ACE Synergy Insurance Berhad (364935-P) 20th Floor, Menara Weld, No 76 Jalan Raja Chulan P.O. Box 10875, 50200 Kuala Lumpur, Malaysi Tel: 03-2058 3000 ; 016-234 8808 (Representative) Tel/Fax: 03 7785 3699 H/P: 016-2348808 S Dated: 6/6/2022 13:11 Name Of Insured : your name and identicard no Age 29 Producer's Named/Account : SIMON POON HIN SAN / 017899006 Policy No./ Vehicle No. : 010600594492-01 car reg no Total premium due to ACE (RM : ______________________________ DIRECT DEBIT AUTHORISATION ___________________________________ Being settlement of premium payment for the under mentioned application. 1. I hereby enclosed a cheque for the payment on application for the undermentioned coverage for my vehicle of the amount by the issuing bank numbered, 2. I hereby authorise ACE Synergy Insurance Berhad to debit the premium to my Diner / Visa / Master Card account :- Credit Card holder's name : Issuing Bank of Credit Card : Credit Card account number: Disclaimer: Expiry date: Cardholder' s Contact Number 019-2526200 ACE Synergy Insurance Berhad (364935-P) Formerly known as Perdana Cigna Insurance Berhad 016 234 8803 7785 36 INTERVIEWER: Assumption of Premium For Your Kind Conside COMPREHENSIVE *PA PACK (Optiona Previous Insurer MAA BERHAD-2008 P. A. BENEFITS COVERING THE DRIVER & PASSENGERS UP TO LIMIT PER PERSON FOR PLAN SELECTE Expiry Date : 29-Dec-08 Policy N 010600594492-01 SILVER GOLD C D Insured your name and identicard no PREMIUM RM53.99 RM121.99 RM221.99 RM311.99 PA SUM INS / PERSO RM20,000 RM50,000 ### ### : 019-2526200 *PLUS PACK MEDICAL EXPENSES RM500 RM1,250 RM2,500 RM3,750 Age : 29 : Make/Model : PERODUA Registration N : car reg no 2004 Hire Purchase : financial interest Eng.Capacity 989 72 225.20 SUM INSURED : Loading 0% 0.00% 30000 29000 28000 27000 26000 25000 24000 23000 22000 DAYS COVERED : 365 1 0.00 979.20 953.20 927.20 901.20 875.20 849.20 823.20 797.20 771.20 PREMIUM : GROSS 72.00 979.20 953.20 927.20 901.20 875.20 849.20 823.20 797.20 771.20 Less NCB 0.00% $- 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 THIRD PARTY PREMIUM $72.00 Gross After NCB 979.20 953.20 927.20 901.20 875.20 849.20 823.20 797.20 771.20 OPTIONAL EXTENDED COVERAGE Replacement C of Windscreen 0 RM0.00 Name Driver Extra Driver(RM50 / NO RM0.00 Waiver during claims: RM 10.00 for additional driver above 2 person. RM 50.00 for com Legal Liabilit 0 Passenger NO RM0.00 RM10 / One Additional > 5 passenger Legal Liability of Passenger YES RM0.00 RM 7.50 Per Vehicle (0.5%SumInsure Flood/Natural Convu NO 0.00% 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 (0.3%SumInsure Riot Strike Civil C NO 0.00% 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 RM0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 979.20 953.20 927.20 901.20 875.20 849.20 823.20 797.20 771.20 ADDITIONAL BENEFITS OPTIONAL *PA.PACK(5 personNO RM0.00 OPTIONAL *PLUS PACK NO-0.00 RM0.00 $0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 SUB – TOTAL 979.20 953.20 927.20 901.20 875.20 849.20 823.20 797.20 771.20 (5%Govt S. Tax)Co. Regist 0.00% 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 (Govt S/ Duty) 10.00 10.00 10.00 10.00 10.00 10.00 10.00 10.00 10.00 TOTAL PREMIUM 989.20 963.20 937.20 911.20 885.20 859.20 833.20 807.20 781.20 Check List on your Premium < 1st time insured NCD 00.00% 989.20 963.20 937.20 911.20 885.20 859.20 833.20 807.20 781.20 < 1st year renewal with no claim NCD 25.00% 744.40 724.90 705.40 685.90 666.40 646.90 627.40 607.90 588.40 < 2nd year renewal with no claim NCD 30.00% 695.44 677.24 659.04 640.84 622.64 604.44 586.24 568.04 549.84 < 3rd year renewal with no claim NCD 38.33% 613.87 597.84 581.80 565.77 549.74 533.70 517.67 501.63 485.60 < 4th year renewal with no claim NCD 45.00% 548.56 534.26 519.96 505.66 491.36 477.06 462.76 448.46 434.16 < 5th year renewal with no claim NCD 55.00% 450.64 438.94 427.24 415.54 403.84 392.14 380.44 368.74 357.04 Simon Poon Agency Office 48-A, Jalan Hujan Rahmat Dua,Taman O.U.G. 58200 Fax: 03-2058 3333 ; 03-2026 1232 SYNERGY INSURANCE BERHAD OR IT'S AGENT ON HOW MUCH YOUR VEHICLE SHOULD BE INSURED FOR. The Quoted Price is an estimate of the prevailing price based on the average asking price for vehicles of the same make, model and year of manufacture as advertised in the “vehicles for sale” column under the Classified Section of two major daily newspapers taken from a day in a week over three weeks before the date of this Guide. The Quoted Price merely serves as a guide to assist in your decision on ascertaining the appropriate value your vehicle should be insured for under your motor insurance policy. ACE Synergy Insurance Bhd shall not be held responsible nor liable for any shortfall or other losses of whatsoever nature which you may suffer or incur as a result of your reliance on the Quoted Price in insuring your vehicle, including without limitation to any unsuccessful claims against your motor vehicle insurance due to the operation of average, excess or under-insurance applied on the policy for the same. Click to find out what is Simon Poon Agency Office 48-A, Jalan Hujan Rahmat Dua, Taman O.U.G. 58200 Kuala Lumpur, Wilayah Persekutuan 20th Floor, Menara Weld, No 76 Jalan Raja Chulan P.O. Box 10875, 50200 Kuala Lumpur, Malaysia. SIMON POON (SERVICER) Tel: 03-2058 3000 Fax: 03-2058 3333 Mrkt Fax: 03-2058 1232 SIMON POON Contact(Compulsor Contact ACCIDENTAL HOSPITAL INCOME RM 200 CASH PER DAY FOR UP TO 100 DAYS TO NOMINATED DR Correspondenc e Your mailing address as Ace will post policy documents to you VEHICLE LOCKOUT BENEFITS FOR LOCKSMITH SERVICES (NOT DAMAGE LOCKSET AND REPLACEMENT) AND TRANSPORTATION COSTS FOR UP TO RM 125 IN AGGREGATE PER ANNUM. KENARI EZ (A) ACE AUTO ASSIST (COMPLIMENTARY) PROVIDE TOLL FREE ASSISTANCE FOR ACCIDENT/BREAKDOWN SERVICE THROUGOUT PENINSULAR MALAYSIA WITH 80 OR MORE REGISTERED PANEL WORKSHOP OR TO THE NEAREST PREFERRED LOCATION WITH LIMITATION OF RM 300.00 PER OCCURENCE. 2007 AUTO Market
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ACE Synergy Insurance Berhad (364935-P)
20th Floor, Menara Weld, No 76 Jalan Raja Chulan P.O. Box 10875, 50200 Kuala Lumpur, Malaysia. Tel: 03-2058 3000 ; 016-234 8808 (Representative) Tel/Fax: 03 7785 3699 H/P: 016-2348808 Skype: simpoon
Dated: 4/8/2023 9:34 ###
###
Name Of Insured : your name and identicard no Age : 29 ###
###
Producer's Named/Account : SIMON POON HIN SAN / 017899006 ###
###
Policy No./ Vehicle No. : 010600594492-01 car reg no ###
###
Total premium due to ACE (RM) : ###
______________________________ DIRECT DEBIT AUTHORISATION ___________________________________###
Being settlement of premium payment for the under mentioned application. ###
###
1. I hereby enclosed a cheque for the payment on application for the undermentioned coverage for my vehicle of ###
the amount by the issuing bank numbered, ###
###
2. I hereby authorise ACE Synergy Insurance Berhad to debit the premium to my Diner / Visa / Master Card account :- ###
Credit Card holder's name : ###
Issuing Bank of Credit Card : ###
###
Credit Card account number: Disclaimer: ###
Expiry date:
Cardholder' sigContact Number 019-2526200
###
ACE Synergy Insurance Berhad (364935-P)Formerly known as Perdana Cigna Insurance Berhad
20th Floor, Menara Weld, No 76 Jalan Raja Chulan P.O. Box 10875, 50200 Kuala Lumpur, Malaysia. 016 234 8808 03 7785 3699Tel: 03-2058 3000 Fax: 03-2058 3333 Mrkt Fax: 03-2058 1232 INTERVIEWER:
Assumption of Premium For Your Kind Consideration COMPREHENSIVE *PA PACK (Optional ) ###
Previous Insurer MAA BERHAD-2008 P. A. BENEFITS COVERING THE DRIVER & PASSENGERS UP TO LIMIT PER PERSON FOR PLAN SELECTED
Expiry Date : 29-Dec-08 Policy No 010600594492-01 SILVER GOLD C D
Insured your name and identicard no PREMIUM RM53.99 RM121.99 RM221.99 RM311.99PA SUM INS / PERSON RM20,000 RM50,000 RM100,000 RM150,000
TOTAL PREMIUM 989.20 963.20 937.20 911.20 885.20 859.20 833.20 807.20 781.20Check List on your Premium ###
< 1st time insured NCD 00.00% 989.20 963.20 937.20 911.20 885.20 859.20 833.20 807.20 781.20< 1st year renewal with no claim NCD 25.00% 744.40 724.90 705.40 685.90 666.40 646.90 627.40 607.90 588.40< 2nd year renewal with no claim NCD 30.00% 695.44 677.24 659.04 640.84 622.64 604.44 586.24 568.04 549.84< 3rd year renewal with no claim NCD 38.33% 613.87 597.84 581.80 565.77 549.74 533.70 517.67 501.63 485.60< 4th year renewal with no claim NCD 45.00% 548.56 534.26 519.96 505.66 491.36 477.06 462.76 448.46 434.16< 5th year renewal with no claim NCD 55.00% 450.64 438.94 427.24 415.54 403.84 392.14 380.44 368.74 357.04
###
Simon Poon Agency Office 48-A, Jalan Hujan Rahmat Dua,Taman O.U.G. 58200 K.Lumpur,W.Persekutuan Opp. Public Bank,Same row as
Fax: 03-2058 3333 ; 03-2026 1232
THE PRICE FOR EACH VEHICLE QUOTED ABOVE (“QUOTED PRICE”) IS NOT A RECOMMENDATION NOR ADVICE BY ACE SYNERGY INSURANCE BERHAD OR IT'S AGENT ON HOW MUCH YOUR VEHICLE SHOULD BE INSURED FOR. The Quoted Price is an estimate of the prevailing price based on the average asking price for vehicles of the same make, model and year of manufacture as advertised in the “vehicles for sale” column under the Classified Section of two major daily newspapers taken from a day in a week over three weeks before the date of this Guide. The Quoted Price merely serves as a guide to assist in your decision on ascertaining the appropriate value your vehicle should be insured for under your motor insurance policy. ACE Synergy Insurance Bhd shall not be held responsible nor liable for any shortfall or other losses of whatsoever nature which you may suffer or incur as a result of your reliance on the Quoted Price in insuring your vehicle, including without limitation to any unsuccessful claims against your motor vehicle insurance due to the operation of average, excess or under-insurance applied on the policy for the same.
Click to find out what is Ace Motor Guard
Simon Poon Agency Office 48-A, Jalan Hujan Rahmat Dua, Taman
O.U.G. 58200 Kuala Lumpur, Wilayah Persekutuan
SIMON POON (SERVICER)
SIMON POON
Contact(Compulsory) ACCIDENTAL HOSPITAL INCOME RM 200 CASH PER DAY FOR UP TO 100 DAYS TO NOMINATED DRIVER.
Correspondence Address
Your mailing address as Ace will post policy documents to you
VEHICLE LOCKOUT BENEFITS FOR LOCKSMITH SERVICES (NOT DAMAGE LOCKSET AND REPLACEMENT) AND TRANSPORTATION COSTS FOR UP TO RM 125 IN AGGREGATE PER ANNUM.
KENARI EZ (A) (METALLIC)
ACE AUTO ASSIST (COMPLIMENTARY)PROVIDE TOLL FREE ASSISTANCE FOR ACCIDENT/BREAKDOWN SERVICE THROUGOUT PENINSULAR MALAYSIA WITH 80 OR MORE REGISTERED PANEL WORKSHOP OR TO THE NEAREST PREFERRED LOCATION WITH LIMITATION OF RM 300.00 PER OCCURENCE.
To Start This Program.Please key in information in Brown text. Sila isikan petak berwarna perang matlumat yang diperlukan dalam kotak berkenaan
G48
Your previous or existing policy/cover note number
D55
Please Select Make
F55
Please select Model
D58
SIMON POON: CU Capacity Comprehensive 1st Thousand S.Insured 1400cc & below RM 225.20 1400 to 1650 RM 251.50 1651 to 2200 RM 277.90 2201 to 3050 RM 304.20 3051 to 4100 RM 330.50 4101 to 4250 RM 356.80 4251 to 4400 RM 383.20 4400 above RM 409.50
H58
SIMON POON: CU Capacity Comprehensive 1st Thousand S.Insured 1400cc & below RM 225.20 1400 to 1650 RM 251.50 1651 to 2200 RM 277.90 2201 to 3050 RM 304.20 3051 to 4100 RM 330.50 4101 to 4250 RM 356.80 4251 to 4400 RM 383.20 4400 above RM 409.50
F60
user: EDIT THIRD PARTY LOADING (%)
G60
user: COMPREHENSIVE LOADING DEPEND ON LATEST UNDERWRITING GUIDELINES BASE ON CLAIM EXPERIENCE,AGE,AGE OF VEHICLE, OCCUPATION OF INSURED ETC
D63
user: No claim discount to encourage policyholder to conserve their premium as low as possible and minimise claim.
F67
user: W/Screen coverage for all front & back, side screen of vehicle. Call your francise holder for price especially the back screen as not much vendors keep stock Premium calculation 15% on Amount Insured selected by insured. Claims- Produce police report, photograph of damage screen before and after repair with date stipulated on photograph. Or call Ace if possible to fix appointment to view damage by claims personnel. (Reinstatement of coverage needed with premium paid to company and approval.)
G67
user: W/Screen coverage for all front & back, side screen of vehicle. Call your francise holder for price especially the back screen as not much vendors keep stock Premium calculation 15% on Amount Insured selected by insured. Claims- Produce police report, photograph of damage screen before and after repair with date stipulated on photograph. Or call Ace if possible to fix appointment to view damage by claims personnel. (Reinstatement of coverage needed with premium paid to company and approval.)
G68
user: RM50 for All Driver only applicable to Co. Registered Vehicle RM10 for Additional Driver Above 2 driver. Purpose: To minimize the use of vehicle other than by insured as responsible and care should be observed when using other's property. Excess for damage vehicle when driven by an authorize driver or person below age 21 due to high risk age group from age categories from statistical department on Motor Vehicle Accident.
user: Legal liability arises from negligence of passenger that cause injury and property damages which is not under the scope of standard cover offered
G71
user: To cover Flood, windstorm, rainstorm, typhoon hurricane, volcanic eruption, earthquake, landslide, landslip or subsidence with the rate of 0.50% on Sum Covered. Recommended to High Electronic Control Component Vehicle.
G72
user: (1) Except in the case of T/Party and Act Only Policies. Loss or damages occassioned by and through or in consequences of SRCC(endorsement 25 must be use) Strike Riot And Civil Commotion Rates (on Sum Insured) No standalone cover permitted (a) Private Cars............................................................................................................0.30% per annum (b) Private Commercial Vehicles...............................................................................0.60% per annum (c) Hire Commercial Vehicles.....................................................................................0.60% per annum (d) Hire Cars and Taxis...............................................................................................0.30% per annum (e) Hire Omnibuses......................................................................................................0.90% per annum (f) Private Omnibuses................................................................................................0.30% per annum (g) Motor Cycles...........................................................................................................0.30% per annum (h) All other classes of vehicles..................................................................................0.30% per annum Minimum premium..............................................................................................RM 5.00 per annum. (per vehicle or per unit) (i) Motor Trade... .......................................................................................................0.30% per annum on values per driver or Trade Plate (2) SRCC rates and conditions are intended to apply to insurance effected when conditions are normal. When conditions are abnormal, or abnormal conditions anticipated, the Committee of the Association may declare an "Apprehensive Period" and notify the application of apprenhensive rates to any area, and the " Special Condition Apprehensive Period" following will operate. (3) Expiry date of SRCC must coincide with that of the Policy. (4) When SRCC cover included during currency of a policy the SRCC premium must be calculated on a short period basis up to the policy renewal date subject to the minimum premium. On renewal of the policy and the SRCC cover for the insured value of the vehicle for twelve months, the insured may be credited with a refund of premium on account of the SRCC cover equal to the difference between the original short period or minimum SRCC premium and that which would have been charged had that original premium been calculated pro rata. (5) No refund of SRCC premium may be made on a Policy being cancelled by the the Insured unless it is replaced by a further policy including SRCC risks in the name of the same Insured, whether on the same vehicle or another vehicle belonging to him. (6)Transferable cover from one vehicle to another vehicle when in the same ownership. (7) No normal SRCC extension/alteration rates allowed during currency of policy until renewal.
G77
user: PLAN PREMIUM SUM INSURED MEDICAL EXPENSES A = RM52 20K/person RM 500 B = RM120 50K/person RM 1250 C = RM220 100K/person RM 2500 D = RM310 150K/person RM 3750
G78
user: PLUS PACK VEHICLE LOCKOUT BENEFITS RM 50/- per occurrence for locksmith service to open the vehicle orRM 50/-per transportation back to collect keys for lock-out vehicle with aggregate benefits of not more than RM 150 per annum. Hospital cash benefits For nominated driver of RM200.00 per days due to accident in the covered vehicle for maximum of 100 days. (RM 20,000).
G82
For Company registered vehicle only: 5 % GSTax inposed.