HDFC ERGO General Insurance Company Limited

Certificate of Insurance cum Policy Schedule
Policy No !"#!!$$"#"%&'!$$$$$
Pri(ate )*o +heeler
Pac,a-e Policy
Insured Name
.r )irumandym Harsha(ardhan
Phone E .ail Re-istration No
Period of Insurance Fo! D"#$ % T&!$
21/10/2013 00:01'(
To D"#$ % T&!$ 20/10/2014 )&*+&,'# Policy Issuance Date 21/10/2013
.a,e .odel 1 2ariant En-ine No Chassis No .f- 3r Seats 4ody )ype CC
)2.HA10E32HH54671 2011 2 S-.- 47
Insured5s Declared
2alue 6ID27
2ehicle )railer Non Electrical /cc Electrical /cc CNG8LPG 9it )otal ID2
18,000 0 0 0 0 18,000
Named Persons : Nominee
Nominee 6O*ner Dri(er7 /ppointee
Hypothecated6I.)1&7 *ith;HDFC 4/N9 L)D<Hydera0ad
Premium Details
( )
Own Damage Premium (a) Liability Premium (b)
Basic Own Damage 262 Basic Third Party Liability 250
Total Basic Premium
Add on Coverages
Zero Depreciation
Emergency ssistance
Total - Add on
LL to Paid Dri$er %&'T(2#)
P *o$er +or Owner Dri$er o+ ,5000

Net Liability Premium (b)
Total Pacage Premium (a!b)
-er$ice Ta. %&ncl/ding Ed/cation *ess 0 1igher Ed/cation *ess2 where$er applicable)
5 0
Net Own Damage Premium (a) !2,3 Total Premium !2,3
"eogra#$ical Area &ndia Com#ulsory Deductible (%&T-'') !000400 (oluntary Deductible (%&T-''A) 0
Payment Details) *he5/e 6o4 2,!,63 Dated ) !78!0820!" Drawn on 1d+c Ban9 Ltd
Previous Policy No* !#0!,!2"!!0023!2 (alid +rom 2!8!0820!2 to 208!0820!"2 o + :EL&6*E No Claim Bonus 0
; &+ declaration +o/nd incorrect2 bene+its /nder the present policy in respect o+ own damage section will stand +or+eited4
List Of Endorsements
,ndt No Descri#tion ,++ective Date ,nd Date Premium (%n )
L%&%TAT%ON- A- TO .-,) The Policy co$ers /se o+ the $ehicle +or any p/rpose other than< a) 1ire or :eward2 b) *arriage o+ goods %other than samples or personal l/ggage)2 c) Organi=ed racing2
d) Pace ma9ing2 e ) -peed testing2 + ) :eliability Trials2 g ) ny p/rpose i n connection with 'otor Trade4 Persons or Class o+ Persons entitled to drive) ny person incl/ding the ins/red2 pro$ided
that a person dri$ing holds a n e++ecti$e dri$ing license at the time o+ the accident and is not dis5/ali+ied +rom holding or obtaining s/ch a license4 Pro$ided also that the person holding an e++ecti$e learner>s
license may also dri$e the $ehicle and that s/ch a person satis+ies the re5/irements o+ :/le " o+ the *entral 'otor ?ehicles :/les2 !7#74 Limits o+ Liability !4 @nder -ection &&(! %i) o+ the policy (
Death o+ or
bodily inA/ry ( -/ch amo/nt as is necessary to meet the re5/irements o+ the 'otor ?ehicles ct2 !7##4 24 @nder -ection && ( !%ii) o+ the policy (Damage to Third Party Property( ,50000 "4
P4 4 *o$er
/nder -ection &&& +or Owner ( Dri$er%*-&)< 200000 Terms/ Conditions 0 ,1clusions) s per the &ndian 'otor Tari++4 personal copy o+ the same is a$ailable +ree o+ cost on re5/est 0
the same is
& 8 Be hereby certi+y that the policy to which the certi+icate relates as well as the certi+icate o+ ins/rance are iss/ed in accordance with the pro$ision o+ chapter C2 C& o+ '4 ?4ct l7##4DDThe stamp d/ty

450 paid b y Demand Dra+t2 $ide :eceipt8*hallan n o 7!2"2 dated !!80!820!2 a s prescribed i n Eo$ernment 6oti+ication :e$en/e and Forest Department 6o '/dran9 200383!258*: 6708'(!2 dated
"!8!2820034DD -er$ice Ta. :egistration 6o4< B*10,"#E-T0034 %&PO2TANT NOT%C,) The &ns/red is not indemni+ied i+ the $ehicle is /sed or dri$en otherwise than in accordance with this -ched/le4 ny
payment made b y the *ompany b y reason o+ wider terms appearing i n the *erti+icate i n order to comply with the 'otor ?ehicle ct2 !7## i s reco$erable +rom the &ns/red4 -ee the cla/se
33A(O%DANC, O4 C,2TA%N T,2&- AND 2%"5T O4 2,CO(,26*33 Disclaimer) The Policy shall be $oid +rom inception i+ the premi/m che5/e is not reali=ed4 &n the e$ent o+ misrepresentation2 +ra/d or
non(disclos/re o+ material +act2 the *ompany reser$es the right to cancel the Policy +rom inception4
Policy Issuin- Office; .um0ai
Fo HDF5 ERG- G$+$"6 I+(7"+8$ 5o!9"+: .#*.
Agent Code :201587086428 Tel No. : 912228561818
D76: 5o+(#&#7#$* A##o+$:
*orporate O++4< 6th Floor2 Leela B/siness Par92 ndheri(G/rla :oad2 ndheri%E)2 '/mbai 300 0574 Toll-4ree No*7899-'-:99-:99 4a1 ;7 '' <<=8=<;; care>$d+cergo*com www*$d+cergo*com
:egistered O++4< :amon 1o/se2 14T4Pare9h 'arg2 !672 Bac9bay :eclamation2 '/mbai 300 0202 &ndia4
Fre=uently /s,ed >uestions 6F/>s7 1 .O)OR INS?R/NCE
Loss or Damage to t$e %nsured (e$icle caused due to) Liability to T$ird Parties)
Personal Accident Cover)
a) Fire2 e.plosion2 sel+ ignition or lightning4
b) B/rglary2 ho/sebrea9ing or the+t
c) ll act o+ Eod perils li9e earth5/a9e2 +lood2 cyclone etc
d) ccidental e.ternal means2 terrorism2 riot and stri9e
Pro$ides co$er +or any legal liability arising o/t o+
the /se o+ the $ehicle +or<
a) ccidental death 8 inA/ry to any third party
b) ny damage to property owned by third party
The policy pro$ides +or mandatory Personal ccident co$er +or
owner dri$er and optional co$er +or passengers co$ering
accidental death and permanent total disability4
a) Eeneral aging2 wear 0 tear2 mechanical or electrical brea9down2 +ail/re2 depreciation2
any conse5/ential loss
b) Damage by a person dri$ing witho/t a $alid license
c) Damage by a person dri$ing /nder the in+l/ence o+ li5/or or dr/gs
d) Loss8damage attrib/table to war2 m/tiny2 n/clear ris9s
e) Damage to tyres and t/bes2 /nless damaged d/ring an accident
+) @sage on hire 0 reward %applicable +or all classes e.pect p/blic commercial $ehicles)
g) Loss or damage to bonnet side parts2 m/dg/ard2 b/mpers2 lamps2 tyres2 t/bes2
headlights2 paint wor9 %applicable +or all commercial $ehiclesH /nless opted additionally)
h) Loss or damage res/lting +rom o$ert/rning arising o/t o+ operation as a tool
%applicable +or mobile cranes2 drilling rigs2 mobile plants2 na$$ies2 sho$els2 grabs2
rippers /nless opted +or additionally)
i) Loss o+ or damage to accessories by b/rglary ho/sebrea9ing or the+t /nless the
$ehicle is stolen at the same time %applicable to all commercial $ehicles 0 two wheelers)
7* D,TA%L- TO ?,,P 5AND6 @5%L, 2,"%-T,2%N" A CLA%&
a) Policy 6o4
b) :egistration details 8 :* copy
c) Dri$ers details at the time o+ accident incl/ding dri$ing license n/mber
d) F&: on a case to case basis
e) :epair estimate
'* 5O@ DO % 4%L, A CLA%&A
For ccidental Damage to &ns/red ?ehicle %Own Damage *laims)<
a) *all o/r c/stomer care Toll(+ree 7899-'-:99-:99 i+ the $ehicle meets with an accident
b) Pro$ide yo/r policy n/mber +or re+erence and register the claim
c) &+ yo/r $ehicle can be dri$en2 ta9e it to the nearest dealer 8 garage
d) Eet a repair estimate2+ill /p the claim +orm and attach a copy o+ the registration
*erti+icate dri$ing license o+the person dri$ing at thetimeo+ the accident
e) &+ the garage is within o/r networ92 yo/ co/ld a$ail o+ cashless claim +acility4 Pay +or non
accident related repairs2 depreciation and ded/ctible4 Be wo/ld settle the rest4
+) &+ the garage is o/tside o/r networ92 yo/ wo/ld ha$e to get the claim reimb/rsed
g) -ign the repairerIs satis+action $o/cher and dri$e o++J
B* CLA%&- DOC.&,NT-) %N CA-, O4 LO-- D., TO T5,4T
a) D/ly +illed and signed claim +orm 0 discharge $o/cher % a+ter loss settlement )
b) Original :egistration *erti+icate %:*)
c) Original policy copy
d) *opy o+ F&: lodged at the nearest police station
e) ll original 9eys 0 $ehicle in$oice copy
+) 6o trace report con+irming that the stolen $ehicle is not traceable
=* CLA%&- DOC.&,NT- - %N CA-, O4 ACC%D,NTAL DA&A", TO %N-.2,D
a) D/ly +illed and signed claim +orm 0 satis+action $o/cher
b) :egistration *erti+icate %:*)
c) Dri$ing license o+ the person dri$ing at the time o+ the accident
d) Policy copy 2 original repair estimate2 repair in$oice
e) Payment receipt +or non(cashless claims
+) Original repair in$oice +or cashless claims
g) 'L doc/ments +or amo/nt more than ! lac %P6 card2 2 passport si=e photo2
residence proo+)4
h) Form "5 0 original 6O* +rom +inancer incase o+ total loss where payment is made
to ins/red4
i) copy o+ police F&:8panchnama is re5/ired +or TP inA/ry8death8property damage
Additional documents reCuired +or commercial ve$icles)
a) -pot s/r$ey
b) Load challan
c) Fitness certi+icate
d) :o/te permit
g) Original 6O* +rom +inancer incase o+ hypothecation 8 1P
h) &ntimation to :TO +or the+t o+ $ehicle
i) D/ly signed :TO trans+er papers %Form 262 2#2272"02"5)
A) :* e.tract with stolen remar9 +rom the concerned :TO a+ter the loss
9) 'L doc/ments +or amo/nt more than ! lac %P6 card2 2 passport si=e photo2
residence proo+)4
l) Deed o+ s/brogation c/m indemnity on A/dicial stamp paper4
7* C$anges related to registration o+ ve$icle or ve$icle details lie) '* 4or addition o+ electrical and non electrical accessoriesDCN" 0 LP" ?it)
a) *orrection in registration n/mber8 location 8 address
b) *orrection in $ehicle ma9e 0 model 8 c/bic capacity 8 seating capacity8 engine 0 chassis
n/mber 8 year o+ man/+act/re
D oc/ment s : e5/i red <
a) :e5/est letter +or the change b) Policy copy c) :egistration *erti+icate copy
=* Documents reCuired to c$ange +inancier details
a) :e5/est letter +or the change
b) Policy copy
c) Endorsed :egistration *erti+icate copy
d) 6O* +rom +inancier %not mandatory +or deletion i+ :* is endorsed)
a) :e5/est letter +or the change
b) Policy copy
c) &n$oice copy %mandatory where $al/e o+ accessory e.ceeds 2020008()
d) Endorsed :egistration *erti+icate *opy %For *6E8LPE 9it)
e) *he5/e +or additional premi/m
*all /s +or additional premi/m details 0 send rele$ant doc/ments copy to o/r corporate
B*C$anges D Correction in Policy 5older3s Name D Corres#ondence Address D
Contact Numbers D ,-mail id D any ot$er c$anges)
E mail /s at < care>$d+cergo*com O2
*all Toll(+ree< 7899 ' :99 :99 D 7899 ''< ''< O2
Fa. yo/r re5/est at< 9'' <<=8 =<<;
a) ?isit www*$d+cergo*co m to renew instantly
online4 b) -'- EE2,N,@ FPOL%C6 NOG EE to ;;;;
:99:99 c) ?isit o/r nearest branch 8 yo/r agent
*all Toll(+ree < 7899 ' :99 :99 D 7899 ''< ''<
Fa. < 9'' <<=8 =<<;
E('ail < care>$d+cergo*com
d) -end a copy o+ the renewal notice along with premi/m che5/e to o/r branch o++ice 8
*orporate o++ice
e) *all o/r toll +ree n/mber 7899 ' :99 :99 D 7899 ''< ''<*
Brite to /s at
< 5D4C ,2"O "eneral %nsurance Com#any Limited
6th +loor2 Leela B/siness Par92 ndheri G/rla :oad2
ndheri%East)2 '/mbai ( 300 057
&anage 6our Port+olio
> $d+cergo*com D
(iew your #olicy details Trac your claims online w$enever t$e need arises
Lin multi#le #olicies o+ yoursel+ and your loved ones 2aise service reCuest D com#laints 0 set renewal reminders
C$ange your #ersonal details on t$e go %n+ormation about branc$es/ garages and $os#itals
H su##orts smart #$ones based on Blacberry/ iP$one/ Android 0 -ymbian #lat+orms
This doc/ment is a s/mmary o+ the bene+its o++ered4 The in+ormation mentioned abo$e is ill/strati$e and not e.ha/sti$e4 &n+ormation m/st be read in conA/nction with the policy wordings4
&n case o+ any con+lict between this doc/ment and the policy wordings2 the terms and conditions mentioned in the policy wordings shall pre$ail4