QSN/SGM-MV/IV/2026:235
Motor Vehicle Insurance
Wording : PSAKBI (Polis Standar Asuransi Kendaraan bermotor Indonesia)
The Insured : JUSMAN QQ FAIZAL FAHMI
as owner and / or its associated and / or its subsidiary and / or inter related companies
for their respective rights and interests
Area : 2 Jakarta, Jawa Barat dan Banten
Period : 15 April 2026 to 15 April 2027
Territorial limit : For Business and Private used
License plate : B 1619 SAS
Year : 2023
Brand/Model : MERC BENZ C 200 AVA W206AT CKD
Sum Insured : Rp 700.000.000,-
Coverage : Comprehensive , Flood, Riot, Strike, Civil Commotion, Earthquake, Terrorism & Sabotage
Third party liability cover max IDR 50.000.000 in Any One Accident
Premium :
Comprehensive 1.2% =
Rp. 8.400.000
Flood (Banjir) 0.1% =
Rp. 700.000
RSMDCC (Huru-Hara) 0.05% =
Rp. 350.000
Earthquake 0.1% =
Rp. 700.000
Terrorism & Sabotage 0.05% =
Rp. 350.000
Third Party Liability (TJH Pihak ke 3) IDR 50.000.000 =
Rp. 375.000
=
Rp. 10.875.000
Discount 25% =
Rp. 2.718.750
Stamp and Duty =
Rp. 62.000
Net Premium =
Rp. 8.218.250


Deductible :

Comprehensive Rp. 300.000 in any one accident
RSMDCC, TSFWD, Earthquake and TS are 10% of claim or min Rp. 500.000 in any one accident
CTL and Stolen are 5% of sum insured

 
Security : Avrist


Disetujui Oleh, Jakarta, 18 April 2026





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