Automobile Insurance is an insurance which covers any loss of/or damage to motor vehicle caused by accident or theft, and

third party liability.

Asuransi Kendaraan Bermotor adalah asuransi yang menjamin kerugian kendaraan bermotor yang diakibatkan kecelakaan atau pencurian, dan tanggung jawab hukum terhadap pihak ketiga. Jenis Penutupan dalam Asuransi Kendaraan Bermotor : Gabungan Menjamin atas setiap kerugian atau kerusakan yang terjadi pada kendaraan bermotor Kerugian Total Ganti rugi diberikan jika nilai kerugian atau kerusakan mencapai 75 % atau lebih dari nilai pasar kendaraan / hilang karena pencurian Perluasan Jaminan untuk Asuransi Kendaraan Bermotor* : Kecelakaan diri pengemudi Kecelakaan diri penumpang Tanggung Jawab Hukum terhadap pihak ketiga Tanggung Jawab Hukum terhadap penumpang Pemogokan, Kerusuhan, dan Huru hara Terorisme & Sabotase Gempa Bumi, Tsunami, Letusan Gunung Api, Banjir dan Badai Untuk setiap ganti rugi akan dikurangi dengan risiko sendiri dan pertanggungan hanya berlaku dalam wilayah Republik Indonesia.
Brosur ini hanya memuat informasi umum dan bukan merupakan kontrak/perjanjian asuransi. Rincian mengenai kondisi pertanggungan akan dituangkan di dalam polis. Diwajibkan untuk membaca dan memahami kondisi pertanggungan tersebut dengan baik.
* Syarat dan Ketentuan Berlaku

Automobile Insurance Asuransi Kendaraan Bermotor

Kinds of Coverage of an Automobile Insurance : Comprehensive Covers any loss or damage in respect of property damage for partial and total loss Total Loss Only Covers any loss of motor vehicle if cost of repair exceeds 75% of value at risk or lost because of theft

PT ASURANSI TOKIO MARINE INDONESIA

Extended Coverage for an Automobile Insurance* : Personal Accident for Passenger Personal Accident for Driver Third Party Liability Passengers Legal Liability Strike Riot Civil Commotions Terrorism & Sabotage Earthquake, Tsunami, Volcanic Eruption, Flood and Storm Indemnity to the insured shall be deducted by its own retention and this insurance applies within the Indonesian territory only.
This brochure contains information which is very general and is not an insurance contract/agreement. Detailed terms and conditions will be referred to the policy. It is crucial that you read and understand the policy's terms and conditions well.
* Terms and Condition Applied

For further information, please contact us:

Untuk keterangan lebih lengkap, silahkan menghubungi kami:

WHERE THE BEST SECURITY COMMITTED TMI QUALITY OBJECTIVE The company have decided a quality objective of claim settlement within 6 (six) working days as of the date of obtaining mutual written agreement between insured and assured on total claim settlement amount and the insured has completed his/her liability. SASARAN MUTU TMI Perusahaan telah menetapkan suatu sasaran mutu bahwa akan membayar uang tuntutan ganti rugi dalam tempo 6 (enam) hari kerja terhitung sejak dicapainya kesepakatan tertulis antara penanggung dan tertanggung mengenai jumlah uang ganti rugi serta tertanggung telah memenuhi kewajibannya dalam mengajukan tuntutan ganti rugi.
Jakarta & Syariah (021) 572 5772 | Surabaya (031) 532 1202, 532 4546-7 | Medan (061) 453 6180, 457 7821, 457 7878 Semarang (024) 845 4191-2 | Bandung (022) 426 7252-3 Makassar (0411) 466 0816 | Pekanbaru (0761) 856 077 Batam (0770) 612 617-8 | Cikarang (021) 8911 7422 www.tokiomarine.co.id

FORMULIR IDENTITAS NASABAH CUSTOMER IDENTITY FORM

Nasabah wajib mengisi Formulir Identitas Nasabah Sesuai UU No. 15 Year 2002. Customers are required to fill in Customer's Identity Form in accordance to law No. UU No. 15 Tahun 2002

Corporate Customer / Nasabah Korporasi

Company Name / Nama Perusahaan :

Interest Information / Informasi Pertanggungan

Brand & Type / Merek dan Tipe : Engine No. / No. Mesin : Chassis No. / No. Rangka : Color / Warna : Manufacturing Year / Tahun Pembuatan : Police No. / No. Polisi :

Individual Customer / Nasabah Perorangan

Full Name/Nama Lengkap: [ ] Male / Pria [ ] Female / Wanita

Business Field / Bidang Usaha :

Tax Number / Nomor NPWP : [ ] Attached / Terlampir License No. / Nomor SIUP : [ ] Attached / Terlampir Register Number. / Nomor TDP : [ ] Attached / Terlampir

ID Number / Nomor Identitas : Address / Alamat :

No :

RT/RW :

City / Kota :

Article of Association and Ratification from Ministry of Justice / Akte Pendirian dan Pengesahan dari Dept. Kehakiman:

Post Code / Kode Pos : Home Tel. No. / No. Telp. Rumah : Mobile / HP : Citizenship / Kewarganegaraan : [ ] Indonesian Citizen / WNI Attached / Terlampir : [ ] ID Card / KTP [ ] Driving License / SIM [ ] Passport / Paspor [ ] KIMS [ ] KITAS [ ] KITAP [ ] Power of Attorney / Surat Kuasa Marital Status / Status Perkawinan : [ ] Not married / Belum Kawin [ ] Married / Kawin [ ] Divorced / Cerai Citizen / Kewarganegaraan : [ ] Indonesian Citizen / WNI Attached / Terlampir : Tax Registration Number (if any) / NPWP (Bila ada) : Company Name / Nama Perusahaan : Title / Jabatan : Business Field / Bidang Usaha : Length of Business / Lama Usaha : Address / Alamat : Year / Tahun Month / Bulan [ [ [ [ [ [ [ ] ID Card / KTP ] Driving License / SIM ] Passport / Paspor ] KIMS ] KITAS ] KITAP ] Power of Attorney / Surat Kuasa [ ] Foreign Citizen / WNA Occupancy / Pekerjaan : [ ] Civil Servant / Pegawai Negeri Sipil [ ] Private Employee / Karyawan Swasta [ ] Self Employed / Wirausaha [ ] Other / Lain-lain : [ ] Foreign Citizen / WNA City / Kota : Telephone No. / No. Telepon : President Director / Direktur Utama : Post Code / Kode Pos : Ext. / Pesawat : [ ] Attached / Terlampir Business Address / Alamat Usaha :

Vehicle Occupation / Penggunaan Kendaraan : [ ] Private / Pribadi [ ] Commercial / Bisnis (Komersil) Sum Insured / Harga Pertanggungan : Coverage / Jenis Jaminan : [ ] All Risk + TPL [ ] PA Driver [ ] TLO + TPL person Limit : SRCC [ ] TS [ ] [ ] TLO (Limit TPL : person Limit : ) Extension / Perluasan Jaminan: [ ] PA Passenger [ ] Earthquake & Volcanic Eruption [ ] Flood & Landslide Accessories / Aksesoris Tambahan : Photos / Foto Kendaraan : [ ] Terlampir Insurance Period / Periode Pertanggungan :

Additional Information / Informasi Tambahan

Other Policies owned / Polis Lain yang telah dimiliki : No. Kind : Insurance Company : Insurance Purpose / Tujuan Berasuransi : [ ] Protection against Personal / Company Asset / Perlindungan terhadap harta Pribadi / Perusahaan [ ] Other / Lain-lain :

Notes / Catatan :
Abbreviation / Singkatan : - KIMS : Temporary Stay Permit Card / Kartu Identitas Menetap Sementara - KITAS : Limited Stay Permit Card / Kartu Identitas Tinggal Sementara - KITAP : Permanent Stay Permit Card / Kartu Identitas Menetap Date / Tanggal

City / Kota : Telephone No. / No. Telepon :

Post Code / Kode Pos : Ext. / Pesawat :

Annual Income / Penghasilan Tahunan : [ ] < 30 Mio. / < 30 Juta [ ] IDR 30 - 100 Mio. / Rp. 30 - 100 Juta [ ] IDR 100 - 300 Mio. / Rp. 100 - 300 Juta [ ] > 300 Mio. / > 300 Juta Primary Income Source / Sumber Penghasilan Utama : [ ] Business Result / Hasil Usaha [ ] Monthly Salary [ ] Self Employed / Wirausaha [ ] Other / Lain-lain :

Client Signature / Tanda tangan Nasabah / Calon Nasabah Company / Association Stamp / Cap Perusahaan / Yayasan