PRIVATE CAR POLICY

Please examine this document and the schedule and if they do not meet your requirements, or if any information is not
correctly stated, kindly return them at once to the issuing office and ask for the corrections to be made.

Documentary Stamps to the value stated above have been properly affixed and cancelled on the duplicate of this Policy.

IMPORTANT NOTICE
The Insurance Commissioner with offices in Manila, Cebu and Davao is the Government Official in charge of the faithful
execution and enforcement of all laws relating to insurance and has supervision over Insurance Companies. He is already at
all times to render assistance in settling any controversy between an insurance Company and the Policyholder relating to
insurance matters.

WHEREAS THE INSURED, by his corresponding proposal and declaration that shall be the basis of this Contract and deemed
incorporated herein has applied to Fortune General Insurance Corporation. (herein referred to as “the Company”) for the insurance
hereinafter contained, subject to the payment of the Premium as consideration for such insurance.

IN WITNESS WHEREOF, the Company has caused this Policy to be signed by its duly authorized representative at the date the date
and place stated in the stated in the Schedule.

NOW THIS POLICY WITNESSETH, that in respect of events occurring during the Period of Insurance, and subject to the following
terms, exceptions and conditions contained therein or endorsed hereon (hereinafter collectively referred to as the Terms of this Policy):

AUTHORIZED DRIVER
Any of the following:

a. The insured; or
b. Any person driving on the Insured’s order or with his permission

Provided, that the person driving is permitted, in accordance with the licensing law or other regulations, to drive the Scheduled Vehicle
or has been permitted and is not disqualified by order of a Court of Law or by reason of any enactment or regulation in that behalf;
provided, further, that for Sections I and II, of this Policy only, Authorized Driver shall include a duly licensed driver.

LIMITATIONS AS TO USE
This Policy shall only cover use of the Scheduled Vehicle for social, domestic and pleasure purposes, and for the Insured’s business or
profession.

This Policy does not cover -

1. Use for the hauling and/or carrying of logs, lumber, sand, gravel, bottled beverages, gasoline products and/or other inflammable articles or materials or for hire
or reward;
2. Use for racing, pacemaking, reliability trial or speed testing;
3. Use for the carriage of PASSENGERS or for hire or reward;
4. Use for any purpose in connection with the Motor Trade.

Limitations (1) and (2) above may be deleted and the risks named therein covered by this Policy upon written agreement by, and
payment of 20% additional premium to, the Company.

COMPULSORY THIRD PARTY LIABILITY (CTPL)

Sections I and II of this Policy covers THIRD PARTY liability arising from bodily injury and/or in amounts set forth under the Schedule of
Indemnities.

Section I – Liability to the Public

1. The Company will, subject to the Limits of Liability pay all sums necessary to discharge liability of the Insured in respect of bodily injury and/or death to any
THIRD PARTY, in an accident caused by or arising, out of the use of the Scheduled Vehicle, provided that the insured’s liability shall have first been determined.
In no case however, shall the Company’s total payment under both Sections I and II combined exceed the Limits of Liability set forth in the Schedule of
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Indemnities. With respect to bodily injury and/or death to aby party, the Company’s payment per victim in any one accident shall not exceed the limits indicated Page 1 of 5
in the Schedule of Indemnities provided for in this Policy.
2. In terms of and subject to the limitations of this Policy, the Company will indemnify -
 a. Any authorized Driver who is driving the Scheduled Vehicle, provided that he.-
i. Observes, fulfills and be subject to the Terms of this Policy insofar as they can apply;
ii. Is not entitled to indemnity under any other Policy subject, however, to Condition No. 9 of the Conditions Applicable To All Sections.
3. In the event of the death of any person entitled to indemnity under this policy the Company will, in respect of the liability incurred to such person indemnify his
personal representatives in terms of, and subject to the conditions hereof.
4. The company will pay all pertinent and reasonable costs and expenses incurred in connection with the accident.
5. In the event of accident involving indemnity under this Policy to more than one person, the Limits Liability shall not exceed the aggregate amount so specified by
law to all persons to be indemnified.
6. Should indemnification both liability of the Insured and that of another part (as provided under Authorized Driver) be provable, the Insured shall have prior right
thereto.
7. Unless the Insured objects object, the Company shall.-
a. Arrange for representation at any inquest or investigation in respect of any death which may be the subject of indemnity under this Section;
b. Undertake the defense in the Insurance Commission under Section 385 of the Insurance Code, or any court of law, for alleged offenses causing, or
relating to, any event which may be the subject to indemnity under this Section.

Section II – No Fault Indemnity

The Company will pay any claim for bodily injury and/or death to any THIRD PARTY without the necessity of proving fault or negligence
of any kind provided that:-

1. The total indemnity in respect of any one THIRD PARTY shall not exceed Fifteen Thousand Pesos, subject to the Schedule of Indemnities provided for in this
Policy in case of death or physical injury without prejudice to the claimant from pursuing his claim further, in which case he shall not be required or compelled by
the Company to execute any Quit Claim or document releasing it from liability under the Policy of insurance.
2. The following proofs of loss, when submitted under oath, shall be sufficient evidence to substantiate the claim.-
a. Police report or accident or any evidence sufficient to establish the accident; and
b. Medical report and evidence of medical or hospital expenses; and/or
c. Death Certificate and evidence sufficient to establish the proper payee.

OWN DAMAGE AND/OR THEFT (OD/TH)

Section III – Loss or Damage
1. The Company will, subject to the Limits of Liability, indemnify the Insured against loss of or damage to the Scheduled Vehicle and its accessories and spare
parts while thereon:-
a. By accidental collision or overturning, or collision or overturning consequent upon wear and tear;
b. By fire, external explosion, self-ignition or lightning or burglary, housebreaking or theft;
c. By malicious act;
d. While in transit (including the processes of loading and unloading) incidental to such transit by road, rail, inland waterway, lift or elevator.
2. At its own option, the Company may pay in cash the amount of the loss or damage, or may repair, reinstate or replace the Scheduled Vehicle or any part thereof
or its accessories or spare parts. The liability of the Company shall not exceed the value of the parts lost or damaged and the reasonable cost of fitting such
parts or the value of the Scheduled Vehicle at the time of the loss or damage, whichever is less. The Insured’s estimate of value stated in the Company In
respect of any claim for loss or damage.
3. In the event of a claim being payable under Section III of this Policy for the cost of replacement parts, the amount of settlement shall be the cost of brand new
part(s) to replace the damaged part(s) of the Scheduled Vehicle less the share of the Insured on the cost of the replacement parts computed based on the
following depreciation schedule:-

RATE OF DEPRECIATION
AGE OF THE VEHICLE
(SHARE OF THE INSURED)

Up to 3 years Nil

Over 3 years up to 4 years 25%

Over 4years up to 5 years 30%

Over 5 years up to 6 years 35%

Over 6 years up to 7 years 40%

Over 7 years 45%

Rebuilt or Reconditioned Vehicles 45%

Batteries, Tires, Ball Joints, Tie Rods and Shock Absorbers (for vehicles over 3 years old) 50%

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It is further declared and agreed that in case of the total loss of the vehicle Insured this Clause shall not apply but the settlement
Page 2 of 5
shall be based on the provisions of Section III, Paragraph No. 2 hereof.
 4. If the Scheduled Vehicle is disabled by reason of loss or damage Insured under this Policy, the company will, subject to the Limits of the Liability for towing, bear
the reasonable cost of protection and removal to the nearest repairer.
5. The insured may authorize the repair of the Scheduled Vehicle necessitated by damage for which the Company may be liable under this Policy provided that:-
a. The estimate cost of such repair does not exceed the Authorized Repair and Limit and;
b. A detailed estimate of the cost is forwarded to the Company without delay.
6. In the event of loss or damage to the Scheduled Vehicle or its accessories or spare parts necessitating the supply of a part not obtainable from stocks held in
the Philippines, or in the event of the Company exercising the option under Paragraph 2 to pay in cash the amount of loss or damage, the liability of the
Company in respect of any such part shall be limited to: -
a. (i) the price quoted in the latest catalogue or price list issued by the Manufacturer or his Agents for the Philippines or (ii) If no such catalogue or price list
exists, the price last obtaining at the Manufacturer’s Works plus the reasonable cost of transport other than by air, to the Philippines, and the amount of
relative import duty; and
b. The reasonable cost of fitting such part.
7. This policy shall be operative while the Scheduled Vehicle is being used for the purpose of towing any one disabled mechanically propelled vehicle provided
that:-
a. Such towed vehicle is not towed for reward;
b. The Company shall not be liable in respect of damage to such towed vehicle or property being conveyed thereby.

Exceptions to Section III

The Company shall not be liable to pay for:-

1. Loss or damage in respect of any claim or series of claims arising out of one event, the first amount of each and every loss for each and every vehicle Insured
by this Policy, such amount being equal to one percent (1.00%) of the Insured’s estimate of Fair Market Value as shown in the Policy Schedule with a minimum
deductible amount of P 500.
2. Consequential loss, depreciation, wear and tear, mechanical or electrical breakdowns, failures or breakages;
3. Damage to tires, unless the Scheduled Vehicle is damaged at the same time;
4. Any malicious damage caused by the Insured, any member of his family or by a person in the Insured’s service.

VOLUNTARY THIRD PARTY LIABILITY (VTPL)

Section IV – Excess Liability Insurance
1. The Company will subject to the Limits of Liability , reimburse the Insured for all sums actually paid by the Insured to discharge liability in accordance with all the
provisions of Section I but only in excess of:-
a. The Limits of Section I and II of this Policy, when such limits have been exhausted or;
b. The liability limits required for the Scheduled Vehicle under Section 377 of the Insurance Code, as amended in the event no coverage exists as described
in paragraph (a) above.
Coverage under this paragraph is not subject to the Schedule of Indemnities under Section I.

2. The Company will, subject to the Limits of Liability, pay all sums necessary to discharge liability of the Insured. In respect of damage to Third Party property in
an accident caused by and arising out of the use of the Scheduled Vehicle, or in connection with the loading or unloading of the Scheduled Vehicle, provided
that the Insured’s liability shall have first been determined either by final court judgement after actual trial, or by written agreement of the Insured, or held in trust
by, or in the custody or control of the Insured or any member of the Insured’s household, or being conveyed by the Schedule Vehicle.
For the purpose of this paragraph, Scheduled Vehicle shall include any Motorcycle while being personally driven by the Insured
not belonging to him and not hired to him under a hire purchase agreement.

General Exceptions
The company shall not be liable under any Section of this Policy in respect of:-

1. Any accident, or liability caused, or incurred

a. Outside the Republic of the Philippines
b. While any MOTOR VEHICLE in respect of which indemnity is provided by this Policy is:-
i. Being used otherwise than in accordance with the limitations as to use;
ii. Being driven by any person other than an Authorized Driver.
2. Any liability which attached by virtue of an agreement but which would not have attached in the absence of such agreement, except liability arising out of an on
the spot agreement or amicable settlement of minor accident to avoid impairing the flow of traffic.
3. Except in respect of claims arising under Sections I and II of this Policy, any accident loss, damage, or liability directly or indirectly, proximately or remotely
occasioned by contributed to by or traceable to, or arising out of, or in connection with flood, typhoon, hurricane, volcanic eruption, earthquake or other
convulsion of nature, invasion, the act of foreign enemies, hostilities or warlike operations (whether war be declared or not), strike, riot, civil commotion, mutiny,
rebellion, insurrection, military, or usurped power, or by any direct or indirect consequences of any of the said occurrences, and in the event of any claim
hereunder, the Insured shall prove that the accident, loss or damage or liability arose independently of, and was in no way connected with, or occasioned by, or
contributed to, any of the said occurrences or any consequence thereof, and in default of such proof the Company shall not be liable to make any payment in
respect of such claim.
4. Any sum which the Insured would have been entitled to recover from any party but for an agreement between the Insured and such party
5. Bodily injury and/or death to any person in the employ of the Insured arising out of and in the course of such employment, or bodily injury and/or death to any
member of the Insured’s household who is riding in the Scheduled Vehicle.

Definitions
1. MOTOR VEHICLE is any vehicle as defined in Section Three, Paragraph (A) of Republic Act – Numbered Four Thousand One Hundred Thirty Six, otherwise
known as the “Land Transformation and Traffic Code”.
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2. THIRD PARTY is any person other than a PASSENGER as defined in the law and shall also exclude a member of the household, or a member of the familyPage 3 of 5
within the second degree of consanguinity or affinity, of a motor vehicle owner of his employee in respect of death, bodily injury or damage to property arising
out of and in the course of employment.
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 Conditions Applicable To All Sections
1. This Policy and the Schedule and any Endorsement thereon shall be read together, as one contract, and any word, or expression to which a specific meaning
has been attached in part of this Policy or of the Schedule shall bear such specific meaning wherever it may appear
2. Every notice or communication required by the Company under this Policy must be in writing addressed to the Branch of Agency of the Company from which
this Policy was issued and notice or knowledge of anything relating to this Policy or any claim hereunder shall not be deemed notice to or within the knowledge
of the Company unless so given. No alteration in the terms of this Policy or any endorsement hereon will be held valid unless the same is signed or initiated by
an authorized representative of the Company.
3. The insured shall take all reasonable steps to safeguard the Scheduled Vehicle from loss or damage to maintain the Scheduled Vehicle in efficient condition,
and the Company shall have at all times free and full access to examine the Scheduled Vehicle or any part thereof or any driver or employee of the Insured.
4. In the event of any accident or breakdown, the Scheduled Vehicle shall not be left unattended without prior precaution being taken to prevent further loss or
damage and, if the Scheduled Vehicle be driven before the necessary repairs are affected, any extension of the damage or any further damage to the
Scheduled Vehicle shall be excluded from the scope of the indemnity granted by this Policy
5. In the event of any accident which may give rise to claim under this Policy, the Insured shall, as soon as possible, give notice thereof to the Company with full
particulars. Every letter, claim, writ, summons and process shall be notified or forwarded to the Company immediately on receipt. Notice shall also be given to
the Company immediately as soon as the Insured shall have knowledge of any impending prosecution, inquest or fatal injury in connection with any such
occurrence. In case of theft or other criminal act which may give rise to a claim under this Policy, the insured shall give immediate notice to the Police and
cooperate with the Company in securing the conviction of the offender.
6. Without the prejudice to No. 2 of the General Exceptions, no admission, offer promise or payment shall be made by or on behalf of the Insured without the
written consent of the Company which shall be entitled to take over the conduct in his name of the defense or settlement of any claim, or to prosecute in his
name for its own benefit any claim for indemnity or damages or otherwise, but shall not exercise any discretion prejudicial to the interest of the Insured in the
conduct of any proceedings in the settlement of any claim, and the Insured shall give all such information and assistance as the Company may require. If the
Company shall with the consent of the Insured make any payment in settlement of any claim and such payment includes any amount not covered by this Policy,
the Insured shall repay the Company the amount not so covered.
7. At any time after the happening of any event giving rise to a claim or series of claims under this Policy, the Company may pay the Insured and the Third Party
claimant jointly the full amount of the Company’s liability and relinquish the conduct of any defense, settlement or proceedings, and the Company shall not be
responsible for any damaged alleged to have been caused to the Insured in consequence of any alleged action or omission of the Company in connection with
such defense, settlement or proceedings or of the Company relinquishing such conduct, nor shall the Company be liable for any costs or expenses whatsoever
incurred by the Insured or any claimant or other person after the Company shall have so relinquished.
8. The Company may cancel this Policy accordance with Sections 64, 65 and 380 of the Insurance Code , in which case the Company shall thereupon return to
the Insured premiums paid less than the prorate portion thereof for the period when the Policy has been in force. The insured may, at any time, cancel the Policy
by surrendering it to the Company and (provided no claim has arisen during the current period of insurance) the Insured shall be entitled to a return of the
premium at the Company’s Short Period Rates for the period when the Policy has been in force. However, in respect of Sections I and II, the cancellation made
by the Insured shall not be effective unless he has secured a similar Policy of Insurance or surety bond to replace the Policy to be cancelled or make a cash
deposit in sufficient amount with the Commissioner and without any gap file within five (5) working days from the date of cancellation the required documentation
with the Land Transportation Office accordance with section 381 of the Insurance Code.
9. If, at any time any claim arises under this Policy, there is any other insurance covering the same loss, damage or liability, the Company shall not be liable to pay
or contribute more than its ratable proportion of any loss, damage, compensation, costs or expenses. Provided always that nothing in this Condition shall
impose on the Company any liability from which, but for this Condition, it would have been relieved under provision (ii) of Section 1, Paragraph 2 of this Policy.
10. Except In case of claims arising under Sections I and II of this Policy, if any difference or dispute shall arise with respect to the amount of the Company’s Liability
under this Policy, the same shall be referred to the decisions of a single arbitrator, to be agreed upon by both parties or failing such agreement of a single
arbitrator, to the decision of two arbitrators, one to be appointed by writing by each of the parties within one calendar month after having been required in writing
so to do by either of the parties and, in case of disagreement between the arbitrators, to the decision of an umpire who shall have been appointed in writing by
the arbitrators, before entering on the reference, and the cost of expenses incidental to the reference shall be dealt with in the award. And it is hereby expressly
stipulated and declared that is shall be a condition precedent to any right of action or suit upon this Policy that the award by such arbitrators or umpire of the
amount of the Company’s liability hereunder, if disputed, shall be first obtained.
11. If a claim made and rejected, and an action or suit be not commended within twelve months after such rejection, or in case of an arbitration taking place as
provided herein, within twelve months after the arbitrator, or arbitrators or umpire shall have made their award, then the claim shall, for all purposes, be deemed
to have been abandoned and shall not thereafter be recoverable hereunder. Provided, however, that in case of any dispute in the enforcement of the provisions
of Section I and Section II of this Policy, the adjudication of such dispute shall be within the original and exclusive jurisdiction of the Insurance Commissioner,
subject to the limitations provided in Section 416 of the Insurance Code, as amended.
12. The due observance and fulfillment of the Terms of this Policy, insofar as they relate to anything to be done or not to be done by the Insured, and the truth of the
statements and answer in the proposal, shall be conditions precedent to any liability of the Company to make any payment under this Policy
13. In the event that the Company should pay or be held liable to pay any claim or claims under the “No Fault” provisions of the Insurance Code the Insured shall
reimburse the Company for all such sums, whenever the Insured or his authorized driver or representative has committed a breach of any warranties, clauses or
conditions of the Policy, or whenever the circumstances fall under any of the EXCEPTIONS listed in the Policy, for which the Company would not have been
liable were it not for the application of the “No-Fault” provision of the Insurance Code.
14. Except only in those specific cases where corresponding rules and regulations which now are or may hereafter be in force provided for the payment of the
stipulated premiums in periodic installments at fixed percentage, it is hereby agreed, declared and warranted that this Policy shall be deemed effective, valid and
binding upon the Company only when the premiums therefore have actually been paid in full acknowledge in a receipt by any authorized official or
representative/agent of the Company.
15. Unless the Company at least forty-five (45) days in advance of the end of the Policy period mails or delivers to the Insured at the address shown in the Policy,
notice of its intention, not to renew the Policy or to condition its renewal upon reduction of limits or elimination of coverages, the assured shall be entitled to
renew the Policy upon payment of the premium due on the effective date of renewal

Nuclear Energy Exclusion Clause

This Policy shall not cover any legal liability whatsoever nature directly or indirectly caused by or arising from ionizing radiations or any
contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel. For the purpose of
this exclusion only, combustion shall include any self-sustaining process of nuclear fission.
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The indemnity provided by this Policy shall not apply to include any loss, destruction, damage or legal liability directly or indirectly Page 4 of 5
caused by or contributed to by or arising from nuclear weapons material.
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 Civil Code Article 1250 Waiver Clause
It is hereby declared and agreed that the provisions of Article 1250 of the Civil Code of the Philippines (Republic Act NO. 386) which
reads:-

“In case an extraordinary inflation or deflation of the currency stipulated should supervene, the value of the currency at the time of the
establishment of the obligation shall be the basis of payment …”

Shall not apply in determining the extent of liability under the provisions of this Policy.

SCHEDULE OF INDEMNTIES FOR BODILY INJURY AND/OR DEATH

The following Schedule of Indemnities shall be observed in the settlement of claims for death, bodily injuries, professional fees and
hospital charges for services rendered to traffic accident victims under the Compulsory Motor Vehicle Liability Insurance Coverage.

A. DEATH INDEMNITY P70,000.00 C. PERMANENT DISABLEMENT AMOUNT

Burial and Funeral Expenses 30,000.00
Loss of or Loss of Use of:
B. BODILY INJURIES AND FRACTURES - Two Limbs P50,000.00
Both Hands, or all fingers & both thumbs 50,000.00
Types of Accommodation Services Rendered Maximum Reimbursable Both Feet 50,000.00
or Professiona Fees and/or Charges One Hand and one Foot 50,000.00
Attendance Extended Sight of Both Eyes 50,000.00
Sight of Both Eyes 50,000.00
1. Hospital Rooms Maximum of 45 days per P500.00/day Injuries resulting in being permanently 50,000.00
accident Laboratory bedridden
Examination fees, X-rays Any other injury causing permanent total 50,000.00
disablement
2. Surgical Expenses Major Operation 7,500.00
Arm at or above elbow 20,000.00
Medium Operation 5,000.00
Arm between elbow and wrist 15,000.00
Minor Operation 1,500.00
Hand 15,000.00
Four Fingers and thumb of one hand 15,000.00
3. Anaesthesiologist’s Fees Major Operation 2,500.00
Four fingers 12,000.00
Medium Operation 2,000.00
Leg at or above knee 20,000.00
Minor Operation 500.00
Leg below knee 15,000.00
4. Operating Room Major Operation 1,500.00 One foot 15,000.00
Medium Operation 1,000.00 All toes of one foot 10,000.00
Minor Operation 500.00 Thumb 8,000.00
Index Finger 6,000.00
5. Medical Expenses For daily visits of 400.00/day Sight of one Eye 20,000.00
Practitioner or Specialists Hearing – both Ears 30,000.00
Hearing – One Ear 15,000.00
The total amount of medical 5,000.00
expenses must not exceed D. OTHER INCIDENTAL EXPENSES
(For a single period of
The Company will pay all pertinent and reasonable expenses
confinement)
incurred in connection with the accident not provided under this
6. Drugs and Medicine Actual value of drugs and 20,000.00 Schedule of Indemnities (A), (B), and (C), subject to a maximum
medicine used but not to amount of but in no case shall the company’s aggregate payment
exceed P10,000.00 exceed the overall Limits of under Section I and II.

7. Ambulance Liability Actual amount charged for 1,500.00

ambulance transport but not
to exceed

SHORT PERIOD RATE SCALE

It is hereby agreed, in the event this Policy is surrendered by the Insured for cancellation, the Company shall retain a premium
in accordance with the following scale for the time the Policy has been in force:

Number of Months 1 2 3 4 5 6 7 8 9 10 11

Percentage 20 30 40 50 60 70 75 80 85 90 95

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