RESTRICTED

MOTOR INSURANCE QUOTATION SLIP

Agency Code : V0031348 - ONE UNITED RISK MANAGEMENT
Quotation No : FL12022M-00142458-001
Quotation Date : 04/21/2022
Applicant : WAN SAHARUDIN B MAAROP
Insured's ID : 710503-01-6271/
Period of Insurance : 28/05/2022 until 27/05/2023
Occupation : Administrator
Marital Status : Married

VEHICLE INFORMATION
Vehicle Registration Number : JKY5105
Vehicle Make : TOYOTA
Vehicle Model : AVANZA E
NVIC : GJU08A
Chassis Number : PN2F601M002543207
Cubic Capacity : 1298
Year of Manufactured : 2008
Seating Capacity/Tonnage/Horse Power : 7
Vehicle Use : Private Use
Vehicle location postcode : 86200

COVERAGE INFORMATION
Product Type : Private Car
Use of Vehicle : Private Car - Private Use
Sum Insured : RM 14300.00 (Market Value)
Cover Type : Comprehensive
Named Drivers : 1) ANY AUTHORISED DRIVER
2) WAN SAHARUDIN B MAAROP
Excess All Claims : RM 0.00

PREMIUM SUMMARY

Basic Premium RM 731.93

NCD (55.00%) RM 402.56
RM 329.37
Windscreen (RM700.00) RM 105.00
Gross Premium RM 434.37
SST ( 6.00%) RM 26.06
Stamp Duty RM 10.00
Total Premium Payable RM 470.43

Validity Period : Until 20/07/2022

Please note that this slip is not the actual policy document and is only intended as a summary of terms and conditions under the policy

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 Important Notice

1. Etiqa General Insurance Berhad (Etiqa General Insurance) is licensed under the Financial Services Act 2013 to
transact both life and general insurance business in Malaysia and is regulated by Bank Negara Malaysia (BNM).

2. Pursuant to Paragraph 5 of Schedule 9 of the Financial Services Act 2013, if you are applying for this
Insurance wholly for the purposes unrelated to your trade, business or profession, you have a duty to
take reasonable care not to make a misrepresentation in answering the questions when you apply for this
insurance. You must answer all questions as fully and accurately.

Failure to take reasonable care in answering the questions may result in avoidance of your contract of
insurance, refusal or reduction of your claim(s), change of terms or termination of your contract of
insurance.

The above duty of disclosure shall continue until the time your contract of insurance is entered into,
varied or renewed with us.

In addition to answering the questions when you applied for this insurance, you are required to disclose
any other matter that you know to be relevant to our decision in accepting the risks and determining the
rates and terms to be applied.

You also have a duty to tell us immediately if at any time after your contract of insurance has been
entered into, varied or renewed with us any of the information given is inaccurate or has changed.

3. Please note that it is an offence under the law of the Republic of Singapore to enter the country without
extending passenger liability cover to your motor takaful. Please ensure your passenger liability cover is
sufficient if you intend to travel to Singapore with your vehicle.

4. Please cover your vehicle for a sum not less that its market value as you are liable to bear a ratable
proportion of the loss in the event that the sum covered at the time of the loss is less than the market
value by 10%.

5. Please note that under Section 84(1) of the Financial Services Act 2013 (FSA), an insurance contract of
this type requires premium due to be paid and received by Etiqa General Insurance before the insurance
cover under the insurance contract commences. If this condition is not complied with, then the insurance
contract shall not be effective and shall become void.

6. All premium (if applicable) will be subjected to relevant charges or taxes as deemed necessary by the
Malaysian tax authorities. It is important to keep any receipt that you receive as proof of payment of
premium.

Please note that this slip is not the actual policy document and is only intended as a summary of terms and conditions under the policy

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