eTigQa Your Ref OurRef 09124266/NAJ Date 16 May 2017 AISHAH BINTI BORHAN WITHOUT PREJUDICE NO 20 JUN JATI 15, TMN JATI BATU BERENDAM 75350 Melaka Dear Madam, INSURED AISHAH BINTIBORHAN POLICY NO BGA-03355389-W1 DATE OF Loss 25 February 2017 DESCRIPTION : BREAK IN/THEFTLOSS OF CONTENTS We refer to the above matter and are pleased to advise that the claim is now in order for settlement, We are pleased to offer settlement to your claim as follow: Home Contents RM 30,174.00 Personal Money RM 4,500.00 Less : Excess/Deductible RM 0.00 Total Claim Payable RM 34,674.00 We hope the above offer meets your acceptance, and if so, we look forward to receiving the duly executedisigned Form of Discharge & Subrogation which is enclosed herewith for your attention. Kindly indicate your Maybank account number should you prefer the payment to be directly credited into your Maybank aceaunt. We undertake to issue our cheque / payment upon receipt ofthe said Form of Discharge & Subrogation ‘Thank you. Yours faithfully, ETIQA INSURANCE BERHAD Nur AiShah pintiJonet Executive, Fire Claims Care Tel No, :03-2298 5948 Fax No, 03-2785 5999 Email :nuraishah j@etiga.com:my GENERAL CLAIM DEPARTMENT eran nsuranes BeR4D (577) (te evar Oar Mer No, sn Mowe 00 Klann, a. (Gsm Aut ae tar Far CO honetocon.ny pierpdan saa MPMIeTiga ORI OF DISCHARGE & SUBROGATION Claim No : 09124266/NAJ We AISHAH BINTI BORHAN hereby confirm my/our agreement to accept the sum of RM31,674.00 from the Etiga Insurance Berhad being full and complete settlement and satisfaction of all my/our claims whatsoever nature of compensation of damage in respect of BREAK IN/THEFTLOSS OF CONTENTS on 25/02/2017, We declare that | am /we are the person(s) entile to receive the above money and do hereby undertake to indemnity the insurer the full amount and costs and incidental to such claims arising out of the said accident or los. “IWe authorize the payment of the above said sum to be made in favour of _*(please initial on this column) We also place on record that by virtual of such payment the company concemed become subrogated to all my/our rights and remedies to commence any proceeding in court in mylour name against any third party for indemnity as they may in their sole discretion decide or deem fit and any receipt and/or discharge executed by the sald Etiqa Insurance Berhad for any recovery shall be unconditionally binding upon mefus. Dated this 2017 Signature of Claimant Name NRIC No. (Individual) Maybank Account No. (ifapplicable) Signature of Witness Name NRIC No. (Individual)Loss Adjustment ‘tam Beserption —esaptna, Argun Commenta——=—~anatatamant Battermany Acute ‘a ae) Seay et = a8 Vemma t mt 4000 te manent dociert nw Moe es, sane Gedcom unoaraly aesneo — 2 Fema eavy 210.00 ta ‘280.00 eK 12800 4 tandohone vou 00.00 nny st mo BSeewen “ 10.00 sa00 2% s2mc0 exten ww 0000 00.00 20m ace 00 Bonavatsn ne 00 ye0.00 2m aco 09 Anse wath ne 290.00 sea.20 20% 7220 © Guonaverwalen 22090 220.00 20% 4820 (60 Slolanawaich 200.00 230.00 20m 20.00 6 Huston 100.00 s.so0.00 20% 142000 () Neuace sm 6ee200 002.00 Ni 590260 ele eoraci-n 3030009 1020000 Nt 1080000 0 Rie sooro1 sone 20.99 wm eco0 ttt ason0 0 pe sea 1490.00 sa 440000 ‘Barmure Gand © boson ‘ va mo o Rea? evie0r0 ‘708.00 tm 790.00 fo wader Ratna mvrei7es ne 4400.99 12 Phone spas va0ea00, 20800 ra 200.08 19 Leptepaarming NE 000.09 com 1200.00 “ “ 1.20000 Nosupoting oo mm ~ open Seeman es oot Suetou auras saree ‘exenrecon! Money + Con Bate Box 25000 Linton tora #000 a ow oan 1510000 Limp te Rat ace 20 120000 © 800.00 Bunrote 2300.00 ‘s0a00