YOUR RSA MOTOR INSURANCE QUOTATION

CUSTOMER DETAILS
Insured Name: Nice Hossain Email:
PO Box & Emirate: Mobile Number: 506612748
QUOTATION DETAILS
Quote Number: 2405758 Policy Type: Motor Smart (Comprehensive) Premium: AED 1,700
Period Of Insurance: 11/02/2020 to 10/03/2021 Date Of Issue: 11/02/2020 VAT 5%: AED 85
Excess: AED 250 Total Payable AED 1,785.00

INSURED VEHICLE DETAILS

Make: Mitsubishi Model: Pajero GLS HIGHLINE 3.5 L V6 Vehicle Type: 4WD
cyls
Manufactured Year: 2014 First Registration:2014 Place of Registration: Abudhabi
Chassis Number: Engine Number: Seating Capacity: 1+6
Plate Number: Colour: Insured Value: AED 39,500
Vehicle Use: Social, Domestic, Pleasure Hire Purchase: Engine Capacity / 3500/ 6 cyls
And Commuting No. of Cylinders:
DRIVER DETAILS
Main Driver: Nice Hossain Date Of Birth: 12/01/1980
Driving Experience: 12 Number Of Declared No Claims: Self Declaration
TABLE OF BENEFITS
MAIN COVERS
Loss or Damage to the insured vehicle As per the Insured value
Third Party Liability for bodily injury Unlimited
Third Party Liability Limit for Property Damage AED 3,500,000
ENHANCED MOTOR PROTECTION
Territory Extended to Oman Yes
Third Party Liability to family members and passengers Yes
Driving another car Yes
Off Road Cover Yes
Ambulance Cost AED 6,770
Perils of nature,riot,strike & civil commotion Yes
Windscreen Yes
Loss of personal items AED 5,000
Emergency medical expenses AED 3,500
Free Agency period 2 Years
Personal injury cover AED 20,000
Replacement of locks AED 5,000
Motor Garage and/or Valet Parking Yes
No Claims Discount Yes
Emergency repairs AED 1,000
New vehicle replacement 6 months
Taxi fares AED 300
ADDITIONAL BENEFITS YOU CAN ADD
Personal Accident Benefit - Driver AED 200,000 Included
Personal Accident Benefit - Passengers AED 200,000 Included
Temporary Rent-A-Car Refer to your motor policy booklet Optional
No Claims Discount Protection Refer to your motor policy booklet Excluded
Territory extended to other GCC countries Own Damage Only Optional
Repairs at RSA Approved Garages Refer to your motor policy booklet Included
24 Hours Accident and Breakdown Recovery Roadside Assistance for your vehicle Included

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Royal & Sun Alliance Insurance (Middle East) B.S.C.(c)
Attaching to and forming part of motor quotation:

QUOTATION NO.:2405758 INSURED : Nice Hossain

SPECIAL CONDITIONS
1 Young and Novice Drivers - All regular drivers below the age of 25 or with less than 12 months driving experience need to be declared on the proposal form and named
on the Policy Schedule.
2 Repairs at RSA Approved Garages - If Repairs at RSA Approved Garages is included in your policy, as shown in your schedule, then we will pay for your vehicle to be
repaired at one of our approved workshops within the UAE following an accident covered under your policy.
3 Vehicle Specification - Your car is in good condition, as per GCC specifications and first purchased from an UAE local authorized dealer.It has not been modified from
the manufacturer original specifications.
4 Young Driver Additional Excess - If the driver at the time of the accident is below 25 years, an additional deductible of 10% of the amount of the admissible claim shall
be paid by the driver or the insured over and above the excess stated on the policy schedule.
5 Additional Excess -Factory Modified Vehicles - The Insured or his representative shall pay the first 15% of the amount of compensation in addition to the standard
policy excess stated on the Policy Schedule.
6 Additional Excess - Non Factory Modified Vehicles - The Insured or his representative shall pay the first 20% of the amount of compensation in addition to the standard
policy excess stated on the Policy Schedule.
7 Total Additional Excess - In case of several multiple additional excesses are applicable the policy shall apply the highest percentage of the deductibles for one accident
in addition to the standard policy excess
8 Additional Excess - Sports car (including any vehicle with 8 or more cylinders) - The Insured or his representative shall pay the first 15% of the amount of
compensation in addition to the standard policy excess stated on the Policy Schedule. This is not applicable to 4WDs.
9 Value Added Tax (VAT) Clause - The insured accepts and agrees to pay any taxes due on this policy including tax on the policy excess where applicable, in compliance
with the laws and regulations applicable in the United Arab Emirates, including, but not limited to, value added tax ("VAT"), within ten working days of the date of any tax
invoice sent from or on behalf of RSA or its approved agent, to the Insured or, as per agreed credit terms. In the event of the applicable tax arising from the policy not
being paid on time, the Insurer may cancel the Policy, provided such cancellation is in accordance with any laws or regulations in place from time to time. Cancellation of
the Policy is at the discretion of the Insurer.
Please click on Car Insurance Policy Wording for full terms, conditions and exclusions of the policy and to know about our other motor products.

IMPORTANT - STATEMENT OF FACTS

You confirm the following statements which form the basis of the contract between You and Us:
1 You have not been convicted, during the last 3 years, for any offence involving a motor accident.
2 You have not had previous motor insurance cover declined, cancelled or imposed with special conditions/terms.
3 The vehicle is not being used for business or commercial use.
4 The insured value indicated on the quotation represents the correct market value of the vehicle.
5 If 'No Claims Discount' is applied,you are required to submit the proof of 'no claims' from your current insurance provider,unless stated otherwise.RSA reserves the
right to amend the premium and extent of your cover incase of non-receipt of accurate proof of 'no claims'.
NON DISCLOSURE OR MISREPRESENTATION: You must tell us immediately if any of the information stated in your quotation is incorrect. Failure to do may invalidate your policy.

WE WILL REQUIRE
1 New Vehicles: Purchase Agreement/ Vehicle Invoice Copy from the dealership, UAE Drivers License, Home country drivers license (if applicable) and Proof of claims
free driving experience (if applicable).
2 2nd Hand Purchases: Existing Registration card (if it is a private purchase) OR Purchase Agreement/ Vehicle Invoice Copy from the dealership, UAE Drivers License,
Home country drivers license (if applicable) and Proof of claims free driving experience (if applicable).
3 Current Owners (but insured elsewhere) - Existing Registration card, UAE Drivers License, Home country drivers license (if applicable) and Proof of claims free
driving experience (if applicable).

HOW TO ACCEPT THIS QUOTATION

CREDIT CARD AUTHORISATION

Visa Mastercard Amex

I hereby authorise Royal & Sun Alliance Insurance (Middle East) B.S.C.(c) to charge an amount
of AED 1,785.00 [AED One Thousand Seven Hundred Eighty Five Only]

The expiry date of the card is: _____________________________________________________________________________

The card is in the name of:________________________________________________________________________________

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Royal & Sun Alliance Insurance (Middle East) B.S.C.(c)
Attaching to and forming part of motor quotation:

QUOTATION NO.:2405758 INSURED : Nice Hossain

DECLARATION
Before signing the Declaration, check the information carefully, particularly if this quotation was completed on your behalf. If you are not the applicant, you must have permission
from the applicant to sign on their behalf.
I declare that to the best of my knowledge and belief, the information given are true and all material information has been disclosed. I confirm the payment of the premium is made
from my own source.
This quote is valid for 30 days from date of issue.
PLEASE SIGN THE DECLARATION BELOW.

Signature of Proposer: Date: / /

This insurance will not commence until the Insurers have indicated their acceptance of the Proposal and a Certificate of Motor Insurance has been issued. The Insurers reserve the
right to decline any Proposal.

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