Asuransi Kecelakaan Diri (Personal Accident)


Asuransi Kecelakaan Diri (Personal Accident)

Personal Accident Insurance
Personal Accident Insurance (Asuransi Kecelakaan Diri) provides protection and  financial support to any unfortunate events as results of any sudden, unforeseen and external accidents.


COVERAGE
Death Benefit:
  • Risk of death due to accident.
  • Permanent Disablement Benefit:


Risk of permanent disability due to accident
  • Temporary Disablement Benefit:
Risk of temporary disability
  • Medical Expenses Benefit
The cost of hospital care due to accident (max. 10% of sum insured)


EXTENSION COVERAGE
  • Risk of riding a motorcycle
  • Molest, RSCCMD.
All Risks covered, except :
  1. Willful act of the policyholder (in case the policyholder is a juridical person, this means its trustee, its director or any other executive) or the insured
  2. Willful act of a person entitled to the benefits under this contract
  3. While the insured is acting in the capacity of or under the direct orders of any branch of the armed forces, or police authorities
  4. War, military action of foreign nations, revolution, insurrection, civil commotion, armed rebellion or other similar disturbance or riot
  5. Criminal act of the insured
  6. Suicide or attempt thereat by the insured
  7. Accident while the insured is driving an automobile or a motorcycle without a current valid license or while under the influence of alcohol and/or drugs
  8. Brain disease, sickness or insanity of the insured
  9. Earthquake, volcanic eruption or tsunami
  10. Medical or surgical treatment except where such treatment is necessary solely by injuries for which the company is liable
  11. Pregnancy, childbirth, premature birth miscarriage of the insured
  12. Accident while insured doing dangerous sport activities


SUM INSURED
Sum Insured is the value you are entitled under the policy benefit if any unfortunate events happen. You have the right fully to determine that value.


COSTS / INSURANCE PREMIUMS
Total premiums charged to you is the product between:
SUM INSURED x RATES OF COVERAGE


Premium Rates for Personal Accident are in PROMIL, and the rates may vary depends on the coverage and  types of risk.


PERSONS ELIGIBLE TO BE INSURED
Individuals ages 20 to 60 years.

==================
Asuransi Kecelakaan Diri
Memberikan jaminan terhadap risiko kematian, cacat tetap, dan biaya perawatan atau pengobatan yang disebabkan oleh kecelakaan.
Kecelakaan adalah suatu kejadian atau peristiwa yang mengandung unsur kekerasan baik yang bersifat fisik maupun kimia dari luar secara tiba-tiba yang mengakibatkan luka atau cidera badan termasuk keracunan karena terhirup gas atau uap beracun, mati lemas atau tenggelam.

Risiko yang dijamin:


Ø       Kematian, Cacat Tetap dan Biaya Perawatan atau Pengobatan akibat Kecelakaan
Ø       Kerusuhan, Pemogokan, dan Huru Hara
Ø       Pembunuhan dan Penganiayaan
Ø       Hilang atau Tidak diketemukan
Ø       Mengendarai Sepeda Motor
Ø       Kegiatan Olah Raga (Non-profesional)
Plus Benefit Tambahan:
Ø       Biaya Ambulance
Ø       Biaya Pengurusan Sertifikat Kematian
Ø       Biaya Pemakaman

Pilihan Plan

Plan
 Capital Sum
 Class 1
 Class 2
 Class 3
 A
       10,000,000
       22,000
       27,500
       33,000
 B
       25,000,000
       55,000
       69,000
       82,500
 C
       50,000,000
     110,000
     137,500
     165,000
 D
     100,000,000
     220,000
     275,000
     328,000
 E
     200,000,000
     440,000
     550,000
     660,000
 F
     300,000,000
     670,000
     825,000
     990,000
 G
     400,000,000
     875,000
  1,100,000
  1,325,000
 H
     500,000,000
  1,100,000
  1,375,000
  1,650,000
 I
  1,000,000,000
  2,200,000
  2,750,000
  3,300,000

Class 1: pekerjaan dalam ruangan kantor, karyawan, akuntan, arsitek, auditor, dokter, pengacara, sekretaris, guru, ibu rumah tangga, dsb
Class 2: pekerjaan dinas luar atau lapangan, insinyur sipil, manajer proyek, sales, supir, pedagang eceran dsb
Class 3: pekerjaan mesin-mesin berat, bengkel, buruh tambang, tukang bangunan, pekerja listrik, dsb

——————————————————————–
Formulir Aplikasi Asuransi

Nama:……………………………………………………
Alamat:………………………..…………………………
……………………………………………………………
Telpon: …………………… Facsimili: ………………..
Pekerjaan:………………………..……………………..

Pilihan Plan:                  A   B   C   D   E   F   G  H   I
Class Pekerjaan:            1    2    3
Premi per tahun:            Rp……………………………

Periode Asuransi:………..……….s/d…..…………….
Nama Ahli Waris: ……….……………………………..
Hubungan: ………………………………………………

*Minimum Premi : Rp 100.000 plus Biaya Polis dan Materai Rp 35.000

Tanda Tangan Pemohon,            Tgl/Bln/Thn


_____________________            _________

*harap lampirkan fotokopi KTP/SIM