ABCDEFGHIJKLMNOPQRSTUVWXYZ
1
2
INSURANCE CLAIMS STATUS
3
4
DOLINSURANCE INFOCLAIM INFO RESULTS / SETTLEMENT
5
6
14-Aug-24INSURED:CITRA GEMILANG MAHADAYA / M2M LOGISTIKPARTICULARS:MATERIAL (INKUBATOR( BROKEN )AWAIT ADDITIONAL DOCUMENTSS FROM THE INSURED
7
 POLICY NO:MOP AC\SI .01001.4.2001.00046LOSS ADJUSTER:NO
8
TSI/ UP[:IDR 128,378,378.38 EST CLAIM:
9
INSURANCE CO:CHUBB SYARIAHSALVAGE:
10
DEDUCTIBLE:10% OF RCA MIN USD 100.00NETT CLAIM PAID:
11
NO
12
8-May-24INSURED:ALTON LOGISTIKPARTICULARS:MATERIAL (PAMPERS)WAS NON DELIVERED BECAUSE OF THE DRIVER ESCAOEDCLAIM WITHDRAWN BECAUSE THE OWNER OF THE MATERIAL COULD NOT PROVIDE DOCS
13
POLICY NO:MOP CARGO ACSI.01001.4.1910.00046LOSS ADJUSTER:INSURANCE CO USING CLAIM INVESTIGATOR
14
TSI/ UP[:IDR 318,617,140.00 EST CLAIM:IDR 318,617,140.00
15
INSURANCE CO:CHUBB SYARIAHSALVAGE:NO
16
DEDUCTIBLE:10% OF RCA MIN USD 100.00NETT CLAIM PAID:NO
17
NO
18
1-Feb-24INSURED:HTL GROUP INTLPARTICULARS:Damage to cargo due tpo accident CLAIM PAID BASED ON EX GRATIA BASIS ON REPOAIR COST
19
POLICY NO:MOP CARGO ACSI.01001.4.1910.00046LOSS ADJUSTER:NO
20
TSI/ UP[:USD 11,208.00EST CLAIM:USD 2,800.00
21
INSURANCE CO:CHUBB SYARIAHSALVAGE:NO
22
DEDUCTIBLE:10% OF RCA MIN USD 100.00NETT CLAIM PAID:USD 1,800.0017-Oct-24
23
24
CLAIM 2023
25
10-Aug-23INSURED:ALTON LOGISTIKPARTICULARS:DAMAGE TO CARGO (PASSBOX DOOR BREAK ANG DAMAGE) DUE TO DURING TRANSIT CLAIM PAID
26
POLICY NO:MOP CARGO ACSI.01001.4.1910.00046LOSS ADJUSTER:NO
27
TSI/ UP[:IDR 658,055,800.00EST CLAIM:IDR 31,500,000.00
28
INSURANCE CO:CHUBB SYARIAHSALVAGE:NO
29
DEDUCTIBLE:10% OF RCA MIN USD 100.00NETT CLAIM PAID:IDR 28,347,000.001-Sep-23
30
31
26-May-23INSURED:ON TIMEPARTICULARS:LOSS DE TP THEFT ON DENPASAR OFFICECLAIM PAID
32
POLICY NO:PAR 11001.2.2306.00789.0LOSS ADJUSTER:NO
33
TSI/ UP[:IDR 137,422,600.00EST CLAIM:IDR 66,039,274.00
34
INSURANCE CO:CHUBB SYARIAHSALVAGE:NO
35
DEDUCTIBLE: IDR. 1.000.000,- NETT CLAIM PAID:IDR 66,039,274.0020-Jun-23
36
37
25-Jan-23INSURED:CITRA GEMILANG MAHADAYA / M2M LOGISTIKPARTICULARS:DAMAGE TO CARGPO HEAD MODULE (PECAH(CLAIM PAID
38
POLICY NO:MOP AC\SI .01001.4.2001.00046LOSS ADJUSTER:NO
39
TSI/ UP[:IDR 147,747,747.00EST CLAIM:IDR 17,052,539.00
40
INSURANCE CO:CHUBB SYARIAHSALVAGE:NO
41
DEDUCTIBLE:10% OF RCA MIN USD 100.00NETT CLAIM PAID:IDR 15,552,539.0028-Feb-23
42
43
2-Jan-23INSURED:ALITA PRAYA MITRAPARTICULARS:DAMAGE TO ANTENNA DUE TO FALLING TREECLAIM PAID
44
POLICY NO:MOP ASKRIDA NO. 122003012300257LOSS ADJUSTER:NO
45
TSI/ UP[:IDR 610,556,166.45 EST CLAIM:IDR 82,526,867.00
46
INSURANCE CO:ASKRIDA SYARIAHSALVAGE:YES
47
DEDUCTIBLE: 10% OF CLAIM MIN USD. 100,00 NETT CLAIM PAID:IDR 74,274,180.30 30-May-23
48
49
CLAIM 2022
50
11-Oct-22INSURED:ALITA PRAYA MITRAPARTICULARS:DAMAGE TO SOLAR PANEL DUE TO ACCIDENT WHILE HANDLINGCLAIM PAID
51
POLICY NO:MOP ASKRIDA NO. 122003012300257LOSS ADJUSTER:NO
52
TSI/ UP[:IDR 1,255,665,194.00 EST CLAIM: 10,000,000.00
53
INSURANCE CO:ASKRIDA SYARIAHSALVAGE:YES
54
DEDUCTIBLE:10% OF RCA MIN USD 100.00NETT CLAIM PAID: 8,502,850.00 30-May-23
55
56
14 SEO 22INSURED:PRIMA ARTHA KREASINDOPARTICULARS:loss of stock due to burglaryCLAIM PAID
57
POLICY NO:12.100.0001.49576LOSS ADJUSTER:
58
TSI/ UP[:IDR 16,500,000,000.00 EST CLAIM:IDR 215,933,200.00
59
INSURANCE CO:SINAR MASSALVAGE:NO
60
DEDUCTIBLE: 2,500,000.00 NETT CLAIM PAID:IDR 145,687,580.00 16-Feb-23
61
62
15-Aug-22INSURED:CITRA GEMILANG MAHADAYA / M2M LOGISTIKPARTICULARS:DAMAGE TO CARGO (SAMPLEGOODS) DURING TRANSITCLAIM PAID
63
POLICY NO:MOP AC\SI .01001.4.2001.00046LOSS ADJUSTER:NO
64
TSI/ UP[:IDR 62,189,500.00 EST CLAIM:IDR 5,237,000.00
65
INSURANCE CO:CHUBB SYARIAHSALVAGE:NO
66
DEDUCTIBLE:10% OF RCA MIN USD 100.00NETT CLAIM PAID:IDR 5,237,000.00 15-Sep-22
67
68
CLAIM 2021
::
69
29-Dec-21INSURED:WID LOGISTICPARTICULARS:DAMAHE TO CARGO (OXY MACHINE DUE TO TRANSPORTATION ROAD) TO KUDUSCLAIM PAID
70
POLICY NO:MOP CARGO ACSI.01001.4.1910.00046LOSS ADJUSTER:Charles Taylor Adjusting
71
TSI/ UP[:IDR 3,439,568,500.00 EST CLAIM:IDR 1,259,868,656.00
72
INSURANCE CO:CHUBB SYARIAHSALVAGE:YES
73
DEDUCTIBLE:10% OF RCA MIN USD 100.00NETT CLAIM PAID:IDR 841,916,440.00 2-Mar-23
74
75
3-Dec-21INSURED:WID LOGISTICPARTICULARS:DAMAHE TO CARGO (OXY MACHINE BROLEN GLASS DOOR) TO MANADOCLAIM PAID
76
POLICY NO:MOP CARGO ACSI.01001.4.1910.00046LOSS ADJUSTER:
77
TSI/ UP[:IDR 1,710,000,000.00EST CLAIM:IDR 10,600,000.00
78
INSURANCE CO:CHUBB SYARIAHSALVAGE:NO
79
DEDUCTIBLE:10% OF RCA MIN USD 100.00NETT CLAIM PAID:IDR 9,155,011.0013-Jan-22
80
81
2-Nov-21INSURED:ALITA PRAYA MITRAPARTICULARS:DAMAGE TO STOCK AT TG MORAWA MEDAN DUE TO FLOODCLAIM PAID
82
POLICY NO:11001-2-2007-01222-1LOSS ADJUSTER:SEDGWIJCK ADJUSTING
83
TSI/ UP[:USD 7,445,192.92EST CLAIM:USD 85,500.00
84
INSURANCE CO:CHUBB 55, SIMAS 34SALVAGE:YES
85
DEDUCTIBLE:10% OF RCANETT CLAIM PAID:USD 81,112.8911-Feb-22
86
87
21-Oct-21INSURED:CITRA GEMILANG MAHADAYA / M2M LOGISTIKPARTICULARS:DAMAGE TO 2 INCH LCD WIDESCREENCLAIM PAID
88
POLICY NO:MOP AC\SI .01001.4.2001.00046LOSS ADJUSTER:NO
89
TSI/ UP[:IDR 14,076,748.00EST CLAIM:IDR 14,076,748.00
90
INSURANCE CO:CHUBB SYARIAHSALVAGE:NO
91
DEDUCTIBLE:10% OF RCA MIN USD 100.00NETT CLAIM PAID:IDR 12,668,533.2010-Dec-21
92
93
5-Sep-21INSURED:CITRA GEMILANG MAHADAYA / M2M LOGISTIKPARTICULARS:LOSS OF 250 PCS TEKKOMSEL CARGO DUE TO HIJACKINGCLAIM PAID
94
POLICY NO:MOP AC\SI .01001.4.2001.00046LOSS ADJUSTER:NO
95
TSI/ UP[:IDR 381,250,000.00EST CLAIM:IDR 381,250,000.00
96
INSURANCE CO:CHUBB SYARIAHSALVAGE:NO
97
DEDUCTIBLE:10% OF RCA MIN USD 100.00NETT CLAIM PAID:IDR 343,125,000.0010-Dec-21
98
99
7-May-21INSURED:ON TIME EXPRESSPARTICULARS:LOSS OF 4 PCS LUXURY WATCHES DUE TO THEFTCLAIM PAID
100
POLICY NO:MOP CARGO ACSI.01001.4.1910.00046LOSS ADJUSTER:NO