Al Ahlia Insurance Co SAOG

PO Box 1463, PC 112,

Ruwi, Oman
24766800:‫ﻫﺎﺗﻒ‬
Tel:24766800
+968 2476 6888:‫ﻓﺎﻛﺲ‬
Fax:+968 2476 6888
rsaoman@om.rsagroup.com ‫ﺍﻟﺒﺮﻳﺪ ﺍﻹﻟﻜﺘﺮﻭﻧﻲ‬
Email:rsaoman@om.rsagroup.com
www.alahliarsa.com ‫ﺍﻟﻤﻮﻗﻊ ﺍﻹﻟﻜﺘﺮﻭﻧﻲ‬
Website:www.alahliarsa.com
Al Ahlia Insurance Co SAOG 1 / 75480 / 7 : ‫ﺕ ﺭﻗﻢ‬.‫( ﺱ‬31) ‫ﺳﺠﻞ ﺷﺮﻛﺎﺕ ﺍﻟﺘﺄﻣﻴﻦ ﺍﻟﺮﻗﻢ‬
Oman Insurance Company Reg. No. 31 CR No. 1 / 75480 / 7

RECEIPT

RECEIVED FROM Mohammed Shafath Ullah Receipt No : 3060060979

Date : 16/11/2021
Amount : 38.1

Rials Omani Thirty Eight and BAIZA 100/1000 Only

PARTICULARS OF RECEIPTS: Cash

GL Code Description Amount in (RO)

1-3-6-11-1410-12401 BEING THE PREMIUM COLLECTED ON MOTOR 38.001

INSURANCE POLICY NO:20018/3
1-3-6-11-8810-100 Baiza Adjustment 0.099

Total : 38.1

245 - RO COLL SOHAR BR BANK MUSCAT 0423 01084798 026 7

Value Added Tax (VAT) Clause: For avoidance of doubt, all amounts mentioned herein are inclusive of Value Added Tax (VAT). The Insured accepts and
agrees to pay any taxes due on this policy in compliance with the laws and regulations applicable in the Sultanate of Oman, including, but not limited to, VAT,
within ten working days of the date of any tax invoice sent from Al Ahlia Insurance Company SAOG to the Insured or, as per agreed credit terms. In the event
of the applicable tax on the policy is not paid on time as aforesaid, the Al Ahlia Insurance Company SAOG may cancel this Policy, provided such cancellation is
in accordance with any laws or regulations in place from time to time. Such cancellation of this Policy shall be at the sole discretion of Al Ahlia Insurance
Company SAOG
For : Al Ahlia Insurance Co SAOG

Authorised Signatory

Printed on: 11/16/2021 ( Hamdan Mohammed AlAjmi )

Page 1 of Policy No: 20018

 Al Ahlia Insurance Co SAOG
PO Box 1463, PC 112,
Ruwi, Oman
24766800:‫ﻫﺎﺗﻒ‬
Tel:24766800
+968 2476 6888:‫ﻓﺎﻛﺲ‬
Fax:+968 2476 6888
rsaoman@om.rsagroup.com ‫ﺍﻟﺒﺮﻳﺪ ﺍﻹﻟﻜﺘﺮﻭﻧﻲ‬
Email:rsaoman@om.rsagroup.com
www.alahliarsa.com ‫ﺍﻟﻤﻮﻗﻊ ﺍﻹﻟﻜﺘﺮﻭﻧﻲ‬
Website:www.alahliarsa.com
Al Ahlia Insurance Co SAOG 1 / 75480 / 7 : ‫ﺕ ﺭﻗﻢ‬.‫ﺱ‬ (31) ‫ﺳﺠﻞ ﺷﺮﻛﺎﺕ ﺍﻟﺘﺄﻣﻴﻦ ﺍﻟﺮﻗﻢ‬
Oman Insurance Company Reg. No. 31 CR No. 1 / 75480 / 7

POLICY SCHEDULE
POLICY NO: SOHAR - <1/1/006/20018/ 3>

Name of Insurer : Al Ahlia Insurance Company Intermediary : SOHAR

Orange Card No : 0 AAA Card No : 8280249
AAA toll free no : Oman - 24605555
UAE - 800 - 4 - 900

Applicant Details
Name as per ID Card: Mohammed Shafath Ullah Joint Name:
ID/CR No: 114803441 Nationality: Indian

Address: PO BOX: 1,P.C.: 1,Sohar Mobile: 79148035

Date of Birth: 12-Feb-1986 Telephone:

Gender: M Fax No:

Occupation: Others Email:

Persons authorized to drive the vehicle

Name Date of Birth / Age Sex ID No
MOHAMMED SHAFATH ULLAH 12-FEB-1986 / 35 M 114803441
‫ﻣﺤﻤﺪ ﺍﺩﺭﻳﺲ ﺍﺣﻤﺪ‬ 01-JAN-1980 / 41 M 1

Vehicle Details
Make & Model Year of Manufacture Body Type Colour Load Capacity in Tons Use of Vehicle
Kia Optima 2015 Saloon Grey Social, Domestic, Pleasure
And Commuting

No.of Passengers Horse Power/C.C Registration No. Chassis No. Engine No.
Including driver
4+1 2359 D / 84415 KNAGM4120G5644814 G4KEFH175035

Details of Cover
Type of Policy: Compulsory Insurance (Section 3) - Motor Third Party
Scheme: Oman Walk In Scheme
Insurance Period(both dates Inclusive): 17/11/2021 00:00 AM to 16/11/2022 11:59 PM

Sum Insured: RO 0
Geographical Area :

Page 2 of Policy No: 20018

Covers Selected
Third Party Insurance covering:

Breakdown Recovery Cover

Medical Expenses

Excess/Deductible: The Insured pays the following amount:

Statement Private vehicles Light commercial Light commercial Heavy commercial
vehicles (except vehicles (rent a car vehicles and
rent a car and and driving school) equipment
driving school)
a If the driver is one of the persons authorized to drive the RO 50 RO 75 RO 150 RO 500
vehicle in the list stated in the insurance application and age is
25 years or more.
b If the driver is one of the persons authorized to drive the RO 75 RO 100 RO 200 RO 750
vehicle in the list stated in the insurance application and age is
less than 25 years.
c If the driver is not one of the persons indicated in the list and RO 75 RO 100 RO 150 RO 1000
age is 25 years or more.
d If the driver is not one of the persons indicated in the list and RO 100 RO 150 RO 200 RO 1500
age is less than 25 years.
e License age is less than 3 years. - RO 50+ -
RO 250+
f License age is less than 5 year. - RO 25+ -

NCD Available: 9 years from Al Ahlia Insurance Company SAOG

Premium Payable:
a. Basic Premium RO 73.68
b. Medical Expenses RO 3
c. Personal accidents premium (if any) RO 2
d. Additional benefits premium RO 0
e. Total insurance premium (a+b+c+d) RO 78.68
f. No claim discount RO 43.147
g. Authorized persons discount RO 0
h. Net insurance premium (e-f-g) RO 35.533
i. Supervision fees (0.6% of net insurance premium) RO 0.213
j. Emergency fund fee (1% of net insurance premium) RO 0.356
k. Guarantee Fund (0.25% of net insurance premium) RO 0.089
l. Orange Card Fee / Admin Fee RO 0
m. AAA Card Fee RO 0
n.Total VATable Supply(h+i+j+k+l+m) RO 36.191
o. VAT 5% RO 1.81

p. Total Premium Payable (n + o) RO 38.001

Note: For cash payments, premium will be rounded upwards to nearest 100 baizas.

Page 3 of Policy No: 20018

1.Limits of the Insurer’s liability :
(a). The maximum liability limit of the Insurer for repair cost in accordance with Clause 3 of Section 2 is RO 150
(b). The maximum amount authorized for protecting and transporting as per Clause 5 of Section 2 is RO 100
(c). The maximum amount for protection and transporting costs as per Item (e) of Clause First of Section 3 is the protection and transportation cost recognized in the
market.
(d). The maximum liability limit of the Insurer under Item (a) of Clause First of Section 3 for any claim or all claims arising from one Accident is the amount of
compensation decided by the court.
(e). The maximum liability limit of the Insurer under Item (b) of Clause First of Section 3 for any claim or all claims arising from one Accident is RO 150,000
(f). The maximum liability limit of the Insurer under Clause 2 of Section 3 is RO 10,000 for the insurance year regardless of the number of Accidents.
(g). The maximum liability limit of the Insurer for first aid expenses stated in Section 4 for any claim or all claims arising from one Accident is RO 400.
2.Authorised Driver:
Any person driving the vehicle provided that he has a valid driving license in accordance with the requirements of the Oman traffic Law and its Executive Regulations
3.Geographical Area:
Unless otherwise stated in the Additional Benefits above, the Geographical Area of this Policy is Sultanate of Oman only
4.Jurisdiction:
It is understood and agreed that the Insurer shall be have no liability under Section 3 of the Policy in respect of:
(a). Compensation for damages from judgements delivered or obtained otherwise through a court of competent jurisdiction within the Geographical Area.
(b). Costs and expenses of litigation recovered by any claimant from the Insured unless incurred and recoverable within the Geographical Area.
5.The Sum insured amount indicated in Clause (10) shall be determined as follows:
(a). The cash value of the vehicle on the purchase date is determined according to its first purchase invoice. If this purchase invoice is not available, a certificate shall be
requested from the agency stating the actual value of the vehicle on the first purchase date.
(b). Depreciation shall be computed as per the approved Depreciation Schedule 1 or 2 of Appendix 1
(c). The difference between Item 1 and Item 2 is considered to be the insurance value of the vehicle at the beginning of insurance during the years following the first year,
and it is the basis of compensation settlement in case of accident.
(d). Where purchase invoice or agency certificate is not available to determine the value of the vehicle the insurance amount shall be computed on the basis of the
market value of the vehicle as per the rules set out by CMA.
(e). As an exception from the above regulations, the insured amount may be higher than the value stated in the aforesaid rules.
6.Restrictions on use:
The Insured shall not use the Vehicle for any purpose other than what is specified in the license. If the Vehicle is used for any other purpose than what is specified in the
license, the insurance shall not cover Accidents resulting from such use.
7.Rules for settlement of medical expenses:
The Insurer is bound to pay to hospitals and medical institutions the expenses incurred for the treatment of bodily injuries of Third Party of the Insured and anyone in his
position and their family members according to the following rules:
(a). The hospital or the medical institution shall prepare a detailed report on the treatment and the actual cost of the same,along with the necessary supporting
documents.
(b). Claims for medical expenses shall be based only on the amount approved by the Ministry of Health.
(c). The Insurer, after reviewing the reports received, shall pay the required amount to the hospital or medical institution which carried out the treatment.
(d). In the event of treatment abroad an evidence from the Ministry of Health shall be provided that treatment in not available in the Sultanate.
8.Value Added Tax (VAT) Clause:
For avoidance of doubt, all amounts mentioned herein are inclusive of Value Added Tax (VAT). The Insured accepts and agrees to pay any taxes due on this policy in
compliance with the laws and regulations applicable in the Sultanate of Oman, including, but not limited to, VAT, within ten working days of the date of any tax invoice
sent from Al Ahlia Insurance Company SAOG to the Insured or, as per agreed credit terms. In the event of the applicable tax on the policy is not paid on time as
aforesaid, the Al Ahlia Insurance Company SAOG may cancel this Policy, provided such cancellation is in accordance with any laws or regulations in place from time to
time. Such cancellation of this Policy shall be at the sole discretion of Al Ahlia Insurance Company SAOG.
I acknowledge having read the contents and schedules of the insurance Policy and agree entirely with its terms and conditions. I also confirm that the information I provided to the
Insurer are true.

Note: This policy is not transferable. For more information on Break down recovery cover (AAA), please visit our website www.alahliarsa.com.

First Party: Second Party:

Insurance Company: Al Ahlia Insurance Co SAOG Name:Mohammed Shafath Ullah

Insurer's Signature: Insured's Signature:

Time: Time:

Date: Date:

Issued By : Hamdan Mohammed AlAjmi / SOHAR

Page 4 of Policy No: 20018

Name: MOHAMMED SHAFATH ULLAH

Chassis No: KNAGM4120G5644814 Vehicle No: D 84415

Make: KIA Model: OPTIMA

Mobile No: 79148035 Policy Start Date: Nov 17, 2021, 12:00 AM

Coupon No: 134296 Policy End Date: Nov 16, 2022, 12:00 AM

Page 5 of Policy No: 20018

Page 6 of Policy No: 20018