Oman United Insurance Company S.A.O.G ‫ﻉ‬.‫ﻉ‬.‫ﻡ‬.

‫ﺍﻟﺸﺮﻛﺔ ﺍﻟﻌﻤﺎﻧﻴﺔ ﺍﻟﻤﺘﺤﺪﺓ ﻟﻠﺘﺄﻣﻴﻦ ﺵ‬

Ruwi - Sultanate of Oman ‫ﺳﻠﻄﻨﺔ ﻋﻤﺎﻥ‬-‫ﺭﻭﻱ‬
C.R.: 1/23725/0 ١/٢٣٧٢٥/٠ ‫ﺕ‬.‫ﺱ‬
Tel.: 24477300 Fax: 24477334 ٢٤٤٧٧٣٣٤ : ‫ ﻓﺎﻛﺲ‬٢٤٤٧٧٣٠٠: ‫ﻫﺎﺗﻒ‬
www.omanutd.com - Info@omanutd.com Security - Service www.omanutd.com - Info@omanutd.com

MOTOR INSURANCE POLICY SCHEDULE ‫ﺟﺪﻭﻝ ﻭﺛﻴﻘﺔ ﺗﺄﻣﻴﻦ ﺍﻟﺴﻴﺎﺭﺍﺕ‬

Issuing Office: WORLD GULF SERVICES COMPREH:‫ ﺟﻬﺔ ﺍﻻﺻﺪﺍﺭ‬Broker/Agent: 125066 :‫ﺍﻟﻮﻛﻴﻞ‬/‫ ﺍﻟﻮﺳﻴﻂ‬Customer Code 125066 :‫ﺭﻣﺰ ﺍﻟﻌﻤﻴﻞ‬
Policy No.: P-2407-91-2023-00351 :‫ ﺭﻗﻢ ﺍﻟﻮﺛﻴﻘﺔ‬Date Of Issue: 28/12/2023 :‫ ﺗﺎﺭﻳﺦ ﺍﻻﺻﺪﺍﺭ‬Issued At: :‫ﺻﺪﺭﺕ ﻓﻲ‬
Insured Name: ‫ﻛﺎﻣﺎﻟﻴﺶ ﺑﺎﻻﻧﻴﺴﺎﻣﻲ‬ :‫ﺍﻟﻤﺆﻣﻦ ﻟﻪ‬

Address: ‫ﺍﺯﻛﻲ‬,SULTANATE OF OMAN :‫ﺍﻟﻌﻨﻮﺍﻥ‬

Occupation: :‫ﺍﻟﻮﻇﻴﻔﺔ‬

Period Of Insurance: (a) From: 28/12/2023 00:00 :‫ﻓﺘﺮﺓ ﺍﻟﺘﺄﻣﻴﻦ ﻣﻦ‬

Both day inclusive To: 27/12/2024 23:59 :‫ ﺍﻟﻰ‬- ‫ﻳﺸﻤﻞ ﺍﻟﺘﺎﺭﻳﺨﻴﻦ‬

Type Of Cover: :‫ﻧﻮﻉ ﺍﻟﺘﺄﻣﻴﻦ‬

PRIVATE COMPREHENSIVE
‫ﻧﻮﻉ ﺍﻟﻤﺮﻛﺒﺔ ﻭﺷﻜﻠﻬﺎ‬ ‫ﺳﻨﺔ ﺍﻟﺼﻨﻊ‬ ‫ﺍﻟﻮﺯﻥ‬-‫ ﺍﻟﺴﻠﻨﺪﺭ‬-‫ ﺳﻌﺔ ﺍﻟﻤﺤﺮﻙ‬- ‫ﺍﻟﻤﻘﺎﻋﺪ‬ ‫ﺍﻟﻐﺮﺽ ﻣﻦ ﺍﻟﺘﺮﺧﻴﺺ‬ ‫ﺭﻗﻢ ﺍﻟﻠﻮﺣﺔ‬ ‫ﺍﻟﺸﺎﺻﻲ‬/ ‫ﺭﻗﻢ ﺍﻟﻤﺤﺮﻙ‬ ‫ﺍﻟﻘﻴﻤﺔ ﺍﻟﺘﺄﻣﻴﻨﻴﺔ‬
Make & Type of Vehicle Year of MFG Seat-C.C-CYL-Tonnage
TOYOTA FORTUNER 2020 2694 7 PRIVATE VEHICLE 9135 H Y 2TRA762781 8,535.700
4 X 4 WD MHFDX8FS2L0108035

Excess: The insured pays the following amount:

1. If the driver is one of the person authorised to drive the vehicle in the list stated in the Insurance application ,
and his age is 25 years old or more.
50.000
2. If the driver is one of the persons authorised to drive the vehicle in the list stated in the insurance 75.000
application, and his age is less than 25 years.
3. If the driver is not one of the persons indicated in the list and his age is 25 years old or more 75.000
4. If the driver is not one of the persons indicated in the list and his age is less than 25 years old.
The insured Amount Indicated in the policy schedule shall be determined as follows: 100.000
a) The cash value of the vehicle on the purchase date is determined according to its first purchase invoice. If
this purchase invoice is not available, a certificate shall be requested from the agency stating the actual value
of the vehicle on the purchase date.
b) Depreciation shall be computed as per the approved depreciation schedule 1 or 2 Appendix 1
c) The difference between item 1 and item 2 is considered to be the insurance value of the vehicle at the
beginning of Insurance during the years following the first year, and it is the basis of compensation settlement
in case of accident.
d) Where purchase invoice or agency certificate is not available to determine the value of the vehicle the
Insurance amount shall be computed on the basis of the market value of the vehicle as per the rules set out by
CMA.
e) As an exception from the above regulations, the insured amount may be higher than the value stated in the
aforesaid rules.
Restrictions on use:
The insured shall not use the vehicle for any purpose other than what is specified in the license. If the vehicle is
used for any other purpose than what is specified in the license, the insurance shall not cover accidents
resulting from such use.
Limits of the Insurer's Liability:
1. The maximum liability limit of the Insurer for repair cost in accordance with Article 3 of Section 1 is R.O. 150
(Rial Omani One Hundred and Fifty)
2. The maximum amount authorised for protecting and transporting as per Article 5 of Section 1 is R.O 100 (Rial
Omani One Hundred)
3. The maximum amount for protection and transporting cost as per clause (I.e of Chapter Three is the .(‫ ﺭﻳﺎﻝ ﻋﻤﺎﻧﻲ )ﻣﺎﺋﺔ ﺭﻳﺎﻝ‬١٠٠ ‫ ﻣﻦ ﺍﻟﻔﺼﻞ ﺍﻻﻭﻝ‬٥ ‫ﺏ( ﺍﻟﺤﺪ ﺍﻷﻗﺼﻰ ﻟﺘﻜﺎﻟﻴﻒ ﺍﻟﺤﺮﺍﺳﺔ ﻭﺍﻟﻨﻘﻞ ﺍﻟﻤﺼﺮﺡ ﺑﻬﺎ ﻭﻓﻘﺎ ﻟﻠﺒﻨﺪ‬
protection and transportation cost recognised in the market.
a) The maximum liability limit of the insurer under item (a) of Article 1 of Section 2 for any claim or all claims
arising from one accident is the amount of compensation decided by the court.
b) The Maximum Liability limit of the insurer under item (b) of Article 1 of Section 2 for any claim or all claims
arising from one accident is R.O. 150,000(One Hundred and Fifty Thousand) unless otherwise agreed by both
parties in writing on a higher amount.
c) The Maximum Liability limit of the insurer under the first para of clause second of Section 2 is R.O.
10,000(Rial Omani Ten Thousand) for the insurance year regardless of the number of accidents.
d) The Maximum Liability limit of the insurer for first aid expenses stated in section 2 for any claim or all claims
arising from one accident is R.O. 400(Rial Omani Four Hundred).
Rules for Settlement of Medical Expenses:
The Insurer is bound to pay hospital and medical institutions the expenses incurred for the treatment of Bodily
injuries of third party or insured and anyone in his possession and their family members according to the
following rules.
a) The hospital or the medical institution shall prepare a detail report on the treatment and the actual cost of the
same, along with the necessary supporting documents.
b) Claims for medical expenses shall be based only on the amount approved by the Ministry of Health.
c) The Insurer, after reviewing the reports received, shall pay the required amount to the hospital or medical
institution which carried out the treatment.
d) In the event of treatment abroad an evidence from the Ministry of Health shall be provided that treatment is
not available in the Sultanate.
I acknowledge having read the contents and schedules of the insurance policy and agree entirely with its terms
and conditions. I also confirm that the information I provided to the Insurer are true.
SUBJECT TO THE SULTANATE OF OMAN UNIFIED MOTOR VEHICLE INSURANCE POLICY.
Commercial Light
Commercial Heavy
UAE MULTIPLE VISITS PA Driver + 6 Passenger Only‫ﺍﻟﻘﺼﻮﻯ‬
Storm, Tempest & Flood
:‫ ﻳﺘﺤﻤﻞ ﺍﻟﻤﺆﻣﻦ ﻟﻪ ﺍﻟﻤﺒﻠﻎ ﺍﻟﻤﻮﺿﺢ ﺃﺩﻧﺎﻩ‬:‫ﺍﻟﺘﺤﻤﻞ‬
.1‫ ﺳﻨﺔ‬٢٥ ‫ﻭﻋﻤﺮﻩ‬،‫ﺍﺫﺍ ﻛﺎﻥ ﺍﻟﺴﺎﺋﻖ ﻣﻦ ﺍﻷﺷﺨﺎﺹ ﺍﻟﻤﺼﺮﺡ ﻟﻬﻢ ﺑﺎﻟﻘﻴﺎﺩﺓ ﺿﻤﻦ ﺍﻟﻘﺎﺋﻤﺔ ﺍﻟﻤﻮﺟﻮﺩﺓ ﻓﻲ ﻃﻠﺐ ﺍﻟﺘﺄﻣﻴﻦ‬
‫ﻓﺄﻛﺜﺮ‬
.2‫ﻭﻋﻤﺮﻩ ﺍﺻﻐﺮ ﻋﻦ‬،‫ﺇﺫﺍ ﻛﺎﻥ ﺍﻟﺴﺎﺋﻖ ﻣﻦ ﺍﻷﺷﺨﺎﺹ ﺍﻟﻤﺼﺮﺡ ﻟﻬﻢ ﺑﺎﻟﻘﻴﺎﺩﺓ ﺿﻤﻦ ﺍﻟﻘﺎﺋﻤﺔ ﺍﻟﻤﻮﺟﻮﺩﺓ ﻓﻲ ﻃﻠﺐ ﺍﻟﺘﺄﻣﻴﻦ‬
25 ‫ﺳﻨﺔ‬
.3‫ ﺳﻨﺔ ﻓﺄﻛﺜﺮ‬٢٥ ‫ﺇﺫﺍ ﻛﺎﻥ ﺍﻟﺴﺎﺋﻖ ﻣﻦ ﺍﻷﺷﺨﺎﺹ ﻏﻴﺮ ﺍﻟﻤﺬﻛﻮﺭﻳﻦ ﺑﺎﻟﻘﺎﺋﻤﺔ ﻭﻋﻤﺮﻩ‬
.4‫ ﺳﻨﺔ‬٢٥ ‫ﺇﺫﺍ ﻛﺎﻥ ﺍﻟﺴﺎﺋﻖ ﻣﻦ ﺍﻷﺷﺨﺎﺹ ﻏﻴﺮ ﺍﻟﻤﺬﻛﻮﺭﻳﻦ ﺑﺎﻟﻘﺎﺋﻤﺔ ﻭﻋﻤﺮﻩ ﺍﺻﻐﺮ ﻋﻦ‬
:‫ﻳﺤﺪﺩ ﻣﺒﻠﻎ ﺍﻟﺘﺄﻣﻴﻦ ﺍﻟﻤﻮﺿﺢ ﻓﻲ ﺟﺪﻭﻝ ﺍﻟﻮﺛﻴﻘﺔ ﻭﻓﻘﺎ ﻟﻤﺎ ﻳﻠﻲ‬
1‫ﺗﺤﺪﺩ ﻗﻴﻤﺔ ﺍﻟﻤﺮﻛﺒﺔ ﻧﻘﺪﺍ ﻋﻨﺪ ﺗﺎﺭﻳﺦ ﺍﻟﺸﺮﺍﺀ ﺣﺴﺐ ﻓﺎﺗﻮﺭﺓ ﺷﺮﺍﺀ ﺍﻟﻤﺮﻛﺒﺔ ﻷﻭﻝ ﻣﺮﺓ ﻓﺎﺫﺍﻟﻢ ﺗﺘﻮﺍﻓﺮ ﻓﺎﺗﻮﺭﺓ ﺍﻟﺸﺮﺍﺀ‬
‫ﺍﻟﻔﻌﻠﻴﺔ ﻟﻠﻤﺮﻛﺒﺔ ﻧﻘﺪﺍ ﻓﻲ ﺗﺎﺭﻳﺦ ﺍﻟﺸﺮﺍﺀ ﻷﻭﻝ ﻣﺮﺓ‬. ‫ﺍﻟﻤﺬﻛﻮﺭ ﻓﺘﻄﻠﺐ ﺷﻬﺎﺩﺓ ﻣﻦ ﺍﻟﻮﻛﺎﻟﺔ ﺑﺎﻟﻘﻴﻤﺔ‬
.2١ ‫( ﻣﻦ ﺍﻟﻤﻠﺤﻖ ﺭﻗﻢ‬٢‫ﺃﻭ‬١) ‫ﻳﺤﺴﺐ ﺍﻻﺳﺘﻬﻼﻙ ﺣﺴﺐ ﺟﺪﺍﻭﻝ ﺍﻻﺳﺘﻬﻼﻙ ﺍﻟﻤﻌﺘﻤﺪ‬
3‫( ﻳﻌﺘﺒﺮ ﺍﻟﻘﻴﻤﺔ ﺍﻟﺘﺎﻣﻴﻨﻴﺔ ﻟﻠﻤﺮﻛﺒﺔ ﻋﻨﺪ ﺑﺪﺀ ﺍﻟﺘﺎﻣﻴﻦ ﻓﻲ ﺍﻟﺴﻨﻮﺍﺕ ﺍﻟﺘﺎﻟﻴﺔ ﻟﻠﺴﻨﺔ ﺍﻻﻭﻟﻰ ﻭﻫﻮ‬٢‫ﺍﻟﺒﻨﺪ‬،١‫ﺍﻟﻔﺮﻕ ﺑﻴﻢ )ﺍﻟﺒﻨﺪ‬
‫ﺍﻟﺘﻌﻮﻳﺾ ﻓﻲ ﺣﺎﻟﺔ ﻭﻗﻮﻉ ﺣﺎﺩﺙ‬. ‫ﺍﻻﺳﺎﺱ ﺍﻟﺬﻱ ﻳﻌﺘﺪ ﺑﻪ ﻓﻲ ﺗﺴﻮﻳﺔ ﻣﺒﻠﻎ‬
4‫ﻓﺎﻧﻪ ﻳﺘﻢ ﺍﺣﺘﺴﺎﺏ ﻣﺒﻠﻎ‬،‫ﻓﻲ ﺣﺎﻟﺔ ﺗﻌﺬﺭ ﺍﻟﺤﺼﻮﻝ ﻋﻠﻰ ﻓﺎﺗﻮﺭﺓ ﺍﻟﺸﺮﺍﺀ ﺃﻭ ﺷﻬﺎﺩﺓ ﺍﻟﻮﻛﺎﻟﺔ ﺍﻟﻤﻌﻨﻴﺔ ﻟﺘﺤﺪﻳﺪ ﻗﻴﻤﺔ ﺍﻟﻤﺮﻛﺒﺔ‬
‫ﻟﻠﻤﺮﻛﺒﺔ ﻭﻓﻖ ﺍﻟﻀﻮﺍﺑﻂ ﺍﻟﺘﻲ ﺗﻀﻌﻬﺎ ﺍﻟﻬﻴﺌﺔ‬. ‫ﺍﻟﺘﺎﻣﻴﻦ ﻋﻠﻰ ﺃﺳﺎﺱ ﺍﻟﻘﻴﻤﺔ ﺍﻟﺴﻮﻗﻴﺔ‬
.5‫ﺍﺳﺘﺜﻨﺎﺀ ﻣﻦ ﺍﻟﻘﻮﺍﻋﺪ ﺍﻟﻤﻨﺼﻮﺹ ﻋﻠﻴﻬﺎ ﺃﻋﻼﻩ ﻳﺠﻮﺯ ﺗﺤﺪﻳﺪ ﻣﺒﻠﻎ ﺍﻟﺘﺄﻣﻴﻦ ﺑﻘﻴﻤﺔ ﺍﻋﻠﻰ ﻣﻦ ﺍﻟﻘﻴﻤﺔ ﺍﻟﺘﻲ ﺗﺤﺪﺩﻫﺎ ﺍﻟﻘﻮﺍﻋﺪ‬
‫ﺍﻟﺴﺎﺑﻘﺔ‬
:‫ﻗﻴﻮﺩ ﺍﻻﺳﺘﻌﻤﺎﻝ‬
‫ﻳﺠﺐ ﻋﻠﻰ ﺍﻟﻤﺆﻣﻦ ﻟﻪ ﺃﻻ ﻳﺴﺘﻌﻤﻞ ﺍﻟﻤﺮﻛﺒﺔ ﺇﻻ ﻟﻠﻐﺮﺽ ﺍﻟﻤﺮﺧﺺ ﻭﻓﻲ ﺣﺎﻟﺔ ﺇﺳﺘﻌﻤﺎﻝ ﺍﻟﻤﺮﻛﺒﺔ ﻓﻲ ﻏﻴﺮ ﺍﻟﻐﺮﺽ‬
‫ﺍﻟﺤﻮﺍﺩﺙ ﺍﻟﻨﺎﺗﺠﺔ ﻋﻦ ﻫﺬﺍ ﺍﻻﺳﺘﻌﻤﺎﻝ‬. ‫ﺍﻟﻤﺮﺧﺼﺔ ﻟﻪ ﻓﻼ ﻳﺸﻤﻞ ﺍﻟﺘﺎﻣﻴﻦ ﺗﻐﻄﻴﺔ‬
:1‫ﺣﺪﻭﺩ ﻣﺴﺆﻭﻟﻴﺔ ﺍﻟﻤﺆﻣﻦ‬
.(‫ ﺭﻳﺎﻻ ﻋﻤﺎﻧﻴﺎ )ﻣﺎﺋﺔ‬١٥٠ ‫ ﻣﻦ ﺍﻟﻔﺼﻞ ﺍﻷﻭﻝ‬٢ ‫ﺃ( ﺍﻟﺤﺪ ﺍﻻﻗﺼﻰ ﻟﻤﺴﺆﻭﻟﻴﺔ ﺍﻟﻤﺆﻣﻦ ﻋﻦ ﺗﻜﺎﻟﻴﻒ ﺍﻻﺻﻼﺡ ﻭﻓﻘﺎ ﻟﻠﺒﻨﺪ‬
‫)ﻭﺧﻤﺴﻮﻥ ﺭﻳﺎﻻ ﻋﻤﺎﻧﻴﺎ‬
‫)ﻋﻤﺎﻧﻲ‬
.(‫ﻫـ( ﻣﻦ ﺍﻟﻔﺼﻞ ﺍﻟﺜﺎﻟﺚ ﻫﻲ ﺗﻜﻠﻔﺔ ﺍﻟﺤﺮﺍﺳﺔ ﻭﺍﻟﻨﻘﻞ‬/‫ﺝ( ﺍﻟﺤﺪ ﺍﻷﻗﺼﻰ ﻟﺘﻜﺎﻟﻴﻒ ﺍﻟﺤﺮﺍﺳﺔ ﻭﺍﻟﻨﻘﻞ ﻭﻓﻘﺎ ﻟﻠﺒﻨﺪ )ﺃﻭﻻ‬
‫ﺍﻟﻤﺘﻌﺎﺭﻑ ﻋﻠﻴﻬﺎ ﻓﻲ ﺍﻟﺴﻮﻕ‬
2‫ ﻣﻦ ﺍﻟﻔﺼﻞ ﺍﻟﺜﺎﻧﻲ ﻋﻦ ﺍﻱ ﻣﻄﺎﻟﺒﺔ ﺃﻭ ﺟﻤﻠﺔ ﻣﻄﺎﻟﺒﺎﺕ‬١ ‫ﺍﻟﺤﺪ ﺍﻷﻗﺼﻰ ﻟﻤﺴﺆﻭﻟﻴﺔ ﺍﻟﻤﺆﻣﻦ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻔﻘﺮﺓ )ﺃ( ﻣﻦ ﺍﻟﺒﻨﺪ‬
‫ﻳﺤﻜﻢ ﺑﻪ ﻗﻀﺎﺋﻴﺎ ﻣﻦ ﺗﻌﻮﻳﺾ‬. ‫ﻧﺸﺄﺕ ﻋﻦ ﺣﺎﺩﺙ ﻭﺍﺣﺪ ﻫﻮ ﻗﻴﻤﺔ ﻣﺎ‬
3‫ ﻣﻦ ﺍﻟﻔﺼﻞ ﺍﻟﺜﺎﻧﻲ ﻋﻦ ﺍﻱ ﻣﻄﺎﻟﺒﺔ ﺃﻭ ﺟﻤﻠﺔ ﻣﻄﺎﻟﺒﺎﺕ‬١ ‫ﺍﻟﺤﺪ ﺍﻷﻗﺼﻰ ﻟﻤﺴﺆﻭﻟﻴﺔ ﺍﻟﻤﺆﻣﻦ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻔﻘﺮﺓ )ﺏ( ﻣﻦ ﺍﻟﺒﻨﺪ‬
‫ﺭﻳﺎﻝ ﻋﻤﺎﻧﻲ )ﻣﺎﺋﺔ ﻭﺧﻤﺴﻮﻥ ﺍﻟﻒ ﺭﻳﺎﻝ ﻋﻤﺎﻧﻲ( ﻣﺎ ﻟﻢ ﻳﺘﻔﻖ ﻛﺘﺎﺑﺔ ﻋﻠﻰ ﻣﺒﻠﻎ ﺍﻛﺒﺮ‬. ١٥٠،٠٠٠ ‫ﻧﺸﺄﺕ ﻋﻦ ﺣﺎﺩﺙ ﻭﺍﺣﺪ‬
4‫ ﺭﻳﺎﻝ ﻋﻤﺎﻧﻲ )ﻋﺸﺮﺓ ﺍﻵﻑ‬١٠،٠٠٠ ‫ ﺛﺎﻧﻴﺎ ﻣﻦ ﺍﻟﻔﺼﻞ ﺍﻟﺜﺎﻧﻲ‬/‫ﺍﻟﺤﺪ ﺍﻷﻗﺼﻰ ﻟﻤﺴﺆﻭﻟﻴﺔ ﺍﻟﻤﺆﻣﻦ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻔﻘﺮﺓ ﺍﻻﻭﻟﻰ‬
‫ﻛﺎﻥ ﺗﻜﺮﺍﺭ ﺍﻟﺤﻮﺍﺩﺙ‬. ‫ﺭﻳﺎﻝ ﻋﻤﺎﻧﻲ( ﻋﻦ ﺍﻟﺴﻨﺔ ﺍﻟﺘﺎﻣﻴﻨﻴﺔ ﺃﻳﺎ‬
5‫ﺍﻟﺤﺪ ﺍﻷﻗﺼﻰ ﻟﻤﺴﺆﻭﻟﻴﺔ ﺍﻟﻤﺆﻣﻦ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻤﺼﺎﺭﻳﻒ ﺍﻻﺳﻌﺎﻓﺎﺕ ﺍﻻﻭﻟﻴﺔ ﺍﻟﻮﺍﺭﺩ ﺑﺎﻟﻔﺼﻞ ﺍﻟﺜﺎﻟﺚ ﻋﻦ ﺃﻱ ﻣﻄﺎﻟﺒﺔ ﺍﻭ ﺟﻤﻠﺔ‬
‫ﺭﻳﺎﻝ ﻋﻤﺎﻧﻲ )ﺃﺭﺑﻌﻤﺎﺋﺔ ﺭﻳﺎﻝ ﻋﻤﺎﻧﻲ‬٤٠٠. ‫)ﻣﻄﺎﻟﺒﺎﺕ ﻧﺸﺄﺕ ﻋﻦ ﺣﺎﺩﺙ ﻭﺍﺣﺪ‬
:‫ﻗﻮﺍﻋﺪ ﺳﺪﺍﺩ ﻣﺼﺎﺭﻳﻒ ﺍﻟﻌﻼﺝ‬
‫ﻳﻠﺰﻡ ﺍﻟﻤﺆﻣﻦ ﺑﺴﺪﺍﺩ ﻣﺼﺎﺭﻳﻒ ﻋﻼﺝ ﺍﻻﺻﺎﺑﺎﺕ ﺍﻟﺒﺪﻧﻴﺔ ﺍﻟﺘﻲ ﺗﻘﻊ ﻋﻠﻰ ﺍﻟﻐﻴﺮ ﺃﻭ ﻟﻠﻤﺆﻣﻦ ﻟﻪ ﻭﻣﻦ ﻓﻲ ﺣﻜﻤﻪ ﻭﺃﻓﺮﺍﺩ‬
‫ﻭﻓﻘﺎ ﻟﻠﻘﻮﺍﻋﺪ ﺍﻻﺗﻴﺔ‬: ‫ﺍﺳﺮﺗﻴﻬﻤﺎ ﻟﻠﻤﺴﺘﺸﻔﻴﺎﺕ ﻭﺍﻟﺠﻬﺎﺕ ﺍﻟﻄﺒﻴﺔ‬
.(‫ﻭﺍﻟﺘﻜﻠﻔﺔ ﺍﻟﺤﻘﻴﻘﺔ ﻣﺪﻋﻤﺎ ﺑﺎﻟﻤﺴﺘﻨﺪﺍﺕ‬،‫ﺃ( ﺗﻌﺪ ﺍﻟﻤﺴﺘﺸﻔﻰ ﺃﻭ ﺍﻟﺠﻬﺔ ﺍﻟﻄﺒﻴﺔ ﺗﻘﺮﻳﺮﺍ ﺗﻔﺼﻴﻠﻴﺎ ﺑﺎﻟﻌﻼﺝ ﺍﻟﺬﻱ ﺗﻢ ﺑﺎﻟﻔﻌﻞ‬
‫ﺍﻟﻼﺯﻣﺔ‬
.(‫ﺏ( ﻳﻌﺘﺪ ﻋﻦ ﺍﻟﻤﻄﻠﺒﺔ ﺑﻤﺼﺎﺭﻳﻒ ﺍﻟﻌﻼﺝ ﺑﺎﻟﻘﻴﻤﺔ ﺍﻟﺘﻲ ﺗﻌﺘﻤﺪﻫﺎ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬
.(‫ﺝ( ﻋﻠﻰ ﺍﻟﻤﺆﻣﻦ ﺑﻌﺪ ﺍﻻﻃﻼﻉ ﻋﻠﻰ ﺃﻭﺭﺍﻕ ﺍﻟﺘﻘﺮﻳﺮ ﺗﻮﺭﻳﺪ ﺍﻟﻤﺒﻠﻎ ﺍﻟﻤﻄﻠﻮﺏ ﺍﻟﻰ ﺍﻟﻤﺴﺘﺸﻔﻰ ﺃﻭ ﺍﻟﺠﻬﺔ ﺍﻟﻄﺒﻴﺔ ﺍﻟﺘﻲ ﺗﻮﻟﺖ‬
‫ﻋﻼﺝ ﺍﻟﻤﺼﺎﺏ‬
.(‫ﺩ( ﻓﻲ ﺣﺎﻟﺔ ﻣﺎ ﺍﺫﺍ ﺗﻢ ﺍﻟﻌﻼﺝ ﺧﺎﺭﺝ ﺍﻟﺴﻠﻄﻨﺔ ﻭﺟﺐ ﺗﻘﺪﻳﻢ ﻣﺎ ﻳﺜﺒﺖ ﻣﻦ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺑﺘﻌﺬﺭ ﺍﻟﻌﻼﺝ ﺩﺍﺧﻞ ﺍﻟﺴﻠﻄﻨﺔ‬
‫ﻟﻘﺪ ﺃﻃﻠﻌﺖ ﻋﻠﻰ ﻣﺤﺘﻮﻳﺎﺕ ﻭﺟﺪﻭﻝ ﻭﺛﻴﻘﺔ ﺍﻟﺘﺄﻣﻴﻦ ﻭﺃﺗﻔﻖ ﺗﻤﺎﻣﺎ ﻣﻊ ﻣﺎ ﻭﺭﺩ ﺑﻬﺎ ﻣﻦ ﺷﺮﻭﻁ ﻭﺍﻟﺘﺰﺍﻣﺎﺕ ﻛﻤﺎ ﺃﻭﻛﺪ ﺑﺄﻥ‬
‫ﺍﻟﻤﺆﻣﻨﺔ ﺻﺤﻴﺤﺔ‬. ‫ﺍﻟﻤﻌﻠﻮﻣﺎﺕ ﺍﻟﺘﻲ ﻗﺪﻣﺘﻬﺎ ﺍﻟﻰ ﺍﻟﺸﺮﻛﺔ‬
.‫ﻫﺬﻩ ﺍﻟﺸﻬﺎﺩﺓ ﺧﺎﺿﻌﺔ ﻟﺸﺮﻭﻁ ﻭﺛﻴﻘﺔ ﺍﻟﺘﺄﻣﻴﻦ ﺍﻟﻌﻤﺎﻧﻴﺔ ﺍﻟﻤﻮﺣﺪﺓ ﻋﻠﻰ ﺍﻟﻤﺮﻛﺒﺎﺕ‬
- ‫ ﺍﻟﺤﻤﻮﻟﺔ‬+ ‫ ﻛﻠﻎ )ﺍﻟﻮﺯﻥ ﺍﻟﻔﺎﺭﻍ‬٦٠٠٠ ‫*)ﺕ ﺥ ﺗﺠﺎﺭﻱ ﺧﻔﻴﻔﺔ ﺃﻗﻞ ﻣﻦ‬
‫ ﺍﻟﺤﻤﻮﻟﺔ ﺍﻟﻘﺼﻮﻯ‬+ ‫ ﻛﻠﻎ )ﺍﻟﻮﺯﻥ ﺍﻟﻔﺎﺭﻍ‬٦٠٠٠ ‫**)ﺕ ﺙ ﺗﺠﺎﺭﻱ ﺛﻘﻴﻞ ﺃﻛﺜﺮ ﻣﻦ‬

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