PRIVATE CAR RENEWAL NOTICE
Date: 24 May 2016
Expiring Policy No. : D15MTPV01006478
CHEONG SWEE HWA
Dear Insured,
BLK 10E BEDOK SOUTH AVE 2_
#09-548
SINGAPORE 464010
We wish to inform you that your policy is expiring on 12 July 2016 and is
due for renewal. Kindly indicate your renewal instruction below and return
this duly signed together with your payment.
Please renew your policy within 15 days prior to ensure your policy record is electronically transmitted to LTA road tax renewal failure of which
you may be issued with notices/penalty by LTA. The penalty for driving / permitting someone to drive an insured vehicle is
disqualification from driving for 12 months. You may also be fined and imprisoned.
RENEWAL TERMS
RENEWAL PERIOD
13 July 2016 TO 12 July 2017 (Both Dates Inclusive)
Cover:
Comprehensive - ExcelDrive Gold
Plan
Excess:
Market value at time of loss
Voluntary Excess
Will not be waived for repairs
at ExcelDrive Workshops
Estimated Value of Vehicle
S$ 500.00 - Section I
(Waived up to $1,000 Standard
Excess each claim at ExcelDrive
Workshops for first 2 claims per
policy year)
Buy Up : S$ 600.00 - Section I
50 %
NCD on Renewal (subject to
Additional Excesses applicable to Named / Unnamed / Elderly, Young
no new claims being made up If you are enjoying 30%, 40% or 50% and Inexperienced Drivers
to expiry date):
NCD on renewal for private car, you
will be granted No Claim Discount
Protection FREE.
RENEWAL PREMIUM:
S$ 725.65
Premium is computed after NCD 50 % discount and inclusive of 7% GST.
For policy with 30% NCD and above, renewal premium is inclusive of 5% OFD.
Terms remain valid for 7 days from expiry date subject to there being no claims till expiry of
policy and no change material to the risk.
REMARKS:
POLICYHOLDER DETAILS
Business / Profession
: ENGINEER
Marital Status
:
MARRIED
Date of Birth & Age
: 22 JUN 1955 & 61 years old
Gender
:
Male
Driving Experience in
Singapore
: 33 years
NRIC / FIN
:
S1129653Z
Identification Type
: NRIC(Singaporean)
DRIVER DETAILS
Named Drivers
: 1.
CHEONG.SWEE HWA
Date of Birth & Age : 22 JUN 1955 & 61 years old
Driving Experience in Singapore: 33 years
Intermediary Name/Code
: PANA HARRISON (ASIA) PTE LTD / 11P02009
Producer Name/Code
: GINA SIM / PHP02082
Page 1 of 3
PRIVATE CAR RENEWAL NOTICE
Date: 24 May 2016
Expiring Policy No. : D15MTPV01006478
VEHICLE DETAILS
Vehicle Reg No.
: SJM6388E
Chassis No.
: KMHDU41BR9U65
4302
Vehicle Make & Model
: HYUNDAI AVANTE
Engine No.
: G4FC8U571999
Cc
: 1591
Type of Body
: SALOON
Year of Registration
: 2009
Seating Capacity (Including driver)
: 5
Estimated Value of
Vehicle
: Market value at time of loss
Hire Purchase Owner
: NIL
Additional Cover
: NIL
IMPORTANT NOTES:
1. Renewal terms may be altered/revised if a claim arises during the interim period while this renewal request is dispatched prior to the
expiration of the Policy or if there are any changes material to the risk as advised by you.
2. The Policy will be renewed from the date of receipt of instruction if renewal instruction is received after and within 7 days from date of expiry
of the policy. Thereafter a new application has to be furnished for underwriting and acceptance.
3. Premium Payment Warranty
Premium is to be paid and received in full by the Company (a) before the inception date where the Policy is issued to an individual,or (b)
within the period specified in the Premium Payment Warranty applied to the policy in all other instances, failing which there will be no liability
under this cover.
4. Duty of Disclosure
We would remind you that you must disclose to us, fully and faithfully, all the facts that you know or ought to know, otherwise you may not
receive any benefits from the policy.
5. I/We understand and agree to the "Personal Data Protection Statement" as per Renewal Conditions and Instructions attached.
RENEWAL INSTRUCTION:
Please renew the policy as shown on this notice for a further period of 12 months
Please renew the policy with / without the following changes ( *Tick if option is selected and check with the Company for the quotation)
(Note: The Company reserves the right to amend the renewal terms on review of the changes declared that has impact on
underwritting considerations. Please check with company for a quotation.)
Changes at Renewal/ Declaration:-
I/We declare that the terms of cover stated above are true and complete and shall be the basis of contract between me / us and Sompo Insurance
Singapore Pte. Ltd.
Insured's Signature:________________________
Date:________________________
Company's Stamp(for corporate only)
Intermediary Name/Code
: PANA HARRISON (ASIA) PTE LTD / 11P02009
Producer Name/Code
: GINA SIM / PHP02082
Page 2 of 3
PRIVATE CAR RENEWAL NOTICE
Date: 24 May 2016
Expiring Policy No. : D15MTPV01006478
PAYMENT INSTRUCTION
TO MY VISA/MASTERCARD. (Please delete where appropriate)
PLEASE CHARGE S$
CARD NO:
-
-
-
EXPIRY DATE:
-
CARDHOLDER'S SIGNATURE :
I/WE ENCLOSED A CHEQUE (NO.
) for S$
crossed and made payable to Sompo Insurance Singapore Pte.
Intermediary Name/Code
: PANA HARRISON (ASIA) PTE LTD / 11P02009
Producer Name/Code
: GINA SIM / PHP02082
Page 3 of 3