AUTO SECURE-TWO WHEELER PACKAGE POLICY

Cert. No. Tata AIG General Insurance Co. Ltd. Prev. Policy No:
3189344184/000000/00 3005/35715779/11576/000
Tenure : 3 Years
customersupport@tataaig.com
Insured Business/Profession Address of The Insured TP Valid From TP Valid To
Mr VIJAYA FLAT NO 12 BLOCK A-5 DABC ACAIA
SRINIVASAN .K Businessman PHASE-1 MAMBAKKAM Chennai TAMIL 04-03-2019 15:53:35 Midnight of 03-03-2022
NADU 600045
Vehicle Regn No. Engine No. Chassis No. Make & Model Year of Mfg Cubic GSTIN No.
Capacity (Customer)
Hero MotoCorp
TN-11-R-2382 HA10EVGHB35911 MBLHA10BSGHB73611 2016 100
PASSION PR O
Declared Value Side Car IDV Non-Electrical Electrical CNG/LPG/Bi-Fuel IDV Total IDV
(IDV) of Vehicle Accessories IDV Accessories
IDV
31380.00 NA 0.00 0.00 0.00 31380.00
Place of Regn. Body Type HP/Lease/Hire- Branch Office Seating Capacity Premium
Purchase Agreement of
With HP/Lease/Hire-
Purchase
Tambaram Solo , --- 2 4433.00
Section A B. Liability Premium Computation (Section II) in Rs.
OD Basic Cover : 1234.00 Basic TP Cover : 2160.00
OD Discount (20%) : 247.00 CNG/LPG/Bi-Fuel Kit : 0.00
Own Damage (OD) Total : 987.00 Compulsary PA Cover (Owner Driver) : 919.00
Accessories : 0.00 Optional PA Cover(Un Named Passenger) : 0.00
Electronic & Electrical Accessories : 0.00 Optional PA Cover(Un Named Driver) : 0.00
Bi-Fuel Kit : 0.00 Legal Liability Cover (Paid Drivers, Cleaners) : 0.00
Geographical Extension : 0.00 Legal Liability Cover (Per Licensed Passenger) : 0.00
Handicapped Discount : 0.00 Total Liablity Premium (B) : 3079.00
For Anti-Theft Discount : 0.00 Total Premium (A + B) : 3757.00
NCB (25 %) : 309.00 For any other extra : 0.00
Total Section (A) : 678.00 CGST @ 9.00% : 338.00
SGST @ 9.00% : 338.00
Gross Premium : 4433.00
1. Registration No. : 108 || 2. CIN No. : U85110MH2000PLC128425 || 3. GSTIN No. : 33AABCT3518Q1Z3 || UIN No.-
IRDAN108P0001V01200001 | IRDAN108P0007V01201516
04-03-2019 To 03-03- 04-03-2020 To 03-03- 04-03-2021 To 03-03-
OD Policy Period NIL NIL
2020 2021 2022
IDV 31380.00 26150.00 23535.00 NIL NIL
CPA Rs. 15 lakhs. Rs. 15 lakhs. Rs. 15 lakhs. NIL NIL
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) c) Organized Racing d) Pace Making e) Speed Testing f) Reliability Trials g) Any purpose in connection with
Motor Trade.
DRIVER: Any person including insured: Provided that a person driving holds an effective driving licence at the time of the accident and is not
disqualified from Holding or obtaining such a licence.Provided also that the person holding an effective Learner's Licence may also drive the
vehicle and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules, 1989.
LIMIT OF LIABILITY: Limit of the amount of the Company's liability under the Section II-I(i) in respect of any one accident as per M.V. Act
1988. Limit of the amount of the Company's liability under Secion II-I(ii) in respect of any one claim or series of claims arising out of one event :
Upto Rs - 100000/
IMPORTANT NOTICE:--The insured is not indemified if the vehicle is used or driven otherwise than in accordance with this Schedule. Any
payment made by the company by reason of wider 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 CERTAIN TERMS AND RIGHTS OF RECOVERY'
I/We certify that the policy to which the certificate relates as well the certificate of insurance are issued in accordance with the provisions of
Chapter X & XI of M.V. Act 1988
Broker : Hero Insurance Broking India Pvt. Ltd. Insured is Liable for a voluntary deductible of Rs. Long
term Two wheeler Package policy.
Received Vide TA16. Depreciation Allowances No of claim allowed 4
Premium of Rs. 4433.00 CASH claims during each year of the period of insurance.
Cash/Cheque No.
Deductible: First Rs. 350 for each and every claim./- for
POORNIMA each Claim, if policy having ND product.
Dated Nominee Name V The policy is subject to a compulsory excess of Rs.
100/- & deductible under depreciation allowance is
Drawn on Nominee Age 34 applicable as per policy terms & conditions*(Please turn
overleaf for details)
Acknowledgement 04-03- Nominee Relation Wife Consolidted Stamp Duty Paid
Dt 2019 Endorsements: IMT - 22
Registration No: 649 Tel No: 1800-102- On behalf of Tata AIG General Insurance Co. Ltd.
4376
04-Mar-2019 FOR RENEWALS CONTACT: Radha Automobiles
Date & Signature of proposer Ph.No- 044-22268200
No - 37, GST Road, Tambaram, Chennai -45
Dealer's Stamp & Signature Duly Constituted Attorney
Received with Thanks Rs 4433.00 from Mr VIJAYA SRINIVASAN .K as premium against the money receipt no 023189344184/000000/00
Regd. & Head Office : Peninsula Business Park, Tower A,15th Floor, G.K. Marg, Lower Parel, Mumbai – 400013
For further information about motor insurance policy please also visit http://irda.gov.in >> Grievances >> Policyholder Handbooks