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Polisa Sab

This travel insurance policy with assistance covers 10 people traveling to Greece from June 3-13, 2015. It provides medical, travel, and legal assistance as well as luggage insurance. The basic coverage is for 15,000 euros. Insured persons must contact the assistance center at +381 11 36 36 999 for medical help and will be treated without cost by the assistance network's healthcare providers. Anyone who does not contact the center and pays for their own care will only be refunded up to average costs. The policy is valid without the insurer's signature.

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Nada Petrović
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341 views

Polisa Sab

This travel insurance policy with assistance covers 10 people traveling to Greece from June 3-13, 2015. It provides medical, travel, and legal assistance as well as luggage insurance. The basic coverage is for 15,000 euros. Insured persons must contact the assistance center at +381 11 36 36 999 for medical help and will be treated without cost by the assistance network's healthcare providers. Anyone who does not contact the center and pays for their own care will only be refunded up to average costs. The policy is valid without the insurer's signature.

Uploaded by

Nada Petrović
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Polisa putnog osiguranja sa asistencijom

Travel insurance policy with assistance


Broj polise

178351

Organiz. jedinica
Prodajno mesto

EKSPOZITURA ZVEZDARA
S.A.B TRAVEL DOO

Naziv zastupnika
ifra zastupnika
Vrsta osiguranja

PUTNA ASISTENCIJA EKSPOZITURE ZVEZDARA


1131100
1802

Br.pasoa/Passport No
Grad/City
Adresa/Address
Mob.tel/Phone

007681112
BEOGRAD
BB
1

Grad/City
Adresa/Address
Mob.tel/Phone

BEOGRAD
DELIGRADSKA 9

Podaci o Osiguraniku / Insured person


Prezime/Surname
Ime/Name
Pol/Sex
JMBG

JEVTIC
ZORICA

2011962715108

br/no

Podaci o Ugovarau / Policy holder


Naziv/Name
JMBG/MB
Pib

S.A.B TRAVEL DOO


21047732

br/no

Period osiguranja / Period of insurance


Od/From
Do/To
Datum ugov./Date

03.06.2015
13.06.2015
02.06.2015

Meseci/Months
Dana boravka/Days
Mesto ugovaranja/Place

11(jedanaest)
BEOGRAD

Podaci o osiguranju / Insurance data


Osnovni rizici/
Basic coverage
Paket pokria/
Pack cover
Suma osiguranja /
Insured sum

STANDARD
15.000,00

Medicinska, putna i pravna asistencija


Osiguranje prtljaga
Nain ugovaranja/
GRUPNO TURISTIKO OSIGURANJE
Agreement manner
Kontinent, Drava/
EVROPA, GRKA
Continent, Country
CEO SVET OSIM SAD, KANADE, JAPANA, AUSTRALIJE,
SOMALIJE, ZAPADNE SAHARE, RUANDE, SUDANA, KONGA,
ETIOPIJE, AVGANISTANA I IRAKA

Uee u teti /
Prticip. in damage

0,00

Teritorijalno pokrie/
Terittorial coverage

Broj osiguranika/
No of ins. persons

10

PREMIJA/PREMIUM

7.879,00

UKUPNA PREMIJA
POREZ

7.879,00
394,00

Doplatak/Surcharge
Popust/Discount

C E N T A R Z A P O M O +381 11 36 36 999

ZA UPLATU

8.273,00

Osiguranik je OBAVEZAN da u sluaju potrebe za medicinskom asistencijom pozove CENTAR ZA POMO +381 11 36 36 999
od kojeg e dobiti instrukcije na srpskom ili engleskom jeziku i biti upuen u najbliu zdravstvenu ustanovu koja je u mrei "Coris assstence" i bie zdravstveno zbrinut bez
plaanja trokova u skladu sa Uslovima osiguranja koji su sastavni deo ove polise. U suprotnom, ukoliko se Osiguranik ne javi Centru za pomo i svojevoljno se obrati
zdravstvenoj ustanovi obavezan je da sam snosi trokove leenja, a Osigurava zadrava pravo da Osiguraniku po povratku u zemlju, refundira trokove leenja
maksimalno do iznosa proseno ugovorene cene medicinskih usluga izmeu "Coris assistence" i zdravstvenih ustanova u dravi ili regiji u kojoj se Osiguranik samovoljno
leio i platio trokove istog. Osiguranik svojim potpisom potvruje da je upoznat sa obavezom javljanja Centru za pomo i Uslovima osiguranja, odnosno da je iste pri
ugovaranju osiguranja preuzeo.

The Insured shall be OBLIGED, in case of a need for medical assistance, to contact the ASSISTANCE CENTER at + 381 11 36 36 999
which will provide him/her with instructions in Serbian or English language and refer him/her to the nearest health institution within the "Coris Assistance" network, where
he/she will receive medical health care without paying the costs, in accordance with the Insurance Terms and Conditions which are an integral part of this policy. Otherwise,
if the Insured fails to contact the Assistance Center, but willfully contacts the health institution on his/her own, he/she shall be obliged to bear the treatment costs
himself/herself, while the Insurer shall reserve the right to refund the treatment costs to the Insured immediately upon his/her return to the country, up to the amount of an
average price of medical services contracted between the "Coris Assistance" and health institutions in the country or region where the Insured willfully received treatment
and paid the costs thereof. The Insured confirms with his/her signature that he/she is familiar with the obligation to contact the Assistance Center and with the Insurance
Terms and Conditions, i.e. that he/she has assumed said upon contracting of the insurance.

NAPOMENA:
Polisa je vaea bez potpisa Osiguravaa
Ugovara/Osiguranik

Akcionarsko drutvo za osiguranje Milenijum osiguranje a.d.o :: Bulevar Mihajla Pupina 10L :: 11000 Beograd, Srbija
potanski fah 427 :: tel: :: fax: 011 7152 329 :: e-mail: [email protected] :: web: www.milenijum-osiguranje.rs

SPISAK OSIGURANIH OSOBA


PO POLISI PUTNE ASISTENCIJE Broj 178351

R.br.

Ime i prezime

Broj pasoa

Datum
roenja

JMBG

Pol

JEVTIC ZORICA

007681112

20.11.1962

2011962715108

JOSIPOVIC GORDANA

008639034

29.12.1961

2912961715330

PETROVIC MILAN

007291590

30.10.1982

3010982710282

ROGIC NADA

009054067

27.06.1985

2706985796812

RISTOVIC ZORAN

009235421

28.07.1956

2807956710454

RISTOVIC ZORANA

009235420

01.03.1959

0103959715223

MILOSEVIC TAMARA

011576455

12.10.2010

1210010715235

PERIC BOZIDAR

009337503

31.03.1983

3103983922028

PERIC JELENA

008449402

10.06.1983

1006983715399

PIVNICKI NEMANJA

008106595

13.01.1985

1301985800042

10

Ugovara/Osiguranik

Akcionarsko drutvo za osiguranje Milenijum osiguranje a.d.o :: Bulevar Mihajla Pupina 10L :: 11000 Beograd, Srbija
potanski fah 427 :: tel: :: fax: 011 7152 329 :: e-mail: [email protected] :: web: www.milenijum-osiguranje.rs

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