Al – Buhaira National Insurance Co.

MOTOR INSURANCE POLICY SCHEDULE

(Comprehensive against loss damage and third party liability)
(‫ﺟﺪﻭﻝ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻟﻮﺛﻴﻘﺔ ﺗﺄﻣﻴﻦ ﺍﻟﻤﺮﻛﺒﺔ )ﺍﻟﻔﻘﺪ ﻭﺍﻟﺘﻠﻒ ﻭﺍﻟﻤﺴﺆﻭﻟﻴﺔ ﺍﻟﻤﺪﻧﻴﺔ‬
Policy No: P/14/105/20/953446 :‫ﺭﻗﻢ ﺍﻟﻮﺛﻴﻘﺔ‬

Insured’s details ‫ﺑﻴﺎﻧﺎﺕ ﺍﻟﻤﺆﻣﻦ ﻟﻪ‬

Name of Insured ABDULLA ABDUL RAHMAN SHAFAE ‫ﺍﺳﻢ ﺍﻟﻤﺆﻣﻦ ﻟﻪ‬
Nationality / Age United Arab Emirates (29 Years) ‫ ﺍﻟﻌُﻤﺮ‬/ ‫ﺍﻟﺠﻨﺴﻴﺔ‬
Address / Phone Dubai/ 0566211373 ‫ ﺍﻟﻬﺎﺗﻒ‬/ ‫ﺍﻟﻌﻨﻮﺍﻥ‬
ID Card No. 000-0000-0000000-0 ‫ﺭﻗﻢ ﺍﻟﻬﻮﻳﺔ‬
(‫ﻣﺪﺓ ﺍﻟﺘﺄﻣﻴﻦ )ﻛﻼ ﺍﻟﺘﺎﺭﻳﺨﻴﻦ‬
Period of Insurance (Both Dates Inclusive) From:27/12/2020 TIME: 17:09, To: 26/01/2022 TIME: 23:59
‫ﻣﺸﻤﻮﻟﻴﻦ‬
Premium AED ‫ﻗﺴﻂ ﺍﻟﺘﺄﻣﻴﻦ‬

Vehicle’s details ‫ﺑﻴﺎﻧﺎﺕ ﺍﻟﻤﺮﻛﺒﺔ‬

‫ﺳﻨﺔ ﺍﻟﺼﻨﻊ‬ ‫ﺷﻜﻞ ﺍﻟﻬﻴﻜﻞ‬ ‫ﻧﻮﻉ ﺍﻟﻤﺮﻛﺒﺔ ﻭﺍﻟﻤﻮﺩﻳﻞ‬ ‫ﺍﻟﻐﺮﺽ ﻣﻦ ﺍﻟﺘﺮﺧﻴﺺ‬ ‫ﺭﻗﻢ ﺍﻟﻠﻮﺣﺔ‬
Year of MFR. Type of Body Make and Model Vehicle’s Permit Plate No
2016 SALOON VOLKSWAGEN GOLF Private Dubai 0
‫ﺭﻗﻢ ﺍﻟﻤﺤﺮﻙ‬ ‫ﺭﻗﻢ ﺍﻟﻘﺎﻋﺪﺓ‬ ‫ﻗﻮﺓ ﺍﻟﻤﺤﺮﻙ ﺑﺎﻷﺣﺼﻨﺔ‬ ‫ﻋﺪﺩ ﺍﻟﺮﻛﺎﺏ ﻣﻊ ﺍﻟﺴﺎﺋﻖ‬ ‫ﻟﻮﻥ ﺍﻟﻤﺮﻛﺒﺔ‬
Engine Number Chassis CC / HP Seating capacity including Driver Vehicle’s Color
3VW447AU6GM01827 5 Black

Insured’s Value of the Vehicle AED 50,000/- : ‫ﻗﻴﻤﺔ ﺍﻟﻤﺮﻛﺒﺔ ﺍﻟﻤﺆﻣﻨﺔ‬

Coverages and benefits: :‫ﺍﻟﺘﻐﻄﻴﺎﺕ ﻭﺍﻟﻤﻨﺎﻓﻊ‬
▪ Insurance Policy Against Own Damage ‫▪ ﻭﺛﻴﻘﺔ ﺗﺄﻣﻴﻦ ﺍﻟﻔﻘﺪ ﻭﺍﻟﺘﻠﻒ‬
▪ Insurance Policy Against Third Party ‫▪ ﻭﺛﻴﻘﺔ ﺗﺄﻣﻴﻦ ﺍﻟﻤﺴﺆﻭﻟﻴﺔ ﺍﻟﻤﺪﻧﻴﺔ‬
▪ Ambulance Services Cover ‫▪ ﺗﻐﻄﻴﺔ ﺧﺪﻣﺔ ﺍﻹﺳﻌﺎﻑ‬
▪ Medical Expenses Limit Up to AED 5,000/- ‫ ﺩﺭﻫﻢ‬5,000 ‫▪ ﺗﻐﻄﻴﺔ ﺍﻟﻨﻔﻘﺎﺕ ﺍﻟﻄﺒﻴﺔ ﺍﻟﻄﺎﺭﺋﺔ ﻟﻐﺎﻳﺔ‬
▪ Windscreen Damages Limit Up to AED 3,000/- (No Excess) 3,000 ‫ﺇﻋﻔﺎﺀ ﻣﻦ ﺑﻨﺪ ﺍﻟﺘﺤﻤﻞ ﺍﻹﺟﺒﺎﺭﻱ ﻋﻨﺪ ﺍﺳﺘﺒﺪﺍﻝ ﺍﻟﺰﺟﺎﺝ ﺍﻷﻣﺎﻣﻲ ﻟﻠﺴﻴﺎﺭﺓ ﻟﻐﺎﻳﺔ‬
▪ Natural Disaster Storm, Strike, Riots, Earth Quake Etc ‫▪ ﺩﺭﻫﻢ‬
▪ Replacement Of Lock Maximum Up to AED 1,000/- ‫ﺃﻋﻤﺎﻝ ﺍﻟﺸﻐﺐ ﻭﺍﻻﺿﻄﺮﺍﺑﺎﺕ‬,‫ﺍﻟﺰﻭﺍﺑﻊ‬,‫▪ ﺣﻤﺎﻳﺔ ﻣﻦ ﺍﻷﻋﺎﺻﻴﺮ‬
▪ Valet Parking Theft Cover(5 Star Hotels Only) ‫ ﺩﺭﻫﻢ‬1,000 ‫▪ ﺗﻐﻄﻴﺔ ﺗﺒﺪﻳﻞ ﺍﻷﻗﻔﺎﻝ ﻟﻐﺎﻳﺔ‬
▪ Personal Effects Limit Up to AED 5,000/- (‫ﺗﻐﻄﻴﺔ ﺍﻟﺴﺮﻗﺔ ﻓﻲ ﺣﺎﻝ ﻭﻗﻮﻋﻬﺎ ﺃﺛﻨﺎﺀ ﺧﺪﻣﺔ ﺻﻒ ﺍﻟﺴﻴﺎﺭﺓ ﻟﻠﻔﻨﺎﺩﻕ )ﺗﺸﻤﻞ ﻓﻨﺎﺩﻕ‬
▪ Road Side Assistance( A A A )Gold –(Toll Free 8008181) ‫ ﻧﺠﻮﻡ ﻓﻘﻂ‬5 ‫▪ ﻓﺌﺔ‬
▪ Personal Accident Benefit Cover to Driver ‫ ﺩﺭﻫﻢ‬5,000 ‫▪ ﺗﻐﻄﻴﺔ ﺍﻟﻤﻤﺘﻠﻜﺎﺕ ﺍﻟﺸﺨﺼﻴﺔ ﻓﻲ ﺣﺎﻝ ﺍﻟﻔﻘﺪ ﺃﻭ ﺍﻟﺴﺮﻗﺔ ﻟﻐﺎﻳﺔ‬
▪ Personal Accident Benefit Cover to Passengers (‫ﺍﻟﺒﻄﺎﻗﺔ ﺍﻟﺬﻫﺒﻴﺔ ﻟﻠﻌﻀﻮﻳﺔ ﺍﻟﻤﺠﺎﻧﻴﺔ ﻟﺨﺪﻣﺔ ﺍﻟﻤﺴﺎﻋﺪﺓ ﻋﻠﻰ ﺍﻟﻄﺮﻳﻖ)ﺍﻟﺮﻗﻢ‬
8008181‫▪ ﺍﻟﻤﺠﺎﻧﻲ‬
‫▪ ﺗﻐﻄﻴﺔ ﺍﻟﺤﻮﺍﺩﺙ ﺍﻟﺸﺨﺼﻴﺔ ﻟﻠﺴﺎﺋﻖ‬
‫▪ ﺗﻐﻄﻴﺔ ﺍﻟﺤﻮﺍﺩﺙ ﺍﻟﺸﺨﺼﻴﺔ ﻟﻠﺮﻛﺎﺏ‬
Geographic Area : UNITED ARAB EMIRATES ‫ﺩﻭﻟﺔ ﺍﻹﻣﺎﺭﺍﺕ ﺍﻟﻌﺮﺑﻴﺔ ﺍﻟﻤﺘﺤﺪﺓ‬ : ‫ﺍﻟﺤﺪﻭﺩ ﺍﻟﺠﻐﺮﺍﻓﻴﺔ‬
Limit of Liability : 1. The maximum authorized repair limit as per clause 3 of ‫( ﻣﻦ‬3) ‫ﺍﻟﺤﺪ ﺍﻻﻗﺼﻰ ﻟﺘﻜﺎﻟﻴﻒ ﺍﻻﺻﻼﺡ ﺍﻟﻤﺼﺮﺡ ﺑﻬﺎ ﻭﻓﻘﺎ ﻟﻠﺒﻨﺪ‬ .1 : ‫ﺗﺤﺪﻳﺪ ﺍﻟﻤﺴﺆﻭﻟﻴﺔ‬
section one is: NIL. .‫ ﻻ ﺷﻲﺀ‬: ‫ﺍﻟﻔﺼﻞ ﺍﻻﻭﻝ‬
2. The company’s maximum liability in respect of paragraph ‫ﺍﻟﺤﺪ ﺍﻻﻗﺼﻰ ﻟﻤﺴﺆﻭﻟﻴﺔ ﺍﻟﺸﺮﻛﺔ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻔﻘﺮﺓ )ﺃ( ﻣﻦ ﺍﻟﺒﻨﺪ‬ .2
(a) of clause 1 of section 2 in respect of any one claim ‫( ﻣﻦ ﺍﻟﻔﺼﻞ ﺍﻟﺜﺎﻧﻲ ﻋﻦ ﺍﻳﺔ ﻣﻄﺎﻟﺒﺔ ﺃﻭ ﺟﻤﻠﺔ ﻣﻄﺎﻟﺒﺎﺕ ﻧﺸﺄﺕ‬1)
or series of Claims resulting from one accident is the ‫ﻫﻮ ﻗﻴﻤﺔ ﻣﺎ ﻳُﺤﻜﻢ ﺑﻪ ﻗﻀﺎ ﺋﻴﺎ ً ﻣﻦ ﺗﻌﻮﻳﺾ ﻣﻬﻤﺎ ﺑﻠﻐﺖ‬
sum Awarded by the court Whatever it may be. ‫ﻋﻦ ﺣﺎﺩﺙ ﻭﺍﺣﺪ‬
3. The company’s maximum liability (TPPD) in respect of ‫ﺍﻟﺤﺪ ﺍﻻﻗﺼﻰ ﻟﻤﺴﺆﻭﻟﻴﺔ ﺍﻟﺸﺮﻛﺔ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻔﻘﺮﺓ )ﺏ( ﻣﻦ‬ .3
paragraph (b) of section 2 in respect of any one claim ‫( ﻣﻦ ﻟﻔﺼﻞ ﺍﻟﺜﺎﻧﻲ ﻋﻦ ﺍﻳﺔ ﻣﻄﺎﻟﺒﺔ ﺃﻭ ﺟﻤﻠﺔ ﻣﻄﺎﻟﺒﺎﺕ‬1) ‫ﺍﻟﺒﻨﺪ‬
or series of claims resulting from one accident is ‫ﻧﺸﺄﺕ ﻋﻦ ﺣﺎﺩﺙ ﻭﺍﺣﺪ‬
 Al – Buhaira National Insurance Co.
MOTOR INSURANCE POLICY SCHEDULE
(Comprehensive against loss damage and third party liability)
(‫ﺟﺪﻭﻝ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻟﻮﺛﻴﻘﺔ ﺗﺄﻣﻴﻦ ﺍﻟﻤﺮﻛﺒﺔ )ﺍﻟﻔﻘﺪ ﻭﺍﻟﺘﻠﻒ ﻭﺍﻟﻤﺴﺆﻭﻟﻴﺔ ﺍﻟﻤﺪﻧﻴﺔ‬
Policy No: P/14/105/20/953446 :‫ﺭﻗﻢ ﺍﻟﻮﺛﻴﻘﺔ‬
Dh 2,000,000/- ( ‫ )ﻣﻠﻴﻮﻧﻴﻦ ﺩﺭﻫﻢ ﻓﻘﻂ‬Dh 2,000,000/-
Special Conditions : ▪ Excess amount: AED 350 350 ‫ﺍﻟﺘﺤﻤﻞ ﺍﻹﺟﺒﺎﺭﻱ ﺩﺭﻫﻢ‬ ▪ : ‫ﺷﺮﻭﻁ ﺧﺎﺻﺔ‬
▪ As per insured request the repair will be Outside Agency ‫ﺑﻨﺎﺀﺍً ﻋﻠﻰ ﻃﻠﺐ ﺍﻟﻤﺆﻣﻦ ﻟﻪ ﻓﺈﻥ ﺇﺻﻼﺡ ﺍﻟﻤﺮﻛﺒﺔ ﺳﻴﻜﻮﻥ ﺧﺎﺭﺝ ﺍﻟﻮﻛﺎﻟﺔ‬ ▪

Al Buhaira National insurance company declares that the Motor Vehicle detailed ‫ﺗُﻘﺮ ﺷﺮﻛﺔ ﺍﻟﺒﺤﻴﺮﺓ ﺍﻟﻮﻃﻨﻴﺔ ﻟﻠﺘﺄﻣﻴﻦ ﺑﺄﻥ ﺍﻟﻤﺮﻛﺒﺔ ﺍﻟﻮﺍﺭﺩﺓ ﺑﻴﺎﻧﺎﺗﻬﺎ ﻓﻲ‬.
above in this Schedule is insured with it according to the provisions of this policy. ‫ﻣُﺆﻣﻨﺔ ﻟﺪﻳﻬﺎ ﻷﺣﻜﺎﻡ ﻫﺬﻩ ﺍﻟﻮﺛﻴﻘﺔ‬
Date & Time 27/12/2020 @ 17:12 ‫ﺍﻟﺘﺎﺭﻳﺦ ﻭﺍﻟﻮﻗﺖ‬
Signed on behalf of: Al-Buhaira National Insurance Co. ‫ﻭﻗﻊ ﻋﻦ ﺷﺮﻛﺔ ﺍﻟﺒﺤﻴﺮﺓ ﺍﻟﻮﻃﻨﻴﺔ ﻟﻠﺘﺄﻣﻴﻦ‬