Annex I

S.no. Name of Insured Policy No. Pre-risk Survey Form Premium Calculation Date of Insurance Additional Remarks

1 Teklearegay Aydefruhm MB/4/OWOD/3386/19 • A single survey form • Fleet discount of 10% • Wrong wording for excess in
filled for two different was granted without the policy schedule.
risks. i.e. Tipper Truck reference to Pick-up • A single proposal form filled
and Pick up vehicle plate no. 03- - for two different risks.
A77996 AA.

2 Asfaw Demisie MB/4/TKOD/3339/19 •The risks were two • Starting date of •Three different endorsement
Trucks but Birr 1,950.00 Insurance was 3 days were signed in the same date
was applied once in back dated 19/07/19 18/07/2019, even, the hand
computing the premium from CSI dated written letter has wroten by
(Human Error). 22/07/2019 the customer on 17/12/19.
• Net premium
was birr 96,038.60 but
collected 95,205.00.

3 YHNK Construction MB/3/TKOD/3338/19 Not properly done • NCD of 10% was granted • Starting date of • Sino Truck (Not Tipper) but
without NCD Certificate. Insurance was 3 days computed by like other trucks.
• The premium on the back, dated 19/07/19 ?
Computation Sheet and on from CSI dated
the CSI was different by 22/07/2019.
Birr 318.41.

4 Zablon Trading Plc. MB/4/TKOD/3404/19 • The premium was • Starting date of

computed by 0.13% and Insurance and CSI date
- did not approve by HO are the same
Officials. “19/09/19”.
5 Eleni Muluwork MB/4/TKOD/3394/19 Not properly done • The premium on the
Computation Sheet and on
the CSI was different by - -
Birr 715.60.

6 Getnet Tesfaye MB/4/OTOD/3113/18 • Starting date of

- Insurance and CSI date -
are the same
7 Beshaha Engineering and MB/3/TKOD/2952/18 • The premium calculated “31/12/18”. • The sum insured of the
Construction plc by 2% and was not seen insured item was decreased to
HO Official’s approval. - Birr 1.4 Mill in the next year.

8 National Premix MB/3/TKOD/3422/19 Survey was done only • The rate applied to • Starting date of
Construction to P.No. 03-75122 ET. calculate the premium Insurance and CSI date
was 0.5% and was not for TP Cover are the
seen HO Official’s same “08/10/19”. -
approval.

9 TNT Construction & MB/3/TKOD/3135/19 • 25% of UD Loading was • SI of the vehicles decreased
Trading. applied instead of 30%. - by 1.9 million each for the
next year.

10 Tamirat Bareda. MB/4/OTOD/1531/17 Not properly done • 3.25% rate applied

against 3.5% flat rate (It
is more than fair - -
premium)

11 Tiku Berhane MB/4/TKOD/1585/17 The renewal was done • The renewal premium
without re-surveyed was calculated by 3.46% -
after the expiry date against the rate chart.
(more than 16 days).
12 Tiku Berhane MB/4/OWOD/1589/17 • The premium calculated
by 1% for Own goods Pick-
up and approved by HO
Official when the policy
was issued. But there was
- not any approval on the - -
time of renewal.
13 Tsemex Global Int’l Plc. MB/3/TKOD/1584/17 One pre-risk survey • NCD should be 15%. • Sino Truck (Not Tipper) but
form filled for Truck Extra 5% was granted computed by like other trucks.
and Trailer • The premium on the If so, revised the excess. ?
Computation Sheet and on -
the CSI was different by
Birr 766.74.

14 Hailu Kindeya MB/4/TROD/1552/17 Pre-risk survey • The rate applied to • OD and BSG for six months,
completed for only one calculate OD premium was But Yellow Card and TP
truck and trailer plate 1.19%. Extension for one year. ?
no. 03-40622 ET/ 03- • The rate applied to
13822 ET. calculate BSG premium
was 0.15% against 0.25%.
• The rate applied to
calculate TP Extension
premium was 1.5% against
2.5%
• The second six months
was calculated by 30% of -
the annual premium,
against the rate chart

and it was not

approved by HO Officials.

15 Yetateku Abate Shume MB/3/TKOD/1353/16 • Extra 5% of NCD was

- granted, It should be 20%. -

16 Natnael Tamirat MB/4/PVOD/0972/15 • 5% of fleet discount was • Sum insured of the vehicle is
- granted without - the same since the inception
reference. period, Corolla, YM 2007. SI=
Birr 590,000.00.
17 Getnet Tesfaye MB/4/TKOD/3111/18 Not properly done There was no computation
sheet but the rate applied
was 0.94% and not
approved by HO official on - -
the time renewal.

18 Aregay Abera & BIB MB/4/TKOD/1095/15 No any Pre-risk Survey • The premium on the
form Computation Sheet and on
the CSI was different by - -
Birr 1,026.40.

19 Evangelical Theological BM/5/PVOD/1318/16 • The premium was not • The SI of the vehicle was the
College calculated by granting 10% same since 2016, Model-5L,
discount instead of 10% YM=2008, SI= Birr 600,000.00
Age Loading and lost Birr
1,799.72.
- • 15% if fleet discount was -
granted without
reference.
 Annex I
Pre-risk
Title Survey Proposal
S.no. Name of IPolicy No.Book Form Form
TeklearegaMB/4/OWO A single A single
survey proposal
form form
filled for filled for
- two two
different different
risks. risks.

1
YHNK Construction
MB/3/TKOD Not
- properly -
done
2
Zablon TradMB/4/TKO Not Proposal
properly was not
done signed
and
- stamped
by the
insured.

3
Eleni Muluwork
MB/4/TKOD Not
- properly -
done
4
Mengistu EMB/4/PVOD Not
- properly -
done
5
Getnet TesMB/4/OTO Not
- properly -
done
6
National P MB/3/TKO Done only
for P.No.
- 03-75122 -
ET.
7
Cactus Plc.MB/3/PVOD Not
- properly -
done
8
Meron Mula
MB/3/OTO Not
properly
- done but -
have pic
9
Tsegaw TafMB/4/TOO Not
- properly -
done
10
 Tamirat BaMB/4/OTO Not
- properly -
done
11
Tiku BerhaMB/4/TKOD The
renewal
was done
without
re-
surveyed
after the
expiry
- date -
(more
than 16
days).

12
Tsemex Glob
MB/3/TKOD One pre-
risk
survey
form
filled for
- Truck and -
Trailer

13
Hailu KindeMB/4/TROD Pre-risk
survey
complete
d for only
one truck
and
trailer
- plate no. -
03-40622
ET/ 03-
13822 ET.

14
 Getnet TesMB/4/TKOD Pre-risk
Survey
was not
properly
complete
d. Even
the
vehicle
- was not -
properly
identified.

15
Getnet TesMB/4/TKOD Not Proposal
properly was not
done signed by
- the
insured.
16
Aregay AbeMB/4/TKOD No any
Pre-risk
- Survey -
form
17
EvangelicalBM/5/PVOD
There was
no Title
Book - -

18