QSN/SGM-MV/IX/2026:705
Motor Vehicle Insurance
Wording : PSAKBI (Polis Standar Asuransi Kendaraan bermotor Indonesia)
The Insured : RICKY QQ FELICIA YOSEPHINE
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 : 04 Oktober 2026 to 04 Oktober 2027
Territorial limit : For Business and Private used
License plate : B 1638 OL
Year : 2014
Brand/Model : MERCEDES BENZ E CLASS E250 AT CKD
Sum Insured : Rp 250.000.000,-
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 2.08% =
Rp. 5.200.000
Loading rate 0.728% =
Rp. 1.820.000
Flood (Banjir) 0.1% =
Rp. 250.000
RSMDCC (Huru-Hara) 0.05% =
Rp. 125.000
Earthquake 0.1% =
Rp. 250.000
Terrorism & Sabotage 0.05% =
Rp. 125.000
Third Party Liability (TJH Pihak ke 3) IDR 50.000.000 =
Rp. 375.000
=
Rp. 8.145.000
Discount 15% =
Rp. 1.221.750
Stamp and Duty =
Rp. 62.000
Net Premium =
Rp. 6.985.250


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, 14 Oktober 2026





Dipersiapkan Oleh,