Gdańsk, 05 - Planeta Młodych

INSURANCE CERTIFICATE
f o r P l a n e t a M ł o d y c h c ar d h o l d e r s
Signal Iduna Polska Towarzystwo Ubezpieczen S.A. hereby confirms that by virtue of General Agreement no.
200552109091 entered into between SIGNAL IDUNA Polska S.A. Insurance Company
and Stowarzyszenie Planeta Młodych, insurance coverage is applied to all Planeta Młodych card holders in the following
scope:
LIMITS OF COVERAGE
TRAVEL / TRAVEL SPORT variant
Medical costs
Ambulatory treatment (up to 24 hours): costs of medicines
and dressing materials, doctor's examination
SUM INSURED
and maximum limits of responsibility
EUR 60 000
Up to EUR 1000
up to the amount of medical costs
insured
up to the amount of medical costs
Stay in hospital or other health care institution
insured
up to the amount of medical costs
Purchase of artificial limbs and additional materials
insured
Costs of dental treatment
800 PLN (EUR 200)
TRA NS P ORTA TI ON A ND REP A TRIA T IONC OS TS (AS S IS TA NCE)
TRAVEL / TRAVEL SPORT variant
Hospitalisation
Transport of the Insured to hospital or other health care
institution
Transport of the Insured from abroad to the country of
residence, in accordance with the written recommendation
of the medical practitioner
Transport of the corpse to the country of residence or
funeral abroad
up to the amount of medical costs
insured
up to the amount of medical costs
insured
up to the amount of medical costs
insured
up to the amount of medical costs
Costs of travel of the accompanying person
insured
up to the amount of medical costs
Costs of board and lodging for the accompanying person
insured
up to the amount of medical costs
Costs of purchasing the coffin
insured
Costs of the visiting person
Up to EUR 100 per day
Costs of convalescence of the insured
Up to EUR 100 per day
Transport the insured in order to continue travel
up to EUR 500
CONS EQ UENC ES OF A CCID ENTS
TRAVEL / TRAVEL SPORT / CLASSIC / CLASSIC SPORT variant
7.000 zł or 12.000 zł or 15.000 zł or
Permanent disablement
20.000 zł it depends on insurance
variant
5.000 zł or 9.000 zł ora 11.000 zł or
Death as a result of accident
15.000 zł it depends on insurance
variant
Daily hospital benefit
40 zł per day (in Poland)
Liability insurance
Personal injury
EUR 40 000
Property
EUR 10 000
The insurance period is identical with a validity of Planeta Młodych card.
Signal Iduna Polska Towarzystwo Ubezpieczeń S.A.
Alojzy Choda
Leslie Jones Breer
President
Vice President
SIGNAL IDUNA Polska Towarzystwo Ubezpieczeń S.A.
KRS: 42793, Zarząd: Alojzy Choda, Leslie J. Breer, Rainer Schönberg
NIP: 583-27-58-112, REGON: 192566592
Siedziba: ul. Jasna 14/16a, 00-041 Warszawa