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Go Digit General Insurance Ltd. Schedule/Receipt

Digit Two-Wheeler Liability Only Policy UIN No.: IRDAN158P0003V01201718

MA
Name VINEET MISHRA Vehicle Registration No. UK17H9810
N Address S/O SURESH KUMAR MISHARA Partner Name PROBUS INSURANCE BROKERS
R/OKUAHEDI KUVAN HEDI
Partner Code 1001221
ROORKEE,Haridwar-247667
Mobile xxxxxxxxx5375 Partner Mobile No. --
Email sxxxxxxxxxxxxxxx4@gxxxl.com Partner Email compliance@probusinsurance.in
Aadhar No. For Claims, contact us at 1800-258-5956
YOUR POLICY DETAILS
PB
Policy No. D011215182 / 11122019 Policy Issue Date 11-Dec-2019 Invoice No. IA009059130
From 12-Dec-2019 13:13:21
Period of Policy Policy Term 1 Year
To 11-Dec-2020 23:59:59
From -- Invoice 11-Dec-2019
Period of Policy for PA Owner Driver
To -- Date
1 YOUR VEHICLE DETAILS
Roorkee,UTTARAKHAN Model/Vehicle
RTO location D Make YAMAHA Variant (Sub- RAY/ZR
IGS
Engine No. E3Y3E0387806 Chassis No. ME1SED1G3J0003399 Type)
PB Body Type Scooter Fuel Type Petrol Year of Regn 2018
Seating
2
Capacity PowerCapacity 113
Cubic 5.2 KW
CC Year of Mfg. --

LIABILITY PREMIUM (`)

MAK
G01 Basic Third-Party Liability (`) 752 PA cover for Owner-Driver (`) --
135
PA cover for 2 unamed passengers each 0 (`) -- PA cover for Paid Driver 0 (`) --
Legal Liability to Employees (`) -- Legal Liability to Paid Driver (`) --
Net Premium (`) 752
IGST @ 18% = (`135) 135

Final Premium (`) 887

OTHER DETAILS

M
FH Previous Insurer -- Previous Policy No. --
IGS Previous Policy
IMT - Endorsements -- Expiry Date --
FH
GSTIN/UIN No. Unregistered State Code 5
Receipt No. RA010127879 Receipt Date 11-Dec-2019
Financier Details -- Nominee Details --

Other Detials --

Geographical Area: Any liability incurred within India shall be covered subject to Policy Terms and Conditions, unless specifically agreed and
endorsed. Limitation as to use: The policy covers use of the vehicle for any purpose other than hire or reward, racing, pace making, reliability trial,
speed testing and use for any purpose in connection with the Motor Trade. Person or Class of persons entitled to drive: Any person including the
insured. 1) Provided that a person driving holds a valid effective driving license at the time of the accident and is not disqualified from holding or
obtaining such a license. 2) Provided also that the person holding a valid effective Learner’s License may also drive the vehicle and that such a
Te person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989 and any subsequent amendment as applicable. Limits of
Liability: 1) Under Section II - 1 (i) of the policy: Death of or bodily injury - Such amount as is necessary to meet the requirements of the Motor
Vehicles Act, 1988 and any subsequent amendment as applicable. 2) Under Section II - 1 (ii) of the policy: Damage to Third Party Property -
(`100000) 3) P.A. Cover for Owner Driver under Section III (CSI) -(`)(per annum).

PA Owner Driver Declaration:The Policy has been issued without Compulsory Personal Accident Cover to Owner Driver on the basis of
your declaration that you do not hold a valid Driving License on or before the date of commencement of this Policy / already have an
alternate Personal Accident insurance cover of Rs. 15 Lakhs
Important Note: Please inform the Company in case of change on account of addition of CNG/PNG kit.

Cheque dishonor / Non-receipt of payment premium paid through Cheque, the policy is void ab-initio in case of dishonor of Cheque or non-receipt
of payment. Violation of Motor Vehicle Act: This policy is issued in accordance with the provision of Chapter X and Chapter XI of MV act, 1988
and any subsequent amendment as applicable. Any violation will forfeit all benefits and coverages under the Policy. 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 of wider terms
http appearing in 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 Right Of Recovery) in the policy. This policy is subject to the standard policy wordings, warranties and conditions applicable
for this product in addition to coverages and exclusions specified in the motor vehicle tariff published by IRDAI. Policy would be void on the ground
that it was obtained by non- disclosure of material fact or by a representation of fact which was false in some material particular

Go Digit General Insurance Ltd. Address: Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru, Karnataka 560095.IRDAI Reg
No. 158 CIN U66010PN2016PLC167410, GST Reg. No.: 27AACCO4128Q1Z0 HSN: 9971/General Insurance Services, GSTIN Address: Mumbai Business
Centre Units 1301 1302 13th Floor Godrej Coliseum C Wing Somaiyya Hospital Road Sion East Mumbai Maharashtra PIN 400022
https://
Go Digit General Insurance Ltd. Schedule/Receipt
Digit Two-Wheeler Liability Only Policy UIN No.: IRDAN158P0003V01201718

MA

Note: The terms and conditions detailed in this policy schedule as well as the policy document sent by Digit shall prevail in case of any dispute.

For & On Behalf of Go Digit General Insurance Ltd.

In case of claim or any other query, please

contact our 24-hour C all C entre at 1800-
258-5956 or email us at hello@godigit.com Praveen Bhat
Vice President – Customer Experience
or visit our website www.godigit.com. praveen.bhat@godigit.com
Authorized Signatory
Printed, Signed, and Executed at Bengaluru
Consolidated Stamp Duty is Deposited with
Department of Stamps, Bengaluru
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Go Digit General Insurance Ltd. Address: Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru, Karnataka 560095.IRDAI Reg
No. 158 CIN U66010PN2016PLC167410, GST Reg. No.: 27AACCO4128Q1Z0 HSN: 9971/General Insurance Services, GSTIN Address: Mumbai Business
Centre Units 1301 1302 13th Floor Godrej Coliseum C Wing Somaiyya Hospital Road Sion East Mumbai Maharashtra PIN 400022