Ahmad Yusri Bin Ismail is submitting a third party claim to Takaful Malaysia Berhad for damages resulting from a car accident on July 16, 2014 that was caused by the negligence of Takaful Malaysia's insured. The claim includes RM 1050 for loss of use over 21 days and RM 1373.64 in excess costs, totaling RM 2423.64. Ahmad has provided supporting documents like police reports and insurance documents and is requesting a letter of offer and discharge voucher be sent as soon as possible.

1. Date 09.04.2015
Ahmad Yusri Bin Ismail,
Lot 3545 Jalan Tokey Kiang,
Kg. Banggol Katong,
20050 Kuala Terengganu.
Terengganu.
Syarikat Takaful Malaysia Berhad,
26th Floor, Annexe Block, Menara TakafulMalaysia,
No. 4 Jalan Sultan Sulaiman, 50000 Kuala Lumpur.
P.O. Box 11483,
50746 Kuala Lumpur.
Attention : Third Party Claim Department (Loss Of Use)
Dear Sir,
VEHICLE NO : TBB 6765 (NISSAN G.LIVINA) ACCIDENT ON :16.07.2014
OUR INSURED : Ahmad Yusri Bin Ismail COVER NOTE NO :TVP-K5304424-T1
YOUR INSURED VEHICLE NO :WQL 9397_____________________________________
I would like to inform you that the above third party vehicle was insured with you at the material time
when the accident occured. The accident was caused by negligence of your insured.
I’m is now making a third party claim against your insured for the sum of RM 2423.64 and I’m enclosed
herewith the following documents to substantiate the claim.
1. Photocopy of my claim form
2. Photocopy of my police report No : 003580/14
3. Photocopy of my cover note insurance
4. Photocopy of my registration card
5. Photocopy of my road tax
6. Photocopy of my driving
7. licence and NRIC
8. Photocopy of (Driver) driving licence and NRIC
9. Photographs Scene Of Accident
10. Photocopy of Discharge Voucer
11. Photocopy of police investigation result, your insured cover note and police report, sketch plan &
key of the said vehicle
The amount of the claim as follows :
1. Loss Of Uses (21 days X RM50.00 per day) RM 1050.00
2. Excess 2F RM 1373.64
TOTAL CLAIM RM 2423.64
Please forward the Letter Of Offer and Discharge Voucer to me as soon as possible. Kindly acknowledge
receipt of this letter. Your kind co-operation in this matter is most appreciated.
Thank you.
Your Sincerly,
.....................................
Ahmad Yusri Bin Ismail