MOTOR INSURANCE POLICY SCHEDULE

Policy No. : 2020040492 ‫ﺭﻗﻢ ﺍﻟﻮﺛﻴﻘﺔ‬

Type Of Cover : Comprehensive Cover ‫ﺿﺪ ﺍﻟﻔﻘﺪ ﻭﺍﻟﺘﻠﻒ ﻭﺍﻟﻤﺴﺆﻭﻟﻴﺔ ﺍﻟﻤﺪﻧﻴﻪ‬ ‫ﻧﻮﻉ ﺍﻟﻮﺛﻴﻘﺔ‬
(Against Loss Damage & Third Party Liability)
Name of Insured : PILAKKAL RAJESH RAHULAN PILAKKAL ‫ﺍﺳﻢ ﺍﻟﻤﺆﻣﻦ ﻟﻪ‬
Address : P.O.Box : 26423,Dubai U.A.E. ‫ﺍﻟﻌﻨﻮﺍﻥ‬
Cover Plan : Prestige Plus (Non Agency) ‫ﺍﻟﻤﻬﻨﺔ ﺃﻭ ﺍﻟﻮﻇﻴﻔﺔ‬
Period of Insurance From : 21/10/2020 12:55 To 20/11/2021 23:59 ‫ﻣﺪﺓ ﺍﻟﺘﺄﻣﻴﻦ ﻣﻦ‬
Premium Inclusive of Tax : AED 1,680.00
Specification of Insured Vehicle ‫ﺃﻭﺻﺎﻑ ﺍﻟﺴﻴﺎﺭﺓ ﺍﻟﻤﺆﻣﻦ ﻋﻠﻴﻬﺎ‬
‫ﻧﻮﻉ ﺍﻟﺴﻴﺎﺭﺓ ﻭﺍﻟﻤﻮﺩﻳﻞ‬ ‫ﺷﻜـﻞ ﺍﻟﻬﻴﻜﻞ‬ ‫ﺳﻨﺔ ﺍﻟﺼﻨﻊ‬ ‫ﻋﺪﺩ ﺍﻟﺮﻛﺎﺏ ﺑﻤﺎﻓﻴﻬﻢ ﺍﻟﺴﺎﺋﻖ‬ ‫ﺍﻟﻠﻮﻥ‬
Make and Model Type of Body Year of Manufacture Seating Capacity Including Colour
Driver
Honda - CR-V 4X4 2014 5 Black
‫ﺭﻗﻢ ﺍﻟﻤﺤﺮﻙ‬ ‫ﺭﻗﻢ ﺍﻟﺘﺴﺠﻴﻞ‬ ‫ﺭﻗﻢ ﺍﻟﺸﺎﺳﻴﻪ‬ ‫ﺍﻟﻐﺮﺽ ﻣﻦ ﺍﻟﺘﺮﺧﻴــﺺ‬ ‫ﻗﻮﺓ ﺍﻟﻤﺤﺮﻙ ﺑﺎﻷﺣﺼﻨﺔ‬
Engine Number Reg No. Chassis Number Use of Vehicle CC / Cylinders
K24Z93010426 57132 5J6RM4850EL702743 Private 4

Insured's Value of the Vehicle : AED 53,000.00 ‫ﺗﻘﺪﻳﺮ ﺍﻟﻤﺆﻣﻦ ﻟﻪ ﻟﻘﻴﻤﺔ ﺍﻟﺴﻴﺎﺭﺓ‬
Remarks :

Geographical Area :United Arab Emirates ‫ﺍﻹﻣﺎﺭﺍﺕ ﺍﻟﻌﺮﺑﻴﺔ ﺍﻟﻤﺘﺤﺪﺓ‬ ‫ﺍﻟﺤﺪﻭﺩ‬

‫ﺍﻟﺠﻐﺮﺍﻓﻴﺔ‬
Limit of Liability :1.The maximum authorized repair limit as per the ‫ﺑﻠﻎ ﻗﻴﻤﺔ ﺍﻟﺤﺪ ﺍﻷﻗﺼﻰ ﻟﺘﻜﺎﻟﻴﻒ ﺍﻹﺻﻼﺡ ﺍﻟﻤﺼﺮﺡ ﺑﻬﺎ ﻭﻓﻘﺍ‬ ‫ﺗﺠﺪﻳﺪ‬
policy is Nil ‫ ﺻﻔﺮ‬:‫ﻟﻠﺒﻮﻟﻴﺼﺔ‬ ‫ﺍﻟﻤﺴﺆﻭﻟﻴﺔ‬
2.The Company's maximum Liability in respect of ‫ﻳﻜﻮﻥ ﺍﻟﺤﺪ ﺍﻷﻗﺼﻰ ﻟﻤﺴﺆﻭﻟﻴﺔ ﺍﻟﺸﺮﻛﺔ ﻋﻦ ﺃﻳﺔ ﻣﻄﺎﻟﺒﺔ ﺃﻭ ﺟﻤﻠﺔ‬
death or bodily injury in respect of any one claim or ‫ﻣﻄﺎﻟﺒﺎﺕ ﻧﺸﺄﺕ ﻋﻦ ﺣﺎﺩﺙ ﻭﺍﺣﺪ ﻫﻮ ﻗﻴﻤﺔ ﻣﺎ ﻳﺣﻜﻢ ﺑﻪ ﻗﻀﺎﺋﻴﺍ ﻣﻦ‬
series of claims resulting from one accident is the ‫ﺗﻌﻮﻳﺾ ﻣﻬﻤﺎ ﺑﻠﻐﺖ ﻗﻴﻤﺘﻪ‬.
sum awarded by the Court whatever it may be.
3.The Company's maximum liability in respect of third ‫ﺗﺒﻠﻎ ﻗﻴﻤﺔ ﺍﻟﺤﺪ ﺍﻷﻗﺼﻰ ﻟﻤﺴﺆﻭﻟﻴﺔ ﺍﻟﺸﺮﻛﺔ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ‬
party property damage in respect of any one claim or ‫ﺑﺎﻷﺿﺮﺍﺭ ﺍﻟﺘﻲ ﺗﻠﺤﻖ ﺑﻤﻤﺘﻠﻜﺎﺕ ﺍﻟﻐﻴﺮ ﻋﻦ ﺃﻳﺔ ﻣﻄﺎﻟﺒﺔ ﺃﻭ ﺟﻤﻠﺔ‬
series of claims resulting from one accident is AED ‫ﻣﻄﺎﻟﺒﺎﺕ ﺗﻨﺸﺄ ﻋﻦ ﺣﺎﺩﺙ ﻭﺍﺣﺪ ﺩﺭﻫﻢ ﺇﻣﺎﺭﺍﺗﻲ‬.
3,500,000.00
Limitation of Use :The insured must not use the vehicle except for the ‫ﻳﺠﺐ ﻋﻠﻰ ﺍﻟﻤﺆﻣـﻦ ﻟﻪ ﺍﻻ ﻳﺴﺘﻌﻤـﻞ ﺍﻟﺴﻴﺎﺭﺓ ﺍﻻ ﻟﻠﻔﺮﺽ‬ ‫ﻗﻴـﻮﺩ‬
purpose for which it is licenced. ‫ﺍﻟﻤﺮﺧﺺ ﻣﻦ ﺃﺟﻠﻪ‬ ‫ﺍﻻﺳﺘﻌﻤـﺎﻝ‬
Special Conditions :250 + Additional Excess , if applicable (Refer Page 2) 250+‫ )ﺇﺫﺍ ﻛﺎﻥ ﻗﺎﺑﻠﺍ ﻟﻠﺘﻄﺒﻴﻖ‬،‫)ﺩﺭﻫﻢ ﺇﻣﺎﺭﺍﺗﻲ ﻓﻲ ﻇﺮﻭﻑ ﺧﺎﺻﺔ‬ ‫ﺷﺮﻭﻁ ﺧﺎﺻﺔ‬
(‫ﺍﺭﺟﻊ ﺇﻟﻰ ﺻﻔﺤﺔ ﺭﻗﻢ‬: 2.
Optional Covers
Agency Repairs NO AAA Road Side Assistance Gold NO
AAA Courtesy Car Benefit (10 days per Claim) YES AAA Road Side Assistance Silver NO
Personal Accident Cover to Driver YES AAA Road Side Assistance Platinum YES
Personal Accident Cover to Passengers YES

Processed By rahul_n-AFIA INSURANCE BROK. SER. LLC-Irfan Ahmed

Date 21-OCT-2020 12:55 PM

Page 1 of 3 Print Date 21-OCT-2020 11:55 AM

Processed By rahul_n-AFIA INSURANCE BROK. SER. LLC-Irfan Ahmed

Date 21-OCT-2020 12:55 PM

Page 2 of 3 Print Date 21-OCT-2020 11:55 AM

Signed on behalf of QATAR INSURANCE COMPANY (Dubai) ‫ﺩﺑـﻲ‬- ‫ﺷﺮﻛﺔ ﻗﻄﺮ ﻟﻠﺘﺄﻣﻴـﻦ‬
Processed By rahul_n-AFIA INSURANCE BROK. SER. LLC-Irfan Ahmed
Date 21-OCT-2020 12:55 PM ‫ﺍﻟﺘﺎﺭﻳﺦ‬
This Motor Insurance Policy Schedule to be Read along with your Policy Booklet for Terms, Limits, Conditions and Exclusions.

Page 3 of 3 Print Date 21-OCT-2020 11:55 AM