Dat

e:21/
11/
2019
YourSmar
tDr
iveMot
orI
nsur
ancePol
i
cy
NameofPol
i
cyHol
der :
MRsSJey
am

Communi
cat
ionAddr
ess : SJey
am,
W/oRSi
vanandham

Si
vagur
ust
ores, ankadu3rdSt
Ser reet
,
Ti
ruppur641606
Pol
i
cyNo : S2572526

Pol
i
cyTy
pe : TwoWheel
er-
Compr
ehensi
ve
I
nsur
ancePol
icy
Tot
alPr
emi
um : 1928

Cont
actNo.
:8015128501 I
nter
medi
aryDet
ail
s: Pol
i
cySt
artDat
e : 21/
11/
201900:
00hrs
Emai
lID:
arul
pasupat
his@gmai
l
.com :
Name:
BHARTIAXADI
RECTA/
C-SM1N Pol
i
cyEndDat
e 20/
11/
2020Midni
ght

UnderHy
pot
hecat
ion/Hi
repur
chase/
Tel
ephoneno.
:080-49123900
Leasewi
th:
Owned-- Code:
11001243

YourVehi
cleDet
ail
s

Vehi
cleReg.
no.
:TN42R2919 YearofManuf
act
ure:
2017 Make/Model
:
HONDA/DREAM DX110 Fuel
Type:
P

I
nsur
edDecl
aredVal
ueoft
heVehi
cle Seat
ingCapaci
ty(
Incl
udi
ng Chassi
s/Engi
neNo:
05109/98137 Cubi
cCapaci
ty:
110

(
IDV):
75842 Dr
iver
):2

YourPr
emi
um Det
ail
s(i
nRs)
OWNDAMAGE(
A) THI
RDPARTY(
B)

Basi
cPr
emi
um f
orv
ehi
cle 1359 Basi
cThi
rdPar
tyPr
emi
um 554

Accessor
iesSum I
nsur
ed(
IMT24)(
0) 0 TPPD 0

CNG/
LPG(
IMT25)Sum I
nsur
ed(
0) 0 PAt
oOwnerDr
iver 50

Basi
cOwnDamagePr
emi
um 1,
359 UnnamedPACov
ert
oPassenger
s(I
MT16)Sum I
nsur
ed(
0) 0

Vol
unt
aryDeduct
ibl
e 0 Legal
Liabi
l
ityt
oPai
dDr
iver(
IMT28) 0

NoCl
aim Bonus(
20%) -
271 Bi
-Fuel
Kit 0

Load/
Discount 0

Handi
cap 0

AAIDi
scount 0

Ant
iThef
t 0

Addi
ti
onal
Cov
ers:

Depr
eci
ati
onCov
er

Hospi
tal
CashCov
er
 Roadsi
deAssi
stanceCov
er

Ambul
anceCov
er

Medi
cal
Cov
er

I
nvoi
cePr
iceCov
er(
Rs.)

KeyRepl
acementCov
er

NoCl
aim BonusSameSl
ab

Hy
drost
ati
cLockCov
er

Consumabl
esCov
er

Tot
alOwnDamagePr
emi
um (
Rs.
)(A) 1,
088 Tot
alThi
rdPar
tyPr
emi
um (
Rs.
)(B) 604

NetPr
emi
um (
A+B) 1692

Ser
viceTax 236

TOTALPREMI
UM OFYOURVEHI
CLE(
Rs.
) 1928

YOURNOMI
NEEDETAI
LS

Nomi
neeName:
JEYAM Nominee I
nsur
er’sr
elat
ionshi
pwi
th Appoint
eeName:
Arul Insur
er’
srel
ati
onshi
pwi
th
Age:50 Nominee:
Mot her Pasupathi appoint
ee:

I
ncaseofacl
aim,
youmayr
eachusat080-49123900oremai
lusatcl
aims@bhar
ti
-axagi
.co.
in.
Pl
easei
nti
mat
eusi
fyouwi
sht
ochangeanyoft
heabov
einf
ormat
ionori
fincor
rect
.
Wet
hanky
ouf
ort
hepat
ronageandconf
idencey
ouhav
epl
acedi
nus.Wel
ookf
orwar
dtoser
vey
ouagai
n.

BestRegar
ds,

G.Raj
agopal
Head–Operati
ons&Cl
aims
Limitationsast ouse: ThePol i
cycov er
suseoft hev ehi
cleforanypur poseotherthan:(a)Hir
eorRewar d(b)Car r
iageofgoods( otherthansamplesofper sonalluggage)(
c)
Organi zedRaci ng( d)PaceMaki ng(e)SpeedTest ing( f
)Reliabi
lit
yTrial(g)Anypurposeinconnect i
onwithMot orTrade.Driv
er'
sCl ause:Per
sonsorCl assesofper son
entit
ledt odrive:Anyper sonincludi
ngt heinsured,providedthataper sondrivi
ngholdsanef fecti
vedri
vi
ngl i
censeatt heti
meoft heaccidentandisnotdi squali
fi
edf r
om
holdingor
obtainingsuchal icense.Prov i
dedalsot hattheper sonholdinganef fect
iveLearner'
sLicensemayal sodri
v ethevehicleandthatsuchaper sonsatisf
iestherequirements
ofRul e
3oft heCent ral Mot orVehiclesRules,1989.Limi t
sofLi abi
li
ty:UnderSect i
onII-1(i
)ofthepolicy(Deat
hoforbodi lyi
njury)
:Suchamountasi snecessarytomeett he
requirement soft heMot orVehiclesAct,1988.UnderSect i
onI I
-1(i
i)ofthepolicy(Damaget oThirdPart
yPr opert
y)Rs.7.5lakhs.UnderSectionII
I:P.Acov ert
oownerdr iver
(CSI):Rs.2,00,000.PAcov ertounnamedpassengerRs.0.Deduct i
bleunderSect i
on-I
:Compul sor
yDeductibleIMT22: Rs.0.VoluntaryDeducti
bleIMT22( A):Rs.0Subject
toIndianMot orTar iffEndorsement( nos.)

UnderHP/HYP/Lease( I
MT5,6,
7)wit
h:
I
/Weherebycerti
fyt
hatthePol
icytowhi
chthi
sCerti
fi
cat
erel
atesaswell
ast hi
sCert
ifi
cateofI
nsurancearei
ssuedi
naccor
dancewi
tht
hepr
ovi
sionsofChapt
erXandXI
ofMotorVehi
clesAct,
1988.I
nwi t
nessoft
hisPol
i
cyhasbeensignedat___
__ _
___
___
_____on____
_______
____
__
Tr
ansact
ionno.:
DHMP3937161695 Ser
viceTaxRegi
str
ati
onno.
:AADCB2008DST001 ForBhar
tiAXAGener
alI
nsur
anceCo.Lt
d.

St
ampdut
ypai
dtot
heaccountofTheDi
str
ictRegi
str
arofSt
amps(
AccHead0030-
02-
103-
0-01)
,Bangal
oreKar
nat
aka.

I
mpor tantNotice:Thei nsuredisnotindemni fi
edifthev ehicleisusedordr i
venot herwisethaninaccordancewiththisschedul e.Anypayment
madebyt hecompanybyr easonofwi dertermsappear ingi nthecerti
fi
cateinor dertocompl ywiththeMotorVehicle'sAct,1988i sr
ecover
able
from theinsured.Seet heclauseheaded" AVOI DANCEOFCERTAI NTERMSANDRI GHTOFRECOVERY" .
TheSchedul e,t
heat tachedPoli
cyand
Endorsement sment ionedher einaboveshal l
readtogetherandwor dorexpressiont owhichaspeci f
icmeaninghasbeenat tachedinanypart
ofthisPolicyoroftheSchedul eshall
beart hesamemeani ngwher everitmayappear .Anyamendment s/modifi
cati
ons/ al
terati
onsmadeon
thissystem generatedpol i
cydocumenti snotv ali
dandCompanyshal lnotbeliableforanyliabi
l
itywhatsoeverari
singfrom suchchanges.Any
changesr equiredtobemadei nthepoli
cyoncei ssued, woul dbev al
idandeffective,onlyaft
erwritt
enrequestismadet othecompanyand
Companyaccept sther equestedamendment s/modi f
ications/alt
erati
onsandr ecor dsthesamet hroughseparateendorsementt obei
ssuedby
theCompany .
Insurancei sthesubjectmatterofsolici
tation.