PROPOSAL FOR CLASS 3 (Third Party Insurance)  FROM     " LMG INSURANCE"
Name/age       Date:
Address :  
Tel: and Mobile   : 
Email address:   
Driver 1   ( name/age/occupation)
Dirver 2   ( name/age/occupation)
Car details/brand   Year produced
How many CC of engine?   Manual/Auto
LMG-Insurance
Contact Agent :  Kanjana Chungkasemsook M: 081 837 9797     (Smile Broker)
FAX /T: 02 633 2895 , M: 0818379797
email: contact@insurancethais.com, kan@insurancethais.com
Downloaded from: http://pattayacitythailand.com/insurance
Package Name   Class 3 (Third Party)
Public Liability(3rdparty)  
1. 3rd party,Bodily injury or death, which is access from government insurance 250,000 Bht./person
10,000,000 Bht./case
2. 3rd party property damage 1,000,000 Bht./case
Additiona cover  
1. Personal Accident Medical expenses  
   Passenger (1+4 persons) for each 50,000 Bht.
2. Bail Bond 200,000 Bht.
 Premium exclude CTPL  2,547 bht.
 Premium included CTPL  2,893 bht.
CTPL : is government insurance
Remarks : car under this conditions
For Personal vehicle register type  110, 210 and  320 and weight not over 3 tons 
       Only cover in case of car damage to car
       Vehicle age over 15 year
For Apply : Copy of Car registration, Driving Licenses, ID card or  Passport
Send the above document with the pay in slip which is shown below to proceed.