RSA Home Proposal Form

8/18/2019 RSA Home Proposal Form

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HOME INSURANCE

HOME

Coverage for everything that makes your house a home.


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A POLICY THAT SUITS ALL YOUR INSURANCE NEEDS

RSA is a world renowned international company, well equipped with the expertise, product offerings and back-up

services for all your insurance needs. So you can be assured that your home and possessions are well protected!

Insurance knowledge perfected over time

We’ve been tailoring insurance solutions and products relevant to the UAE for over 50 years. Supported by a 300year heritage, with international credentials and a reputation for seamless and efcient claims handling, isn’t it time

you harnessed our global power and local knowledge to your advantage?

Expertise with convenience

Any policy you take is supported by efcient customer service. Call our service centres anytime between

8am - 8pm, Sunday to Thursday and 8am - 5pm on Saturday. Our knowledgeable team of advisors will gladly assist

you with any queries that you may have and guide you through the application process.

Perfection is our policy With the experience we have garnered through an established global presence and ve decades in this region, we

can now offer you a wide range of comprehensive insurance options, ensuring you will nd the policy that provides

you with all the cover you need under one roof!

Our home insurance cover includes:

• A New for Old Cover that ensures that damaged items are replaced with new ones i.e. there is no depreciation

for wear and tear (like for e.g., with clothing) provided that the sums insured are at new replacement values.

• Free of cost accidental damage for all Contents and Buildings Cover.

• Legal Liability and Worldwide Personal Liability of up to AED 1 million for the policyholder or a member of the

family (as occupiers under the Contents section). Owner’s liability to the public is also covered if Buildings

Insurance has been taken.

• All Risks Cover available for personal possessions (both specied and unspecied) anywhere in the UAE for the

duration of the policy, and worldwide for 60 days.

• 24-hour Cover for Workmen’s Compensation for all sponsored employees in the household such as servants

and maids, and Employer’s Liability Extension of up to AED 250,000.

For more information, please call any of our ofces/agents or log on to www.rsadirect.ae


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YES NO

YES NO

‘HOME INSURANCE’ PROPOSAL FORM

Please complete this form in BLOCK letters and fax it to our ofces. Please attach a separate sheet(s), if required.

Full Name

PO Box

Mobile

Occupation

Emirate

Email

I. Insured’s Details

Building Name

Flat/Villa No.

Street

Emirate

II. Building Details

Effective Date (DD/MM/YY)

Is your property:

III. Policy Details

Expiry Date (DD/MM/YY)

IV. General Questions

Building Value in AED

If required on the policy, please state the details of the nance

company / mortgagee and the telephone number.

Loan Amount

If you have suffered any claim for the building, please provide details

including the Date of Loss as well as claim amount paid.

V. Cover 1 - The Buildings

Value includes the home and domestic outbuildings, garages, swimming pools, tennis courts, patios, terraces, drives,

pavement, walls, gates, hedges & fences, including landlords xtures & ttings - all on the same site.

Claim Amount (in AED)

Value includes household goods, furniture, personal effects and valuables

(Note: Each item valued over AED 20,000 to be listed separately)

If you have suffered any claim on the contents, please provide details


VI. Cover 2 - Contents



YES NO

YES NO

YES NO

Is your home built of concrete?

Is your home used solely as a private living accommodation for your household?

Has your home been built on reclaimed land?

Do you ever leave your home unattended for more than 60 consecutive days?

Has any insurer declined / cancelled / imposed special terms or conditions?

If you have ticked any of the shaded boxes, please give details here or separately.

Apartment Detached Semi-detached Terraced


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VII. Cover 3 - Personal Possessions

VIII. Declaration

In addition to any other details supplied to the Insurers, I, the undersigned, declare that to the best of my knowledge

and belief the information given by me is true and complete and that all material information has been disclosed

and I agree that this application shall be the basis of the contract between me and the insurance company. I further

declare that the payment of my premium is made from my own source. I understand and accept that the insurers

reserve the right to accept or reject a proposal at their discretion. I will give notice to the company of any change

in the information relating to the insured, as stated above.

Signature Date Location

Please note that we reserve the right to ask for any additional information, impose special terms or decline.

The liability of the Company does not commence until the acceptance of the Proposal has been intimated by the

Company or ofcial cover note issued.

Registered under UAE Federal Law No. (9) of 1984, Registration No. 65

Are you interested in a quote for any of the following personal insurances?

a) Unspecied Valuables

It covers personal items you can take outside home like expensive jewellery & other

personal effects. Please note maximum value of one item not to exceed AED 5,000/-

b) Specied Valuables

It covers clothing, valuables, personal effects, mobile phones, cameras, laptops and similar

personal equipment.

c) Sports Equipment & Accessories

It covers any accidental loss or damage to sport equipment & accessories owned by

any member of your household.

Proof of purchase / valuation is required for items under section VII (b) & (c) whose value is above AED 5,000.

At the time of issuance of the policy we will contact you to arrange for a copy of these documents.

d) Pedal Cycles & Accessories

It covers any accidental loss or damage to pedal cycles and accessories

owned by any member of your household.

If you have suffered any claim on the Personal Possessions, please provide details


Do you require Workmen’s compensation for any domestic

staff under your sponsorship?

Unspecied Valuables Value

(in AED)

Specied Valuables Value

(in AED)

Sports Equipment Value

(in AED)

Pedal Cycles Value

(in AED)

Make Model Serial No.Value


No. of Staff YES NO

Travel Motor Golf Yacht Medical Personal Accident


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With a presence in over 130 countries and a total of over 20 million customers worldwide,

we’re one of the largest and most trusted names in insurance. And as we’re the longest

established insurer in the Middle East, you can rely on us for cover and service that

understands and suits you perfectly.

RSA Personal Insurance covers:

Motor Insurance, Travel Insurance, Yacht and Pleasure Craft Insurance, Medical Insurance,

Golf Insurance, Personal Accident Insurance

DubaiGround Floor, Ofce Court Building, Oud Metha Road

PO Box 28648 Dubai

Tel +971 4 302 9800 / 334 4474

Toll Free 800 RSA (772)

Fax +971 4 337 7230 / 334 8861

Email [email protected]

Abu DhabiSuite 2, Habib Bank Building, Hamdan Street

PO Box 646, Abu Dhabi

Tel +971 2 635 1800

Fax +971 2 635 1808


SharjahSuite 701, Al Mubarak Centre, Al Arouba Street

PO Box 3761, Sharjah Tel +971 6 563 1819

Fax +971 6 563 1850


For more information visit www.rsagroup.ae

For an online quote visit www.rsadirect.ae

RSA Home Proposal Form

Documents

Transcript of RSA Home Proposal Form