QSN/SGM-MV/IX/2026:713
Motor Vehicle Insurance
Wording : PSAKBI (Polis Standar Asuransi Kendaraan bermotor Indonesia)
The Insured : VIVI ANDRIANA QQ LISA ANDRIANA
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 : 09 Oktober 2026 to 09 Oktober 2027
Territorial limit : For Business and Private used
License plate : B 9651 TVB
Year : 2024
Brand/Model : DAIHATSU S403RP-PMRFJJ NP (GRAN MAX)
Sum Insured : Rp 135.000.000,-
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 2.39% =
Rp. 3.226.500
Flood (Banjir) 0.1% =
Rp. 135.000
RSMDCC (Huru-Hara) 0.05% =
Rp. 67.500
Earthquake 0.1% =
Rp. 135.000
Terrorism & Sabotage 0.05% =
Rp. 67.500
Third Party Liability (TJH Pihak ke 3) IDR 50.000.000 =
Rp. 562.500
=
Rp. 4.194.000
Discount 10% =
Rp. 419.400
Stamp and Duty =
Rp. 62.000
Net Premium =
Rp. 3.836.600


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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