QSN/SGM-MV/IX/2026:747
Motor Vehicle Insurance
Wording : PSAKBI (Polis Standar Asuransi Kendaraan bermotor Indonesia)
The Insured : TONY KUSDJAJA QQ PT PRIMA ENERGI UTAMA
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 : 17 Oktober 2026 to 17 Oktober 2027
Territorial limit : For Business and Private used
License plate : B 2055 SIR
Year : 2019
Brand/Model : MAZDA CX-9 AT
Acc Tambahan : KACA FILM 3M (Include TSI)
Sum Insured : Rp 401.000.000,-
Coverage : Comprehensive , Flood, Riot, Strike, Civil Commotion
Third party liability cover max IDR 50.000.000 in Any One Accident
Premium :
Comprehensive 1.2% =
Rp. 4.812.000
Loading rate 0.12% =
Rp. 481.200
Flood (Banjir) 0.1% =
Rp. 401.000
RSMDCC (Huru-Hara) 0.05% =
Rp. 200.500
Third Party Liability (TJH Pihak ke 3) IDR 50.000.000 =
Rp. 375.000
=
Rp. 6.269.700
Discount 20% =
Rp. 1.253.940
Stamp and Duty =
Rp. 60.000
Net Premium =
Rp. 5.075.760


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 : Arthagraha


Disetujui Oleh, Jakarta, 14 Oktober 2026





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