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The Driver Exclusion Form is a critical document used in the United Arab Emirates insurance industry to modify existing vehicle insurance policies by formally excluding specific drivers from coverage. This document becomes necessary when policyholders need to explicitly exclude certain individuals from operating insured vehicles, whether due to high-risk driving history, licensing issues, or other insurance-related concerns. The form must comply with UAE Federal Insurance Authority regulations and includes detailed information about the insurance policy, vehicle(s), policyholder, and excluded driver(s). It serves as a legally binding amendment to the insurance policy and requires clear acknowledgment from all parties involved. The document is particularly important in risk management and liability limitation, especially for corporate fleet management and personal vehicle insurance policies.

1. Insurance Policy Information: Details of the existing insurance policy including policy number, insurance company name, and policy period

2. Policyholder Information: Full identification details of the policyholder including name, Emirates ID, contact information, and address

3. Vehicle Information: Comprehensive details of the insured vehicle including make, model, year, VIN, and registration number

4. Excluded Driver Details: Complete information about the driver(s) being excluded including full name, Emirates ID, date of birth, and relationship to policyholder

5. Exclusion Declaration: Clear statement of exclusion specifying that the named individual(s) are not covered under the insurance policy when operating the specified vehicle

6. Acknowledgment of Understanding: Statement confirming that all parties understand the implications of the exclusion, including that there will be no coverage if excluded drivers operate the vehicle

7. Signatures: Signature blocks for policyholder, excluded driver(s), and insurance company representative, with date fields