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V7.12/2020 1 The Pacific Insurance Berhad (91603-K) 40-01, Q Sentral, 2A Jalan Stesen Sentral 2, Kuala Lumpur Sentral, 50470 Kuala Lumpur, Malaysia. (P.O. Box 12490, 50780 Kuala Lumpur, Malaysia.) Tel: +603-2633 8999 Fax: +603-2633 8998 Website: www.pacificinsurance.com.my PRODUCT DISCLOSURE SHEET Please read this Product Disclosure Sheet before you decide to take up the following product. and please seek clarification from our Agent if you do not understand any of the terms herein. Be sure to also read the general terms and conditions of the policy. Drivers & Passengers Personal Accident Insurance 1. What is this product about? This policy provides compensation in the event of injuries, disability or death caused solely by a sudden, unforeseen and fortuitous event to the insured person whilst driving or riding as a passenger boarding or alighting from the vehicle named in the policy. 2. What are the covers or benefits provided? This policy covers: Death RM 10,000.00 Dismemberment and Loss of Sight 1. Loss of Both Hands or Both Feet or Sight Both Eyes RM 10,000.00 2. Loss of One Hand and One Foot RM 10,000.00 3. Loss of Either Hand or Foot and Sight of One Eye RM 10,000.00 4. Loss of Either Hand or Foot RM 5,000.00 5. Loss of Sight of One Eye RM 5,000.00 Medical Expenses RM 500.00 Note: Please refer to the scale of benefits for death and disablement in the sample policy/policy contract. Duration of cover is for one year. You need to renew your insurance cover annually. 3. How much premium do I have to pay? The total premium that you have to pay may vary depending on the seating capacity of the vehicle and the compensation benefits as per the underwriting requirements of The Pacific Insurance Berhad. You need only pay: Seating capacity ( including Driver ) Schedule of Annual Premium (Ringgit Malaysia) exclusive of Government Tax (if applicable ) 4 50.00 5 60.00 6 70.00 Each additional seat 8.00 4. Apart from the premium and government tax (as applicable ), what other fees and charges that I have to pay? Commission paid to the insurance agent Stamp Duty 10% of Gross Premium * RM10.00

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Microsoft Word - Driver & Passengers_PDS_BI_062018.docV7.12/2020 1
The Pacific Insurance Berhad (91603-K) 40-01, Q Sentral, 2A Jalan Stesen Sentral 2,
Kuala Lumpur Sentral, 50470 Kuala Lumpur, Malaysia.
(P.O. Box 12490, 50780 Kuala Lumpur, Malaysia.) Tel: +603-2633 8999 Fax: +603-2633 8998
Website: www.pacificinsurance.com.my
PRODUCT DISCLOSURE SHEET
Please read this Product Disclosure Sheet before you decide to take up the following product.
and please seek clarification from our Agent if you do not understand any of the terms herein.
Be sure to also read the general terms and conditions of the policy.
Drivers & Passengers Personal Accident Insurance
1. What is this product about?
This policy provides compensation in the event of injuries, disability or death caused solely by a sudden, unforeseen and fortuitous event to the insured person whilst driving or riding as a passenger boarding or alighting from the vehicle named in the policy.
2. What are the covers or benefits provided?
This policy covers:
Death RM 10,000.00
Dismemberment and Loss of Sight
1. Loss of Both Hands or Both Feet or Sight Both Eyes RM 10,000.00
2. Loss of One Hand and One Foot RM 10,000.00
3. Loss of Either Hand or Foot and Sight of One Eye RM 10,000.00
4. Loss of Either Hand or Foot RM 5,000.00
5. Loss of Sight of One Eye RM 5,000.00
Medical Expenses RM 500.00
Note: Please refer to the scale of benefits for death and disablement in the sample policy/policy contract. Duration of cover is for one year. You need to renew your insurance cover annually.
3. How much premium do I have to pay?
The total premium that you have to pay may vary depending on the seating capacity of the vehicle and the compensation benefits as per the underwriting requirements of The Pacific Insurance Berhad. You need only pay:
Seating capacity ( including Driver ) Schedule of Annual Premium (Ringgit Malaysia) exclusive of
Government Tax (if applicable ) 4 50.00
5 60.00
6 70.00
Each additional seat 8.00
4. Apart from the premium and government tax (as applicable ), what other fees and charges that I have to pay?
Commission paid to the insurance agent Stamp Duty
10% of Gross Premium * RM10.00
V7.12/2020 2
11. What other types of Personal Accident Insurance cover are available from The Pacific Insurance Berhad?
Other types of personal accident insurance covers are available which include but is not limited to:
• Pacific Super Protector
• Family Personal Accident
• Student Personal Accident
• Senior Care Personal Accident
IMPORTANT NOTE:
YOU ARE ADVISED TO NOTE THE SCALE OF BENEFITS FOR DEATH AND DISABLEMENT IN YOUR INSURANCE POLICY. YOU MUST
NOMINATE A NOMINEE AND ENSURE THAT YOUR NOMINEE IS AWARE OF THE PERSONAL ACCIDENT POLICY THAT YOU HAVE
PURCHASED. YOU SHOULD READ AND UNDERSTAND THE INSURANCE POLICY AND DISCUSS WITH THE INSURANCE AGENT OR
CONTACT THE PACIFIC INSURANCE BERHAD DIRECTLY FOR MORE INFORMATION.