QSN/SGM-MV/IV/2026:237
Motor Vehicle Insurance
Wording : PSAKBI (Polis Standar Asuransi Kendaraan bermotor Indonesia)
The Insured : LOREN HERNANDO HIDAYAT
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 : 21 Mei 2026 to 21 Mei 2027
Territorial limit : For Business and Private used
License plate : B 2860 UUI
Year : 2024
Brand/Model : MITSUBISHI XFC ULT 1.5L 4X2 AT
Sum Insured : Rp 280.000.000,-
Coverage : Comprehensive
Third party liability cover max IDR 10.000.000 in Any One Accident
Premium :
Comprehensive 2.08% =
Rp. 5.824.000
Third Party Liability (TJH Pihak ke 3) IDR 10.000.000 =
Rp. 100.000
=
Rp. 5.924.000
Discount 20% =
Rp. 1.184.800
Stamp and Duty =
Rp. 62.000
Net Premium =
Rp. 4.801.200


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, 14 Agustus 2026





Dipersiapkan Oleh,