AUTO PLUS ACCIDENT INSURANCE POLICY
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- Abigayle Hoover
- 5 years ago
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1 AUTO PLUS ACCIDENT INSURANCE POLICY NOTICE: For all intents and purposes where there is a conflict or ambiguity as to the meaning in the Bahasa Malaysia provisions of any part of the Contract, it is hereby agreed that the English version of the Contract shall prevail. WHEREAS the Insured described in the Schedule hereto being desirous of insuring in the manner hereinafter mentioned with Berjaya Sompo Insurance Berhad (hereinafter called "The Company") has made a proposal and declaration which proposal and declaration is agreed shall be the basis of the contract for the Insurance hereby intended to be made and incorporated herein and has paid to the Company the First Premium stated in the Schedule as a consideration for the Insurance for the period stated herein. NOW THIS POLICY OF INSURANCE WITNESSES that if during the Period of Insurance the Life Insured Person(s) shall suffer Death or Loss or Disablement which is solely and directly occasioned by accidental bodily injury caused by violent external and visible means whilst the Insured Person(s) with the permission of the named Insured is driving or riding as a passenger or whilst mounting into or dismounting from the Specified Vehicle described in the Schedule then the Company shall pay to the Insured Person(s) or to his legal personal representative the sum stated under such benefit as payable in respect thereof provided that:- 1. Either the Benefit I or 2 only shall be payable in respect of any one Insured Person(s) in connection with the same accident. 2. On the happening of an accident giving rise to a claim under Benefit 1 or 100% of Benefit 2, this Policy shall thereafter cease to apply. 3. Where Benefit 1 or 100% of Benefit 2 becomes payable Benefits 3 to 5 shall cease to be paid for the same bodily injury for any one Insured Person. 4. Death Los or Disablement must occur independently or any other cause with twelve months from the date of the accident. 5. In the event of an accident giving rise to a claim under the policy and the actual number of passengers exceeds the number stated in Schedule of the Company's Limit of Liability per person under all benefits shall be proportionately reduced. DUTY OF DISCLOSURE Where the Life Insured has applied for this Insurance wholly for purposes unrelated to Life lnsured's trade, business or profession, Life Insured had a duty to take reasonable care not to make a misrepresentation in answering the questions in the Proposal Form (or when Life Insured applied for this insurance). Life Insured should have answered the questions fully and accurately. Failure to have taken reasonable care in answering the questions may result in avoidance of Life lnsured's contract of insurance, refusal or reduction of claim(s), change of terms or termination of contract of insurance in accordance with the remedies in Schedule 9 of the Financial Services Act Life Insured was also required to disclose any other matter that the Life Insured knew to be relevant to The Company's decision in accepting the risks and determining the rates and terms to be applied. Life Insured also have a duty to tell The Company immediately if at any time after Life lnsured's contract of insurance has been entered into, varied or renewed with The Company any of the information given in the Proposal Form (or when Life Insured applied for this insurance) is inaccurate or has changed. INSURED PERSONS (A) COMMERCIAL VEHICLE 1. Insured Persons shall be the occupants of the motor vehicle as describe in the Schedule on an unnamed basis. 2. The passengers from the age of 3 to 70 are covered. 3. Passengers aged between 3 to 15 are entitled to only 50% of all benefits (B) MOTORCYCLE COVERED ON SINGLE RIDER 1. Either the registered owner or the named rider is covered. If a named rider is declared in the schedule then the registered owner is not covered. 2. The rider age shall not be less than 16 years and not more than 70 years of age. (CJ MOTORCYCLE COVERED ON AU RIDERS 1. A rider and a pillion rider are covered at any one time whilst riding the motorcycle described in the Schedule. 2. Where the motorcycle is owned by a corporate body the Insured Persons shall be the authorised riders of the corporate body. (AP-PA/PW ) 1
2 3. The rider age shall not be less than 16 years and not more than 70 years of age. 4. Pillion rider aged between 3 to 15 are entitled to only 50% of all benefits. DEFINITION OF COMMERCIAL VEHICLE Commercial vehicle shall means only commercial van, taxi or lorry. seeci PREVIOUS DISABILITY If a consequences of the Accident the Insured Person(s) shall sustain an injury and if such injury has been or shall be aggravated by any disability and/or condition which existed before the accident occurred (hereinafter referred to as "condition") the amount of any compensation payable shall be the amount that the Company as its sole and absolute discretion considers would have been payable if such condition had not existed and the bodily injury had not been so aggravated. Benefit 1 DEATH BENEFITS PAYABLE Benefit 2 PERMANENT DISABLEMENTS Percentage of the Sum Insured of Benefit 2 Total and irrecoverable loss of all sight in both eyes % Sum Insured (per person) Total loss by physical severance at or above the wrist or ankle of both hands or both feet or of one hand together with one foot % Total loss by physical severance at or above the wrist or ankle of one hand or one foot together with the total and irrecoverable loss of all sight in one eye % Total paralysis % Total and irrecoverable loss all sight In one eye % Total loss of physical severance at or above wrist or ankle of one hand or one foot % The aggregrate of all percentages payable under benefit 2 in respect of any one accident and/or any one period of insurance shall not exceed 100% Benefit 3 MEDICAL - EXPENSES The Company will pay to the Insured Person(s) the reasonable expenses incurred for medical treatment attended by a qualified and registered Medical Practitioner confinement in a hospital or home nursing care services rendered by a qualified and registered Nurse. As specified in the Schedule The maximum compensation payable for this benefit arising out of any accident shall not exceed the amount specified in the Schedule. Benefit 4 DAILY HOSPITAL INCOME Daily Cash Allowance shall be payable from the second day of hospital confinement up to a maximum of 150 days per year whilst the insurance is in force and as a result of accidental bodily injury requiring hospitalizsation in a registered hospital or government hospital provided that such hospitalisation occur within 14 days of the accident. Benefit 5 SURGEON EXPENSES Reimburse charges for the fees charged by the Surgoen for the operation. This includes pre surgical assessment Surgoen' s visits and all normal post-surgical care up to 31 days before and after the operation not exceeding the limits specified in the Schedule in respect of any one accident. Benefit 6 BURIAL OR CREMATION ALLOWANCE The Company will pay to the Insured Person's next-of-kin or legal personal representative the sum stated in the Schedule in the event of Benefit 1 payable. TERRITORIAL LIMIT Anywhere within Malaysia, Republic of Singapore, Negara Brunei Darussalam and Thailand. 2
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7 POLISI INSURANS KEMALANGAN DIRI AUTO PLUS PEMBERITAHUAN: Bagi tujuan dan maksud sekiranya terdapat konflik atau kekaburan berkenaan makna di dalam Bahasa Malaysia tentang mana-mana bahagian Kontrak, adalah dipersetujui bahawa kontrak versi Bahasa lnggeris akan digunakan. BAHAWASANYA Pihak Diinsuranskan yang dihuraikan di dalam Jadual dalam dokumen ini berhasrat untuk diinsuranskan dalam cara yang disebutkan kemudian dari ini dengan BERJAYA SOMPO INSURANCE BERHAD (dinamakan sebagai "Syarikat" kemudian dari ini) telah membuat cadangan dan akuan yang mana cadangan dan akuan tersebut telah dipersetujui, akan menjadi asas kepada kontrak lnsurans tersebut dengan ini bertujuan untuk dibuat atau dimasukkan dalam perjanjian ini dan telah membayar kepada Syarikat Premium Pertama yang dinyatakan di dalam Jadual sebagai balasan kepada insurans tersebut untuk tempoh yang telah dinyatakan dalam perjanjian ini. MAKA POLISI INSURANS INI MEMPERSAKSIKAN bahawa jika semasa Tempoh lnsurans, Orang Diinsuranskan mengalami Kematian atau Kerugian atau Ketidakupayaan akibat semata-mata dan secara langsung daripada suatu kecederaan anggota kemalangan yang disebabkan oleh cara-cara ganas, luaran dan ketara semasa Orang Diinsuranskan sedang memandu, membonceng sebagai penumpang atau semasa menaiki ke dalam atau menuruni dari kenderaan motor yang dinyatakan dalam Jadual dengan kebenaran Pihak Diinsuranskan yang dinamakan, maka Syarikat akan membayar kepada Orang Diinsuranskan atau wakil peribadinya di sisi undang-undang jumlah yang dinyatakan di bawah manfaat sedemikian yang boleh dibayar berhubung dengannya dengan syarat bahawa:- 1. Sama ada Manfaat 1 atau 2, hanya akan dibayar berhubung dengan mana-mana satu Orang Diinsuranskan berkenaan dengan kemalangan yang sama. 2. Ketika berlakunya suatu kemalangan yang mengakibatkan suatu tuntutan di bawah Manfaat 1 atau 100% daripada Manfaat 2, Polisi ini tidak lagi diterima pakai selepas itu. 3. Apabila Manfaat 1 atau 100% daripada Manfaat 2 boleh dibayar, Manfaat 3 hingga 5 tidak akan dibayar untuk kecederaan anggota yang sama untk mana-mana satu Orang Diinsuranskan. 4. Kematian, Kerugian atau Ketidakupayaan mesti berkaku secara berasingan daripada mana-mana sebab lain dalam masa dua belas bulan dari tarikh kemalangan. 5. Jika berlakunya kemalangan yang menimbulkan tuntutan di bawah polisi ini dan bilangan penumpang sebenar melebihi bilangan yang dinyatakan dalam Jadual polisi, Had liabiliti Syarikat bagi setiap orang di bawah semua manfaat hendaklah dikurangkan secara bersekadar. KEWAJIPAN PENDEDAHA..ccN.. Apabila Orang yang Diinsuranskan telah memohon insurans ini sepenuhnya untuk tujuan yang tidak berkaitan dengan perdagangan, perniagaan atau profesion Orang yang Diinsuranskan, Orang yang Diinsuranskan mempunyai kewajipan untuk mengambil langkah yang munasabah untuk tidak salah nyata dalam menjawab soalan yang terdapat dalam borang cadangan (atau semasa permohonan insurans ini). Orang yang Diinsuranskan perlu menjawab soalan yang dengan penuh dan tepat. Kegagalan dalam mengambil langkah munasabah dalam menjawab soalan-soalan boleh mengakibatan pembatalan kontrak insurans, keengganan atau pengurangan gantirugi, Perubatan terma atau penamatan kontrak insurans Orang yang Diinsuranskan selaras dengan remedi di Jadual 9 Akta Perkhidmatan Kewangan Orang yang Diinsuranskan juga dikehendaki mendedahkan perkara-perkara lain yang Orang yang Diinsuranskan tahu akan mempengaruhi keputusan Syarikat dalam menerima risiko dan menentukan kadar dan terma yang dikenakan. Orang yang Diinsuranskan juga mempunyai kewajipan untuk memberitahu Syarikat dengan serta-merta jika pada bila-bila masa selepas kontrak insurans Orang yang Diinsuranskan ditandatangani, diubah atau diperbaharui dengan Syarikat, apa-apa maklumat yang diberikan di dalam Borang Cadangan (atau semasa permohonan insurans ini) tidak tepat atau telah berubah. Orang Diinsuranskan (A) KENDERAAN KOMERSIL 1. Orang Diinsuranskan adalah penumpang kenderaan motor yang tidak dinamakan sebagaimana dihuraikan dalam Jadual. 2. Penumpang dari umur 3 hingga 70 tahun adalah dilindungi 3. Penumpang yang berumur diantara 3 hingga 15 tahun hanya berhak ke atas 50% daripada semua manfaat. 7
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12 (ii) Tindakan pihak berkuasa yang sah di sisi undang-undang dalam membanteras atau percubaan untuk membanteras mana-mana gangguan sedemikian atau dalam mengurangkan akibat gangguan sedemikian. (iii) Perbuatan sengaja mana-mana pemogok atau pekerja yang disekat-masuk yang dilakukan sebagai lanjutan daripada suatu mogok atau sebagai tentangan kepada suatu sekat-masuk. (iv) Tindakan mana-mana pihak berkuasa yang sah untuk mencegah atau cuba mencegah mana-mana perbuatan sedemikian atau dalam mengurangkan akibat mana-mana perbuatan sedemikian. Dengan syarat bahawa Fasal ini tidak boleh diterima pakai ke atas mana-mana Kematian atau Ketidakupayaan akibat kemalangan atau apa-apa kerugian lain yang secara langsung atau tidak langsung secara dekat atau jauh disebabkan oleh, diakibatkan oleh atau boleh dikesan kepada atau timbul daripada atau berkaitan dengan:- (i) Peperangan, serangan, perbuatan musuh asing, permusuhan atau operasi seakan peperangan (sama ada peperangan diisytiharkan atau tidak diisytiharkan), peperangan sivil, pemberontakan, revolusi, penentangan, kekecohan awam yang menghampiri atau mencecah tahap kebangkitan ketenteraan atau rampasan kuasa; atau (ii) Apa-apa tindakan keganasan. FASAL PENGECUAUAN RISIKO TENAGA NUKLEAR Polisi ini hendaklah mengecualikan Kematian atau Ketidakupayaan atau mana-mana kerugian lain yang disebabkan secara langsung atau tidak langsung oleh atau diakibatkan oleh atau timbul daripada Risiko Tenaga Nuklear. Bagi semua tujuan Polisi ini, Risiko Tenaga Nuklear adalah bermaksud kesemua insurans pihak pertama dan/atau pihak ketiga (selain daripada Pampasan Pekerja and Tanggungjawab Majikan) berhubung dengan: I) Semua harta, atas tapak stesen kuasa nuklear. Reaktor Nuklear, reaktor bangunan dan loji dan peralatan dalam dokumen ini di atas mana-man tapak selain daripada stesen kuasa nuklear. II) Semua harta, atas mana-mana tapak (termasuk tetapi tidak terhad kepada tapak yang dirujuk dalam I di atas) yang digunakan atau telah digunakan untuk: (a) Penjagaan tenaga nuklear; atau (b) Penghasilan, Penggunaan atau Penyimpanan Bahan Nuklear Ill) Mana-mana harta lain yang layak untuk lnsurans oleh Kumpulan dan/atau Persatuan lnsurans Nuklear tempatan yang berkaitan, tetapi hanya sejauh mana keperluan Kumpulan dan/atau Persatuan itu. IV) Bekalan barang dan perkhidmatan kepada mana-mana tapak, yang dihuraikan dalam I hingga Ill di atas, melainkan insurans sedemikian hendaklah mengecualikan peril sinaran dan pencemaran oleh Bahan Nuklear. Melainkan seperti yang dinyatakan di bawah, Risiko Tenaga Nuklear adalah tidak termasuk: (i) (ii) Mana-mana insurans berkenaan dengan pembinaan atau cacakan atau pemasangan atau penggantian atau pembaikan atau penyelenggaran atau penamatan harta seperti yang dihuraikan dalam I dan Ill di atas (termasuk tapak dan peralatan kontraktor); Mana-mana insurans Kerosakan Mesin atau Kejuruteraan lain yang tidak termasuk dalam skop (i) di atas. Senantiasa dengan syarat bahawa insurans sedemikian tidak termasuk peril atau sinaran dan pencemaran oleh Bahan nuklear. Waiau bagaimanapun, pengecualian di atas tidak dilanjutkan kepada:- 1. Peruntukan mana-mana insurans walauapapun berkenaan: (a) Bahan Nuklear (b) Mana-mana Harta dalam Zon atau Kawasan Radioaktiviti Tinggi untuk mana-mana Pemasangan Nuklear seperti daripada pengenalan Bahan Nuklear atau - untuk pemasangan reaktor - seperti daripada memuatkan bahan api atau keadaan amat kritikal pertama yang telah dipersetujui dengan Kumpulan dan/atau Persatuan lnsurans Nuklear Tempatan yang berkaitan 2) Peruntukan mana-mana insurans bagi peril yang dinyatakan di bawah: Kebakaran, petir, letupan; Gempa bumi; Pesawat udara dan peranti aerial lain atau barang yang jatuh daripadanya; Sinaran dan pencemaran radioaktif Mana-mana peril lain yang diinsuranskan oleh Kumpulan dan/atau Persatuan lnsurans Nuklear yang berkaitan; Berkenaan dengan mana-mana Harta lain yang tidak ditetapkan dalam I di atas yang secara langsung melibatkan Penghasilan, Penggunaan atau Penyimpanan Bahan Nuklear seperti daripada pengenalan Bahan Nuklear kepada Harta Sedemikian. TAKRIF "Bahan Nuklear" bermaksud: i) Bahan api nuklear, selain daripada uranium semula jadi dan uraniam kosong, berkeupayaan menghasilkan tenaga oleh proses rantaian pembelahan nuklear yang mampu diri di luar Reaktor Nuklear, sama ada dengan sendiri atau dalam kombinasi dengan beberapa bahan lain; dan 12
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