CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED

Registered Office: 2nd Floor "DARE HOUSE", 2, N.S.C. Bose Road, Chennai ‐ 600 001.
Toll free: 1800 208 5544, T: +91﴾0﴿ 44 4044 5400, F: +91﴾0﴿ 44 4044 5550
E‐mail: customercare@cholams.murugappa.com; website: cholainsurance.com
IRDAI Regn. No.123 PAN AABCC6633K CIN: U66030TN2001PLC047977 3361/02250749/000/00

Motor Two ‐ Wheelers Package Policy ‐ Schedule cum Certificate of Insurance

[UIN: IRDAN123RP0002V02200203]

Certificate Number: 3361/02250749/000/00

Policy Number: 3361/02250749/000/00
Registration Address: Nagla Budi Sheetla road Dayal Bagh Agra
Mobile‐ 8937868113,Landline‐ ‐
Name & Communication Address: Mr. Naval Kishor
Period of Insurance:
Nagla Budi Sheetla road Dayal Bagh Agra
From : 00:01hrs on 23/Oct/2021
Mobile: 8937868113|Landline: ‐|Mail: abhisekkumar983727@gmail.com
To : 23:59hrs on 22/Oct/2022

PAN No: G S T I N:

EIA No:
Geographical A r e a: India
Business / Profession: Corporate
PARTICULARS OF VEHICLE INSURED
Date of Registration 03/02/2018 Place of Registration AGRA Registration Number UP80EL3251
Make HERO Model SUPER SPLENDOR ‐ DRUM BS VI Variant SUPER SPLENDOR ‐ DRUM BS VI
Year of Mfg 2018 Type of Body Two wheeler Fuel Used PETROL
Cubic Capacity 125 Engine No JA05EGH9M18551 Chassis No MBLJAR033H9M18088
Licensed passenger Carrying Capacity 2 Driver 0 Cleaner ‐
Total Seating Capacity
Conductor ‐ K.Watt 0 2
Including Driver
IDV ﴾Insured's Declared Value﴿
Value of Chassis ﴾Rs﴿ 0.00 Value of Body ﴾Rs﴿ 0.00 For Vehicle ﴾Rs﴿ 39972
For Trailer ﴾Rs﴿ 0.00 Non‐Electrical Accessories﴾Rs﴿ 0.00 Electrical/Electronic Accessories ﴾Rs﴿ 0.00
Value of CNG/LPG Kit ﴾Rs﴿ 0.00 Total Value ﴾Rs﴿ 39972
PREMIUM
A.OWN DAMAGE B.LIABILITY
Sum Insured
IMT Premium﴾Rs﴿
﴾Rs.﴿ No.of
Basic OD 39972 670.00 Sum Insured IMT Premium﴾Rs﴿
Person
Electrical or Electronic Accessories 00 24 0
Non Electrical or Electronic Basic TP 752.00
00 0
Accessories
CNG Kit‐TP 0 25 .00
CNG Kit‐OD 00 25 0
TOTAL 670.00 TOTAL 752.00

Geographical Extension‐OD 1 0 Geographical Extension‐TP 1 .00

Sub Total:﴾additions﴿ 0
TOTAL PREMIUM﴾B﴿ 752.00
Less: 0
C.PERSONAL ACCIDENT COVERS
Anti‐Theft Device‐OD 10 0
Bonus Discount﴾ 0.00 %﴿ 0.00 PA Cover 0.00
Sub Total:﴾discounts﴿ 0.00 TOTAL PREMIUM﴾C﴿ 0.00
Total 670.00
TOTAL ﴾A+B+C+D﴿ 886.00
Own Damage Premium 670.00
Detariff Discount 536.00 TOTAL PACKAGE PREMIUM 886.00
GST Discount ﴾ %﴿ 0.00 CGST ﴾0%﴿﴾Rs.﴿ 0.00
TOTAL﴾A﴿ 134.00
SGST ﴾0%﴿﴾Rs.﴿ 0.00
D.ADD‐ON COVERS﴾BENEFITS﴿ Benefit No OptionNo. Premium﴾Rs
POS ‐ Daily Cash Allowance IGST ﴾18%﴿﴾Rs.﴿ 160.00
﴾Excluding TotalLoss / Constructive 0
Total Loss﴿ TOTAL AMOUNT
1046.00
COLLECTED
POS ‐ Waiver of Depreciation for
0
Partial Lossclaims
Chola Value Added Services ‐ Two
0.00
WheelerPackage Policy
Chola value added services 0.00
CVAS New 0.00
ADD‐ON COVERS PREMIUM 0.00
TOTAL ADD‐ON‐COVERS
0.00
PREMIUM﴾D﴿

Refer website for policy wordings and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS C H O L A to 56677 | Visit w w w . c h o l a i n s u r a n c e . c o m | Email customercare@cholams.murugappa.com
Disclaimer: The company may contact you for matters related to your policy or to provide details of products & services offered. To opt out from the facility, please register
under Do Not Call section on our website.
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor "DARE HOUSE", 2, N.S.C. Bose Road, Chennai ‐ 600 001.
Toll free: 1800 208 5544, T: +91﴾0﴿ 44 4044 5400, F: +91﴾0﴿ 44 4044 5550
E‐mail: customercare@cholams.murugappa.com; website: cholainsurance.com
IRDAI Regn. No.123 PAN AABCC6633K CIN: U66030TN2001PLC047977 3361/02250749/000/00

Motor Two ‐ Wheelers Package Policy ‐ Schedule cum Certificate of Insurance

[UIN: IRDAN123RP0002V02200203]

LIMITATIONS AS TO USE: The Policy covers use of the vehicle for any purpose other than: a﴿ Hire or Reward b﴿ Carriage of goods ﴾Other than samples or personal luggage﴿
inconnection with any trade or business or use for any purpose in connection with motor trade c﴿ Organized racing d﴿ Pace making e﴿ Speed Testing f﴿ Reliability Trial g﴿ Tuition h﴿
Useonly with side car if attached
DRIVER CLAUSE: Any person including insured provided that a person driving holds an effective driving license at the time of the accident and is not disqualified from holding or
obtaining such a license. Provided also that the person holding an effective learner's license may also drive the vehicle and that such a person satisfies the requirements of Rule 3 of
the Central Motor Vehicles Rules 1989.
LIMITS OF LIABILITY: Under Section II ‐ 1﴾i﴿ of the Policy ‐ Death or bodily injury such amount as is necessary to meet the requirements of the Motor Vehicle Act, 1988. Under
SectionII ‐ 1﴾ii﴿ of the Policy ‐ Damage to Third Party Property ‐ Rs.1,00,000.00 P.A. Cover for the Owner cum Driver Under Section III ﴾CSI﴿‐ Rs.0.00
Deduction Under Section 1: Rs.100
Additional compulsory deductibles under Section 1 Rs.0
Additional Imposed deductibles under Section 1 Rs.0 Subject to I.M.T. Endt. Nos. and Memorandum: 22,7 .
Coverage under this policy is subject to realisation of premium cheque﴾s﴿. Incase of dishonor of cheque﴾s﴿, no separate intimation will be given and the policy stands cancelled
frominception.
Applicable benefits:
Please visit our website for Policy terms and conditions
Date and Signature of the proposal 20/10/2021.
Warranties: Warranted that NCB under this Policy is based on representation regarding NCB and absence of claim under the previous Policy.If the information be found incorrect
orfalse in any aspect,this Policy shall be void ab initio and no benefit shall be payable by the company.It is hereby warranted the coverage under this Policy commences only from
theRisk Start time and Date as mentioned in the Policy schedule.No Liability shall attach under this Policy in respect of any Accident/Loss prior to the time and date of
commencement ofPeriod of insurance
It is Warranted that the vehicle should possess a valid POLLUTION UNDER CONTROL certificate during the policy period, failing which assessment of own damage claims will
berepudiated.
S l . N o . Name of the Nominee Relationship Age of the Nominee %age of share Name of the Guardian Guardian relationship with Nominee

No Claim Bonus is applicable at the end of the policy period.

NOTE: The Motor Policy Schedule cum Certificate of Insurance is an important document issued based on your declaration. We request you to verify the details and ensure
thateverything is in order. In case of any discrepancies, please contact us within 15 days from the date of issuance of policy.
Financier Name & Address:
Intermediary Name: POLICYBAZAAR INSURANCE BROKERS PRIVATE LIMTED
Code: 2009936529320001 Contact No: 1800‐258‐5970
For Cholamandalam MS General Insurance Company Ltd.

Place: Chennai Date:20/10/2021

Duly Constituted Attorney﴾s﴿

Business Location: Chennai Head Office
2nd Floor "DARE HOUSE", 2, N.S.C. Bose Road,
Chennai ‐ 600 001
GST Invoice No: 3361/02250749/000/00 | GSTIN: 33AABCC6633K1ZQ | SAC Code:997134 | SAC Description: Motor vehicle insurance services
Consolidated Stamp Duty Paid to Commercial Taxes and Registration ﴾j1﴿ Department, Tamil Nadu
I/We hereby certify that the policy to which this certificate relates as well as this certificate of insurance are issued in accordance with the provisions of Chapter X and Chapter XI
ofthe Motor Vehicles Act, 1988.
IMPORTANT NOTICE: The insured is not indemnified if the vehicle is used or driven otherwise than in accordance with this schedule. Any payment made by the company by
reason ofwider terms appearing in the Certificate in order to comply with the Motor Vehicle Act, 1988, is recoverable from the insured. See the clause headed "AVOIDANCE OF
CERTAINTERMS AND RIGHT OF RECOVERY".
For legal interpretation, English Version will hold good.
Whether tax is payable under reverse change basis ‐ No
Note: UIN for the related add‐on covers availed under this policy are as mentioned in the attached sheet, which forms part of the policy schedule.

Add on cover Name IRDA BAP UIN UIN

Refer website for policy wordings and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS C H O L A to 56677 | Visit w w w . c h o l a i n s u r a n c e . c o m | Email customercare@cholams.murugappa.com
Disclaimer: The company may contact you for matters related to your policy or to provide details of products & services offered. To opt out from the facility, please register
under Do Not Call section on our website.