Chapter Two: The Unified Comprehensive Insurance Policy for Motor Vehicles Financially Leased to Individuals
Article 12
The Policy shall be treated as individual insurance policies regarding -for example but not limited to- pricing, eligible Discounts and Claims settlement.
Article 13
The insurance coverage request that was completed and signed by the insurance applicant or their legal representative shall form an integral part of the Policy; which contains the provisions, conditions, exclusions, coverage limits and schedule; and any Endorsement agreed upon, whether at the start of the insurance coverage or following its effectiveness.
Article 14
Insurance Coverage
Coverage under the Policy shall include loss or damage to the insured Motor Vehicle, and third party civil liability.
Article 15 General Provisions
1. Scope of Coverage:
The Insurer shall compensate the beneficiary for loss or damage to the Motor Vehicle, including any installed accessories, occurring due to any incident, including fire, theft or damage resulting from lightening or natural disasters such as floods or hailstones, according to the Policy conditions provided below.
2.Maximum Indemnity Limit:
a. Partial Loss: The maximum indemnity limit in case of Partial Loss or Damage is the cost of reinstatement of the Motor Vehicle, in addition to the costs of transportation and storage, after calculating the Deductible amount and the depreciation rate if applicable according to the conditions stated in the Policy, and this amount shall be determined by entities licensed to conduct vehicle damage assessments.
b. Total Loss: The Insurer’s maximum liability limit in case of Total Loss shall not exceed the Sum Insured for the Motor Vehicle. The Motor Vehicle is deemed as Total Loss or damaged if the damage assessment shows that the needed repairs are economically or technically infeasible, provided that such assessment is conducted by entities licensed to conduct vehicle damage assessments.
3. Deductible:
a- In the event of Partial Loss or Damage to the Motor Vehicle the Insurer may charge the Deductible amount specified in the Policy Schedule for each Claim.
b- The Insurer’s liability starts after the Deductible has been exhausted, and this is only applicable to damages or losses occurring to the insured Motor Vehicle, and it does not apply on claims arising from civil liability coverage against third party.
c- The First Beneficiary shall not be charged a Deductible if the Lessee or the Driver were not held liable for the Accident, according to the report prepared by the entity attending the Accident scene.
d- In case the First Beneficiary or the Driver is held partially liable for the Accident, the percentage of Deductible amount shall be calculated as per the percentage of liability accounted for by the Lessee or the Driver regarding the Accident only.
e- Under no circumstance shall the Deductible be multiplied within this Policy for a single motor Accident.
4. Storage and Transportation:
The Insurer shall pay the expenses incurred by the Insureds when transporting the damaged Motor Vehicle, due to an Accident covered under the Policy, to a safe location, auto repair shop, certified dealership, or to an assessment center in the case the vehicle was immobile. Such expenses will be limited to a maximum of SAR (500) within the city and SAR (1,000) outside the city; provided that the transportation receipt is submitted when filing the Claim.
6. Claim Settlement Procedures:
a- Either the First or the Second Beneficiary may file a Claim request to the Insurer upon the occurrence of loss or damage covered under the Policy. The Insurer shall provide the Claimant, within (3) business days, with a notice acknowledging receipt of the Claim and informing them of any missing documents. The Insurer may also appoint an assessor or loss adjuster, if necessary, within a period not exceeding (3) business days from receiving the Claim completed with all documents, provided that the Insurer informs the Claimant of whether the Claim is accepted or rejected, within (10) business days from the date of filing the Claim completed with all documents.
b- If the Claim is accepted and deemed to be Partial Loss, the Insurer shall approve repairing the insured Motor Vehicle at the respective certified dealership or the certified auto repair shops approved by the Insurer (as specified in the Policy Schedule) within (5) business days, ensuring that the First Beneficiary receives the Motor Vehicle after it has been reinstated to its former condition before the loss or damage. The Insurer shall also provide details regarding the due indemnity process and what does it cover (the amount of spare parts and labor charges).
c- If the insured Motor Vehicle is deemed to be Total Loss, the Insureds shall compensate the Second Beneficiary with the Sum Insured specified in the Policy Schedule - after calculating the Deductible, if any - and inform the First Beneficiary of the amount indemnified to the Second Beneficiary via a reliable communication means. The Insurer shall settle the Claim sustained under this Policy with integrity and fairness, without any compromises, and within a maximum period of (10) business days from the date of the Claim completed with all documents. The Second Beneficiary shall deliver the Motor Vehicle wreckage to the Insurer.
d-In the event of damage or loss of the Motor Vehicle caused by a third party, The Insurer shall compensate beneficiaries in
accordance to these Rules. The Insurer has the right of recovery against the Insurer of the third party whom caused the accident.
e- The Insurer shall prioritize the First Beneficiary in purchasing the insured Motor Vehicle wreckage when its loss or damage is deemed as economically Total Loss, according to the value determined by the authorized entity in assessing the Motor Vehicle after the occurrence of the damage.
f- In case of Motor Vehicle theft, the Insureds or any of them shall report to the competent authorities and the Insurer promptly, and the Claim shall only be accepted after a period of (60) days from the date of submission of such report.
g- If an Insurer does not issue the necessary approval for repairing the Motor Vehicle or settling the Claim within the prescribed period without a legal justification, both beneficiaries - after filing a complaint to the Insurer- are entitled to submit a complaint against the Insurer via SAMACares website (www.Samacares.com) or with the Committees for Resolution of Insurance Disputes and Violations, so as to compel the Insurer to settle the Claim and compensate such beneficiaries for any costs incurred as a result of their inability to use the Motor Vehicle due to the Insurer's delay in settling the Claim.
h- In case of rejection of the Claim, the Insurer shall:
1.Provide the Claimant with the reasons for rejection.
2.Inform the Claimant of their right to submit a complaint at SAMACares website (www.Samacares.com) or refer their case to the Committees for Resolution of Insurance Disputes and Violations for consideration.
3. Provide the Claimant with a copy of documents related to the Claim upon their request.
Article 16 Coverage Exclusions
This coverage excludes:
1- A Motor Vehicle found to be driven by a person who does not hold a valid license corresponding to the type of vehicle driven, according to the relevant laws and regulations, or in the event that an order is issued by a concerned authority for the forfeiture of the Driver’s license, or if the license was expired at the time of the Accident unless it was renewed within (50) business days from the date of the Accident.
2-The Deductible amount stated in the Policy Schedule.
3-Consequential loss or denial of usage.
4-Manufacturing defects and damages resulting due to the usage of the Motor Vehicle or from mechanical or electrical malfunctions.
5-Damage, loss or theft of tires, rims, and/or hubcaps (wheel covers), unless such loss or damage occurred thereto at the time of the covered Accident.
6-Death or physical injury to the Insured or the Driver.
7-Emergency medical expenses.
8-Loss or damage to goods and/or personal belongings while being loaded, unloaded or transported in or on the Motor Vehicle.
9-Loss or damage to any trailer unless expressly stated otherwise in the Policy Schedule.
10-Loss or damage to a Motor Vehicle as a result of theft or attempt theft due to leaving the Motor Vehicle running or abandoning the keys inside of it, or due to not shutting down the windows or closing the doors.
11-All additional Motor Vehicle’s accessories, apart from those already fitted by the manufacturer and whose price is already included in the original price of the Motor Vehicle, unless the type and value of such accessories are explicitly and specifically stated in the Policy Schedule.
12-If the Motor Vehicle is used in contravention to restrictions set forth in the Policy Schedule.
13-Carrying passengers beyond the permitted loading capacity of the Motor Vehicle or overloaded; if it is proven that the Accident was caused by such violation.
14-If the Motor Vehicle is used for any type of racing or for acceleration, endurance or speed testing.
15-A Motor Vehicle driven by a person under the influence of drugs, alcohol, or medicines which medically prohibit driving after taking it.
16-If the Motor Vehicle is being used or operated as working machinery.
17-Car drifting, running a red light or driving against direction of traffic if it is proven that this was the cause of the Accident according to the report prepared by the authorized entity of traffic Accidents.
18-A Motor Vehicle driven in areas that are normally off-limits to the public, such as airports or seaports.
19-Any liabilities or costs that were directly or indirectly incurred due to criminal and hostile acts committed by the Insureds and/or the Driver.
20-If the Driver escapes the scene of the Accident for no acceptable justification.
21-If it is proven in the report prepared by the authorized entity attending traffic Accidents that the Accident was caused deliberately by the Insured or the Driver.
22-Submitting inaccurate information or concealing material facts in the insurance coverage request.
23-Accidents occurring outside the territorial borders of the Kingdom of Saudi Arabian.
24-Any liability or expenses arising, directly or indirectly, from the following:
a) War, invasion, acts of foreign enemy, hostilities, warlike acts (whether war is declared or not), or civil war.
b) Rebellion, military or popular uprising, insurgence, revolution, usurping authority, martial laws, siege; or any events or reasons leading to declaring or continuation of martial laws, siege, or acts of vandalism and terrorism committed by person(s) working individually or on behalf of or related to any terrorist organization. Terrorism shall mean the use of violence for political, intellectual, philosophical, racial, ethnic, social, or religious purposes. The use of violence includes putting the public and/or a segment of it under panic condition; affecting and/or causing turmoil; intervening in any operations and/or activities or policies related to the government; or causing turbulence negatively affecting the national economy or any of its sectors.
c- Strikes, riots, or civil or labor unrest.
d-What has been caused, or contributed to, by nuclear weapons, ionizing radiations, radioactive contamination due to any nuclear fuel or waste, or contamination due to nuclear fuel combustion. For the purposes of this exclusion, combustion shall include any nuclear fission.
The Lessee may opt to cancel any of the exclusions above, which will be included as an Additional Benefits, unless deemed to be in conflict with relevant laws.
Article 17
Covering Third Party Civil Liability
The determination of coverage in this section is subject to the Unified Compulsory Motor Insurance Policy issued by Saudi Central Bank.
General conditions
1. Subrogation:
Following indemnification of an insurance beneficiary, the Insurer has the right to act on behalf of the Insured in pursuing their Claim against the person at fault, unless it is the First Beneficiary.
2. Right of Recovery:
In the case that an Insurer made indemnity payments to any party whomsoever for damage or loss, and it was later discovered that the payments were made upon a risk excluded from or not covered under the Policy; or if the Claim involved deceit, fraud, misinformation or forgery, the Insurer is entitled to recover against the indemnified person for the indemnity payments. The Insurer is also entitled to recourse against any person at fault in case of attempted theft or theft of the insured Motor Vehicle or when the insured Motor Vehicle is driven by any person without permission from the Insureds.
3. Changes:
The Insureds shall notify the Insurer, within 20 business days of any Material Changes to the information submitted in the insurance coverage request. The Insurer shall notify the Insureds in case it intends to increase the amount of the Premium, or reimburse part of the Premium to the lessor when it is reduced. If no notification is sent to the Insured by the Insurer within five business days, then this shall indicate the Insurer’s agreement to continue providing the coverage at the Premium rate agreed upon at the time of signing the Policy.
5. Obligations of the Insureds or Driver in Case the Occurrence of an Accident Covered under the Policy:
a) Shall inform the concerned entities as soon as an Accident occurs and shall not leave the scene of the Accident until procedures have been completed, except in cases where leaving the scene is required such as the case of physical injuries.
b) Shall not Claim responsibility with the intention of harming the Insurer, pay or undertake to pay any amount to any party involved in the Accident except after obtaining a prior written approval from the Insurer.
c) Shall cooperate with the Insurer, and issue powers of attorney enabling the Insurer to carry out the pleading, defending and settlement procedures on behalf of the Insured or the Driver, if the Insurer expresses its desire to do so.
d) Shall, at the Insurer's expense, perform all actions required to guarantee the Insurer's right for recovering any of its due entitlements from any other party, as a result of indemnity paid in accordance with the Policy.
e) Shall inform the concerned entities in case of theft or any other criminal act and shall cooperate with the Insurer in securing the conviction of the offender.
6. Fraud:
All rights arising from the Policy shall be forfeited if the Claim involves fraud, or if the Insureds or the Driver adopts fraudulent ways or methods to gain benefit under this Policy, or if the liability or damage resulted from a deliberate act by or collusion with, the Insureds, the Driver, or others. The Insurer has the right of recover against any party found to be responsible for such fraud, whether as a conspirator or an accomplice.
7. Cancellation:
Neither the Insurer nor the Insureds has the right to cancel the Policy after its issuance, except in the following cases:
a. The write-off of the Motor Vehicle’s registrar.
b. Transfer of ownership of a Motor Vehicle to another owner.
c. The existence of alternative Policy that provides the same coverage indicated in the Rules and covers the remaining term of the Policy to be cancelled.
d. Termination or cancelation of the finance leasing contract between the Lessor and the Lessee.
The Insurer shall refund the Lessor the due amount payable for the uncovered period by depositing the amount to their bank account via IBAN, and it will be added to Lessee Insurance Account, within three business days from the date on which the Insurer becomes aware of the occurrence of any of the cases mentioned above. The due amount payable to the Insureds for the uncovered period is calculated by subtracting the elapsed days from the total Policy term (in days) and then dividing the result by the total Policy term. The result is then multiplied by the insurance Premium less administrative fees (a maximum of SAR 25), and as follows:
(365 - elapsed days) /365 × insurance Premium less administrative fees (a maximum of SAR 25) = return Premium payable to the Insured.
The Insurer is exempted from paying the return Premium in the case that there is a Claim—related to the Policy to be cancelled and on the Motor Vehicle covered by the Policy—whose value exceeds the amount to be refunded as per the calculation formula mentioned above.
Notwithstanding the foregoing, Insurers, Insureds and Drivers shall remain bound by the provisions of this Policy with respect to the obligations arising prior to its cancellation.
8. Policy Issuance and Renewal Notification:
The Insurer may not issue this Policy unless it is automatically linked to the system of the authorized entity in the collection, maintenance, and sharing of insurance information. The Insurer shall notify the Insureds of the expiry date of the Policy- (45) days as maximum- in advance, in order to enable them to renew the Policy or replace it with another Policy from another insurance company.