ ﻓﻲ ﺍﻝﻤﻁﺎﻝﺒﺎﺕ ﺒﺨﺼﻭﺹ ﺍﻝﺜﻴﺎﺏ ﺃﻭ ﺍﻝﻤﺘﻁﻠﺒﺎﺕ ﺍﻝﻀﺭﻭﺭﻴﺔ ﺍﻝﺘﻲ ﻴﺘﻡ ﺸﺭﺍﺅﻫﺎ ﺒﺴﺒﺏ ﺘﺄﺨﺭ ﺍﻻﻤﺘﻌﺔ ﻓﻲ ﺤﺎل ﺘﻡ ﺸﺭﺍﺀ ﺘﻠﻙ ﺍﻷﺸﻴﺎﺀ ﺨﻼل ‪ 4‬ﺃﻴﺎﻡ ﺒﻌـﺩ‬
‫ﻤﻭﻋﺩ ﺍﻝﻭﺼﻭل ﺍﻝﻔﻌﻠﻲ ﺇﻝﻰ ﺍﻝﻭﺠﻬﺔ ﺍﻝﻤﻘﺼﻭﺩﺓ‪.‬‬
‫ﺇﺫﺍ ﺘﺒﻴﻥ ﺃﻥ ﺍﻷﻤﺘﻌﺔ ﺘﺄﺨﺭﺕ ﺃﻭ ﻀﺎﻋﺕ ﻓﻲ ﻤﻁﺎﺭ ﺍﻝﻭﺠﻬﺔ‪ ،‬ﻴﺠﺏ ﺃﻥ ﻴﻘﻭﻡ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻝﻪ ﺒﺈﺨﻁﺎﺭ ﺍﻝﻨﺎﻗل ﺍﻝﺠﻭﻱ ﺍﻝﻤﻌﻨﻲ ﺭﺴﻤﻴﹰﺎ ﻭﻋﻠﻰ ﺍﻝﻔﻭﺭ‪ .‬ﻴﺠـﺏ ﺘﻘـﺩﻴﻡ‬
‫ﺇﺜﺒﺎﺕ ﺫﻝﻙ ﺍﻹﺨﻁﺎﺭ‪.‬‬
‫‪ 3.2.3‬ﺘﺄﺨﺭ ﺍﻝﺭﺤﻠﺔ‬
‫ﺴﺘﻘﻭﻡ ﺍﻝﺸﺭﻜﺔ ﺒﺘﻌﻭﻴﺽ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻝﻪ ﻋﻥ ﺍﻝﻤﺼﺎﺭﻴﻑ ﺍﻝﻀﺭﻭﺭﻴﺔ ﺍﻝﻤﻌﻘﻭﻝﺔ ﺍﻝﺘﻲ ﻴﺘﻡ ﺘﻜﺒﺩﻫﺎ ﺒﺴﺒﺏ ﺍﻝﺘﺄﺨﻴﺭ ﻏﻴﺭ ﺍﻝﻤﺘﻭﻗﻊ ﻝﻠﺭﺤﻠﺔ ﻭﺒﻌﺩ ﻤﺩﺓ ﺍﻝﺘﺤﻤل‪ ،‬ﺸـﺭﻁ‬
‫ﺘﻘﺩﻴﻡ ﺍﻝﻔﻭﺍﺘﻴﺭ ﺍﻻﺼﻠﻴﺔ ﻝﻠﻤﺼﺎﺭﻴﻑ ﺍﻝﻀﺭﻭﺭﻴﺔ ﺍﻝﺘﻲ ﺘﻜﺒﺩﻫﺎ ﺍﻝﻤﺅﻤﻥ ﻝﻪ ﺃﺜﻨﺎﺀ ﺍﻝﺘﺄﺨﻴﺭ‪ ،‬ﻝﺤﺩ ﺍﻝﻤﺒﻠﻎ ﺍﻝﻤﺒﻴﻥ ﻓﻲ ﺠﺩﻭل ﺍﻝﻤﻨﺎﻓﻊ ﻭﺍﻝﺘﻲ ﺘﻨﺘﺞ ﻋﻥ‪:‬‬
‫ﻓﻘﺩ ﺍﻭ ﺴﺭﻗﺔ ﻭﺜﺎﺌﻕ ﺍﻝﺴﻔﺭ )ﺘﺫﺍﻜﺭ ﺍﻝﺴﻔﺭ‪ ،‬ﺠﻭﺍﺯﺍﺕ ﺍﻝﺴﻔﺭ ﻭﺍﻝﺘﺄﺸﻴﺭﺍﺕ(‬
‫ﺃﻱ ﺤـﺎﺩﺙ ﺃﻭ ﻋﻁل ﻤﻴﻜﺎﻨﻴﻜﻲ‪/‬ﻜﻬﺭﺒﺎﻨﻲ ﻴﺘﻌﻠﻕ ﺒﺎﻝﻨﻘل ﺍﻝﺫﻱ ﻗﺎﻡ ﺒﺘﺭﺘﻴﺏ ﺍﻝﺴﻔﺭ ﻋﻠﻴﻪ ﺍﻭ ﻜﺎﻥ ﻤﺴﺎﻓﺭ ﻋﻠﻴﻪ ﻝﻐﺭﺽ ﺍﻝﻭﺼﻭل ﺇﻝﻰ ﻨﻘﻁﺔ ﺍﻝﻤﻐﺎﺩﺭﺓ ﻭ‪/‬ﺃﻭ ﻨﻘﻁﺔ ﺍﻝﻤﻐﺎﺩﺭﺓ‬
‫ﺍﻝﺘﻲ ﻗﺼﺩ ﻤﻨﻬﺎ ﺍﻝﺒﺩﺀ ﻓﻲ ﺭﺤﻠﺔ ﺘﺎﻝﻴﺔ‬
‫ﺍﻝﺘﺄﺨﺭ ﻓﻲ ﺍﻝﻤﻐﺎﺩﺭﺓ ﺍﻝﻤﻘﺭﺭﺓ ﻝﻭﺴﻴﻠﺔ ﻨﻘل ﻋﺎﻡ ﺒﺴﺒﺏ ﺃ( ﻨﺯﺍﻉ ﻋﻤﺎﻝﻲ‪ ،‬ﺇﻀﺭﺍﺏ ﺃﻭ ﺇﺠﺭﺍﺀ ﺃﻭ )ﺏ( ﺍﻝﻅﺭﻭﻑ ﺍﻝﺠﻭﻴﺔ ﺍﻝﻤﻨﺎﻭﺌﺔ ﻭﺘـﺸﻤل ﺍﻷﻋﺎﺼـﻴﺭ‪ ،‬ﻭﺍﻷﻋﺎﺼـﻴﺭ‬
‫ﺍﻝﺤﻠﺯﻭﻨﻴﺔ‪ ،‬ﻭﺍﻝﻔﻴﻀﺎﻨﺎﺕ‪ ،‬ﻭﺃﻋﺎﺼﻴﺭ ﺍﻝﺘﻴﻔﻭﻥ‪ ،‬ﺍﻝﻌﻭﺍﺼﻑ ﺍﻝﺜﻠﺠﻴﺔ‪ ،‬ﺃﻭ ﺍﻝﻜﻭﺍﺭﺙ ﺍﻝﻁﺒﻴﻌﻴﺔ ﻓﻲ ﺍﻝﺒﻼﺩ ﺍﻝﺘﻲ ﻴﺴﺎﻓﺭ ﺇﻝﻴﻬﺎ ﺃﻭ ﻤﻥ ﺨﻼﻝﻬﺎ ﺃﻭ ﺝ( ﺍﻷﻋﻁﺎل ﺍﻝﻤﻴﻜﺎﻨﻴﻜﻴـﺔ ‪/‬‬
‫ﺍﻝﻜﻬﺭﺒﺎﺌﻴﺔ ‪ ،‬ﺃﻭ ﺩ( ﺘﻌﻁل ﻭﺴﺎﺌل ﺍﻝﻨﻘل ﺍﻝﻌﺎﻡ‪.‬‬
‫‪ 3.2.3.1‬ﺍﻻﺴﺘﺜﻨﺎﺀﺍﺕ ﺍﻝﺨﺎﺼﺔ‬
‫ﻝﻥ ﺘﺩﻓﻊ ﺍﻝﺸﺭﻜﺔ ﻤﻘﺎﺒل ﺍﻝﻨﻔﻘﺎﺕ ﺍﻝﺘﻲ ﻴﺘﻡ ﺘﺤﻤﻠﻬﺎ‪:‬‬
‫ﺤﻴﺙ ﻴﻜﻭﻥ ﻗﺩ ﺘﻡ ﺘﻭﻓﻴﺭ ﻨﻘل ﺒﺩﻴل ﺘﺎﻝﻲ ﻤﺸﺎﺒﻪ ﺇﻝﻰ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻀﻤﻥ ﺍﻝﺘﺠﺎﻭﺯ ﺒﻌﺩ ﻭﻗﺕ ﺘﺎﺭﻴﺦ ﺍﻝﻤﻐﺎﺩﺭﺓ ﺍﻝﻤﻘﺭﺭ ﻝﺭﺤﻠﺔ ﻁﻴﺭﺍﻥ ﺘﻡ ﺤﺠﺯﻫﺎ ﺃﻭ ﻀـﻤﻥ‬
‫ﺍﻝﺘﺠﺎﻭﺯ ﺒﻌﺩ ﺍﻝﻭﺼﻭل ﺍﻝﻔﻌﻠﻲ ﻝﺭﺤﻠﺔ ﺍﻝﻁﻴﺭﺍﻥ )ﻓﻲ ﺤﺎﻝﺔ ﺭﺤﻠﺔ ﺍﻝﻁﻴﺭﺍﻥ ﺭﺒﻁ( ﺃﻭ‬
‫ﺤﻴﺙ ﻴﺨﻔﻕ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻓﻲ ﺍﻝﺤﻀﻭﺭ ﻭﻓﻘﺎ ﻝﻤﺴﺎﺭ ﺍﻝﺭﺤﻠﺔ ﺍﻝﺫﻱ ﺘﻡ ﺘﻘﺩﻴﻤﻪ‪ ،‬ﻤﺎ ﻴﻜﻥ ﻫﺫﺍ ﺍﻹﺨﻔﺎﻕ ﺴﺒﺏ ﺇﻀﺭﺍﺏ ﺃﻭ ﺇﺠﺭﺍﺀ ﻋﻤﺎﻝﻲ‬
‫ﺃﻭ‬
‫ﺤﻴﺙ ﻴﻜﻭﻥ ﺍﻝﺘﺄﺨﻴﺭ ﻨﺎﺘﺞ ﻋﻥ ﻨﺯﺍﻉ ﻋﻤﺎﻝﻲ‪ ،‬ﺇﻀﺭﺍﺏ ﺃﻭ ﺇﺠﺭﺍﺀ ﻜﺎﻥ ﻗﺎﺌﻡ ﺃﻭ ﺘﻡ ﺘﻘﺩﻴﻡ ﺍﺸﻌﺎﺭ ﻤﺴﺒﻕ ﺒﺸﺄﻨﻪ ﻓﻲ ﺃﻭ ﻗﺒل ﺍﻝﺘﺎﺭﻴﺦ ﺍﻝﺫﻱ ﺒﺩﺃﺕ ﻓﻴﻪ ﺍﻝﺭﺤﻠـﺔ ﺍﻝﻤـﺅﻤﻥ‬
‫ﻋﻠﻴﻬﺎ‪.‬‬
‫ﺤﻴﺙ ﻴﻜﻭﻥ ﺍﻝﺘﺄﺨﻴﺭ ﺒﺴﺒﺏ ﺍﻝﺴﺤﺏ ﻤﻥ ﺍﻝﺨﺩﻤﺔ ﻤﺅﻗﺘﺎ ﺃﻭ ﺒﺸﻜل ﺩﺍﺌﻡ ﻵﻱ ﻭﺴﻴﻠﺔ ﻨﻘل ﻋﺎﻤﺔ ﺒﻤﻭﺠﺏ ﻗﺭﺍﺭﺍﺕ ﺃﻭ ﺘﻭﺼﻴﺎﺕ ﻤﻥ ﺃﻱ ﺴﻠﻁﺔ ﻤﻴﻨﺎﺀ ﺁﻭ ﺴﻠﻁﺔ ﻁﻴـﺭﺍﻥ‬
‫ﻤﺩﻨﻲ ﺃﻭ ﺃﻱ ﻜﻴﺎﻥ ﺃﺨﺭ ﻤﺸﺎﺒﻪ ﻓﻲ ﺃﻱ ﺩﻭﻝﺔ ﻭﺍﻝﺫﻱ ﺘﻡ ﺒﺸﺄﻨﻪ ﺘﻘﺩﻴﻡ ﺇﺸﻌﺎﺭ ﻤﺴﺒﻕ ﻓﻲ ﺃﻭ ﻗﺒل ﺍﻝﺘﺎﺭﻴﺦ ﺍﻝﺫﻱ ﺒﺩﺃﺕ ﻓﻴﻪ ﺭﺤﻠﺔ ﻤﺅﻤﻥ ﻋﻠﻴﻬﺎ‪.‬‬
‫ﻋﻥ ﺍﻝﺘﺄﺨﻴﺭ ﺍﻝﻨﺎﺘﺞ ﻋﻥ ﺍﻝﺸﺭﻜﺔ ﺍﻝﻨﺎﻗﻠﺔ ﺤﻴﺙ ﺘﻜﻭﻥ ﺘﻜﻠﻔﺔ ﺍﻝﻨﻔﻘﺎﺕ ﻗﺎﺒﻠﺔ ﻝﻼﺴﺘﺭﺩﺍﺩ ﻤﻥ ﺍﻝﺸﺭﻜﺔ ﺍﻝﻨﺎﻗﻠﺔ‪.‬‬
‫)‪© AIG, all rights reserved (V 1.0 – June 20, 2013‬‬
‫‪ 3.2.4‬ﻓﻘﺩﺍﻥ ﺠﻭﺍﺯ ﺍﻝﺴﻔﺭ‬
‫ﺴﻭﻑ ﺘﺩﻓﻊ ﺍﻝﺸﺭﻜﺔ ﺍﻝﻤﺼﺎﺭﻴﻑ ﺍﻝﺘﻲ ﻴﺘﺤﻤﻠﻬﺎ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻭﺘﻘﺘﺼﺭ ﻋﻠﻰ ﺍﻝﺭﺴﻭﻡ ﻭﺍﻝﻐﺭﺍﻤﺎﺕ ﻭﺭﺴﻭﻡ ﺍﻝﺒﺭﻴﺩ ﺍﻝﺴﺭﻴﻊ ﺒﺸﺄﻥ ﺍﺴﺘﺒﺩﺍل ﻭﺜﺎﺌﻕ ﺍﻝﺴﻔﺭ ﺒـﺩﻻ‬
‫ﻋﻥ ﺠﻭﺍﺯ ﺍﻝﺴﻔﺭ ﺍﻝﻤﻔﻘﻭﺩ ﻁﺒﻘﺎ ﻝﻠﻤﺒﻠﻎ ﺍﻝﻤﺤﺩﺩ ﻓﻲ ﺠﺩﻭل ﺍﻝﻤﻨﺎﻓﻊ‪ ،‬ﻭﺫﻝﻙ ﻁﺒﻘﺎ ﻝﻠﺒﺭﻨﺎﻤﺞ ﺍﻝﻤﺨﺘﺎﺭ ﻭﺒﺎﻝﺨﻀﻭﻉ ﺇﻝﻰ ﺨﻁﺎﺏ ﻴﺒﻠﻎ ﻋﻥ ﻓﻘﺩ ﺠﻭﺍﺯ ﺍﻝﺴﻔﺭ ﻭﻴﺘﻡ ﺇﻗﺭﺍﺭﻩ ﻤﻥ‬
‫ﺍﻝﺴﻠﻁﺎﺕ ﺍﻝﻤﻨﺎﺴﺒﺔ‪.‬‬
‫‪ 3.2.4.1‬ﺇﺴﺘﺜﻨﺎﺀﺍﺕ ﺨﺎﺼﺔ‬
‫ﺤﺠﺯ ﺠﻭﺍﺯ ﺍﻝﺴﻔﺭ ﻤﻥ ﻗﺒل ﺃﻱ ﺴﻠﻁﺎﺕ‬
‫ﻓﻲ ﺤﺎﻝﺔ ﻗﺎﺒﻠﻴﺔ ﺘﻌﻭﻴﺽ ﺍﻝﺨﺴﺎﺭﺓ ﺒﻤﻭﺠﺏ ﺘﺄﻤﻴﻥ ﺃﺨﺭ ﺃﻭ ﻗﺎﺒﻠﻴﺔ ﺘﻌﻭﻴﻀﻬﺎ ﻤﻥ ﻤﺼﺩﺭ ﺁﺨﺭ‪.‬‬
‫‪ 3.2.5‬ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ‬
‫ﺘﻘﺩﻡ ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﺨﺩﻤﺎﺕ ﻤﺴﺎﻋﺩﺓ ﻓﻲ ﺤﺎﻝﺔ ﺍﻝﻁﻭﺍﺭﺉ ﻭﺘﺸﻤل ﺍﻝﺨﺩﻤﺎﺕ ﺍﻝﻁﺒﻴﺔ ﻭﺍﻝﻔﻨﻴﺔ ﻭﺍﻝﻌﺎﻤﺔ ﺍﻝﻭﺍﺭﺩﺓ ﻓﻴﻤﺎ ﻴﻠﻲ‪ .‬ﻭﻴﻤﻜﻥ ﻝﻸﺸﺨﺎﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻬﻡ ﺍﻻﺘـﺼﺎل‬
‫ﺒﺈﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﻋﻠﻰ ﺭﻗﻡ ‪:‬‬
‫‪ +1 817 826 7276‬ﻋﻠﻰ ﻤﺩﺍﺭ ﺍﻝـ ‪ 24‬ﺴﺎﻋﺔ ﻴﻭﻤﻴﺎ‪.‬‬
‫‪ 3.2.5.1‬ﺍﻝﺨﺩﻤﺎﺕ ﺍﻝﻁﺒﻴﺔ‪:‬‬
‫ﺍﻹﺤﺎﻝﺔ ﺍﻝﻁﺒﻴﺔ ‪ :‬ﺴﻭﻑ ﺘﻘﺩﻡ ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﺇﻝﻰ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺍﺴﻡ ﻭﻋﻨﻭﺍﻥ ﻭﺭﻗﻡ ﻫﺎﺘﻑ ﻭﺴﺎﻋﺎﺕ ﻋﻤل ﻭﻤﺴﺎﻋﺩﺓ ﺘﺭﺠﻤﺔ ﻝﻐـﺔ ﺍﻨﺠﻠﻴﺯﻴـﺔ ﻝﻠﻤﻬﻨﻴـﻴﻥ‬
‫ﺍﻝﻌﺎﻤﻠﻴﻥ ﻓﻲ ﻤﺠﺎل ﺍﻝﻌﻨﺎﻴﺔ ﺍﻝﻁﺒﻴﺔ ﻭﺍﻝﺼﺤﻴﺔ ﻓﻲ ﺃﻱ ﻤﻜﺎﻥ ﻓﻲ ﺠﻤﻴﻊ ﺃﻨﺤﺎﺀ ﺍﻝﻌﺎﻝﻡ ﻴﺘﻡ ﻁﻠﺒﻬﻡ ﺒﺸﻜل ﻤﻌﻘﻭل ﻤﻥ ﻗﺒل ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪ :‬ﺍﻷﻁﺒﺎﺀ ﻭﺍﻝﻤﺴﺘـﺸﻔﻴﺎﺕ‬
‫ﻭﺴﻴﺎﺭﺍﺕ ﺍﻹﺴﻌﺎﻑ‪ ،‬ﻭﻏﻴﺭﻫﺎ ﻤﻥ ﺍﻝﺨﺩﻤﺎﺕ ﺍﻝﻁﺒﻴﺔ ﺍﻝﻁﺎﺭﺌﺔ )ﺒﺸﻜل ﺠﻤﺎﻋﻲ‪ ،‬ﻤﻘﺩﻤﻲ ﺍﻝﺨﺩﻤﺎﺕ ﺍﻝﻁﺒﻴﺔ(‪ .‬ﻭﻜﻠﻤﺎ ﺤﺼﻠﺕ ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﻋﻠﻰ ﻤﻌﻠﻭﻤﺎﺕ ﻜﺎﻓﻴﺔ ﻝﻠﻘﻴﺎﻡ‬
‫ﺒﺫﻝﻙ‪ ،‬ﻭﺠﺏ ﻋﻠﻴﻬﺎ ﺇﺤﺎﻝﺔ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻻﺜﻨﻴﻥ ﺃﻭ ﺃﻜﺜﺭ ﻤﻥ ﻤﻘﺩﻤﻲ ﺍﻝﺨﺩﻤﺎﺕ ﺍﻝﻁﺒﻴﺔ ﺍﻝﻤﺫﻜﻭﺭﻴﻥ‪ ،‬ﻭﺘﺤﺩﻴﺩ ﺍﻝﻤﻭﺍﻋﻴﺩ ﻭﺍﻝﺘﺭﺠﻤﺔ ﺇﺫﺍ ﻝﺯﻡ ﺍﻷﻤﺭ‪ ،‬ﻭﺍﻝﺘﻨﺴﻴﻕ ﻤﻊ‬
‫ﺸﺭﻜﺔ ﺍﻝﺘﺄﻤﻴﻥ ﺍﻝﻁﺒﻲ ﺍﻷﺴﺎﺴﻴﺔ ﻝﻠﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ‪ .‬ﺘﻘﻭﻡ ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﺒﺎﺴﺘﺨﺩﺍﻡ ﺃﻓﻀل ﺠﻬﻭﺩﻫﺎ ﺍﻝﻤﻌﻘﻭﻝﺔ ﻝﻀﻤﺎﻥ ﺃﻥ ﺍﻹﺤﺎﻝﺔ ﺍﻝﻁﺒﻴﺔ ﺍﻝﺘﻲ ﺘﻘﻭﻡ ﺒﻬﺎ ﻫـﻲ‬
‫ﻝﻤﻘﺩﻤﻲ ﺍﻝﺨﺩﻤﺎﺕ ﺍﻝﻁﺒﻴﺔ ﺍﻝﺫﻴﻥ ﻴﺴﺘﻭﻓﻭﻥ ﺍﻝﻤﻌﺎﻴﻴﺭ ﺍﻝﻤﻬﻨﻴﺔ ﺍﻝﺴﺎﺭﻴﺔ ﻓﻲ ﺍﻝﺒﻠﺩ ﻭﺍﻝﻤﺩﻴﻨﺔ ﺍﻝﺘﻲ ﺘﻘﻊ ﻓﻴﻬﺎ‪ .‬ﻭﺴﻭﻑ ﺘﺒﺫل ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﺃﻓﻀل ﺍﻝﺠﻬﻭﺩ ﻝﻠﺘﻔﺎﻭﺽ ﺍﻝﻤﺴﺒﻕ‬
‫ﻋﻠﻰ ﺭﺴﻭﻡ ﺍﻝﺨﺩﻤﺎﺕ ﻤﻊ ﻤﻘﺩﻤﻲ ﺍﻝﺨﺩﻤﺎﺕ ﺍﻝﻁﺒﻴﺔ‪ ،‬ﻭﺘﻭﺠﻴﻪ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻝﺩﻯ ﺃﻴﻪ ﺃﻱ ﺠﻲ ﻤﻴﺎ ﺍﻝﻤﺤﺩﻭﺩﺓ ﺇﻝﻰ ﻤﻘﺩﻤﻲ ﺍﻝﺨﺩﻤﺔ ﻓـﻲ ﺍﻝـﺸﺒﻜﺔ‪ ،‬ﻭﺘﺭﺘﻴـﺏ‬
‫ﺍﻝﻔﻭﺍﺘﻴﺭ ﻤﺒﺎﺸﺭﺓ ﻤﻊ ﻤﻘﺩﻤﻲ ﺍﻝﺨﺩﻤﺔ ﺍﻝﻁﺒﻴﺔ ﻜﻠﻤﺎ ﻜﺎﻥ ﺫﻝﻙ ﻤﻤﻜﻨﺎ ﻝﺘﻐﻁﻴﺔ ﺍﻝﻨﻔﻘﺎﺕ ﺍﻝﻤﺘﻜﺒﺩﺓ ﻤﻥ ﻗﺒل ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻤﻥ ﺇﻴﻪ ﺃﻱ ﺠﻲ ﻤﻴﺎ ﺍﻝﻤﺤﺩﻭﺩﺓ‪ .‬ﻭﺴـﻭﻑ‬
‫ﺘﺒﺫل ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﻜل ﺠﻬﺩ ﻤﻤﻜﻥ ﻝﺘﻭﻓﻴﺭ ﻤﺭﺠﻊ ﻁﺒﻲ ﻤﺅﻫل ﻓﻲ ﻏﻀﻭﻥ ‪ 24‬ﺴﺎﻋﺔ ﻤﻥ ﺍﻝﻁﻠﺏ ﺍﻷﻭﻝﻲ‪ ،‬ﻭﻝﻜﻥ ﻋﻨﺩﻤﺎ ﻻ ﻴﻜﻭﻥ ﺫﻝﻙ ﻤﻤﻜﻨﺎ‪ ،‬ﻻ ﻴﻤﻜﻥ ﺃﻥ ﺘﻜـﻭﻥ‬
‫ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﻤﺴﺌﻭﻝﺔ ﻋﻥ ﺍﻝﻅﺭﻭﻑ ﺍﻝﺨﺎﺭﺠﺔ ﻋﻥ ﻨﻁﺎﻕ ﺴﻴﻁﺭﺘﻬﺎ‪ .‬ﻭﻓﻲ ﺠﻤﻴﻊ ﺍﻝﺤﺎﻻﺕ‪ ،‬ﺴﻭﻑ ﺘﺨﻁﺭ ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻥ ﻭﻀﻊ ﺍﻝﻁﻠﺏ ﻓﻲ‬
‫ﻏﻀﻭﻥ ﻫﺫﺍ ﺍﻹﻁﺎﺭ ﺍﻝﺯﻤﻨﻲ‪.‬‬
‫ﺍﻝﺩﻓﻊ ﺍﻝﻤﻘﺩﻡ ﻝﻠﻤﺼﺎﺭﻴﻑ ﺍﻝﻁﺒﻴﺔ‪ :‬ﻋﻨﺩﻤﺎ ﻴﻌﺘﺒﺭ ﺫﻝﻙ ﻤﻨﺎﺴﺒﺎ ﻁﺒﻴﺎ‪ ،‬ﺴﻭﻑ ﺘﻘﺩﻡ ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﻤﺎ ﻴﺼل ﺇﻝﻰ ﺍﻝﻤﺒﻠﻎ ﺍﻝﻤﺴﻤﻭﺡ ﺒﻪ ﻓـﻲ ﺍﻝﻭﺜـﺎﺌﻕ ﺍﻝـﺼﺎﺩﺭﺓ ﺇﻝـﻰ‬
‫ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻝﺩﻓﻊ ﺍﻝﻤﺼﺎﺭﻴﻑ ﺍﻝﻁﺒﻴﺔ‪ .‬ﻭﺃﻱ ﺘﻘﺭﻴﺭ ﻤﻥ ﻗﺒل ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﻝﻠﺩﻓﻊ ﺍﻝﻤﻘﺩﻡ ﻝﻬﺫﻩ ﺍﻝﻤﺼﺎﺭﻴﻑ ﺴﻭﻑ ﻴﺴﺘﻨﺩ ﻋﻠﻰ ﺇﺸﻌﺎﺭ ﻭﻤﻭﺍﻓﻘﺔ ﺇﻴـﻪ ﺃﻱ‬
‫ﺠﻲ ﻤﻴﺎ ﺍﻝﻤﺤﺩﻭﺩﺓ ﻋﻠﻴﻬﺎ‪ .‬ﺇﺫﺍ ﻝﻡ ﻴﻜﻥ ﻫﻨﺎﻙ ﺘﻐﻁﻴﺔ‪ ،‬ﺃﻭ ﺇﺫﺍ ﻜﺎﻨﺕ ﺍﻝﺘﻐﻁﻴﺔ ﻏﻴﺭ ﻜﺎﻓﻴﺔ ﺒﻤﻭﺠﺏ ﻭﺜﻴﻘﺔ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪ ،‬ﻓـﺈﻥ ﺃﻱ ﻤـﺼﺎﺭﻴﻑ ﻏﻴـﺭ ﻤﻐﻁـﺎﺓ‬
‫ﻤﺭﺘﺒﻁﺔ ﺒﺎﻝﻤﺼﺎﺭﻴﻑ ﺍﻝﻁﺒﻴﺔ ﻝﻠﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺴﻭﻑ ﺘﻜﻭﻥ ﻤﺴﺅﻭﻝﻴﺔ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻭﺤﺩﻩ ﺃﻭ ﺍﻝﺸﺨﺹ )ﺍﻷﺸﺨﺎﺹ( ﺍﻝﺫﻱ ﻴﺘﺼﺭﻑ ﻨﻴﺎﺒـﺔ ﻋـﻥ‬
‫ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪.‬‬
‫ﻀﻤﺎﻥ ﺭﺴﻭﻡ ﺍﻻﺴﺘﺸﻔﺎﺀ‪ :‬ﻋﻨﺩﻤﺎ ﻴﻌﺘﺒﺭ ﺫﻝﻙ ﻤﻨﺎﺴﺏ ﻁﺒﻴﺎ‪ ،‬ﺴﻭﻑ ﺘﻀﻤﻥ ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﺩﻓﻊ ﺭﺴﻭﻡ ﺍﻻﺴﺘﺸﻔﺎﺀ ﻝﻠﻤﺒﻠﻎ ﺍﻝﻤﺴﻤﻭﺡ ﺒﻪ ﻓﻲ ﻭﺜﻴﻘﺔ ﺍﻝﺸﺨﺹ ﺍﻝﻤـﺅﻤﻥ‬
‫ﻋﻠﻴﻪ ﻋﻥ ﻤﻨﺎﻓﻊ ﺍﻻﺴﺘﺸﻔﺎﺀ‪ .‬ﻭﺍﻱ ﻗﺭﺍﺭ ﻤﻥ ﻗﺒل ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﻝﻀﻤﺎﻥ ﺘﻠﻙ ﺍﻝﻤﺒﺎﻝﻎ ﺴﻭﻑ ﻴﺨﻀﻊ ﺇﻝﻰ ﺍﻝﻤﻭﺍﻓﻘﺔ ﺍﻝﻤﺴﺒﻘﺔ ﻋﻠﻴﻬﺎ ﻤﻥ ﺇﻴﻪ ﺃﻱ ﺠﻲ ﻤﻴﺎ ﺍﻝﻤﺤﺩﻭﺩﺓ ﻭﻓﻘﺎ‬
‫ﻝﻬﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ‪ .‬ﻭﻓﻲ ﺤﺎﻝﺔ ﻭﺠﻭﺩ ﺘﻐﻁﻴﺔ ﺒﻤﻭﺠﺏ ﻭﺜﻴﻘﺔ ﺼﺎﺩﺭﺓ ﺇﻝﻰ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻤﻥ ﺇﻴﻪ ﺃﻱ ﺠﻲ ﻤﻴﺎ ﺍﻝﻤﺤﺩﻭﺩﺓ ‪ ،‬ﻋﻨﺩﺌﺫ ﺴﻭﻑ ﺘﺩﻓﻊ ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﻤﺒﻠﻎ‬
‫ﻴﺼل ﺇﻝﻰ ﺍﻝﺤﺩ ﺍﻷﻗﺼﻰ ﺍﻝﻤﺘﺎﺡ ﺒﻤﻭﺠﺏ ﺍﻝﻭﺜﻴﻘﺔ ﻝﺭﺴﻭﻡ ﺍﻻﺴﺘﺸﻔﺎﺀ‪ .‬ﻭﻓﻲ ﺤﺎﻝﺔ ﻋﺩﻡ ﻭﺠﻭﺩ ﺘﻐﻁﻴﺔ ﺃﻭ ﻋﺩﻡ ﻜﻔﺎﻴﺔ ﺍﻝﺘﻐﻁﻴﺔ ﺒﻤﻭﺠﺏ ﺍﻝﻭﺜﻴﻘﺔ‪ ،‬ﺴـﻭﻑ ﺘﻜـﻭﻥ ﺃﻱ‬
‫ﻤﺼﺎﺭﻴﻑ ﻏﻴﺭ ﻤﻐﻁﺎﺓ ﻤﺭﺘﺒﻁﺔ ﺒﺎﺴﺘﺸﻔﺎﺀ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻤﺴﺅﻭﻝﻴﺔ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻭﺤﺩﻩ ﺃﻭ ﺍﻝﺸﺨﺹ )ﺍﻷﺸﺨﺎﺹ( ﺍﻝﺫﻴﻥ ﻴﻘﻭﻤﻭﻥ ﺒﺎﻝﺘﺼﺭﻑ ﻨﻴﺎﺒﺔ‬
‫ﻋﻥ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‬
‫ﺍﻹﺠﻼﺀ ﺍﻝﻁﺒﻲ‪ :‬ﺴﻭﻑ ﺘﻘﻭﻡ ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﺘﺭﺘﻴﺏ ﻭﺘﻨﺴﻴﻕ ﺍﻹﺠﻼﺀ ﺍﻝﻁﺒﻲ ﻤﻥ ﺨﻼل ﻭﺴﺎﺌل ﺍﻝﻨﻘل ﺍﻝﺠﻭﻱ ﺍﻝﺘﻲ ﺘﺸﻤل ﻭﻻ ﺘﻘﺘﺼﺭ ﻋﻠﻰ ﺍﻝﻨﻘل ﺍﻝﺘﺠﺎﺭﻱ ﺍﻝﺠﻭﻱ ﻤﻊ‬
‫ﺃﻭ ﺒﺩﻭﻥ ﻤﺭﺍﻓﻕ ﻁﺒﻲ‪ ،‬ﺍﻝﻨﻘل ﺒﺎﻹﺴﻌﺎﻑ ﺍﻝﺠﻭﻱ‪ ،‬ﻭ‪/‬ﺃﻭ ﻓﻲ ﺤﺎﻝﺔ ﻤﻼﺌﻤﺔ ﺫﻝﻙ – ﻭﺴﺎﺌل ﺍﻝﻨﻘل ﺍﻷﺨﺭﻯ ﻝﻠﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻤﻥ ﻤﺴﺘﺸﻔﻰ ﺃﺠﻨﺒﻲ ﺃﻭ ﻤﺭﻓﻕ ﺭﻋﺎﻴﺔ‬
‫ﺼﺤﻴﺔ ﺇﻝﻰ ﻤﺴﺘﺸﻔﻰ ﺃﺠﻨﺒﻲ ﺃﻭ ﻤﺭﻓﻕ ﺭﻋﺎﻴﺔ ﺼﺤﻴﺔ ﺃﺨﺭ‪ ،‬ﺃﻭ ﺇﻝﻰ ﻤﺴﺘﺸﻔﻰ ﺃﻭ ﻤﺭﻓﻕ ﺭﻋﺎﻴﺔ ﺼﺤﻴﺔ ﻓﻲ ﺩﻭﻝﺔ ﺇﻗﺎﻤﺔ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪ ،‬ﻋﻨـﺩ ﺍﻋﺘﺒـﺎﺭ‬
‫ﺍﻝﻁﺒﻴﺏ ﺍﻝﻤﺤﺩﺩ ﻤﻥ ﻗﺒل ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﻝﻤﺭﺍﻗﺒﺔ ﻭﻤﻌﺎﻝﺠﺔ ﺤﺎﻝﺔ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﺃﻥ ﻫﺫﺍ ﺍﻹﺠﻼﺀ ﺃﻭ ﺍﻝﻨﻘل ﻀﺭﻭﺭﻱ ﻭﻓﻘﺎ ﻝﺭﺃﻴﻪ ﺍﻝﻤﻬﻨـﻲ‪ .‬ﻭﺴـﻭﻑ ﺘﺒـﺫل ﺇﺩﺍﺭﺓ‬
‫ﺍﻝﻤﺴﺎﻋﺩﺓ ﻗﺼﺎﺭﻯ ﺠﻬﻭﺩﻫﺎ ﻝﻀﻤﺎﻥ ﺃﻥ ﻜﺎﻓﺔ ﺍﻝﺨﺩﻤﺎﺕ ﺍﻝﺘﻲ ﺘﻡ ﺘﺭﺘﻴﺒﻬﺎ ﻜﻤﺎ ﻫﻭ ﻤﺫﻜﻭﺭ ﻴﺘﻡ ﺘﺭﺘﻴﺒﻬﺎ ﻤﻊ ﻤﻘﺩﻤﻲ ﺨﺩﻤﺎﺕ ﻁﺒﻴﺔ ﻤﺴﺘﻭﻓﻭﻥ ﻝﻠﻤﻌﺎﻴﻴﺭ ﺍﻝﻤﻬﻨﻴـﺔ ﺒﺎﻝﺩﻭﻝـﺔ‬
‫)‪© AIG, all rights reserved (V 1.0 – June 20, 2013‬‬
‫ﻭﺍﻝﻤﺩﻨﻴﺔ ﺍﻝﺘﻲ ﻴﻨﺸﺄ ﻤﻨﻬﺎ ﺍﻹﺨﻼﺀ‪ .‬ﻭﺴﻭﻑ ﺘﺩﻓﻊ ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﺍﻝﻤﺼﺎﺭﻴﻑ ﻨﻴﺎﺒﺔ ﻋﻥ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺤﺘﻰ ﺤﺩﻭﺩ ﺍﻝﻭﺜﻴﻘﺔ ﺍﻝﺼﺎﺩﺭﺓ ﻋﻥ ﺇﻴﻪ ﺃﻱ ﺠـﻲ ﻤﻴـﺎ‬
‫ﺍﻝﻤﺤﺩﻭﺩﺓ‪.‬‬
‫ﻤﺭﺍﻗﺒﺔ ﺍﻝﺤﺎﻝﺔ ﺍﻝﻁﺒﻴﺔ‪ :‬ﺒﻌﺩ ﻜﺎﻓﺔ ﺍﻹﺤﺎﻻﺕ ﺍﻝﻁﺒﻴﺔ ﺃﻭ ﺍﻝﻤﺴﺎﻋﺩﺓ ﺍﻷﺨﺭﻯ ﺇﻝﻰ ﺸﺨﺹ ﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺒﺎﻻﺭﺘﺒﺎﻁ ﻤﻊ ﺍﻝﻁﻭﺍﺭﺉ ﺍﻝﻁﺒﻴﺔ‪ ،‬ﺴﻭﻑ ﺘﻘـﻭﻡ ﺇﺩﺍﺭﺓ ﺍﻝﻤـﺴﺎﻋﺩﺓ‬
‫ﺒﻤﺭﺍﻗﺒﺔ ﺍﻝﺤﺎﻝﺔ ﻭﺍﻝﻌﻼﺝ ﺍﻝﻁﺒﻲ ﻝﻠﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺤﺘﻰ ﻴﺘﻡ ﺇﺨﺭﺍﺝ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻤﻥ ﺍﻝﻌﻼﺝ ﺃﻭ ﻴﻌﻭﺩ ﺇﻝﻰ ﺍﻝﻤﻨﺯل‪.‬‬
‫ﻨﻘل ﺍﻝﺠﺜﻤﺎﻥ ﺍﻝﻰ ﺍﻝﻭﻁﻥ ﺍﻷﻡ‪ :‬ﻋﻨﺩ ﺇﺒﻼﻍ ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﺒﻭﻓﺎﺓ ﺃﻱ ﺸﺨﺹ ﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺃﺜﻨﺎﺀ ﺍﻝﺴﻔﺭ‪ ،‬ﺴﻭﻑ ﺘﻘﻭﻡ ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﺒﺎﻝﺘﺤﻘﻕ ﻤﻥ ﺴـﺭﻴﺎﻥ ﺍﻝﺘـﺄﻤﻴﻥ‬
‫ﺍﻝﻭﺍﺠﺏ ﺍﻝﺘﻁﺒﻴﻕ ﻋﻠﻰ ﺍﻝﺠﺜﻤﺎﻥ‪ .‬ﻭﻤﻊ ﻤﺭﺍﻋﺎﺓ ﺃﻱ ﻤﻥ ﺍﻝﻨﻅﻡ ﺍﻝﺤﻜﻭﻤﻴﺔ ‪ ،‬ﺴﻭﻑ ﺘﺴﺎﻋﺩ ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﺃﻴﻀﺎ ﻓﻲ ﺍﺘﺨﺎﺫ ﺍﻝﺘﺭﺘﻴﺒﺎﺕ ﺍﻝﻼﺯﻤﺔ ﻹﻋﺎﺩﺓ ﺠﺜﻤﺎﻥ ﺍﻝـﺸﺨﺹ‬
‫ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺇﻝﻰ ﺍﻝﻤﻜﺎﻥ ﺍﻝﻤﺤﺩﺩ ﻤﻥ ﻗﺒل ﺃﻗﺭﺏ ﺍﻝﻤﻘﺭﺒﻴﻥ ﻝﻠﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪ .‬ﻭﺴﻭﻑ ﺘﺩﻓﻊ ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﻨﻴﺎﺒﺔ ﻋﻥ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺍﻝﻨﻔﻘﺎﺕ ﺍﻝﻤﻌﻘﻭﻝﺔ‬
‫ﺍﻝﺘﻲ ﺘﺼل ﺇﻝﻰ ﺤﺩﻭﺩ ﺍﻝﻭﺜﻴﻘﺔ ﺍﻝﺼﺎﺩﺭﺓ ﻋﻥ ﺇﻴﻪ ﺃﻱ ﺠﻲ ﻤﻴﺎ ﺍﻝﻤﺤﺩﻭﺩﺓ‪ .‬ﻭﺃﻱ ﻨﻔﻘﺎﺕ ﺘﺭﺘﺒﻁ ﺒﻨﻘل ﺠﺜﻤﺎﻥ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺍﻝﻰ ﺍﻝﻭﻁﻥ ﺍﻻﻡ ﺘﺘﺠـﺎﻭﺯ ﺍﻝﻤﺒﻠـﻎ‬
‫ﺍﻝﻤﺘﺎﺡ ﻤﻥ ﺨﻼل ﺍﻝﺘﺄﻤﻴﻥ ﺴﻭﻑ ﺘﻜﻭﻥ ﻤﺴﺌﻭﻝﻴﺔ ﺍﻝﺸﺨﺹ ﺍﻝﺫﻱ ﻴﺘﺼﺭﻑ ﻨﻴﺎﺒﺔ ﻋﻥ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺍﻝﻤﺘﻭﻓﻰ ﻭﺤﺩﻩ‪.‬‬
‫ﺘﻨﺴﻴﻕ ﺍﻝﺘﺄﻤﻴﻥ‪/‬ﺍﻝﻤﻁﺎﻝﺒﺎﺕ‪ :‬ﻓﻲ ﺃﻱ ﻤﻥ ﺍﻝﺤﺎﻻﺕ ﺍﻝﻁﺒﻴﺔ ﺍﻝﻁﺎﺭﺌﺔ ‪ ،‬ﺴﻭﻑ ﻴﺘﻡ ﺍﻝﺘﻌﺎﻤل ﻤﻊ ﺍﻻﺘﺼﺎﻻﺕ ﻭﻤﻭﺍﻀﻴﻊ ﺘﻘﺩﻴﻡ ﺍﻝﻁﻠﺒﺎﺕ ﺒـﻴﻥ ﻤـﺯﻭﺩﻭ ﺨـﺩﻤﺎﺕ ﺍﻝﺘـﺄﻤﻴﻥ‬
‫ﻭﺸﺭﻜﺎﺕ ﺍﻝﺘﺄﻤﻴﻥ ﻷﻱ ﻤﻥ ﺍﻷﺸﺨﺎﺹ ﺍﻝﻤﺅﻤﻥ ﻝﻬﻡ ﻭﺫﻝﻙ ﺒﻬﺩﻑ ﺘﺴﻭﻴﺔ ﺴﺩﺍﺩ ﺍﻝﻤﺼﺭﻭﻓﺎﺕ ﺍﻝﻁﺒﻴﺔ‪.‬‬
‫ﺍﻝﺨﺩﻤﺎﺕ ﺍﻝﻔﻨﻴﺔ‪:‬‬
‫ﺍﻝﺤﻘﺎﺌﺏ ﻭﺍﻷﻤﺘﻌﺔ ﺍﻝﺸﺨﺼﻴﺔ ﺍﻝﻤﻔﻘﻭﺩﺓ‪/‬ﺍﻝﻤﺴﺭﻭﻗﺔ‪ :‬ﻴﻤﻜﻥ ﻝﻠﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺍﻝﺫﻱ ﻴﻔﻘﺩ ﺤﻘﺎﺌﺒﻪ ﺃﻭ ﺃﻤﺘﻌﺘﻪ ﺍﻝﺸﺨﺼﻴﺔ ﺃﻭ ﻴﺘﻡ ﺴـﺭﻗﺘﻬﺎ ﺘﻭﻗـﻊ ﺍﻝﻤـﺴﺎﻋﺩﺓ ﻤـﻥ‬
‫ﺍﻝﺴﻠﻁﺎﺕ ﻭﺍﻝﺩﻭﺍﺌﺭ ﺍﻝﻤﺤﻠﻴﺔ‪ .‬ﻭﺴﻭﻑ ﺘﻘﻭﻡ ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﺒﺎﻝﺘﻨﺴﻴﻕ ﻤﻊ ﺍﻝﻨﺎﻗل ﺍﻝﻌﺎﻡ ﻝﺘﺤﺩﻴﺩ ﻤﻜﺎﻥ ﻭﺍﺴﺘﺭﺩﺍﺩ ﺍﻝﺤﻘﺎﺌﺏ ﺍﻝﻤﻔﻘﻭﺩﺓ ﺃﻭ ﺍﻝﻤﺴﺭﻭﻗﺔ‪ ،‬ﺍﻝﺫﻱ ﻴﺸﻤل ﺍﺴﺘﺨﺩﺍﻡ‬
‫ﻜﺎﻓﺔ ﺃﻨﻅﻤﺔ ﺍﻝﺘﺘﺒﻊ ﺍﻝﻤﺘﺎﺤﺔ ﻭﺍﻝﺘﻨﺴﻴﻕ – ﻨﻴﺎﺒﺔ ﻋﻥ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪ -‬ﻤﻊ ﻭﺴﺎﺌل ﺍﻝﻨﻘل ﻭﺍﻝﻤﻁﺎﺭﺍﺕ ﻭﺍﻝﻔﻨﺎﺩﻕ ﻭﺍﻝﺴﻠﻁﺎﺕ ﺍﻝﺤﻜﻭﻤﻴﺔ ﻭﺍﻵﺨﺭﻴﻥ ‪ .‬ﻜﻤﺎ ﺴـﻭﻑ‬
‫ﺘﻘﻭﻡ ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﺃﻴﻀﺎ ﺒﺘﻨﺴﻴﻕ ﺍﻝﺘﺭﺘﻴﺒﺎﺕ ﻝﻤﺴﺎﻋﺩﺓ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻓﻲ ﺘﻨﻔﻴﺫ ﻜﺎﻓﺔ ﻤﻁﺎﻝﺒﺎﺕ ﺍﻝﺘﺄﻤﻴﻥ ﺍﻝﻨﺎﺘﺠﺔ ﻋﻥ ﺍﻝﺤﻘﺎﺌﺏ ﺍﻝﻤﻔﻘﻭﺩﺓ‪.‬‬
‫ﻭﺜﺎﺌﻕ‪/‬ﺘﺫﺍﻜﺭ ﺍﻝﺴﻔﺭ ﺍﻝﻤﻔﻘﻭﺩﺓ‪/‬ﺍﻝﻤﺴﺭﻭﻗﺔ‪ :‬ﻓﻲ ﺤﺎﻝﺔ ﻓﻘﺩﺍﻥ ﺃﻭ ﺴﺭﻗﺔ ﻭﺜﺎﺌﻕ ﺍﻝﺴﻔﺭ ﺍﻝﺸﺨﺼﻴﺔ ﺍﻝﺨﺎﺼﺔ ﺒﺄﻱ ﻤﺴﺎﻓﺭ‪ ،‬ﻴﻤﻜﻥ ﻝﻠﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺘﻭﻗـﻊ ﺍﻝﺤـﺼﻭل‬
‫ﻋﻠﻰ ﻤﺴﺎﻋﺩﺓ ﻝﻠﺤﺼﻭل ﻋﻠﻰ ﻭﺜﺎﺌﻕ ﺒﺩﻴﻠﺔ ﻭﺇﻝﻐﺎﺀ ﺍﻝﻭﺜﺎﺌﻕ ﺍﻷﺼﻠﻴﺔ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻝﻙ ﺍﻝﻘﻴﺎﻡ ﺒﺎﻝﺤﺠﻭﺯﺍﺕ ﺍﻝﺒﺩﻴﻠﺔ ﻭﺘﺭﺘﻴﺏ ﺍﻝﺤﺼﻭل ﻋﻠﻰ ﺘﺫﺍﻜﺭ ﻁﻴﺭﺍﻥ‪/‬ﻗﻁﺎﺭ ﺒﺩﻴﻠﺔ ﻋﻨـﺩ‬
‫ﺍﻝﻀﺭﻭﺭﺓ‪ .‬ﻭﺴﻭﻑ ﺘﺒﺫل ﺇﺩﺍﺭﺓ ﺍﻝﻤﺴﺎﻋﺩﺓ ﺃﻓﻀل ﺠﻬﺩﻫﺎ ﻝﻤﺴﺎﻋﺩﺓ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻓﻲ ﺘﺤﺩﻴﺩ ﻤﻭﻗﻊ ﺍﻝﻭﺜﺎﺌﻕ ﺍﻝﻤﻔﻘﻭﺩﺓ )ﻭﺘﺸﻤل ﻋﻠﻰ ﺴﺒﻴل ﺍﻝﻤﺜﺎل ﻻ ﺍﻝﺤـﺼﺭ‬
‫ﺠﻭﺍﺯﺍﺕ ﺍﻝﺴﻔﺭ ﻭﺍﻝﺘﺄﺸﻴﺭﺍﺕ ﺍﻝﻤﻔﻘﻭﺩﺓ(‪ ،‬ﻭﺒﻨﺎﺀ ﻋﻠﻰ ﺍﻝﻁﻠﺏ‪ ،‬ﺍﺴﺘﺒﺩﺍل ﻫﺫﻩ ﺍﻝﻭﺜﺎﺌﻕ ﻤﻥ ﺨﻼل ﺘﺤﺩﻴﺩ ﻭﺍﻻﺘﺼﺎل ﺒﺎﻝﻬﻴﺌﺎﺕ ﺍﻝﺤﻜﻭﻤﻴﺔ ﺍﻝﻤﻨﺎﺴـﺒﺔ‪ ،‬ﻭﺠﻤـﻊ ﺍﻝﻤﻌﻠﻭﻤـﺎﺕ‬
‫ﺍﻝﻼﺯﻤﺔ ﻭﺨﻼﻑ ﺫﻝﻙ ﺍﺘﺨﺎﺫ ﻜﺎﻓﺔ ﺍﻝﺨﻁﻭﺍﺕ ﺍﻝﻀﺭﻭﺭﻴﺔ ﻝﺘﺴﻬﻴل ﺍﺴﺘﺒﺩﺍل ﺍﻝﻭﺜﺎﺌﻕ ﺍﻝﻤﻔﻘﻭﺩﺓ ﺒﺄﺴﻠﻭﺏ ﻓﻌﺎل ﻭﻓﻲ ﺍﻝﻭﻗﺕ ﺍﻝﻤﺤﺩﺩ‪.‬‬
‫ﺍﻝﺨﺩﻤﺎﺕ ﺍﻝﻌﺎﻤﺔ‬
‫ﻭﺜﺎﺌﻕ ﺍﻝﺴﻔﺭ ‪ :‬ﺘﻘﺩﻴﻡ ﺍﻝﻨﺼﺢ ﺒﺸﺄﻥ ﺸﺭﺍﺀ ﻭﺜﺎﺌﻕ ﺍﻝﺴﻔﺭ ﻭﻤﺘﻁﻠﺒﺎﺕ ﺠﻭﺍﺯ ﺍﻝﺴﻔﺭ‪/‬ﺍﻝﺘﺄﺸﻴﺭﺍﺕ ﻭﺍﻝﻘﻴﻭﺩ ﻭﺍﻝﻠﻭﺍﺌﺢ ﺍﻝﺠﻤﺭﻜﻴﺔ ﻋﻠﻰ ﺍﻝﺩﺨﻭل‪ /‬ﺍﻝﺨﺭﻭﺝ‪.‬‬
‫ﺍﻝﺘﺤﺼﻴﻨﺎﺕ ﺍﻝﻁﺒﻴﺔ ‪ :‬ﺘﻘﺩﻴﻡ ﺍﻝﻨﺼﺢ ﺒﺸﺄﻥ ﺍﻝﺘﺤﺼﻴﻨﺎﺕ ﺍﻝﻁﺒﻴﺔ ﺍﻝﻼﺯﻤﺔ ﻝﻠﺭﺤﻠﺔ ﻭﺍﻝﻤﻌﻠﻭﻤﺎﺕ ﺒﺸﺄﻥ ﺍﻝﺘﺤﺫﻴﺭﺍﺕ ﺍﻝﻁﺒﻴﺔ ﺍﻝﻤﺤﻠﻴﺔ ﻭﺍﻷﻭﺒﺌﺔ ﻭﺍﻝﺘﺩﺍﺒﻴﺭ ﺍﻝﻭﻗﺎﺌﻴﺔ ﺍﻝﻤﺘﺎﺤﺔ‬
‫ﺍﻝﻌﻤﻠﺔ ﻭﻤﻭﺍﻗﻊ ﺃﺠﻬﺯﺓ ﺍﻝﺼﺭ‪‬ﺍﻑ ﺍﻵﻝﻲ ‪ :‬ﺘﺘﻭﻓﺭ ﺃﺴﻌﺎﺭ ﺘﻐﻴﻴﺭ ﺍﻝﻌﻤﻼﺕ ﻭﻜﺫﻝﻙ ﺍﻝﻤﻌﻠﻭﻤﺎﺕ ﺒﺸﺄﻥ ﺇﺠﺎﺯﺍﺕ ﺍﻝﺒﻨﻭﻙ‪ /‬ﺍﻝﺤﻜﻭﻤﺔ ﺍﻝﻤﺤﻠﻴﺔ‪.‬‬
‫ﺍﻝﻁﻘﺱ ﺍﻝﻌﺎﻝﻤﻲ‪ :‬ﺘﻭﻗﻌﺎﺕ ﺍﻝﻁﻘﺱ ﺍﻝﻌﺎﻡ ﻭﺘﻭﻗﻌﺎﺕ ﺠﻭﻴﺔ ﺤﺩﻴﺜﺔ ﻝﻠﻭﺠﻬﺎﺕ ﺍﻝﻤﺤﻠﻴﺔ ﻭﺍﻝﺩﻭﻝﻴﺔ‪.‬‬
‫ﺘﺭﺠﻤﺔ ﻋﺒﺭ ﺍﻝﻬﺎﺘﻑ ﻝﻠﺤﺎﻻﺕ ﺍﻝﻁﺒﻴﺔ ﺍﻝﻁﺎﺭﺌﺔ‪ :‬ﻝﻠﻤﺴﺎﻓﺭﻴﻥ ﻓﻲ ﺃﻱ ﻤﻥ ﺍﻝﺤﺎﻻﺕ ﺍﻝﻁﺒﻴﺔ ﺍﻝﻁﺎﺭﺌﺔ ﺍﻝﺫﻴﻥ ﻻ ﻴﺘﺤﺩﺜﻭﻥ ﺍﻝﻠﻐﺔ ﺍﻝﻤﺤﻠﻴﺔ‪ ،‬ﻴﺘﻡ ﺘﻭﻓﻴﺭ ﻤﺴﺘـﺸﺎﺭﻴﻥ ﻤﺘﻌـﺩﺩﻱ‬
‫ﺍﻝﻠﻐﺎﺕ ‪ 24‬ﺴﺎﻋﺔ ﻓﻲ ﺍﻝﻴﻭﻡ‪ 7 ،‬ﺃﻴﺎﻡ ﻓﻲ ﺍﻷﺴﺒﻭﻉ‪ ،‬ﻝﻠﺘﺭﺠﻤﺔ ﻋﺒﺭ ﺍﻝﻬﺎﺘﻑ‪.‬‬
‫ﺍﻻﺴﺘﺜﻨﺎﺀﺍﺕ ﺍﻝﻤﻭﺤﺩﺓ‬
‫ﻝﻥ ﺘﻐﻁﻲ ﺍﻝﺸﺭﻜﺔ ﺍﻝﺨﺴﺎﺭﺓ ﺃﻭ ﺍﻹﺼﺎﺒﺔ ﺃﻭ ﺍﻝﻀﺭﺭ ﺃﻭ ﺍﻝﻤﺴﺅﻭﻝﻴﺔ ﺍﻝﻘﺎﻨﻭﻨﻴﺔ ﺍﻝﻨﺎﺠﻤﺔ ﻋﻥ ﻭﺍﻝﺘﻲ ﻴﺘﻡ ﺍﻝﺘﻌﺭﺽ ﻝﻬﺎ ﺃﻭ ﺘﻨﺸﺄ ﺒﺸﻜل ﻤﺒﺎﺸﺭ ﺃﻭ ﻏﻴﺭ ﻤﺒﺎﺸﺭ ﻋﻥ‪:‬‬
‫ﺍﻝﺤﺭﺏ‪ ،‬ﺍﻝﻐﺯﻭ‪ ،‬ﺃﻋﻤﺎل ﺍﻝﻌﺩﻭ ﺍﻷﺠﻨﺒﻲ‪ ،‬ﺍﻷﻋﻤﺎل ﺍﻝﻌﺩﺍﺌﻴﺔ‪ ،‬ﻭﺍﻝﺤﺭﺏ ﺍﻷﻫﻠﻴﺔ ﻭﺍﻝﺘﻤﺭﺩ ﻭﺍﻝﺜﻭﺭﺓ ﻭﺍﻝﻌﺼﻴﺎﻥ ﻭﺍﻝﻘﻭﺓ ﺍﻝﻌﺴﻜﺭﻴﺔ ﺃﻭ ﺍﻝﻤﻐﺘﺼﺒﺔ‪ ،‬ﻭﺍﻻﻀﻁﺭﺍﺒﺎﺕ ﺍﻝﻌﻤﺎﻝﻴـﺔ‬
‫ﻭﺍﻝﺸﻐﺏ ﻭﺍﻹﻀﺭﺍﺏ ﺃﻭ ﺇﻴﻘﺎﻑ ﺍﻝﻌﻤل ﻝﻠﻀﻐﻁ ﻋﻠﻰ ﺍﻝﻌﻤﺎل‪ .‬ﻭﻤﻊ ﺫﻝﻙ‪ ،‬ﺴﻭﻑ ﻴﺴﺘﻤﺭ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻓﻲ ﺍﺴﺘﺤﻘﺎﻗﻪ ﻝﻠﺘﻐﻁﻴﺔ ﻝﻤﺩﺓ ‪ 7‬ﺃﻴﺎﻡ ﺘﻘﻭﻴﻤﻴﺔ ﻤﻨﺫ ﺒـﺩﺀ‬
‫ﺍﻷﻋﻤﺎل ﺍﻝﻌﺩﺍﺌﻴﺔ ﻓﻲ ﺤﺎﻝﺔ ﺍﻨﻪ ﻓﻭﺠﺊ ﺒﻤﺜل ﻫﺫﻩ ﺍﻷﺤﺩﺍﺙ ﻓﻲ ﺍﻝﺨﺎﺭﺝ ﺒﻘﺩﺭ ﻋﺩﻡ ﻤﺸﺎﺭﻜﺘﻪ ﺍﻝﻔﻌﺎﻝﺔ ﻓﻴﻬﺎ‪.‬‬
‫ﺍﻻﺴﺘﺨﺩﺍﻡ ﺍﻝﻤﺘﻌﻤﺩ ﻝﻠﻘﻭﺓ ﺍﻝﻌﺴﻜﺭﻴﺔ ﻻﻋﺘﺭﺍﺽ ﺃﻭ ﻤﻨﻊ ﺃﻭ ﺘﺨﻔﻴﻑ ﺃﻱ ﻋﻤل ﺇﺭﻫﺎﺒﻲ ﻤﻌﺭﻭﻑ ﺃﻭ ﻴﺸﺘﺒﻪ ﻓﻴﻪ‬
‫ﺃﻱ ﻋﻤل ﺇﺭﻫﺎﺒﻲ ﺃﻭ ﺤﺎﺩﺙ ﺍﻨﻔﺠﺎﺭ ﻗﻨﺒﻠﺔ ﺃﻭ ﺍﻝﺘﻬﺩﻴﺩ ﺒﺫﻝﻙ‬
‫ﺍﺴﺘﺨﺩﺍﻡ ﺃﻭ ﺇﻁﻼﻕ ﺃﻭ ﺘﺴﺭﺏ ﺍﻝﻤﻭﺍﺩ ﺍﻝﻨﻭﻭﻴﺔ ﺍﻝﺘﻲ ﺘﻨﺘﺞ ﺒﺼﻭﺭﺓ ﻤﺒﺎﺸﺭﺓ ﺃﻭ ﻏﻴﺭ ﻤﺒﺎﺸﺭﺓ ﻓﻲ ﺍﻝﺘﺄﻴﻥ‪ ،‬ﻭﺍﻹﺸﻌﺎﻉ ﺃﻭ ﺍﻝﺘﻠﻭﺙ ﻤﻥ ﺨﻼل ﺍﻝﻨﺸﺎﻁ ﺍﻹﺸـﻌﺎﻋﻲ ﻤـﻥ ﺃﻱ‬
‫ﻭﻗﻭﺩ ﻨﻭﻭﻱ ﺃﻭ ﻤﻥ ﻤﻭﺍﺩ ﺍﻷﺴﻠﺤﺔ ﺍﻝﻨﻭﻭﻴﺔ‪ .‬ﻭﻝﻐﺭﺽ ﻫﺫﺍ ﺍﻻﺴﺘﺜﻨﺎﺀ‪ ،‬ﻴﺸﻤل ﺍﻻﺤﺘﺭﺍﻕ ﺃﻱ ﻋﻤﻠﻴﺔ ﺍﻨﺸﻁﺎﺭ ﻨﻭﻭﻱ ﺫﺍﺘﻴﺔ‪.‬‬
‫ﺇﻁﻼﻕ‪ ،‬ﻨﺸﺭ ﺃﻭ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻝﻤﻭﺍﺩ ﺍﻝﻤﺴﺒﺒﺔ ﻝﻼﻤﺭﺍﺽ ﺃﻭ ﺍﻝﻤﻭﺍﺩ ﺍﻝﺒﻴﻭﻝﻭﺠﻴﺔ ﺃﻭ ﺍﻝﻜﻴﻤﻴﺎﺌﻴﺔ ﺍﻝﺴﺎﻤﺔ‬
‫)‪© AIG, all rights reserved (V 1.0 – June 20, 2013‬‬
‫ﺍﻝﺘﻭﺍﺠﺩ ﻓﻲ ﺍﻝﺨﺩﻤﺔ ﺃﻭ ﺍﻝﻭﺍﺠﺏ ﺃﻭ ﺍﻝﺨﻀﻭﻉ ﻝﻠﺘﺩﺭﻴﺏ ﻤﻊ ﺃﻱ ﻗﻭﺓ ﻋﺴﻜﺭﻴﺔ ‪1‬ﺃﻭ ﻗﻭﺓ ﺸﺭﻁﺔ‪ ،‬ﺃﻭ ﻤﻴﻠﻴﺸﻴﺎ ﺃﻭ ﻤﻨﻅﻤﺔ ﺸﺒﻪ ﻋﺴﻜﺭﻴﺔ‬
‫ﺍﻻﻨﺨﺭﺍﻁ ﻓﻲ ﺍﻷﻨﺸﻁﺔ ﺍﻝﻤﻬﻨﻴﺔ ﺘﺤﺕ ﺍﻷﺭﺽ ﺃﻭ ﺍﻝﺘﻲ ﺘﺘﻁﻠﺏ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻝﻤﺘﻔﺠﺭﺍﺕ‬
‫ﺍﻝﺘﻌﺭﺽ ﺍﻝﻤﺘﻌﻤﺩ ﺃﻭ ﺍﻝﻤﻘﺼﻭﺩ ﻝﻠﺨﻁﺭ )ﻤﺎ ﻋﺩﺍ ﻓﻲ ﻤﺤﺎﻭﻝﺔ ﻹﻨﻘﺎﺫ ﺤﻴﺎﺓ ﺇﻨﺴﺎﻥ(‪ ،‬ﺍﻹﺼﺎﺒﺔ ﺍﻝﻤﺘﻌﻤﺩﺓ ﻝﻠﺫﺍﺕ‪ ،‬ﻭﺍﻻﻨﺘﺤﺎﺭ ﺃﻭ ﻤﺤﺎﻭﻝﺔ ﺍﻻﻨﺘﺤﺎﺭ‬
‫ﺍﻨﺘﻬﺎﻙ ﻤﺘﻌﻤﺩ ﻝﻠﻘﺎﻨﻭﻥ ﺍﻝﺠﻨﺎﺌﻲ‬
‫ﺍﻝﺴﻔﺭ ﻋﻥ ﻁﺭﻴﻕ ﺍﻝﺠﻭ ﻋﻠﻰ ﻤﺘﻥ ﻁﺎﺌﺭﺓ ﻤﺭﺨﺼﺔ ﻗﺎﻨﻭﻨﺎ ﻭﺍﻝﺘﻲ ﻴﻌﻤل ﻓﻴﻬﺎ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻜﻁﻴﺎﺭ ﺃﻭ ﺠﺯﺀ ﻤﻥ ﻁﺎﻗﻡ ﺍﻝﻁﺎﺌﺭﺓ‬
‫ﺍﻻﻀﻁﺭﺍﺒﺎﺕ ﺍﻝﻌﻘﻠﻴﺔ ﺒﻤﺎ ﻓﻲ ﺫﻝﻙ‪ ،‬ﻭﻝﻜﻥ ﻻ ﺘﻘﺘﺼﺭ ﻋﻠﻰ ﺍﻀﻁﺭﺍﺒﺎﺕ ﺍﻝﻘﻠﻕ‪ ،‬ﺍﻀﻁﺭﺍﺒﺎﺕ ﺍﻷﻜل‪ ،‬ﺍﻀﻁﺭﺍﺒﺎﺕ ﻨﻔﺴﻴﺔ‪ ،‬ﺍﻀﻁﺭﺍﺒﺎﺕ ﻋﺎﻁﻔﻴﺔ ﻭﺍﻻﻀـﻁﺭﺍﺒﺎﺕ ﻓـﻲ‬
‫ﺍﻝﺸﺨﺼﻴﺔ‪ ،‬ﺍﻀﻁﺭﺍﺒﺎﺕ ﺘﻌﺎﻁﻲ ﺍﻝﻤﺨﺩﺭﺍﺕ‪ ،‬ﻭﺍﻀﻁﺭﺍﺒﺎﺕ ﺠﺴﺩﻴﺔ‪ ،‬ﺍﻀﻁﺭﺍﺒﺎﺕ ﺍﻝﺘﻔﻜﻙ‪ ،‬ﻭﺍﻀﻁﺭﺍﺒﺎﺕ ﻨﻔﺴﻴﺔ ﺠﻨﺴﻴﺔ‪ ،‬ﻭﺍﻀـﻁﺭﺍﺒﺎﺕ ﺍﻝﺘﻜﻴـﻑ‪ ،‬ﻭﺍﻻﻀـﻁﺭﺍﺒﺎﺕ‬
‫ﺍﻝﺫﻫﻨﻴﺔ ﺍﻝﻌﻀﻭﻴﺔ ﻭﺍﻝﺘﺨﻠﻑ ﺍﻝﻌﻘﻠﻲ ﻭﺍﻝﺘﻭﺤﺩ‬
‫ﺍﻝﺤﻤل ﻭﺠﻤﻴﻊ ﺍﻝﻅﺭﻭﻑ ﺫﺍﺕ ﺍﻝﺼﻠﺔ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻝﻙ ﺍﻝﺨﺩﻤﺎﺕ ﻭﺍﻝﻠﻭﺍﺯﻡ ﺫﺍﺕ ﺍﻝﺼﻠﺔ ﻝﺘﺸﺨﻴﺹ ﺃﻭ ﻋﻼﺝ ﺍﻝﻌﻘﻡ ﺃﻭ ﻏﻴﺭﻩ ﻤﻥ ﺍﻝﻤﺸﺎﻜل ﺍﻝﻤﺘﻌﻠﻘﺔ ﺒﻌـﺩﻡ ﺍﻝﻘـﺩﺭﺓ ﻋﻠـﻰ‬
‫ﺍﻹﻨﺠﺎﺏ‪ ،‬ﻭﺘﺤﺩﻴﺩ ﺍﻝﻨﺴل‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻝﻙ ﺍﻹﺠﺭﺍﺀﺍﺕ ﻭﺍﻷﺠﻬﺯﺓ ﺍﻝﺠﺭﺍﺤﻴﺔ‬
‫ﺍﻷﻤﺭﺍﺽ ﺍﻝﺘﻲ ﺘﻨﺘﻘل ﻋﻥ ﻁﺭﻴﻕ ﺍﻻﺘﺼﺎل ﺍﻝﺠﻨﺴﻲ ﻭﺍﻝﺤﺎﻻﺕ ﺍﻝﻤﻌﺭﻭﻓﺔ ﺒﺎﺴﻡ ﺍﻹﻴﺩﺯ ﺃﻭ ﻓﻴﺭﻭﺱ ﻨﻘﺹ ﺍﻝﻤﻨﺎﻋﺔ ﺍﻝﺒﺸﺭﻴﺔ ﻭ ‪ /‬ﺃﻭ ﺃﻱ ﻤﺭﺽ ﺃﻭ ﺤﺎﻝﺔ ﺫﺍﺕ ﺍﻝﺼﻠﺔ ﺒﻤﺎ‬
‫ﻓﻲ ﺫﻝﻙ ﺍﻝﻤﺸﺘﻘﺎﺕ ﻋﻨﻪ ﺃﻭ ﺍﻝﻔﺼﺎﺌل ﺍﻝﻤﺘﻨﻭﻋﺔ ﻝﻪ‪ ،‬ﻤﻬﻤﺎ ﻜﺎﻥ‪ ،‬ﺍﻝﺫﻱ ﻴﺘﻡ ﺍﻜﺘﺴﺎﺒﻪ ﺃﻭ ﺍﻝﺘﺴﺒﺏ ﻓﻴﻪ‪.‬‬
‫ﻤﺘﻼﺯﻤﺔ ﺍﻝﺘﻌﺏ ﺍﻝﻤﺯﻤﻥ ﺃﻭ ﺍﻝﺘﻬﺎﺏ ﺍﻝﺩﻤﺎﻍ ﻭﺍﻝﻨﺨﺎﻉ ﺍﻝﻌﻀﻠﻲ )‪) (ME‬ﺍﻝﻜﺎﺭﺩﻴﻭﻝﻴﺒﻴﻥ ﺍﻷﺠﺴﺎﻡ ﺍﻝﻤﻀﺎﺩﺓ ﺇﻴﺠﺎﺒﻴﺎ ﻝﻤﻀﺎﺩ ﺍﻝﻜﺎﺭﺩﻴﻭﻝﻴﺒﻴﻥ( ﺃﻭ ﺍﻝﻤﺭﺽ ﺍﻝﺫﻱ ﻴﺸﺎﺭ ﺇﻝﻴﻪ‬
‫ﻋﻤﻭﻤﺎ ﺒﺎﺴﻡ ﺃﻨﻔﻠﻭﻨﺯﺍ ﺍﻝﻤﺘﺭﻑ‬
‫ﺃ( ﻴﻜﻭﻥ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺘﺤﺕ ﺘﺄﺜﻴﺭ ﺍﻝﻜﺤﻭل ﺒﺄﻜﺜﺭ ﻤﻥ ﺍﻝﺤﺩ ﺍﻝﻘﺎﻨﻭﻨﻲ ﻝﻠﻜﺤﻭل ﻓﻲ ﺩﻤﻪ ﺃﻭ ﺍﻝﺘﻨﻔﺱ‪ ،‬ﺃﻭ ﺏ( ﻤﻥ ﺨﻼل ﺍﻝﻔﺤﻭﺹ ﺍﻝﻁﺒﻴﺔ ﻴﻜـﻭﻥ ﺍﻝـﺸﺨﺹ‬
‫ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺘﺤﺕ ﺘﺄﺜﻴﺭ ﺍﻝﻤﺨﺩﺭﺍﺕ ﺃﻭ ﺍﻝﻤﺅﺜﺭﺍﺕ ﺍﻝﻌﻘﻠﻴﺔ ﻤﺎ ﻝﻡ ﺘﻜﻥ ﻫﺫﻩ ﺍﻝﻤﺨﺩﺭﺍﺕ ﺃﻭ ﺍﻝﻤﺅﺜﺭﺍﺕ ﺍﻝﻌﻘﻠﻴﺔ ﻤﻭﺼﻭﻓﺔ ﻤﻥ ﻗﺒل ﻁﺒﻴﺏ ﺃﻭ ﻤﺎ ﻝﻡ ﻴﺘﻡ ﻭﺼﻔﻬﺎ ﻭﺘﻨﺎﻭﻝﻬﺎ‬
‫ﻭﻓﻘﺎ ﻝﺘﻭﺠﻴﻬﺎﺕ ﺍﻝﻁﺒﻴﺏ‪ ،‬ﺃﻭ ﺝ( ﺤﺎﺩﺙ ﻴﻘﻊ ﺃﺜﻨﺎﺀ ﻗﻴﺎﺩﻩ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻝﺴﻴﺎﺭﺓ ﻤﻊ ﺃﻜﺜﺭ ﻤﻥ ﺍﻝﺤﺩ ﺍﻝﻘﺎﻨﻭﻨﻲ ﻝﻠﻜﺤﻭل ﻓﻲ ﺩﻤـﻪ ﺃﻭ ﺍﻝﺘـﻨﻔﺱ‪ ،‬ﺃﻭ ﺩ( ﺘﻌـﺎﻁﻲ‬
‫ﺍﻝﻜﺤﻭل ﻭﺇﺩﻤﺎﻥ ﺍﻝﻜﺤﻭل‪ ،‬ﻭﺘﻌﺎﻁﻲ ﺍﻝﻤﺨﺩﺭﺍﺕ‪ ،‬ﻭﺍﻹﺩﻤﺎﻥ ﻋﻠﻰ ﺍﻝﻤﺫﻴﺒﺎﺕ‪ ،‬ﻭﺃﺤﻭﺍل ﺘﻌﺎﻁﻲ ﺍﻝﻤﺨﺩﺭﺍﺕ ﺃﻭ ﺍﻹﺩﻤﺎﻥ ﻤﻥ ﺃﻱ ﻨﻭﻉ‬
‫)ﺃ( ﺃﻱ ﺤﺎﻝﺔ ﻁﺒﻴﺔ ﻤﻭﺠﻭﺩﺓ ﻤﻥ ﻗﺒل‪ ،‬ﺃﻭ )ﺏ( ﺃﻱ ﻤﺭﺽ ﻝﻸﻭﻋﻴﺔ ﺍﻝﺩﻤﻭﻴﺔ ﺃﻭ ﺍﻷﻭﻋﻴﺔ ﺍﻝﺩﻤﻭﻴﺔ ﺍﻝﺩﻤﺎﻏﻴﺔ ﺃﻭ ﻤﺭﺽ ﺍﻷﻭﻋﻴﺔ ﺍﻝﺩﻤﻭﻴﺔ ﺍﻝﻘﻠﺒﻴﺔ ﺃﻭ ﺃﻤﺭﺍﺽ ﺍﻝﻘﻠـﺏ ﺃﻭ‬
‫ﺃﻭﻀﺎﻉ ﺃﻭ ﻋﻘﺎﺒﻴل ﺃﻭ ﺍﻝﻤﻀﺎﻋﻔﺎﺕ ﺍﻝﺘﻲ ﺘﻜﻭﻥ‪ ،‬ﻓﻲ ﺭﺃﻱ ﻁﺒﻴﺏ ﺘﻌﻴﻨﻪ ﺍﻝﺸﺭﻜﺔ‪ ،‬ﻤﺘﻌﻠﻘﺔ ﺒﺫﻝﻙ ﺒﺸﻜل ﻤﻌﻘﻭل‪ ،‬ﺇﺫﺍ ﺤﺼل ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻋﻠـﻰ ﺍﻹﺴﺘـﺸﺎﺭﺓ‬
‫ﺍﻝﻁﺒﻴﺔ ﺃﻭ ﺍﻝﻌﻼﺝ )ﺒﻤﺎ ﻓﻲ ﺫﻝﻙ ﺍﻝﺩﻭﺍﺀ( ﻻﺭﺘﻔﺎﻉ ﻀﻐﻁ ﺍﻝﺩﻡ ﻗﺒل ﺴﻨﺘﻴﻥ ﻤﻥ ﺒﺩﺀ ﺍﻝﺭﺤﻠﺔ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻬﺎ‬
‫ﺍﻝﺸﺫﻭﺫ ﺍﻝﺨﻠﻘﻲ ﻭﺍﻷﻭﻀﺎﻉ ﺍﻝﻨﺎﺸﺌﺔ ﺃﻭ ﺍﻝﻨﺎﺘﺠﺔ ﻋﻨﻬﺎ ﻭﺍﻝﻔﺘﻕ‬
‫ﺍﻝﺘﺤﻠﻴﻕ ﺒﺄﻱ ﻁﺎﺌﺭﺓ ﻴﺘﻡ ﺍﻤﺘﻼﻜﻬﺎ ﺃﻭ ﺍﺴﺘﺌﺠﺎﺭﻫﺎ ﺃﻭ ﺘﺸﻐﻴﻠﻬﺎ ﻨﻴﺎﺒﺔ ﻋﻥ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺃﻭ ﺃﻱ ﻓﺭﺩ ﻤﻥ ﺃﻓﺭﺍﺩ ﺃﺴﺭﺓ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪.‬‬
‫ﺴﻔﺭ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺨﻼﻓﹰﺎ ﻝﻠﻨﺼﻴﺤﺔ ﺍﻝﻁﺒﻴﺔ ﺃﻭ ﻁﻠﺏ ﺍﻝﻌﻨﺎﻴﺔ ﺍﻝﻁﺒﻴﺔ ﺃﻭ ﺍﻝﻤﺸﻭﺭﺓ ﺃﻭ ﺤﺎﻝﺔ ﻤﺅﺩﻴﺔ ﺇﻝﻰ ﺍﻝﻭﻓﺎﺓ ﺘﻡ ﺘﺸﺨﻴﺼﻬﺎ ﻗﺒل ﺭﺤﻠـﺔ ﺍﻝﻤـﺅﻤﻥ ﻋﻠﻴـﻪ ﺃﻭ‬
‫ﻋﻨﺩﻤﺎ ﻻ ﻴﺼﻠﺢ ﻝﻠﻘﻴﺎﻡ ﺒﺫﻝﻙ‪.‬‬
‫ﺃ( ﺍﻝﻭﻅﻴﻔﺔ ﺍﻝﺘﻲ ﺘﻨﻁﻭﻱ ﻋﻠﻰ ﺍﻝﻌﻤل ﺍﻝﻴﺩﻭﻱ‪ ،‬ﺒﺨﻼﻑ ﺨﺎﺭﺝ ﺍﻝﻌﻤل ﺃﻭ ﺏ( ﺍﻝﺘﻭﻅﻴﻑ ﻋﻠﻰ ﺃﺴﺎﺱ ﺩﺍﺌﻡ ﺃﻭ ﺃﺴﺎﺱ ﻋﻘﺩ ﺍﻝﺫﻱ ﻻ ﻴﻜـﻭﻥ ﻋـﺎﺭﺽ‪ ،‬ﺒﺨـﻼﻑ ﺃﺜﻨـﺎﺀ‬
‫ﺍﻝﻭﺠﻭﺩ ﻓﻲ ﺭﺤﻠﺔ ﺘﺭﻓﻴﻬﻴﺔ‬
‫ﺃ( ﺍﻝﻤﺸﺎﺭﻜﺔ ﻓﻲ ﺃﻱ ﺭﻴﺎﻀﺔ ﻜﻼﻋﺏ ﻤﺤﺘﺭﻑ ﺃﻭ )ﺏ( ﺍﻷﻨﺸﻁﺔ ﺍﻝﺭﻴﺎﻀﻴﺔ ﺍﻝﻤﺩﺭﺴﻴﺔ )ﻤﺎ ﻝﻡ ﻴﺘﻡ ﺇﺼﺩﺍﺭ ﻤﻠﺤﻕ ﻭﻓﺭﺽ ﻗﺴﻁ ﺘﺄﻤﻴﻥ ﺇﻀﺎﻓﻲ ﻭﺍﻋﺘﻤﺎﺩ ﺫﻝـﻙ ﻤـﻥ‬
‫ﺍﻝﺸﺭﻜﺔ ﻭﺩﻓﻌﻪ ﻤﻥ ﻗﺒل ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ(‪.‬‬
‫ﺃﻱ ﻤﻤﺎﺭﺴﺎﺕ ﻭﺭﻴﺎﻀﺔ ﺃﻭ ﺃﻨﺸﻁﺔ ﺨﻁﺭﺓ ﺘﻘﺩﻡ ﺃﻭ ﺘﺯﻴﺩ ﻤﻥ ﺇﻤﻜﺎﻨﻴﺔ ﺍﻝﺨﺴﺎﺭﺓ ﻋﻠﻰ ﺴﺒﻴل ﺍﻝﻤﺜﺎل ﻻ ﺍﻝﺤﺼﺭ ﺍﻻﻨﺨﺭﺍﻁ ﻓﻲ ﺭﻴﺎﻀﺔ ﺍﻝـﺩﺭﺍﺠﺎﺕ ﺍﻝﺒﺨﺎﺭﻴـﺔ )ﺤﻴـﺙ‬
‫ﻴﺘﺠﺎﻭﺯ ﻗﺩﺭﺓ ﺍﻝﻤﺤﺭﻙ ‪ CC200‬ﺃﻭ ﺩﻭﺭﺓ ﺘﺤﺕ ﺴﻴﻁﺭﺓ ﺴﺎﺌﻕ ﻏﻴﺭ ﻤﺭﺨﺹ(‪ ،‬ﺍﻝﻤﻁﺎﺭﺩﺍﺕ‪ ،‬ﺃﻭ ﻝﻌﺒﺔ ﺍﻝﺒﻭﻝﻭ ﻭﺭﻜﻭﺏ ﺍﻝﺨﻴل‪ ،‬ﻭﺍﻝﺼﻴﺩ‪ ،‬ﻭﺍﻝﻘﻔﺯ ﺒﺎﻝﺤﺒﺎل‪ ،‬ﻭﺍﻝﻬﺒﻭﻁ ﻤﻥ‬
‫ﻗﻤﻡ ﺍﻝﺠﺒﺎل‪ ،‬ﻭﺭﻜﻭﺏ ﺍﻝﺭﻤﺙ ﺒﺎﻝﻤﻴﺎﻩ ﺍﻝﺒﻴﻀﺎﺀ‪ ،‬ﺍﻝﻤﺸﻲ ﻝﻤﺴﺎﻓﺎﺕ ﻁﻭﻴﻠﺔ )ﻤﺎ ﻝﻡ ﻴﻜﻥ ﻤﺼﺤﻭﺒﺎ ﺒﻤﺭﺸﺩ ﻤﻌﺘﺭﻑ ﺒﻪ ﺃﻭ ﻋﻠﻰ ﻤﻌﺭﻓﺔ ﺒﺸﻜل ﻭﺍﻀﺢ ﺒﺎﻝﻁﺭﻴﻕ(‪ ،‬ﻭﺘﺴﻠﻕ‬
‫ﺍﻝﺠﺒﺎل ﺍﻝﺫﻱ ﻴﺘﻁﻠﺏ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻝﺤﺒﺎل ﺃﻭ ﺍﻝﻤﻌﺩﺍﺕ‪ ،‬ﻭﺍﻝﻐﻭﺹ )ﻤﺎ ﻝﻡ ﻴﻜﻥ ﻤﺭﺨﺼﺔ ﺃﻭ ﻤﺼﺤﻭﺒﺎ ﺒﻤﺩﺭﺏ ﻤﺅﻫل(‪ ،‬ﻭﺍﻝﻘﺘﺎل )ﺇﻻ ﻓﻲ ﺍﻝﻨﻴﺔ ﺍﻝﺤﺴﻨﺔ ﻝﻠﺩﻓﺎﻉ ﻋﻥ ﺍﻝﻨﻔﺱ(‪،‬‬
‫ﻭﺍﻝﺴﺒﺎﻕ )ﻋﺩﺍ ﺴﻴﺭﺍ ﻋﻠﻰ ﺍﻷﻗﺩﺍﻡ ﺃﻭ ﺍﻝﺴﺒﺎﻕ ﺍﻝﺸﺭﺍﻋﻲ ﻓﻲ ﺍﻝﻤﻴﺎﻩ ﺍﻝﺩﺍﺨﻠﻴﺔ(‪ ،‬ﻜﻭﻨﻪ ﻋﻀﻭ ﻓﻲ ﻁﺎﻗﻡ ﻋﻠﻰ ﻤﺘﻥ ﺴﻔﻴﻨﺔ ﺃﻭ ﻗﺎﺭﺏ ﻴﺴﺎﻓﺭ ﻤﻥ ﺒﻠﺩ ﺇﻝـﻰ ﺁﺨـﺭ‪ ،‬ﺴـﺒﺎﻕ‬
‫ﺍﻝﺴﺭﻋﺔ ﺃﻭ ﺴﺒﺎﻗﺎﺕ ﺍﻝﺘﺤﻤل ﺃﻭ ﺍﻝﺘﺩﺭﻴﺒﺎﺕ ﻋﻠﻴﻬﺎ )ﻋﺩﺍ ﺃﻝﻌﺎﺏ ﺍﻝﻘﻭﻯ(‪ ،‬ﺃﻭ ﺍﻝﺘﺩﺭﻴﺏ ﻋﻠﻴﻬﺎ ﺃﻭ ﺍﻻﻨﺨﺭﺍﻁ ﻓﻲ ﺭﻴﺎﻀﺎﺕ ﺘﺘﻁﻠﺏ ﺍﻻﺤﺘﻜـﺎﻙ ﺍﻝﺠـﺴﺩﻱ ﺤﻴـﺙ ﻴﻜـﻭﻥ‬
‫ﺍﻻﺘﺼﺎل ﺍﻝﺠﺴﺩﻱ ﺒﻴﻥ ﺍﻝﻼﻋﺒﻴﻥ ﺠﺯﺀﺍ ﻤﻘﺒﻭﻻ ﻤﻥ ﺍﻝﻠﻌﺏ ﻭ ﺍﻝﺘﺯﻝﺞ ﻭﺍﻝﺘﺯﺤﻠﻕ ﻋﻠﻰ ﺍﻷﺭﺽ‪ ،‬ﺍﻝﺘﺯﻝﺞ ﺍﻷﺤﺎﺩﻱ‪ ،‬ﺍﻝﺘﺯﻝﺞ ﻋﺒـﺭ ﺍﻝﺩﻭﻝـﺔ‪ ،‬ﺍﻝﺘـﺯﻝﺞ ﻋﺒـﺭ ﻁـﺎﺌﺭﺍﺕ‬
‫ﺍﻝﻬﻠﻴﻜﻭﺒﺘﺭ‪ ،‬ﺍﻝﺘﺯﻝﺞ ﺨﺎﺭﺝ ﺍﻝﺯﺤﻠﻘﺔ )ﻓﻘﻁ ﻋﻨﺩﻤﺎ ﻴﻜﻭﻥ ﺒﺼﺤﺒﺔ ﻤﺭﺸﺩ ﺭﺴﻤﻲ(‪ ،‬ﻭﺍﻝﺘﺯﺤﻠﻕ ﻋﻠﻰ ﺍﻝﺠﻠﻴﺩ )ﻝﻴﺱ ﺘﺯﻝﺞ ﺍﻝﺴﺭﻋﺔ(‪ ،‬ﺼﻌﻭﺩ ﺍﻝﺜﻠـﻭﺝ‪ ،‬ﺍﻝﺘـﺯﻝﺞ ﺒـﺎﻷﻝﻭﺍﺡ‪،‬‬
‫ﺴﻠﻴﺩﺠﻴﻨﺞ‪ ،‬ﺍﻝﺘﺯﺤﻠﻕ‪ ،‬ﺍﻝﺼﻴﺩ‪ ،‬ﺍﻝﺘﺯﻝﺞ ﺍﻝﺸﺭﺍﻋﻲ‪ ،‬ﻭﺍﻹﺒﺤﺎﺭ‪ ،‬ﺭﻜﻭﺏ ﺍﻷﻤﻭﺍﺝ‪ ،‬ﺍﻝﺘﺯﻝﺞ ﻋﻠﻰ ﺍﻝﻤﺎﺀ‪ ،‬ﺭﻜﻭﺏ ﺍﻷﻤﻭﺍﺝ ﻭﺍﻝﺭﻴﺎﺡ‪ ،‬ﻤﺎ ﻝﻡ ﻴﻜﻥ ﻗﺩ ﺘﻡ ﻓﺭﺽ ﻗﺴﻁ ﺇﻀـﺎﻓﻲ‬
‫ﻭﺘﻡ ﺍﻋﺘﻤﺎﺩ ﺫﻝﻙ ﻤﻥ ﺍﻝﺸﺭﻜﺔ ﻭﻗﻴﺎﻡ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺒﺩﻓﻌﻪ‪ .‬ﻭﺴﻭﻑ ﻴﻅل ﺫﻝﻙ ﻭﻓﻘﺎ ﻝﺘﻘﺩﻴﺭ ﺍﻝﺸﺭﻜﺔ‪.‬‬
‫ﺍﻝﺨﺴﺎﺭﺓ ﺍﻝﺘﺒﻌﻴﺔ ﻤﻥ ﺃﻱ ﻨﻭﻉ ﺃﻭ ﺍﻝﺨﺴﺎﺭﺓ ﺍﻝﻤﺎﻝﻴﺔ ﻭ ‪ /‬ﺃﻭ ﺍﻝﻤﺼﺎﺭﻴﻑ ﺍﻝﺘﻲ ﻝﻡ ﻴﺘﻡ ﺘﻐﻁﻴﺘﻬﺎ ﻋﻠﻰ ﻭﺠﻪ ﺍﻝﺘﺤﺩﻴﺩ‬
‫ﺍﻝﺘﻘﺼﻴﺭ ﺃﻭ ﺍﻹﻋﺴﺎﺭ ﻤﻥ ﺠﺎﻨﺏ ﺍﻝﻨﺎﻗل‬
‫ﻨﻴﺔ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻝﻠﻬﺠﺭﺓ‪ ،‬ﺇﻻ ﺇﺫﺍ ﺴﺒﻕ ﺍﻻﺘﻔﺎﻕ ﻋﻠﻴﻬﺎ ﺨﻁﻴﺎ ﻤﻊ ﺍﻝﺸﺭﻜﺔ‪.‬‬
‫)‪© AIG, all rights reserved (V 1.0 – June 20, 2013‬‬
‫ﺍﻝﺴﻔﺭ ﻓﻲ‪ ،‬ﺇﻝﻰ ﺃﻭ ﻤﻥ ﺨﻼل ﺃﻓﻐﺎﻨﺴﺘﺎﻥ ﻭﺍﻝﻌﺭﺍﻕ ﻭﻜﻭﺒﺎ ﺃﻭ ﺠﻤﻬﻭﺭﻴﺔ ﺍﻝﻜﻭﻨﻐﻭ ﺍﻝﺩﻴﻤﻘﺭﺍﻁﻴﺔ‪.‬‬
‫ﺃﻱ ﺇﺭﻫﺎﺒﻲ ﺃﻭ ﻋﻀﻭ ﻓﻲ ﻤﻨﻅﻤﺔ ﺇﺭﻫﺎﺒﻴﺔ‪ ،‬ﻭﻤﻬﺭﺏ ﻤﺨﺩﺭﺍﺕ ﺍﻭ ﻤﻭﺭﺩ ﻝﻸﺴﻠﺤﺔ ﺍﻝﻨﻭﻭﻴﺔ ﺃﻭ ﺍﻝﻜﻴﻤﻴﺎﺌﻴﺔ ﺃﻭ ﺍﻝﺒﻴﻭﻝﻭﺠﻴﺔ‪.‬‬
‫ﺍﻝﻨﻭﺒﺔ ﺍﻝﻘﻠﺒﻴﺔ ﺃﻭ ﺃﻱ ﺤﺎﻝﺔ ﻤﺭﺘﺒﻁﺔ ﺒﺎﻝﻘﻠﺏ‬
‫ﺃﻱ ﺤﺎﻝﺔ ﻨﺎﺠﻤﺔ ﻋﻥ ﻭﺭﻡ ﺃﻭ ﺘﺘﻌﻠﻕ ﺒﺎﻝﺴﺭﻁﺎﻥ‪.‬‬
‫‪ .5‬ﺸﺭﻭﻁ ﻋﺎﻤﺔ‬
‫ﺤﺩﻭﺩ ﺍﻝﻌﻤﺭ ‪:‬‬
‫ﺘﻐﻁﻲ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﺍﻝﺤﻭﺍﺩﺙ ﺍﻝﻤﺅﻤﻥ ﻀﺩﻫﺎ ﺍﻝﺘﻲ ﺘﻘﻊ ﻝﻠﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻭﻴﺒﻠﻎ ﻋﻤﺭﻩ ﻤﻥ ‪ 18‬ﺍﻝﻰ ‪ 69‬ﺴﻨﺔ ﻓﻲ ﺘﺎﺭﻴﺦ ﻫﺫﺍ ﺍﻝﺤﺎﺩﺙ‪.‬‬
‫ﺸﺭﻜﺔ ﺍﻝﻁﻴﺭﺍﻥ‪:‬‬
‫ﻝﻥ ﻴﻜﻭﻥ ﻋﻠﻰ ﺍﻝﺸﺭﻜﺔ ﺃﻱ ﻤﺴﺌﻭﻝﻴﺔ ﻝﺩﻓﻊ ﺃﻱ ﻤﻨﻔﻌﺔ ﺘﺘﻌﻠﻕ ﺒﺄﻱ ﺤﺎﺩﺙ ﻤﺅﻤﻥ ﻀﺩﻩ ﻴﻤﻜﻥ ﻝﻠﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻁﻠﺏ ﺘﻌﻭﻴﺽ ﻋﻨﻪ ﻤﻥ ﺸﺭﻜﺔ ﺍﻝﻁﻴـﺭﺍﻥ‪ .‬ﻭﻓـﻲ‬
‫ﺤﺎﻝﺔ ﺇﺜﺒﺎﺕ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺍﻨﻪ ﻗﺎﻡ ﺒﺎﺘﺨﺎﺫ ﻜﺎﻓﺔ ﺍﻝﺨﻁﻭﺍﺕ ﺍﻝﻤﻌﻘﻭﻝﺔ ﻭﺍﻝﻀﺭﻭﺭﻴﺔ ﻝﻠﻤﻁﺎﻝﺒﺔ ﻤﻥ ﺸﺭﻜﺔ ﺍﻝﻁﻴﺭﺍﻥ‪ ،‬ﺴﻭﻑ ﺘﻘﻭﻡ ﺍﻝﺸﺭﻜﺔ ﺒﺩﻓﻊ ﺠﺯﺌﻲ ﺘﻨﺎﺴﺒﻲ ﻤﻥ‬
‫ﺍﻝﻤﻨﺎﻓﻊ‪ .‬ﻭﺴﻭﻑ ﻴﺘﻡ ﺍﺤﺘﺴﺎﺏ ﻤﺴﺅﻭﻝﻴﺔ ﺍﻝﺸﺭﻜﺔ ﻤﻥ ﺨﻼل ﺘﺨﻔﻴﺽ ﺍﻝﻤﻨﺎﻓﻊ ﺒﺎﻝﻤﺒﻠﻎ ﺍﻝﺫﻱ ﺘﻌﺘﺒﺭﻩ ﺍﻝﺸﺭﻜﺔ ﺇﻥ ﺸﺭﻜﺔ ﺍﻝﻁﻴﺭﺍﻥ ﻤﺴﺅﻭﻝﺔ ﻋﻨﻪ‪.‬‬
‫ﺍﻝﻌﻤﻠﺔ‬
‫ﺘﻡ ﺫﻜﺭ ﻜﺎﻓﺔ ﺍﻝﻤﺒﺎﻝﻎ ﺒﺎﻝﺩﻭﻻﺭ ﺍﻷﻤﺭﻴﻜﻲ‪ .‬ﻭﻓﻲ ﺤﺎﻝﺔ ﺘﺤﻤل ﺍﻝﻤﺼﺎﺭﻴﻑ ﺒﻌﻤﻠﺔ ﺃﺠﻨﺒﻴﺔ‪ ،‬ﺴﻭﻑ ﻴﺘﻡ ﺍﺴﺘﺨﺩﺍﻡ ﺴﻌﺭ ﺍﻝﺼﺭﻑ ﻤﻘﺎﺒل ﺍﻝﻤﻌﺩل ﺍﻝﺤﺎﻝﻲ ﻓﻲ ﻭﻗـﺕ ﺘﺤﻤـل‬
‫ﺍﻝﻤﺼﺎﺭﻴﻑ ﺃﻭ ﺍﻝﺘﻌﺭﺽ ﻝﻠﺨﺴﺎﺭﺓ‪.‬‬
‫ﺍﻝﻤﻼﺤﻕ‬
‫ﻴﺠﻭﺯ ﺘﻌﺩﻴل‪ ،‬ﺘﻤﺩﻴﺩ ﺃﻭ ﺘﻐﻴﻴﺭ ﺍﻝﻭﺜﻴﻘﺔ ﻤﻥ ﻗﺒل ﺍﻝﺸﺭﻜﺔ ﻤﻥ ﺨﻼل ﺇﺼﺩﺍﺭ ﻤﻠﺤﻕ‪ ،‬ﺸﺭﻴﻁﺔ ﺃﻥ ﻴﺘﻡ ﺘﻘﺩﻴﻡ ﺍﻝﻁﻠﺏ ﺨﻁﻴﺎ ﺇﻝﻰ ﺍﻝﺸﺭﻜﺔ ﻗﺒل ﺘـﺎﺭﻴﺦ ﺇﻨﻬـﺎﺀ ﺼـﻼﺤﻴﺔ‬
‫ﺍﻝﻭﺜﻴﻘﺔ ﺍﻝﺤﺎﻝﻴﺔ ﻭﻻ ﺘﻭﺠﺩ ﻤﻁﺎﻝﺒﺎﺕ ﺤﺎﻝﻴﺔ ﺃﻭ ﺘﻡ ﺍﻝﺸﺭﻭﻉ ﻓﻴﻬﺎ ﻓﻴﻤﺎ ﻴﺨﺹ ﺍﻝﻭﺜﻴﻘﺔ ﺍﻝﺤﺎﻝﻴﺔ‪.‬‬
‫ﺍﻝﻤﺴﺅﻭﻝﻴﺔ‬
‫ﻝﻥ ﺘﻜﻭﻥ ﺍﻝﺸﺭﻜﺔ ﻤﺴﺅﻭﻝﺔ ﺃﻭ ﻤﻠﺯﻤﺔ ﺒﻤﺎ ﻴﻠﻲ )ﺃ( ﺍﻹﻫﻤﺎل ﻭﺍﻝﺘﺼﺭﻓﺎﺕ ﺍﻝﺨﺎﻁﺌﺔ ﻭ‪/‬ﺃﻭ ﺍﻹﻏﻔﺎل ﻤﻥ ﻗﺒل ﺃﻱ ﻤﻬﻨﻲ ﻗﺎﻨﻭﻨﻲ ﻭ‪/‬ﺃﻭ ﻤﻬﻨﻲ ﺭﻋﺎﻴﺔ ﻁﺒﻴﺔ ﺃﻭ ﺃﻱ ﺸﺨﺹ‬
‫ﺃﻭ ﺃﺸﺨﺎﺹ ﺁﺨﺭﻴﻥ ﺃﻭ ﺠﻬﺔ ﻗﺎﻨﻭﻨﻴﺔ ﺘﻘﺩﻡ ﺨﺩﻤﺔ ﻤﺒﺎﺸﺭﺓ ﺃﻭ ﻏﻴﺭ ﻤﺒﺎﺸﺭﺓ ﺇﻝﻰ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ )ﺏ( ﺇﺨﻔﺎﻕ ﺃﻱ ﻭﻜﻴل ﺃﻭ ﻭﺴﻴﻁ ﻓﻲ ﺍﻹﻴﻀﺎﺡ ﺒﺸﻜل ﻜـﺎﻓﻲ‬
‫ﺸﺭﻭﻁ ﻭﺃﺤﻜﺎﻡ ﻭﻤﻼﺤﻕ ﻭﺇﻨﻬﺎﺀ ﻭﺍﺴﺘﺜﻨﺎﺀﺍﺕ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ‪.‬‬
‫ﺍﻝﻠﻐﺔ‬
‫ﺍﻝﻨﺴﺨﺔ ﺍﻻﺼﻠﻴﺔ ﻝﻬﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﺒﺎﻝﻠﻐﺔ ﺍﻻﻨﺠﻠﻴﺯﻴﺔ‪ .‬ﻭﺘﺸﻤل ﺍﻝﻜﻠﻤﺎﺕ ﺒﺼﻴﻐﺔ ﺍﻝﻤﻔﺭﺩ ﺍﻝﻜﻠﻤﺎﺕ ﺒﺼﻴﻐﺔ ﺍﻝﺠﻤﻊ ﻭﺍﻝﻌﻜﺱ ﺼﺤﻴﺢ‪ ،‬ﻭﺍﻝﻜﻠﻤﺎﺕ ﺒﺼﻴﻐﺔ ﺍﻝﻤﺫﻜﺭ ﺘﺸﻤل ﺼﻴﻐﺔ‬
‫ﺍﻝﻤﺅﻨﺙ‪.‬‬
‫ﺍﻝﺘﺴﻭﻴﻕ‬
‫ﻓﻲ ﺤﺎﻝﺔ ﻭﺠﻭﺩ ﺃﻱ ﺍﺨﺘﻼﻓﺎﺕ ﺒﻴﻥ ﺍﻝﻭﺜﻴﻘﺔ ﻭﺃﻱ ﻤﻁﺒﻭﻋﺎﺕ ﻴﺘﺴﻠﻤﻬﺎ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪ ،‬ﻓﺈﻥ ﺸﺭﻭﻁ ﻭﺃﺤﻜﺎﻡ ﻭﻤﻼﺤﻕ ﻭﺤﺎﻻﺕ ﺍﻹﻨﻬﺎﺀ ﻭﺍﻻﺴﺘﺜﻨﺎﺀﺍﺕ ﺍﻝـﻭﺍﺭﺩﺓ‬
‫ﻓﻲ ﺍﻝﻭﺜﻴﻘﺔ ﺴﻭﻑ ﻴﻌﺘﺩ ﺒﻬﺎ ﻓﻲ ﻜﺎﻓﺔ ﺍﻝﺤﺎﻻﺕ‪.‬‬
‫ﺍﻝﻤﻌﻠﻭﻤﺎﺕ ﺍﻝﺨﺎﻁﺌﺔ‬
‫ﺘﻌﺘﺒﺭ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﺒﺎﻁﻠﺔ )ﺒﻨﺎﺀ ﻋﻠﻰ ﺘﻘﺩﻴﺭ ﺍﻝﺸﺭﻜﺔ( ﻓﻲ ﺤﺎﻝﺔ ﺘﻘﺩﻴﻡ ﻤﻌﻠﻭﻤﺎﺕ ﺨﺎﻁﺌﺔ‪ ،‬ﺃﻭﺼﺎﻑ ﺨﺎﻁﺌﺔ ﺃﻭ ﻋﺩﻡ ﺘﺼﺭﻴﺢ ﻤﻥ ﺠﺎﻨﺏ ﺃﻭ ﻨﻴﺎﺒﺔ ﻋﻥ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ‬
‫ﻋﻠﻴﻪ ﻵﻱ ﻤﻌﻠﻭﻤﺎﺕ ﻤﺎﺩﻴﺔ ﻝﻬﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ‪.‬‬
‫ﺍﻝﻤﻨﺘﺠﺎﺕ ﻭﺍﻝﺨﺩﻤﺎﺕ ﺍﻝﻤﺎﻝﻴﺔ ﺍﻷﺨﺭﻯ‬
‫ﻝﻥ ﺘﻘﺒل ﺍﻝﺸﺭﻜﺔ ﺃﻱ ﻤﺴﺅﻭﻝﻴﺔ ﺃﻴﺎ ﻜﺎﻨﺕ ﻋﻥ ﺃﻱ ﺘﺄﻤﻴﻥ ﺁﻭ ﻤﻨﺘﺠﺎﺕ ﺃﻭ ﺨﺩﻤﺎﺕ ﻤﺎﻝﻴﺔ ﺃﺨﺭﻯ ﻴﺘﻡ ﺒﺒﻴﻌﻬﺎ ﺒﺎﻻﺭﺘﺒﺎﻁ ﻤﻊ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﻭﻴﺘﻡ ﺘﻘﺩﻴﻤﻬﺎ ﺃﻭ ﺍﻻﺸﺘﺭﺍﻙ ﻓﻴﻬـﺎ‬
‫ﻤﻥ ﻗﺒل ﺃﻱ ﺸﺭﻜﺎﺕ ﺘﺄﻤﻴﻥ ﺃﻭ ﻀﻤﺎﻥ ﺃﺨﺭﻯ ﻭ‪/‬ﺃﻭ ﺸﺭﻜﺎﺕ ﻤﺴﺎﻋﺩﺓ ﻭ‪/‬ﺃﻭ ﻤﻘﺩﻤﻴﻥ ﻤﺎﻝﻴﻴﻥ‪.‬‬
‫ﺘﺎﻤﻴﻨﺎﺕ ﺃﺨﺭﻯ‬
‫ﻓﻲ ﺤﺎﻝﺔ ﺘﻤﻜﻥ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻤﻥ ﺍﻝﻤﻁﺎﻝﺒﺔ ﺒﻤﻭﺠﺏ ﺃﻱ ﻭﺜﺎﺌﻕ ﺃﺨﺭﻯ )ﻭﺘﺸﻤل ﺍﻝﺘﺄﻤﻴﻥ ﺍﻝﻘﺎﻨﻭﻨﻲ ﻭ‪/‬ﺃﻭ ﺍﻝﺘﺄﻤﻴﻥ ﻋﻠﻰ ﺍﻝﺴﻔﺭ ﻝﺒﻁﺎﻗﺔ ﺍﻻﺌﺘﻤﺎﻥ ﺍﻝﺘﻠﻘﺎﺌﻲ( ﻤـﻥ‬
‫ﺘﻐﻁﻴﻪ ﺠﻤﻴﻊ ﺃﻭ ﺠﺯﺀ ﻤﻥ ﺍﻝﺤﺎﺩﺙ ﺍﻝﻤﺅﻤﻥ ﻀﺩﻩ )ﻤﻁﺎﻝﺒﺎﺕ ﺃﺨﺭﻯ(‪ ،‬ﺴﻭﻑ ﺘﻜﻭﻥ ﺍﻝﺸﺭﻜﺔ ﻤﺴﺅﻭﻝﺔ ﻓﻘﻁ ﻋﻥ ﺩﻓﻊ ﺠﺯﺌﻬﺎ ﺍﻝﺘﻨﺎﺴﺒﻲ ﻤﻥ ﺍﻝﻤﻁﺎﻝﺒﺔ ﺍﻝﻤﻘﺩﻤﺔ ﻓﻲ ﺸﺭﻭﻁ‬
‫ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ‪.‬‬
‫ﻭﻓﻘﺎ ﻝﺘﻘﺩﻴﺭﻫﺎ‪ ،‬ﺇﺫﺍ ﻗﺭﺭﺕ ﺍﻝﺸﺭﻜﺔ ﺩﻓﻊ ﺍﻝﻤﻁﺎﻝﺒﺔ ﺒﺎﻝﻜﺎﻤل‪ ،‬ﻋﻨﺩﺌﺫ ﻝﻥ ﺘﻜﻭﻥ ﻤﻠﺯﻤﺔ ﺒﺘﺴﺩﻴﺩ ﺍﻝﻤﺩﻓﻭﻋﺎﺕ ﻤﺎ ﻝﻡ ﻴﺘﻨﺎﺯل ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺇﻝﻰ ﺍﻝﺸﺭﻜﺔ ﻋﻥ ﻜﺎﻓـﺔ‬
‫ﺤﻘﻭﻗﻪ ﻓﻴﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺎﻝﻤﻁﺎﻝﺒﺎﺕ ﺍﻷﺨﺭﻯ‪.‬‬
‫ﻓﻲ ﺤﺎﻝﺔ ﻗﻴﺎﻡ ﺍﻝﺸﺭﻜﺔ ﺒﺩﻓﻊ ﺍﻝﻤﻨﺎﻓﻊ ﺍﻝﻭﺍﺭﺩﺓ ﻓﻲ ﺸﺭﻭﻁ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ‪ ،‬ﻓﺈﻥ ﻜﺎﻓﺔ ﺤﻘﻭﻕ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻓﻴﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺎﻝﻤﻁﺎﻝﺒﺎﺕ ﺍﻷﺨﺭﻯ ﺴﻭﻑ ﻴـﺘﻡ ﺍﻝﺘﻨـﺎﺯل‬
‫ﻋﻨﻬﺎ ﺘﻠﻘﺎﺌﻴﺎ ﺇﻝﻰ ﺍﻝﺸﺭﻜﺔ‪.‬‬
‫)‪© AIG, all rights reserved (V 1.0 – June 20, 2013‬‬
‫ﺒﺩﻭﻥ ﺘﻘﻴﻴﺩ ﺃﻱ ﺤﻜﻡ ﻓﻲ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﺃﻭ ﺃﻱ ﺍﻝﺘﺯﺍﻡ ﻗﺎﻨﻭﻨﻲ‪ ،‬ﻴﺘﻌﻴﻥ ﻋﻠﻰ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺍﻝﺘﻌﺎﻭﻥ ﺒﺎﻝﻜﺎﻤل ﻤﻊ ﺍﻝﺸﺭﻜﺔ ﻓﻴﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺎﻝﻤﻁﺎﻝﺒـﺎﺕ ﺃﺨـﺭﻯ ﺃﻭ‬
‫ﺍﻹﺠﺭﺍﺀﺍﺕ ﺍﻝﻘﺎﻨﻭﻨﻴﺔ ﻭﺘﺸﻤل )ﺃ( ﻋﺩﻡ ﺍﻝﻘﻴﺎﻡ ﺒﺄﻱ ﺸﻲﺀ ﻴﻤﺱ ﺃﻭ ﻴﻘﻴﺩ ﺤﻘﻭﻕ ﺍﻝﺸﺭﻜﺔ )ﺏ( ﻤﻨﺢ ﺍﻝﺸﺭﻜﺔ ﺃﻱ ﻤﻌﻠﻭﻤﺎﺕ ﻭﻭﺜﺎﺌﻕ ﺘﻘﻭﻡ ﺒﻁﻠﺒﻬﺎ )ﺝ( ﺘﻭﻗﻴﻊ ﺃﻱ ﻭﺜﻴﻘﺔ ﺃﻭ‬
‫ﺇﻓﺎﺩﺓ ﻗﺩ ﺘﻁﻠﺒﻬﺎ ﺍﻝﺸﺭﻜﺔ ﻝﺘﻤﻜﻴﻨﻬﺎ ﻤﻥ ﻤﻤﺎﺭﺴﺔ ﺤﻘﻭﻗﻬﺎ‪.‬‬
‫ﺃﻁﺭﺍﻑ ﺃﺨﺭﻯ )ﻁﺭﻑ ﺜﺎﻝﺙ(‬
‫ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﻤﺒﺭﻤﺔ ﺒﻴﻥ ﺍﻝﺸﺭﻜﺔ ﻭﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻓﻘﻁ ﻭﺠﻤﻴﻊ ﺃﺤﻜﺎﻤﻬﺎ ﻭﺸﺭﻭﻁﻬﺎ ﻫﻲ ﻝﻠﻤﺼﻠﺤﺔ ﺍﻝﻭﺤﻴﺩﺓ ﻭﺍﻝﺤﺼﺭﻴﺔ ﻝﻬﺫﻴﻥ ﺍﻝﻁﺭﻓﻴﻥ‪ .‬ﻭﻻ ﻴﻘﺼﺩ ﺃﻥ ﻴﻜﻭﻥ‬
‫ﺃﻱ ﺸﻲﺀ ﻓﻲ ﻫﺫﻩ ﺍﻻﺘﻔﺎﻗﻴﺔ – ﺼﺭﻴﺢ ﺃﻡ ﻀﻤﻨﻲ – ﺍﻥ ﻴﻤﻨﺢ ﺇﻝﻰ ﺃﻱ ﺸﺨﺹ ﺃﺨﺭ ﺃﻱ ﺤﻘﻭﻕ ﺃﻭ ﺘﺩﺍﺒﻴﺭ ﻤﻥ ﺃﻱ ﻁﺒﻴﻌﺔ ﺃﻴﺎ ﻜﺎﻨﺕ ﺒﻤﻭﺠﺏ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﺃﻭ ﺃﻱ ﻤـﻥ‬
‫ﺃﺤﻜﺎﻤﻬﺎ‪ .‬ﻭﺒﺩﻭﻥ ﺘﺤﺩﻴﺩ‪ ،‬ﻝﻥ ﻴﻜﻭﻥ ﻵﻱ ﻁﺭﻑ ﺜﺎﻝﺙ ﺃﻱ ﺤﻘﻭﻕ ﺒﻤﻭﺠﺏ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﺃﻭ ﺃﻱ ﺤﻕ ﻝﻠﺤﺼﻭل ﻋﻠﻰ ﻤﻨﺎﻓﻊ ﺍﻝﻭﺜﻴﻘﺔ‪ .‬ﻭﺴﻭﻑ ﻴﻜـﻭﻥ ﺍﺴـﺘﻼﻡ ﺍﻝﻤﻨـﺎﻓﻊ‬
‫ﺍﻝﻤﺩﻓﻭﻋﺔ ﺇﺒﺭﺍﺀ ﺫﻤﺔ ﺴﺎﺭﻱ ﺍﻝﻤﻔﻌﻭل ﻝﻤﺴﺅﻭﻝﻴﺔ ﺍﻝﺸﺭﻜﺔ ﺒﻤﻭﺠﺏ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ‪.‬‬
‫ﻻ ﻴﻤﻜﻥ ﺍﻝﺘﻨﺎﺯل ﻋﻥ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﺃﻭ ﺘﺤﻭﻴﻠﻬﺎ ﺒﺄﻱ ﻁﺭﻴﻘﺔ ﺇﻝﻰ ﻁﺭﻑ ﺜﺎﻝﺙ‪ .‬ﻭﺴﻭﻑ ﻴﺴﺘﺤﻕ ﺩﻓﻊ ﺍﻝﻤﻨﺎﻓﻊ ﻓﻘﻁ ﺇﻝﻰ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺃﻭ ﻤﻤﺜﻠﻪ ﺍﻝﻘﺎﻨﻭﻨﻲ‪.‬‬
‫ﺘﺫﺍﻜﺭ ﻭﺴﺎﺌل ﺍﻝﻨﻘل ﺍﻝﻌﺎﻡ‬
‫ﻴﺤﻕ ﻝﻠﺸﺭﻜﺔ ﺍﺴﺘﺨﺩﺍﻡ ﺘﺫﺍﻜﺭ ﻭﺴﺎﺌل ﺍﻝﻨﻘل ﺍﻝﻌﺎﻡ ﺍﻝﺨﺎﺼﺔ ﺒﺎﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻤﻥ ﺃﺠل ﺘﺴﻭﻴﺔ ﻨﻔﻘﺎﺕ ﺍﻝﺸﺭﻜﺔ‪.‬‬
‫ﻗﺎﻨﻭﻥ ﺩﻭﻝﺔ ﺍﻹﺼﺩﺍﺭ‬
‫ﺘﺨﻀﻊ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﺇﻝﻰ ﻗﻭﺍﻨﻴﻥ ﺍﻝﺩﻭﻝﺔ ﺍﻝﺘﻲ ﺘﻡ ﺇﺼﺩﺍﺭ ﺍﻝﻭﺜﻴﻘﺔ ﻓﻴﻬﺎ ﻭﺴﻭﻑ ﻴﻜﻭﻥ ﻝﻤﺤﺎﻜﻤﻬﺎ ﺍﻻﺨﺘﺼﺎﺹ ﺍﻝﻘﻀﺎﺌﻲ ﺍﻝﺤﺼﺭﻱ ﻤﻊ ﺍﺴﺘﺒﻌﺎﺩ ﺍﻝﻤﺤﺎﻜﻡ ﺍﻝﺨﺎﺼـﺔ ﺒـﺄﻱ‬
‫ﺩﻭﻝﺔ ﺃﺨﺭﻯ‪.‬‬
‫ﺤﻠﻭل ﺍﻝﺤﻕ‬
‫ﻴﺤﻕ ﻝﻠﺸﺭﻜﺔ ﺒﺩﺀ ﺃﻭ ﻤﺒﺎﺸﺭﺓ ﺍﻹﺠﺭﺍﺀﺍﺕ ﺍﻝﻘﺎﻨﻭﻨﻴﺔ ﺒﺎﺴﻡ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻤﻥ ﺃﺠل ﺍﻝﺩﻓﺎﻉ ﻋﻥ ﺃﻭ ﺘﺴﻭﻴﺔ ﺃﻱ ﻤﻁﺎﻝﺒﺔ‪ ،‬ﺃﻭ ﻤﻼﺤﻘﺔ ﺃﻭ ﻤﻘﺎﻀﺎﺓ ﺃﻱ ﻁﺭﻑ ﺃﺨﺭ‬
‫ﻻﺴﺘﺭﺩﺍﺩ ﺍﻷﻤﻭﺍل ﺍﻝﻭﺍﺠﺒﺔ ﺍﻝﺩﻓﻊ ﻤﻨﻬﻡ ﺒﻤﻭﺠﺏ ﺍﻝﻘﺎﻨﻭﻥ‪ .‬ﻭﻴﺘﻌﻴﻥ ﻋﻠﻰ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺍﻝﺘﻌﺎﻭﻥ ﻤﻊ ﺍﻝﺸﺭﻜﺔ ﻭﻋﺩﻡ ﺍﻝﻘﻴﺎﻡ ﺒﺄﻱ ﺸﻲﺀ ﻴﻌﻴﻕ ﺤﻘﻭﻕ ﺍﻝﺸﺭﻜﺔ‪.‬‬
‫ﺍﻝﻀﺭﺍﺌﺏ ﺃﻭ ﺍﻝﺭﺴﻭﻡ‬
‫ﺴﻭﻑ ﻴﺘﺤﻤل ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺩﺍﺌﻤﺎ ﻋﺏﺀ ﻀﻤﺎﻥ ﻭﺍﻹﻗﺭﺍﺭ ﺒﺸﻜل ﺼﺤﻴﺢ ﻭﺩﻓﻊ ﺃﻱ ﺍﻝﺘﺯﺍﻡ ﻀﺭﻴﺒﻲ ﻤﻘﺎﺒل ﺃﻱ ﻤﻨﻔﻌﺔ ﻴﺘﻡ ﺩﻓﻌﻬﺎ ﻭﺘﺨﻀﻊ ﺇﻝـﻰ ﻀـﺭﻴﺒﺔ ﺃﻭ‬
‫ﺭﺴﻭﻡ ﻤﻥ ﺃﻱ ﻁﺒﻴﻌﺔ‪.‬‬
‫ﺍﻝﻜﺸﻑ ﻋﻥ ﺍﻝﺒﻴﺎﻨﺎﺕ‬
‫ﻤﻥ ﺨﻼل ﺍﻝﺘﻭﻗﻴﻊ ﻋﻠﻰ ﻋﻘﺩ ﺍﻝﺘﺄﻤﻴﻥ ﺍﻝﻤﺎﺜل‪ ،‬ﻴﻭﺍﻓﻕ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻋﻠﻰ ﻗﻴﺎﻡ ﺸﺭﻜﺔ ﺍﻝﺘﺄﻤﻴﻥ ﺒﻤﻌﺎﻝﺠﺔ ﺍﻝﺒﻴﺎﻨﺎﺕ ﺫﺍﺕ ﺍﻝﺼﻠﺔ ﺒﺎﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻤﻥ ﺃﺠل ﺘﻘـﺩﻴﻡ ﻤﻨﺘﺠـﺎﺕ‬
‫ﻭﺨﺩﻤﺎﺕ ﺍﻝﺘﺄﻤﻴﻥ ﻭﺍﻷﻏﺭﺍﺽ ﺍﻝﻘﺎﻨﻭﻨﻴﺔ ﻭﺍﻹﺩﺍﺭﻴﺔ ﻭﺨﺎﺼﺔ ﻝﻤﻌﺎﻝﺠﺔ ﺃﻱ ﺒﻴﺎﻨﺎﺕ ﺸﺨﺼﻴﺔ ﺤﺴﺎﺴﺔ ﺘﺘﻌﻠﻕ ﺒﺎﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪.‬‬
‫ﻭﻴﻭﺍﻓﻕ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻋﻠﻰ ﻗﻴﺎﻡ ﺸﺭﻜﺔ ﺍﻝﺘﺄﻤﻴﻥ ﺒﺈﺘﺎﺤﺔ ﻫﺫﻩ ﺍﻝﻤﻌﻠﻭﻤﺎﺕ ﺇﻝﻰ ﺍﻝﻐﻴﺭ ﻋﻠﻰ ﺴﺒﻴل ﺍﻝﻤﺜﺎل ﻻ ﺍﻝﺤﺼﺭ ﻷﻱ ﺸﺭﻜﺔ ﺘﺎﺒﻌﺔ ﻝﻠﻤﺠﻤﻭﻋﺔ‪ ،‬ﻭﺃﻭﻝﺌﻙ ﺍﻝﺫﻴﻥ ﻴﻘﺩﻤﻭﻥ‬
‫ﺍﻝﻤﻨﺘﺠﺎﺕ ﺃﻭ ﺍﻝﺨﺩﻤﺎﺕ ﺇﻝﻰ ﺸﺭﻜﺔ ﺍﻝﺘﺄﻤﻴﻥ ﺃﻭ ﺃﻱ ﺸﺭﻜﺔ ﺘﺎﺒﻌﺔ ﻝﻠﻤﺠﻤﻭﻋﺔ ﻭﺍﻝﻬﻴﺌﺎﺕ ﺍﻝﺘﻨﻅﻴﻤﻴﺔ ﺩﺍﺨل ﻭﺨﺎﺭﺝ ﺩﻭﻝﺔ ﺇﻗﺎﻤﺔ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪.‬‬
‫ﺍﺴﺘﺜﻨﺎﺀ ﺍﻝﻌﻘﻭﺒﺎﺕ ﺍﻻﻗﺘﺼﺎﺩﻴﺔ‬
‫ﺍﺴﺘﻨﺎﺩﺍ ﺇﻝﻰ ﺃﻱ ﻗﺎﻨﻭﻥ ﺃﻭ ﻻﺌﺤﺔ ﻭﺍﺠﺒﺔ ﺍﻝﺘﻁﺒﻴﻕ ﻋﻠﻰ ﺸﺭﻜﺔ ﺍﻝﺘﺄﻤﻴﻥ‪ ،‬ﻓﻲ ﺤﺎﻝﺔ ﺃﻥ ﺸﺭﻜﺘﻬﺎ ﺍﻷﻡ ﺃﻭ ﺍﻝﺠﻬﺔ ﺍﻝﻨﻬﺎﺌﻴﺔ ﺍﻝﻤﺴﻴﻁﺭﺓ ﻋﻠﻴﻬﺎ – ﻋﻨﺩ ﺒﺩﺍﻴﺔ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﺃﻭ ﻓﻲ‬
‫ﺃﻱ ﻭﻗﺕ ﺒﻌﺩ ﺫﻝﻙ – ﻭﺘﻘﻭﻡ ﺒﺘﻘﺩﻴﻡ ﺍﻝﺘﻐﻁﻴﺔ ﺇﻝﻰ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺘﻜﻭﻥ ﺁﻭ ﺘﺼﺒﺢ ﻏﻴﺭ ﻗﺎﻨﻭﻨﻴﺔ ﺒﺴﺒﺏ ﺍﻨﺘﻬﺎﻜﻬﺎ ﻝﻌﻘﻭﺒﺔ ﺃﻭ ﺤﻅﺭ‪ ،‬ﻴﻨﺒﻐﻲ ﻋﻠﻰ ﺸﺭﻜﺔ ﺍﻝﺘﺄﻤﻴﻥ ﺍﻝﻤـﺫﻜﻭﺭﺓ‬
‫ﻋﺩﻡ ﺘﻘﺩﻴﻡ ﺍﻝﺘﻐﻁﻴﺔ ﻭﻝﻥ ﻴﻜﻭﻥ ﻋﻠﻴﻬﺎ ﺃﻱ ﻤﺴﺅﻭﻝﻴﺔ ﺃﻴﺎ ﻜﺎﻨﺕ ﻭﻝﻥ ﺘﻘﺩﻡ ﺃﻱ ﺩﻓﺎﻉ ﺇﻝﻰ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺃﻭ ﺘﺴﺩﻴﺩ ﺃﻱ ﻤﺩﻓﻭﻋﺎﺕ ﺘﺘﻌﻠﻕ ﺒﻤﺼﺎﺭﻴﻑ ﺍﻝـﺩﻓﺎﻉ ﺃﻭ ﺘﻘـﺩﻡ ﺃﻱ‬
‫ﺸﻜل ﻤﻥ ﺃﺸﻜﺎل ﺍﻝﻀﻤﺎﻥ ﻨﻴﺎﺒﺔ ﻋﻥ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪ ،‬ﻭﺫﻝﻙ ﻝﻠﺤﺩ ﺍﻝﺫﻱ ﺘﻜﻭﻥ ﺒﻤﻭﺠﺒﻪ ﻤﻨﺘﻬﻜﺔ ﻝﻬﺫﻩ ﺍﻝﻌﻘﻭﺒﺔ ﺃﻭ ﺍﻝﺤﻅﺭ‪.‬‬
‫ﺴﻴﺎﺴﺔ ﺍﻝﺨﺼﻭﺼﻴﺔ‬
‫ﻤﻥ ﺍﺠل ﺍﻻﻁﻼﻉ ﻋﻠﻰ ﺴﻴﺎﺴﺔ ﺍﻝﺨﺼﻭﺼﻴﺔ ﻝﺩﻴﻨﺎ‪ ،‬ﻴﺭﺠﻰ ﺯﻴﺎﺭﺓ ﻤﻭﻗﻊ‪:‬‬
‫‪http://www.AIG.ae‬‬
‫ﺍﻝﺸﻜﺎﻭﻯ ﻭﺍﻝﻨﺯﺍﻋﺎﺕ‬
‫ﻓﻲ ﺤﺎﻝﺔ ﻭﺠﻭﺩ ﺃﻱ ﺸﻜﻭﻯ ﻝﺩﻴﻙ ﺘﺘﻌﻠﻕ ﺒﻭﺜﻴﻘﺘﻙ‪ ،‬ﻴﺭﺠﻰ ﺍﻻﺘﺼﺎل ﺒـ ‪:‬‬
‫ﻤﺠﻤﻭﻋﺔ ﺨﺩﻤﺎﺕ ﺍﻝﻌﻤﻼﺀ‬
‫ﺇﻴﻪ ﺃﻱ ﺠﻲ ﻤﻴﺎ ﺍﻝﻤﺤﺩﻭﺩﺓ )ﻓﺭﻉ ﺍﻝﻜﻭﻴﺕ(‬
‫ﺍﻝﻁﺎﺒﻕ ﺍﻝﺨﺎﻤﺱ ‪ ،‬ﺒﺭﺝ ﺍﻝﺨﺭﺍﻓﻲ ‪ ،‬ﺸﺎﺭﻉ ﺃﺴﺎﻤﺔ ﺒﻥ ﻤﻨﻘﺫ‪ ،‬ﻤﻨﻁﻘﺔ ‪7‬‬
‫ﺍﻝﻘﺒﻠﺔ‪ ،‬ﻤﺩﻴﻨﺔ ﺍﻝﻜﻭﻴﺕ‪ ،‬ﺍﻝﻜﻭﻴﺕ‬
‫ﻫﺎﺘﻑ‪ ، 965 2 247 4260 :‬ﻓﺎﻜﺱ ‪965 2 247 4264 :‬‬
‫ﺒﺭﻴﺩ ﺍﻝﻜﺘﺭﻭﻨﻲ‪servicecenter-me@AIG.com :‬‬
‫)‪© AIG, all rights reserved (V 1.0 – June 20, 2013‬‬
‫ﺸﺭﻭﻁ ﺍﻝﻤﻁﺎﻝﺒﺎﺕ‬
‫ﺍﻻﻝﺘﺯﺍﻡ‬
‫ﻴﺘﻌﻴﻥ ﻋﻠﻰ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺍﻻﻝﺘﺯﺍﻡ ﺒﻤﺸﻭﺭﺓ ﺃﻭ ﺘﻌﻠﻴﻤﺎﺕ ﺍﻝﺸﺭﻜﺔ ﻭﺨﻼﻑ ﺫﻝﻙ ﻗﺩ ﺘﺭﻓﺽ ﺍﻝﺸﺭﻜﺔ ﺩﻓﻊ ﺠﻤﻴﻊ ﺃﻭ ﺃﻱ ﺠﺯﺀ ﻤﻥ ﺍﻝﻤﻁﺎﻝﺒﺔ‪.‬‬
‫ﺍﻹﺠﺭﺍﺀﺍﺕ ﺍﻝﻘﺎﻨﻭﻨﻴﺔ‬
‫ﻓﻲ ﺤﺎﻝﺔ ﺭﻓﺽ ﺍﻝﺸﺭﻜﺔ ﻝﻠﻤﺴﺅﻭﻝﻴﺔ ﻋﻥ ﺃﻱ ﻤﻁﺎﻝﺒﺔ ﻭﻝﻡ ﻴﺘﺨﺫ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺇﺠﺭﺍﺀ ﻝﺭﻓﻊ ﺩﻋﻭﻯ ﻗﻀﺎﺌﻴﺔ ﻭﺘﺒﻠﻴﻎ ﺼـﺤﻴﻔﺔ ﺍﻝـﺩﻋﻭﻯ ﺇﻝـﻰ ﺍﻝـﺸﺭﻜﺔ )ﺃﻭ‬
‫ﺍﻝﺸﺭﻭﻉ ﻓﻲ ﺇﺠﺭﺍﺀﺍﺕ ﺍﻝﺘﺤﻜﻴﻡ ﻓﻲ ﺤﺎﻝﺔ ﺃﻥ ﺍﻝﺸﺭﻜﺔ ﻭﺍﻓﻘﺕ ﻋﻠﻰ ﺍﻝﺨﻀﻭﻉ ﺇﻝﻰ ﺍﻝﺘﺤﻜﻴﻡ( ﺨﻼل ‪ 36‬ﺸﻬﺭ ﺒﻌﺩ ﻫﺫﺍ ﺍﻝﺭﻓﺽ‪ ،‬ﻓﺈﻥ ﻜﺎﻓﺔ ﻤﻨﺎﻓﻊ ﻫﺫﻩ ﺍﻝﻤﻁﺎﻝﺒـﺔ ﺴـﻭﻑ‬
‫ﺘﺴﻘﻁ‪.‬‬
‫ﺇﺸﻌﺎﺭ ﺍﻝﻤﻁﺎﻝﺒﺔ ﻭﺇﺜﺒﺎﺕ ﺍﻝﺨﺴﺎﺭﺓ‬
‫ﻴﺘﻌﻴﻥ ﻋﻠﻰ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺃﻥ ﻴﻤﻨﺢ ﺇﺸﻌﺎﺭ ﺨﻁﻲ ﺇﻝﻰ ﺍﻝﺸﺭﻜﺔ‪:‬‬
‫ﺨﻼل ‪ 60‬ﻴﻭﻡ ﻤﻥ ﺍﻝﺤﺎﺩﺙ ﺍﻝﻤﺅﺩﻱ ﺇﻝﻰ ﻤﻁﺎﻝﺒﺔ ﺒﻤﻭﺠﺏ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ‪ .‬ﻭﺃﻱ ﻤﻨﻔﻌﺔ ﺘﺘﻌﻠﻕ ﺒﺎﻝﻭﻓﺎﺓ ﺴﻭﻑ ﺘﺴﺘﺤﻕ ﺍﻝﺩﻓﻊ ﻓﻘﻁ ﻓﻲ ﺤﺎﻝﺔ ﺍﺴﺘﻼﻡ ﺍﻝﺸﺭﻜﺔ ﻹﺸﻌﺎﺭ ﺨﻁـﻲ‬
‫ﺒﺎﻝﻭﻓﺎﺓ ﺨﻼل ‪ 30‬ﻴﻭﻡ‪ .‬ﻭﻴﺤﻕ ﻝﻠﺸﺭﻜﺔ ﺃﻥ ﺘﻌﻤل ﻋﻠﻰ ﺇﺠﺭﺍﺀ ﻓﺤﺹ ﻝﻠﺠﺜﺔ ﺒﻌﺩ ﺍﻝﻭﻓﺎﺓ‪.‬‬
‫ﺨﻼل ‪ 30‬ﻴﻭﻡ ﻤﻥ ﺃﻱ ﺤﺎﺩﺙ ﺁﺨﺭ ﻗﺩ ﻴﺅﺩﻱ ﺇﻝﻰ ﻤﻁﺎﻝﺒﺔ ﺒﻤﻭﺠﺏ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ‪.‬‬
‫ﻭﻴﺘﻌﻴﻥ ﻋﻠﻰ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺃﻥ ﻴﻘﻭﻡ ﻋﻠﻰ ﺤﺴﺎﺒﻪ ﺒﺘﻘﺩﻴﻡ ﺃﻱ ﺸﻬﺎﺩﺍﺕ ﻭﻤﻌﻠﻭﻤﺎﺕ ﻭﺩﻝﻴل ﻤﻭﺜﻕ )ﺍﻝﺩﻝﻴل( ﺍﻝﺫﻱ ﺘﻁﻠﺒﻪ ﺍﻝﺸﺭﻜﺔ ﺒﺨﺼﻭﺹ ﺍﻝﺤـﺎﺩﺙ ﺍﻝﻤـﺅﻤﻥ‬
‫ﻀﺩﻩ‪.‬‬
‫ﺍﻝﻤﺒﺎﻝﻎ ﺍﻝﻤﺴﺘﺭﺩﺓ‬
‫ﻜﺎﻓﺔ ﺍﻝﻤﺒﺎﻝﻎ ﺍﻝﻤﺴﺘﺭﺩﺓ ﺍﻝﺼﺎﻓﻴﺔ ﻤﻥ ﻨﻔﻘﺎﺕ ﺍﻝﺘﻌﻭﻴﺽ ﺍﻝﻔﻌﻠﻴﺔ ﻝﺩﻯ ﺍﻝﺸﺭﻜﺔ ﺴﻭﻑ ﻴﺘﻡ ﺘﻭﺯﻴﻌﻬﺎ ﺃﻭﻻ ﻋﻠﻰ ﺍﻝﺸﺭﻜﺔ ﻤﻘﺎﺒل ﻜﺎﻓﺔ ﺍﻝﻤﺒﺎﻝﻎ ﺍﻝﻤﺩﻓﻭﻋﺔ ﻭﺃﻱ ﻤﺒﻠـﻎ ﻤﺘﺒﻘـﻲ‬
‫ﺴﻭﻑ ﻴﺘﻡ ﺩﻓﻌﻪ ﺇﻝﻰ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ‪.‬‬
‫ﺍﻝﻤﻁﺎﻝﺒﺎﺕ ﺍﻻﺤﺘﻴﺎﻝﻴﺔ‬
‫ﻓﻲ ﺤﺎﻝﺔ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺃﻭ ﺃﻱ ﺸﺨﺹ ﻴﻌﻤل ﻨﻴﺎﺒﺔ ﻋﻨﻪ ﻵﻱ ﻭﺴﺎﺌل ﺃﻭ ﺃﺩﻭﺍﺕ ﺍﺤﺘﻴﺎﻝﻴﺔ ﻝﻠﺤﺼﻭل ﻋﻠﻰ ﻤﻨﻔﻌﺔ‪ ،‬ﻋﻨﺩﺌﺫ ﺃﻱ ﻤﺒﻠﻎ ﻭﺍﺠﺏ ﺍﻝﺩﻓﻊ ﻓﻴﻤـﺎ‬
‫ﻴﺘﻌﻠﻕ ﺒﻬﺫﻩ ﺍﻝﻤﻁﺎﻝﺒﺔ ﺴﻭﻑ ﻴﺘﻡ ﺇﺴﻘﺎﻁﻪ‪ ،‬ﻭﺴﻭﻑ ﻴﺘﻡ ﺇﻝﻐﺎﺀ ﺍﻝﻭﺜﻴﻘﺔ ﻭﻝﻥ ﻴﺘﻡ ﺭﺩ ﺃﻱ ﻗﺴﻁ ﺘﺄﻤﻴﻥ‪.‬‬
‫ﻋﺎﻡ‬
‫ﻴﻨﺒﻐﻲ ﻋﻠﻰ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺃﻥ ﻴﺨﻀﻊ ﻝﻠﻔﺤﺹ ﺍﻝﻁﺒﻲ ﻋﻠﻰ ﺤﺴﺎﺏ ﺍﻝﺸﺭﻜﺔ ﻭﻓﻘﺎ ﻝﻌﺩﺩ ﺍﻝﻤﺭﺍﺕ ﺍﻝﻤﻁﻠﻭﺒﺔ ﺒﺎﻻﺭﺘﺒﺎﻁ ﻤﻊ ﺃﻱ ﻤﻁﺎﻝﺒـﺔ‪ .‬ﻭﺃﻱ ﺘﻘﺭﻴـﺭ ﻴـﺘﻡ‬
‫ﺇﺼﺩﺍﺭﻩ ﻨﺘﻴﺠﺔ ﻝﻬﺫﺍ ﺍﻝﻔﺤﺹ ﺴﻭﻑ ﻴﻜﻭﻥ ﻤﻠﻜﻴﺔ ﺍﻝﺸﺭﻜﺔ ﻭﺴﻭﻑ ﻴﻌﺘﺒﺭ ﻤﻌﻠﻭﻤﺎﺕ ﺴﺭﻴﺔ ﻋﺎﺌﺩﺓ ﻝﻠﺸﺭﻜﺔ‪.‬‬
‫ﻴﺘﻡ ﻁﻠﺏ ﺍﻝﻌﻼﺝ ﺍﻝﻁﺒﻲ ﻭﺇﺘﺒﺎﻋﻪ ﻓﻭﺭﺍ ﻋﻨﺩ ﺤﺩﻭﺙ ﺇﺼﺎﺒﺔ ﺁﻭ ﻤﺭﺽ ﻭﻝﻥ ﺘﻜﻭﻥ ﺍﻝﺸﺭﻜﺔ ﻤﺴﺅﻭﻝﺔ ﻋﻥ ﻫﺫﺍ ﺍﻝﺠﺯﺀ ﻤﻥ ﺃﻱ ﻤﻁﺎﻝﺒﺔ ﺍﻝﺫﻱ ﻴﻨﺸﺄ ﻭﻓﻘﺎ ﻝﺭﺃﻱ ﺍﻝﻁﺒﻴﺏ ﻤﻥ‬
‫ﺍﻹﻫﻤﺎل ﺁﻭ ﺍﻹﺨﻔﺎﻕ ﻏﻴﺭ ﺍﻝﻤﻌﻘﻭل ﺁﻭ ﺍﻝﻤﺘﻌﻤﺩ ﻤﻥ ﻗﺒل ﺃﻱ ﺸﺨﺹ ﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻓﻲ ﻁﻠﺏ ﻭﺍﻝﺒﻘﺎﺀ ﺘﺤﺕ ﺭﻋﺎﻴﺔ ﻁﺒﻴﺏ ﻤﺅﻫل‪.‬‬
‫ﻜﺎﻓﺔ ﺍﻝﻤﻁﺎﻝﺒﺎﺕ ﺍﻝﺘﻲ ﺘﻨﺸﺄ ﻋﻥ ﺤﻭﺍﺩﺙ ﺠﻨﺎﺌﻴﺔ ﻴﺠﺏ ﺘﺄﻴﻴﺩﻫﺎ ﻭﻤﺭﺍﻓﻘﺘﻬﺎ ﺒﺘﻘﺭﻴﺭ ﻤﻌﺘﻤﺩ ﻤﻥ ﺍﻝﺸﺭﻁﺔ‪.‬‬
‫ﺍﻻﻝﺘﺯﺍﻡ ﻭﺍﻷﺩﺍﺀ ﻜﻤﺎ ﻴﺠﺏ ﻝﻬﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ ﺇﻝﻰ ﻤﺩﻯ ﺘﻌﻠﻘﻬﺎ ﺒﺄﻱ ﺸﻲﺀ ﻴﺘﻡ ﺍﻝﻘﻴﺎﻡ ﺒﻪ ﺃﻭ ﺍﻻﻝﺘﺯﺍﻡ ﺒﻪ ﻤﻥ ﻗﺒل ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺴـﻭﻑ ﻴﻜـﻭﻥ ﺸـﺭﻁ ﻤـﺴﺒﻕ‬
‫ﻝﻠﻤﺴﺅﻭﻝﻴﺔ ﻋﻥ ﺘﺴﺩﻴﺩ ﺃﻱ ﻤﺩﻓﻭﻋﺎﺕ ﺒﻤﻭﺠﺏ ﻫﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ‪.‬‬
‫ﻴﺤﻕ ﻝﻠﺸﺭﻜﺔ ﺍﻻﻁﻼﻉ ﻋﻠﻰ ﺃﻱ ﺴﺠﻼﺕ ﻁﺒﻴﺔ ﺤﺎﻝﻴﺔ ﺃﻭ ﺴﺎﺒﻘﺔ ﺨﺎﺼﺔ ﺒﺎﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﻝﻜﻲ ﻴﺘﻡ ﺇﻨﻬﺎﺀ ﻭ‪/‬ﺃﻭ ﻤﺒﺎﺸﺭﺓ ﺘﻘﻴﻴﻡ ﺍﻝﻤﻁﺎﻝﺒﺔ ﻭ‪/‬ﺃﻭ ﺘﻘﺩﻴﻡ ﺍﻝﻤـﺴﺎﻋﺩﺓ ﺍﻝﻁﺒﻴـﺔ‪.‬‬
‫ﻭﺍﺴﺘﻨﺎﺩﺍ ﻝﻬﺫﺍ ﺍﻝﺒﻨﺩ‪ ،‬ﺴﻭﻑ ﻴﻌﺘﺒﺭ ﺍﻝﺸﺨﺹ ﺍﻝﻤﺅﻤﻥ ﻋﻠﻴﻪ ﺍﻨﻪ ﻤﻨﺢ ﻝﻠﺸﺭﻜﺔ ﻤﻭﺍﻓﻘﺔ ﺨﻁﻴﺔ ﻝﻼﻁﻼﻉ ﻋﻠﻰ ﺃﻱ ﺴﺠﻼﺕ ﻁﺒﻴﺔ ﺤﺎﻝﻴﺔ ﺃﻭ ﺴﺎﺒﻘﺔ ﺘﺘﻌﻠﻕ ﺒﺎﻝﺸﺨﺹ ﺍﻝﻡﺅﻤﻥ‬
‫ﻋﻠﻴﻪ‪.‬‬
‫ﻝﻥ ﺘﺴﺘﺤﻕ ﺃﻱ ﻓﺎﺌﺩﺓ ﻋﻥ ﺃﻱ ﻤﺒﻠﻎ ﻭﺍﺠﺏ ﺍﻝﺩﻓﻊ ﻭﻓﻘﺎ ﻝﻬﺫﻩ ﺍﻝﻭﺜﻴﻘﺔ‬
‫)‪© AIG, all rights reserved (V 1.0 – June 20, 2013‬‬