AMI Insurance

PO Box 3233 Phone 0800 100 200

Wellington 6140

12 February 2023

Mr Weiyan Li
12 Valley Crescent
Wanaka 9305

Dear Mr Li

Customer reference: 4518038

Policy type: Private Vehicle
Here is your policy documentation
Thanks for choosing AMI for your insurance. We’ve enclosed your policy documentation, which provides details
of your cover. Remember to keep it in a safe place.
What you need to do now
Please read and check your policy documentation and get in touch if you have any questions about the type and
extent of your cover. This is really important, because if anything isn’t right this could cause difficulties at a later
stage and it could mean we are unable to pay your claim.
The Premium Advice provides details about the premium to be paid. Please pay by your due date to ensure your
cover continues.
Remember, we’re right here
Important stuff at your fingertips
You can now view your policy documents at My AMI*, your online account. Go to ami.co.nz to set up your
account and view your policies in one place. Or download the AMI app from the App Store or Google Play.
Easy ways to pay
You can pay your insurance online at ami.co.nz/ways-to-pay, or set up a direct debit payment.
Protecting half a million Kiwis
AMI has been protecting people up and down the country for over 90 years.
Cancelling your cover
In addition to any rights to cancel contained in these policy documents, you can also cancel this policy within 5
working days of receiving this agreement, by giving us a call. We’ll give you a full refund of any premiums paid.
If you’ve got any questions or would like more information, visit ami.co.nz or call us on 0800 100 200.

The team at AMI

*At the moment you can view your vehicle, house and contents policies in My AMI. However, if your policy is under the name of an organisation or body
corporate it can’t be viewed online.
AMI Insurance
PO Box 3233 Phone 0800 100 200
Wellington 6140

Policy Schedule
Private Vehicle Policy
Mr Weiyan Li Policy Number
12 Valley Crescent M0018487114
Wanaka 9305

Period of Insurance
From 12 February 2023
To 12 February 2024

Particulars of Insured Vehicle Purpose of Use Agreed Value

2009 BMW X3 KFN52 Private $9,188

The Following Sections of your Car Policy apply

Cover for your vehicle

Cover for additional costs
Bonus cover
Cover if you damage other people's property (Legal liability)

Optional Cover
Glass excess buy-out
AMI Breakdown Service - Standard
Cover for extra call-outs: No
Extra cover for service costs: No
Cover for towed vehicles: No

Also available but not selected by you

Under 25 driver cover
Medical expenses
Rental vehicle option
Substitute transport costs
Accidental death or permanent disability compensation
Excesses Applicable

Main Driver Information follows.

You must contribute the amount shown below towards the cost of any claim for loss of or damage to the Insured
Vehicle:

IMPORTANT: This schedule forms part of your policy and replaces any previous schedule. Please refer to
www.ami.co.nz/policy-documents for a copy of the policy document wording that accompanies this contract.
Please keep it with your policy. If any of the above details are incorrect, please contact us.

Page 1 Continued on next page Issued: 12/02/2023

AMI Insurance
PO Box 3233 Phone 0800 100 200
Wellington 6140

Policy Schedule
Private Vehicle Policy
Mr Weiyan Li Policy Number
12 Valley Crescent M0018487114
Wanaka 9305

Period of Insurance
From 12 February 2023
To 12 February 2024

Excess
Excess on Glass Claims Nil
Excess on Theft, Conversion or Malicious Damage Claims $100
Main Driver: Weiyan Li $100
Named Driver: Weichao Feng $100

For any drivers not named in the Policy Schedule:

Excess
Driver aged 25 years and over $100
Drivers licenced less than 12 months Additional excess: $250

For all other claims, the policy excess of $100 applies.

Cover does not apply if the driver or person in charge of the Insured Vehicle is under the age of 25 years and
is not named on this schedule.

IMPORTANT: This schedule forms part of your policy and replaces any previous schedule. Please refer to
www.ami.co.nz/policy-documents for a copy of the policy document wording that accompanies this contract.
Please keep it with your policy. If any of the above details are incorrect, please contact us.

Page 2 Issued: 12/02/2023

AMI Insurance
PO Box 3233, Wellington 6140

Premium advice
Tax invoice

Mr W Li
12 Valley Crescent, Wanaka 9305
Insured asset
2009 BMW X3 KFN52
Policy type Policy number
Private Vehicle M0018487114
Period of cover Agreed Value
From 3.14pm 12/02/2023 to 12.00am 12/02/2024 $9,188

Please note: AMI premium $759.49

This document sets out the details of
the premium for this policy and Policy options (before discounts)
becomes a tax invoice when paid. Glass excess buy-out $52.17
Discounts included in AMI premium: AMI Breakdown Service - Standard $27.83
- No claims bonus of 60% Sub-total of policy options $80.00

Premium based on an excess of $100. Government charges

Fire Service Levy $8.45
Please read your Policy Schedule for
further details of insured assets, their Total premium excluding GST $847.94
sums insured and excesses. Goods and Services Tax $127.19
GST No. 51-860-403 Total premium including GST $975.13

Direct debit details

Person authorising payment: Weiyan Li
Date authority given: 12 February 2023
Name of the bank: ANZ Bank
Bank account name: Weiyan Li
Bank account number: 01 0653 00053695 000
Initiator: AMI Insurance
Authorisation code: 1227355
Payment frequency: Monthly

The instalment amount of $81.16 will be Direct Debited on 12 February 2023.

Note: This document may not account for any overdue amount owing on this policy, nor any credits on this policy.
AMI Payment Advice

Mr W Li
12 Valley Crescent
Wanaka 9305 Policy number: M0018487114
Customer reference: 4518038
Amount due: $81.16
Due date: 12 February 2023
Amount paid: $
Page 1 of 2 Issued: 12/02/2023
Keep us in the loop
You’ll need to tell us if there is anything that may affect this policy that we don’t already know about. If you
don’t tell us, then your insurance may not be valid and you may not be covered if you ever need to make a
claim.
Example of things you should tell us about are:
Any instance of insurance being declined, cancelled, refused or having special conditions imposed in the
last 5 years;
Accidents or losses over the last 5 years and convictions in the last 7 years;
Any change in circumstances that may increase the risk of a claim.
Please call us on 0800 100 200, if you’re not sure what issues might affect your insurance. We treat all
information you give us in accordance with the Privacy Act 2020.

Easy way to pay

It’s simple to pay your premium by direct debit or online banking. With direct debit you can choose to pay by
either bank account or credit/debit card. And with online banking your bank already has our account details, so
all you'll need is your Customer reference. Just visit ami.co.nz/ways-to-pay to find out more.

Specific conditions relating to notices and disputes

I may ask my bank to reverse a direct debit up to 120 calendar days after the debit if:
- I don’t receive a written notice of the amount and date of each direct debit from the initiator, or
- I receive a written notice but the amount or the date of debiting is different from the amount or the date
specified on the notice.

I may ask my bank to reverse a direct debit up to 9 months after the date the initiator sent the first direct debit
under the authority if I am not reasonably satisfied that the authority authorised my bank to debit my account
with the amount of the direct debit.

The initiator is required to give a written notice of the amount and date of each direct debit in a series of direct
debits no less than 10 calendar days before the date of the first direct debit in the series. The notice is to include:
- the dates of the debits, and
- the amount of each direct debit.

If the initiator proposes to change an amount or date of a direct debit specified in the notice, the initiator is
required to give you notice:
- no less than 30 calendar days before the change, or
- if the initiator's bank agrees, no less than 10 calendar days before the change.

The initiator may also send a direct debit if you have:

- asked the initiator to send it, and
- agreed the amount of the direct debit

Where you have asked the initiator to send a direct debit, the initiator is required to give you a written notice of
the amount and date of each direct debit no less than the date of the debit.

If the bank dishonours a direct debit but the initiator sends the direct debit again within 5 business days of the
dishonour, the initiator is not required to give you a second notice of the amount and date of the direct debit.

Insurer financial strength rating

Your insurance is underwritten by AMI Insurance, a business division of IAG New Zealand Limited (IAG). IAG has
received a Standard & Poor’s (Australia) Pty Ltd. Insurer financial strength rating of AA- ‘Very Strong’.
The rating scale is:
AAA (Extremely Strong) BB (Marginal) SD (Selective Default)
AA (Very Strong) B (Weak) D (Default)
A (Strong) CCC (Very Weak) R (Regulatory Supervision)
BBB (Good) CC (Extremely Weak) NR (Not Rated)
Ratings from 'AA' to 'CCC' may be modified by the addition of a plus (+) or minus (-) sign to show relative
standing within the major rating categories. A full description of this rating scale can be obtained from
www.standardandpoors.com.

AMI abides by the Insurance Council of New Zealand ‘Fair Insurance Code’. Call us toll free on 0800 100 200 for a copy.

Page 2 of 2 Issued: 12/02/2023

AMI Insurance
PO Box 3233 Phone 0800 100 200
Wellington 6140

12 February 2023

Instalment schedule

Customer name Payment method

Mr Weiyan Li Direct Debit

Monthly instalments
Future Policy Total for
instalment Policy number Insured asset instalment instalment
date amounts date

12/03/2023 M0018487114 2009 BMW X3 KFN52 $81.27 $81.27

12/04/2023 M0018487114 2009 BMW X3 KFN52 $81.27 $81.27

12/05/2023 M0018487114 2009 BMW X3 KFN52 $81.27 $81.27

12/06/2023 M0018487114 2009 BMW X3 KFN52 $81.27 $81.27

12/07/2023 M0018487114 2009 BMW X3 KFN52 $81.27 $81.27

12/08/2023 M0018487114 2009 BMW X3 KFN52 $81.27 $81.27

12/09/2023 M0018487114 2009 BMW X3 KFN52 $81.27 $81.27

12/10/2023 M0018487114 2009 BMW X3 KFN52 $81.27 $81.27

12/11/2023 M0018487114 2009 BMW X3 KFN52 $81.27 $81.27

12/12/2023 M0018487114 2009 BMW X3 KFN52 $81.27 $81.27

12/01/2024 M0018487114 2009 BMW X3 KFN52 $81.27 $81.27

The instalment amounts may vary slightly. This occurs when the premium cannot be divided equally by the number of
instalments over the period of cover.

The total instalment amount will be deducted from your account on the instalment date.

Note: This form shows the details of your remaining individual premium instalments and is not an invoice.

Issued:12/02/2023
AMI Insurance
PO Box 3233 Phone 0800 100 200
Wellington 6140

Proposal for vehicle insurance

Customer Reference 4518038

Policy Number M0018487114

customer details
Mr Weiyan Li
12 Valley Crescent
Wanaka 9305

Contact 1 (027) 485-7601 Contact 2

Age 45 Occupation Unknown

vehicle & driver details

Year Make, Model and Type

2009 BMW X3 xDrive20d Steptronic WAGON

Registration No. Vehicle ID No. Purchase Date Purchase Price Policy Sum Insured
KFN52 WBAPE12020WA53394 $12,250 $9,188

____________________________________________________________________________________________________
1. Is the vehicle used for commercial purposes? No
____________________________________________________________________________________________________
2. Is the vehicle leased? No
____________________________________________________________________________________________________
3. Will the vehicle be used for Motorsport or Racing? No
____________________________________________________________________________________________________
4. Is this vehicle a Vintage or Classic Car? No
____________________________________________________________________________________________________
5. What is the vehicle weight?
<= 3.5 tonne
____________________________________________________________________________________________________
6. Does the vehicle have any modifications? No
____________________________________________________________________________________________________
7. Does your vehicle have Accessories with a total value of $1,500 or more? No
____________________________________________________________________________________________________
8. Are you the registered owner of the vehicle? Yes
____________________________________________________________________________________________________
9. At what address will the vehicle be parked at night?
39 DAVEY CRESCENT OREWA 0931

Page 1 of 4 Issued: 12/02/2023

Customer Reference 4518038
Policy Number M0018487114

____________________________________________________________________________________________________
10. How securely is the vehicle parked at night?
Not asked
____________________________________________________________________________________________________
11. Who will be the main drivers of this vehicle?
Gender Age Licence Type of Years Additional Total
Licence Excess Excess
Weiyan Li
Male 45 Yes NZ Full 5+ yrs $0 $100

____________________________________________________________________________________________________
12. Do you need cover for drivers under 25 years of age? No
____________________________________________________________________________________________________
13. Other named drivers covered by this policy:
Weichao Feng 40
____________________________________________________________________________________________________
14. Is there a Financial or Security interest in this vehicle? No
____________________________________________________________________________________________________

policy details

Period of insurance: From 3.14pm 12/02/2023 to 12.00am 12/02/2024

Cover Type: Full

____________________________________________________________________________________________________
15. Selected level of excess Chosen: $100
(the higher the excess, the lesser the premium)
____________________________________________________________________________________________________
16. Do you wish to have no excess on glass claims? Yes
____________________________________________________________________________________________________
17. Do you wish to have death or disability cover for $50,000? No
____________________________________________________________________________________________________
18. Do you wish to purchase $500 Medical Expenses cover? No
____________________________________________________________________________________________________
19. Do you wish to purchase substitute transport costs for your vehicle? No
____________________________________________________________________________________________________
20. Do you wish to purchase the Rental Vehicle Option? No
____________________________________________________________________________________________________
21. Do you wish to purchase the AMI Breakdown Service option? Yes
Level of cover (Standard or Premier)
____________________________________________________________________________________________________

additional details
____________________________________________________________________________________________________
22. Have you or any other policyholder, held previous motor insurance in your No
own name, or jointly with any other policyholder or in the name of an entity
such as a business or trust?

Page 2 of 4 Issued: 12/02/2023

Customer Reference 4518038
Policy Number M0018487114

____________________________________________________________________________________________________
23. In the last 5 years have you, your partner or spouse, or any other person who Yes
to your knowledge will use or have access to this vehicle had any vehicle that
you owned or controlled damaged, either as a result of an accident, fire, theft
or other occurrence, whether or not an insurance claim was made?

2022, Glass, Weiyan Li, Unsure, Not asked, Not asked;

2021, Glass, Weiyan Li, Unsure, Not asked, Not asked;
2018, At fault Accident, Weiyan Li, Unsure, Not asked, Not asked;
2021, Not At Fault Accident, Weiyan Li, Unsure, Not asked, Not asked
____________________________________________________________________________________________________
24. In the last 5 years have you, your partner or spouse, or any other person who No
to your knowledge will use or have access to this vehicle had an insurance
claim declined?

____________________________________________________________________________________________________
25. In the last 5 years have you, your partner or spouse, or any other person who No
to your knowledge will use or have access to this vehicle had a conviction or
been fined or are awaiting prosecution for any motoring offence (other
than parking)?

____________________________________________________________________________________________________
26. In the last 5 years have you, your partner or spouse, or any other person who No
to your knowledge will use or have access to this vehicle had insurance cancelled
or renewal refused?

____________________________________________________________________________________________________
27. In the last 7 years have you, your partner or spouse, or any other person No
who to your knowledge will use this vehicle, committed a criminal offence
or been convicted of, or awaiting prosecution for, a criminal offence?
Note: Failure to disclose full details may invalidate your policy and/or debar
any claim.

____________________________________________________________________________________________________

declaration

I confirm that:

1. The information given is entirely true and correct and that I have not withheld any information relevant to
the acceptance of this insurance. Where I have given information about someone else, I confirm that I have
their permission to do so and that their information may be treated in the same way as mine.

2. Where any information I have provided is incorrect or has been withheld, AMI Insurance, its successors and
assigns may reduce my claim or treat my policy as void from the outset.

3. Where I have disclosed now, or in the past, convictions that have been concealed by the Criminal Records
(Clean Slate) Act 2004, I acknowledge that such disclosure was voluntary.

4. AMI, a business division of IAG New Zealand Limited and the other companies within the IAG New Zealand
Limited Group (together the “IAG Group”), is authorised to:

Page 3 of 4 Issued: 12/02/2023

Customer Reference 4518038
Policy Number M0018487114

a. Obtain from any other person, including other members of the IAG NZ Group and Southern
Response Earthquake Services Limited (“Southern Response”) information about my insurance history
(including information related to claims) or any other matter relevant to this policy, or additional or
future insurance I might take out with AMI or other members of the IAG NZ Group and use and
disclose such information for the purposes of IAG NZ Group’s insurance business in accordance with
its applicable privacy policy;

b. Disclose to any other party, including other members of the IAG NZ Group, information about this
policy or previous or future insurance with the IAG NZ Group, if the person making the request is
entitled to the information or if the IAG NZ Group determines at its discretion that the person is
properly acting on my behalf and that the disclosure of the information will be to my benefit;

c. Disclose information that the IAG NZ Group has collected or collects about me, to Southern Response
for the purposes of Southern Response evaluating, processing, managing and settling any claims, and
any matters that are necessary for, or incidental to, such purposes and other insurance purposes, in
accordance with Southern Response’s privacy policy; and

d. Send me commercial electronic messages (e.g. texts, emails and faxes) for any of the purposes set out
in AMI’s privacy policy, including the marketing to me of products and services of the IAG NZ Group.

5. I understand this information is obtained and will be held by the IAG NZ Group at 1 Fanshawe Street,
Auckland for the purposes of considering whether to provide insurance to me and to administer my
insurance policy, and may also be used to tell me about other products offered by the IAG NZ Group.

6. I am aware that the Privacy Act 2020 entitles me to have access to and request correction of this
information.

Any question not answered will be taken in the negative.

Page 4 of 4 Issued: 12/02/2023