QSN/SGM-MV/VIII/2026:624
Motor Vehicle Insurance
Wording : PSAKBI (Polis Standar Asuransi Kendaraan bermotor Indonesia)
The Insured : NIZAR ANTONIUS HENDRAWAN QQ PRIYO UTOMO
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 : 02 September 2026 to 02 September 2027
Territorial limit : For Business and Private used
License plate : B 225 MIV
Year : 2020
Brand/Model : TOYOTA LCRUISER200VXR 4X4AT
Sum Insured : Rp 1.900.000.000,-
Coverage : Comprehensive , Flood, Riot, Strike, Civil Commotion
Third party liability cover max IDR 100.000.000 in Any One Accident
Premium :
Comprehensive 1.05% =
Rp. 19.950.000
Loading rate 0.0525% =
Rp. 997.500
Flood (Banjir) 0.1% =
Rp. 1.900.000
RSMDCC (Huru-Hara) 0.05% =
Rp. 950.000
Third Party Liability (TJH Pihak ke 3) IDR 100.000.000 =
Rp. 500.000
=
Rp. 24.297.500
Discount 10% =
Rp. 2.429.750
Stamp and Duty =
Rp. 62.000
Net Premium =
Rp. 21.929.750


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





Dipersiapkan Oleh,