Extended Warranty Insurance: Proposal & Policy Schedule
Extended Warranty Insurance: Proposal & Policy Schedule
Extended Warranty Insurance: Proposal & Policy Schedule
ISN
A01982
01/01/1980 No
Corporate Details
Company Name Address Suburb State, Postcode Business Phone ABN Number Registered for GST
Vehicle Details
Make Model Compliance Year Reg No. ABARTH 500 CONVERTIBLE 2013 ASMAUT VIN Number Drive Type Odometer at purchase Vehicle Use 11/07/2013 11/07/2013 ESANDA - ANZ BANKING GROUP LIMITED 412054 12000 PRIVATE Body Type Cylinders Transmission Fuel Type 12 0 11/07/2013 CONVERTIBLE T4 5 SP AUTOMATED MANUA
Factory Warranty Start date Vehicle Purchase Date Financier (if financed) Vehicle Modifications
Factory Warranty Length (mths) Statutory Warranty Length (days) Date First Registered
Cover Term
Type of Cover Vehicle Use Dealer Service Waiver 12 Months PRIVATE NO EXTENDED WARRANTY SILVER Vehicle Class Period Of Insurance B From: 11/07/2014 To: 11/07/2015
Premium Details
Premium Details Net Premium GST on Premium Stamp Duty Establishment Fee Total Premium . Declaration by Insured Person(s) I/We the undersigned declare that; I/We have answered all questions truthfully and have not withheld any relevant information. I/We certify that any answers not in our own handwriting have been checked by me/us and are correct. I/We have read and understand the PDS and Policy Document and agree to be bound by all terms and conditions. I/We agree that the Proposal and Policy Schedule is the basis of the insurance contract. I/We agree to allow the administrator to obtain any relevant information from the financier or interested parties. Agent Name: POMI Agent No: RA00011 ISN: A01982 When the premium has been paid the Proposal & Policy Schedule may be used as a Tax Invoice. This Cover is underwritten by VIRGINIA SURETY COMPANY, INC $ 454.55 $ 45.45 $ 25.00 $ 0.00 $ 525.00 Payment Details Finance Credit Card Cash Other
ISN
A01982
01/01/1980 No
Corporate Details
Company Name Address Suburb State, Postcode Business Phone ABN Number Registered for GST
Vehicle Details
Make Model Compliance Year Reg No. ABARTH 500 CONVERTIBLE 2013 ASMAUT VIN Number Drive Type Odometer at purchase Vehicle Use 11/07/2013 11/07/2013 ESANDA - ANZ BANKING GROUP LIMITED 412054 12000 PRIVATE Body Type Cylinders Transmission Fuel Type 12 0 11/07/2013 CONVERTIBLE T4 5 SP AUTOMATED MANUA
Factory Warranty Start date Vehicle Purchase Date Financier (if financed) Vehicle Modifications
Factory Warranty Length (mths) Statutory Warranty Length (days) Date First Registered
Cover Term
Type of Cover Vehicle Use Dealer Service Waiver 12 Months PRIVATE NO EXTENDED WARRANTY SILVER Vehicle Class Period Of Insurance B From: 11/07/2014 To: 11/07/2015
Premium Details
Premium Details Net Premium GST on Premium Stamp Duty Establishment Fee Total Premium $ 454.55 $ 45.45 $ 25.00 $ 0.00 $ 525.00 Payment Details Finance Credit Card Cash Other Declaration by Insured Person(s) I/We the undersigned declare that; I/We have answered all questions truthfully and have not withheld any relevant information. I/We certify that any answers not in our own handwriting have been checked by me/us and are correct. I/We have read and understand the PDS and Policy Document and agree to be bound by all terms and conditions. I/We agree that the Proposal and Policy Schedule is the basis of the insurance contract. I/We agree to allow the administrator to obtain any relevant information from the financier or interested parties. Agent Name: POMI Agent No: RA00011 ISN: A01982 When the premium has been paid the Proposal & Policy Schedule may be used as a Tax Invoice. This Cover is underwritten by VIRGINIA SURETY COMPANY, INC
Extended Warranty
Product Disclosure Statement and Policy Wording
Product Disclosure Statement Prepared on the 22 May 2013 Insurer: Virginia Surety Company, Inc (ABN 63 080 339 957) Australian Financial Services Licence number 245579
To Be Eligible For This Policy The Vehicle Must Meet The Following Requirements:
Extended Warranty Bronze The vehicle must be less than 10 years old and travelled no more than 200,000 kms. Minimum purchase price $5,000. All cover ceases at 250,000 kms. The vehicle must be less than 10 years old and travelled no more than 200,000 kms. Minimum purchase price $5,000. All cover ceases at 250,000 kms. The vehicle must be less than 3 years old and travelled no more than 100,000 kms. Minimum purchase price $5,000. All cover ceases at 250,000 kms. Vehicles are categorised into two classes. Please refer to Your dealer to obtain the list of vehicle categories. Certain vehicles will attract additional charges. Please refer to Your dealer to obtain the list of vehicles. Certain vehicles are excluded from this Policy please refer to Your dealer to obtain the list of excluded vehicles.
The Period of Cover ceases on the first to occur of the following: upon the expiry of the Cover Term; upon reaching the kilometre limitation specified in the Proposal & Policy Schedule; when the Maximum Policy Benefit has been reached; and if the Vehicle is sold and no valid Transfer of Ownership Form is accepted by Us Subject to Our approval, the Policy can be transferred to the Vehicles new owner when a private sale takes place Includes additional benefits in the event of a claim
See page 12 of the Policy Wording for further details See page 12 of the Policy Wording for further details
Policy Exclusions
The insurance policy is not a repair and maintenance plan, but intended to cover unforeseen Mechanical Breakdown of certain parts of Your Vehicle. There are a number of policy exclusions, including: Normal Wear & Tear or deterioration of parts; parts other than those covered by Manufacturer Warranty; circumstances where the Vehicle has been subjected to misuse, abuse or negligence; parts which have not failed and which are replaced during servicing; any claim where We are not contacted for authorisation prior to the commencement of repairs; or losses resulting from accident damage. This list does not include all policy exclusions. Please refer to the Policy Exclusions section on pages 9 to 10 of the Policy Wording to ensure that You are aware of all exclusions which apply to the Cover provided.
Significant Risks
You should be aware of the following risks associated with the Cover: Policy Coverage: The Cover provided is not a mirror image of that provided by the manufacturer. (See Policy Exclusions on pages 9 to 10 of the Policy Wording for further details). Service Requirements: If the Vehicle is not serviced in accordance with the service requirements of this Cover, We may cancel the Policy or refuse to pay a claim. (See page 10 of the Policy Wording for further details). Disclosure Obligations: Failure to comply with disclosure obligations may have consequences in relation to the Cover being provided or may affect a claim being paid. These consequences are outlined under Your Duty of Disclosure in the Policy Wording. (See page 7 of the Policy Wording for further details). Period of Cover: The Period of Cover depends on a number of factors including the Cover Term, the number of kilometres travelled, the Maximum Policy Benefit and whether the Vehicle is sold. The Cover Term is not necessarily the Period of Cover. (See page 11 of the Policy Wording for further details). Limit of Liability: Depending on the type of Cover You choose, there may be individual claim limits or a Maximum Policy Benefit. (See pages 7 to 10 of the Policy Wording for further details).
How To Apply
To apply for Cover, the Proposal & Policy Schedule will need to be completed via Our electronic system by the dealer. Upon completion You will be given a copy of the Proposal & Policy Schedule for You to sign confirming its accuracy.
Taxation Information
Premiums are subject to Goods and Services Tax (GST) and stamp duty incurred by Commonwealth and State Governments. These amounts will be shown separately on Your Proposal & Policy Schedule. GST will also affect any claim You make under this Policy. Please refer to the claims section on page 12 for full details. Generally, Your premiums are not tax deductible and claims payments are not assessable income for tax purposes unless You purchase Your Policy for business purposes and Your Vehicle is registered for business purposes. This taxation information is a general statement only. You should seek professional taxation advice for information about Your personal circumstances.
Cooling-off Period
You may cancel Your Policy within 14 days of the earlier of: receiving confirmation from Us of the purchase of the Policy; and the end of the fifth day after the day on which the Policy is issued to You. If You wish to cancel Your Policy during this period, You must notify Us in writing. If You do so, We will refund the premium in full. However, We will not refund the premium if a claim has been lodged on Your insurance policy. To cancel Your Policy at other times, please refer to the How Can Your Policy be Cancelled section on page 11 of the Policy Wording.
Dispute Resolution
Should You have a concern relating to any area of Our business or Your Policy You may request that it be dealt with by the supervisor or manager directly responsible for that area. If Your complaint is not resolved by the supervisor or manager, Your complaint may then be referred to Our Internal Dispute Resolution Panel. You can contact Our Internal Dispute Resolution Panel: by phone on 1300 654 611; in writing to PO Box 246, Balwyn VIC 3103; or by emailing Us at customerfeedback@thewarrantygroup.com .
We will respond to Your complaint in writing within 15 working days provided they have all the necessary information. Our dispute resolution process is provided to You free of charge. If You are not satisfied with the outcome of Our process You may refer the matter to the Financial Ombudsman Service (FOS). The FOS may be contacted: by phone on 1300 780 808 (local call fee applies); by fax on (03) 9613 6399; by post: GPO Box 3, Melbourne VIC 3001; by emailing them at: info@fos.org.au; or on the web http://www.fos.org.au. The FOS provides an independent service which will investigate Your complaint and provide a ruling at no cost to You.
Your Privacy
Virginia Surety Company, Inc is bound by the National Privacy Principles contained in the Privacy Act 1988. By submitting a Proposal & Policy Schedule, You will be supplying Us with personal information. We collect this information so that We can assess the risk and determine the appropriate terms, conditions and exclusions that will apply to the Policy. If We accept Your proposal, We will use the information so that We can administer Your Policy, including processing claims and responding to Your queries. The information collected is held by Us and will be disclosed to financiers and/or service providers such as promoters, claims processors, assessors or loss adjusters, as well as companies in The Warranty Group. With some exceptions You have rights of access to, and correction of, Your personal information upon request. We value the privacy of personal information and We ensure that information about You is handled as permitted and required by law. Please contact Our Privacy Officer on 1300 654 611 if You have any queries or would like a copy of Our privacy brochure.
Subrogation
When We pay a claim under the Policy, We have the right to take over and enforce any right You may have to recover the loss from another party. We may do this in Your name and You have an obligation to assist Us as required.
Jurisdiction
This Policy shall, at all times and in all respects, be governed by and subjected to the laws of the State or Territory in Australia where this Policy was issued and whose courts shall have jurisdiction in any dispute arising under or in connection with this Policy. This condition shall not preclude the parties from agreeing to submit any dispute to Arbitration, or to any other form of Alternative Dispute Resolution, after it has arisen.
Type Of Cover
The Policy is not a repair and maintenance plan, but Mechanical Breakdown insurance which covers You against sudden and unforeseen failure of certain parts of the Vehicle during the Period of Cover. We agree to pay for the reasonable cost to repair or replace Covered Components of the Vehicle, or reimburse You, at Our option, due to Mechanical Breakdown (subject to the limit of liability for the Cover You have selected as shown below and on the Proposal & Policy Schedule). If Covered Components require replacement the repairer may replace with a similar or reconditioned part. You can also choose a Cover Term of 12, 24, 36 or 60 months for Your nominated level of coverage. However, 60 months is only available for Bronze and Silver Cover. Your Proposal and Policy Schedule will show the level of coverage and the Cover Term You have selected. The Cover Term is not necessarily the Period of Cover. You should refer to page 11 of the Policy Wording for details of the Period of Cover.
Limit of Liability
Each individual claim is limited to the amount specified below for the Cover You have selected. Regardless of the number of claims made the maximum amount payable under Your Policy is limited to the Maximum Policy Benefit listed below for the Cover You have selected.
Cover Option
Extended Warranty Bronze Extended Warranty Silver Extended Warranty Gold
Maximum Policy Benefit $3,000 Current Market Value Current Market Value
Propshaft: universal joints and bearings. Fuel system petrol/diesel: Mechanical/electrical fuel pump, carburettor, electronic carburettor sensors and stepper motor, choke assembly and injection system. Front/rear suspension: Shock absorbers, coil springs, upper and lower wishbones, ball joints, swivel joints, McPherson struts, suspension arms, anti-roll bar, self levelling units and reservoir, pump and regulator valves, seals, displacer and hydro pneumatic system. Wheel bearings: Front and rear wheel bearings. Clutch: Centre plate, pressure plate, thrust bearing, clutch fork, cable, master cylinder and slave cylinder. Electrical: Starter/solenoid, alternator, regulator, coil, distributor, electronic ignition module, front and rear window/headlamp wiper motors, heater fan motor, indicator interrupter unit, electric window motor, sun roof motor, instrumentation gauges, centralised locking solenoids/ pumps, switches, relays, sensors, electric aerial motor, horn and cruise control system. Electronic Control Unit: Ignition system, fuel system and transmission system. Casings: Cylinder block, gearbox and axle, if they have been damaged by a Mechanical Breakdown of one of the Covered Components.
Policy Exclusions
The following are not covered by any of Extended Warranty Bronze, Silver or Gold Cover: failure arising from Normal Wear & Tear and the gradual reduction in operating performance of the Vehicle or part; any item that requires periodic replacement as part of normal Vehicle maintenance incl uding but not limited to batteries, tyres, fillers, hoses, brake pads and linings, spark plugs, belts,worn clutch, wiper blades, lubricants, coolants; parts other than those covered by Manufacturer Warranty; parts subject to recall by the vehicle manuf acturer; parts and repairs subject to manufacturer technical bulletins; parts which have not failed and which are replaced during routine servicing or maintenance; any loss caused through modification of covered parts or to any non -manufacturer fitted part or directly related to or caused by the fitting of any non-manufacturer fitted part; any part which is covered but not available (liability will be restricted to the required part only and not to any replacement or repair of an entire component); consequential loss or damage of any kind; Vehicles that have not been maintained in accordance with the service requirements of this Cover (see section below, titled Service Requirements); repair of oil leaks caused by gasket or seal failure;
failure caused by misuse, neglect, abuse or improper servicing or any repairs required as a result of continued operation of the Vehicle once a defect or fault has occurred; any problem caused by the failure to maintain proper levels of fluids, fuels, lubricants or coolants or contamination of fluids; any problem caused by the use of contaminated or incorrect types and grades of fuel, oil or lubricants; any claims where We have not been contacted prior to the commencement of repair or repairs and where We have not issued an authorisation number; the costs incurred in improving or reconditioning the Vehicle or parts to a condition superior to that at the time of purchase; component parts or design elements which are found to have been defective at the commencement of Cover, or can be described as having an inherent design fault; repairs to the Vehicle caused by corrosion, rust, fire, illegal use, malicious damage, impact, accident, earthquake, flood or other occurrence of nature, riot or civil commotion, war, invasion, strikes or resulting from nuclear fission, fusion or radioactivity; any freight costs for shipping parts; any workshop consumables and environmental disposal levy; diagnostic or dismantling costs unless accepted as part of a n authorised claim; software upgrades, reprogramming or technical channel/upgrade; any loss caused through having Your Vehicle modified from factory specifications (for example, addition of turbocharger, or instillation of oversize piston valves), unless the modifications are Manufacturer approved or installed; any loss attributed to the Vehicle being fitted with an LPG unit parts expressly excluded for engines running on LPG includes (but not limited to): air flow motors, fuel, pumps, injections, inlet and exhaust valves and/or seals, exhaust systems and all inlet tract components; any loss caused by not accepting service recommendations for additional repairs or adjustments; any loss caused by not following the Vehicle Manufacturers operating gu idelines or exceeding the Manufacturers operating limits; repairs on superficial damage such as cosmetic or surface corrosion from stone chips or scratches in the paint; any loss covered by any other warranty or guarantee including dealer statutory warranty, Manufacturers Warranty and/or repairers guarantee; any repairs performed by a non authorised repairer; any loss arising from the mechanical failure of a Covered Component which has prior to the mechanical failure, been repaired by someone other than an authorised repairer; the cleaning of any component including the removal of any carbon or sludge; any loss outside of the Period of Cover; or any fraudulent loss. The Policy will cease and no claims will be accepted for any Vehicle which: is being or has been used in competitions, rallies, racing, pacemaking, reliability trials, speed or hill climbing or by overloading of the Vehicle; is being used for or has previously been used for the conveyance of passengers for hire or reward, rent al, delivery or courier use, Police or emergency vehicle, drivers instruction or tuition for reward; has been used for towing without suitable equipment as recommended by the Vehicle manufacturer; or has an odometer reading that cannot be accurately determined. In relation to the Policy Exclusions, You should also read the next section, titled Service Requirements carefully.
Service Requirements
It is a condition of Cover that Your Vehicle is maintained in a roadworthy, mechanically sound condition and serviced regularly in accordance with the Vehicle manufacturers recommendations. A Duly Authorised Dealer must carry out any service or repairs. Any defect or fault or any parts identified as needing repair or replacement or which are identified as a potential problem, including those identified while the Vehicle is still covered by Dealer Warranty or Manufacturer Warranty, must be immediately rectified. Upon becoming aware of the development of any mechanical problem, You or any other person driving the Vehicle must take all necessary steps to minimise any damage that might arise. Failure to comply with servicing and repairs of the Vehicle in accordance with these requirements will end Your insurance Cover.
When Am I Covered?
The Period of Cover is the period beginning on the date Cover commences and ending on the date Cover ceases. Provided You have paid the premium, We will insure You during the Period of Cover subject to the terms, conditions and exclusions set out in this PDS. The start of Your Cover Cover will commence on the later of: the date that the Manufacturer Warranty expires; the date that the Dealer Warranty expires; and if no Manufacturer Warranty or Dealer Warranty exists, upon the expiry of 90 days after the Proposal & Policy Schedule is signed, or when the Vehicle has travelled 5,000 kilometres from the date of purchase, whichever occurs first. The end of Your Cover Your Cover will cease on the first to occur of: at 4 pm on the date that the Cover Term has elapsed from the date the Cover commences; upon reaching the kilometre limitation as specified in the Proposal & Policy Schedule; when the Vehicle has travelled 250,000 kms; when the Vehicle has not been serviced in accordance with the Service Req uirements; when the Maximum Policy Benefit has been reached; when the Policy is cancelled; and if the Vehicle is sold and no valid Transfer of Ownership Form is accepted by Us, within the specified timeframe.
If We cancel Your Policy, no premium is refunded if You have already had a claim on the Policy. If You have financed the premium for this Cover, We will require the approval of the finance company before cancelling the Policy. Any refund will be made to the financier. If You or We cancel Your Policy We will refund Your premium (less any cancellation fee), but We may deduct a reasonable amount of the premium for the time on risk, reasonable administrative costs related to the acquisition and termination of Your Policy and any government taxes or duties that We cannot recover. Whilst the level of Cover We provide is maintained for the duration of the Policy, the level of risk changes over time. Generally the level of risk (or the Gap) is significantly higher in the early years and lower during the final years. Any refund provided will reflect these changing circumstances. We use the Rule of 78 to determine what refund is due.
Additional Benefits
In the event of an authorised claim, the following additional benefits are provided for under the Extended Warranty and will be reimbursed upon receiving receipts: Accommodation We will pay up to $100 per day, subject to an overall limit of $300 for all claims during the Period of Cover, if Your Vehicle is immobilised beyond 100km from Your usual home address and the repair is not completed on the day of Our authorisation of repairs. Car Rental We will pay up to $50 per day for car rental, subject to an overall limit of $300 for all claims during the Period of Cover if Your Vehicle is immobilised for more than two consecutive days after Our authorisation of repairs.
Locksmith Service We will pay up to $100 for the services of a professional locksmith, subject to an overall limit of $300 for all claims during the Period of Cover, if Your Vehicles ignition or door key is lost, broken or accidentally locked in Your Vehicle. Towing We will pay up to $100 for any one claim, subject to an overall limit of $300, for all claims during the Period of Cover. Cover is only provided for costs incurred in excess of that provided by Your motoring organisation.
SERVICE RECORDS
These records will be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each service.
Date of Service ________________________ Subaru Assured Service Records Dealer Name _________________________
Invoice No ____________________________
Dealer Stamp These records Service Adviserwill be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each Name _______________________________ service.
SERVICE RECORDS
These records will be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each service.
Date of Service ________________________ Subaru Assured Service Records Dealer Name _________________________
Invoice No ____________________________
Dealer Stamp These records Service Adviserwill be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each Name _______________________________ service.
SERVICE RECORDS
These records will be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each service.
Date of Service ________________________ Subaru Assured Service Records Dealer Name _________________________
Invoice No ____________________________
Dealer Stamp These records Service Adviserwill be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each Name _______________________________ service.
SERVICE RECORDS
These records will be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each service.
Date of Service ________________________ Subaru Assured Service Records Dealer Name _________________________
Invoice No ____________________________
Dealer Stamp These records Service Adviserwill be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each Name _______________________________ service.
SERVICE RECORDS
These records will be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each service.
Date of Service ________________________ Subaru Assured Service Records Dealer Name _________________________
Invoice No ____________________________
Dealer Stamp These records Service Adviserwill be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each Name _______________________________ service.
SERVICE RECORDS
These records will be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each service.
Date of Service ________________________ Subaru Assured Service Records Dealer Name _________________________
Invoice No ____________________________
Dealer Stamp These records Service Adviserwill be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each Name _______________________________ service.
SERVICE RECORDS
These records will be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each service.
Date of Service ________________________ Subaru Assured Service Records Dealer Name _________________________
Invoice No ____________________________
Dealer Stamp These records Service Adviserwill be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each Name _______________________________ service.
SERVICE RECORDS
These records will be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each service.
Date of Service ________________________ Subaru Assured Service Records Dealer Name _________________________
Invoice No ____________________________
Dealer Stamp These records Service Adviserwill be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each Name _______________________________ service.
SERVICE RECORDS
These records will be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each service.
Date of Service ________________________ Subaru Assured Service Records Dealer Name _________________________
Invoice No ____________________________
Dealer Stamp These records Service Adviserwill be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each Name _______________________________ service.
SERVICE RECORDS
These records will be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each service.
Date of Service ________________________ Subaru Assured Service Records Dealer Name _________________________
Invoice No ____________________________
Dealer Stamp These records Service Adviserwill be required in the event of a claim. Please ensure that Your Duly Authorised Dealer completes and stamps to verify each Name _______________________________ service.
Policy Number: .......................................... Current Owners Details First Name ......................................................... Last Name ................................................................... Address .................................................................................................................................................... City ........................................................... State .............................................. Postcode ...................... Phone ............................................. Vin No ...................................................... Reg No ......................... Model .............................................................. Kms at sale date ............................................................ Signature .................................................................................................... Date .................................... New Owners Details First Name ........................................................ Last Name .................................................................... Address .................................................................................................................................................... City ......................................................... State ................................................... Postcode ................... Phone ...................................................................... Date of Transfer ............................... Use: Private Business/Private Commercial
I have been provided with the PDS, including the Proposal & Policy Schedule, and accept the terms, conditions and exclusions of the Extended Warranty.