QSN/SGM-MV/IX/2026:702
Motor Vehicle Insurance
Wording : PSAKBI (Polis Standar Asuransi Kendaraan bermotor Indonesia)
The Insured : DERRY HALIM QQ KUI HUI ALI
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 : 03 Oktober 2026 to 03 Oktober 2027
Territorial limit : For Business and Private used
License plate : B 2718 GF
Year : 2011
Brand/Model : MERCEDES BENZ C250 CGI COUPE AT CBU
Sum Insured : Rp 200.500.000,-
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 2.08% =
Rp. 4.170.400
Loading rate 1.04% =
Rp. 2.085.200
Flood (Banjir) 0.1% =
Rp. 200.500
RSMDCC (Huru-Hara) 0.05% =
Rp. 100.250
Earthquake 0.1% =
Rp. 200.500
Terrorism & Sabotage 0.05% =
Rp. 100.250
Third Party Liability (TJH Pihak ke 3) IDR 50.000.000 =
Rp. 375.000
=
Rp. 7.232.100
Discount 10% =
Rp. 723.210
Stamp and Duty =
Rp. 62.000
Net Premium =
Rp. 6.570.890


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, 13 Oktober 2026





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