THE NEW INDIA ASSURANCE CO. LTD.

(Government of India Undertaking)

The New India Assurance Co.Ltd.

MALAKPET DO (612800)
Tel. No.: 04024557149/04024550409/
Email: nia.612800@newindia.co.in/

Private Car Package Policy

IRDAN190RP0042V01100001
Policy Number: 61280031210100000828
Vehicle: MARUTI/DZIRE

Period of Cover
From: 14/06/2021 12:12:18 PM
To: 13/06/2022 11:59:59 PM

Insured Details
JAIPAL REDDY B
To: B BAL REDDY,H NO 6-8/80,BACHUPALLY,QUTHBULLAPUR MANDAL,HYDERABAD,Rangareddi
,TELANGANA, 500072

For Insurance Renewals contact

CH. USHA RANI
Tel. No.: / /
Email: /

For Claims contact our OFFICE

HYDERABAD CLAIMS HUB

Tel. No.: 04027155114
Email: ch61@newindia.co.in

Tax Invoice No : 61280021E0003161

IRDA Registration Number: 190

Signature Not
Verified
Digitally signed
by Srinivasan
Vaideswaran
Date: 2021.06.14
12:28:03 IST
Policy No. : 61280031210100000828Document generated by 22090 at 14/06/2021 12:27:58 Hours.
Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.

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 THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

[B]
POLICY SCHEDULE CUM CERTIFICATE OF INSURANCE
Private Car Package Policy

UIN Number - IRDAN190RP0042V01100001

Policy Number :61280031210100000828

POLICY ISSUING OFFICE: BUSINESS CHANNEL/CPSC User: CLAIM CONTACT:
MALAKPET DO (612800), NAME:Mr. V KUMAR - (DE00003209) CLAIMS HUB (610001)
FLAT NO. 101, 1ST FLOOR, TIRUMALA Ms. Ch. Usha Rani - (NIAC3895346), HYDERABAD CLAIMS HUB,,;04027155114//
TOWERS, JUDGES COLONY, MALAKPET, PHONE NUMBER: / / PHONE NUMBER: 04027155114 /
HYDERABAD - 500036 , I ST FLOOR, LAND/FAX NUMBER:/ MOBILE NUMBER:
TIRUMALA TOWERS , JUDGES COLONY, EMAIL: / Email: ch61@newindia.co.in
MALAKPET ,
TELANGANA , 500036.
PHONE NUMBER:04024557149 /
04024550409
FAX NUMBER:04024554484 / NA
Email:nia.612800@newindia.co.in

INSURED DETAILS
Insured Name JAIPAL REDDY B Customer ID PO79293385 (PAN No :NA)
Insured Address B BAL REDDY,H NO 6- Contact Number / / 9866143115
8/80,BACHUPALLY,QUTHBULLAPUR
MANDAL,HYDERABAD,
Rangareddi ,TELANGANA, 500072
Email
GSTIN NA

POLICY DETAILS
Period of cover 14/06/2021 12:12:18 PM to 13/06/2022 11:59:59 PM Receipt Number 61280081210000001191 -
14/06/21
Previous Insurer THE NEW INDIA ASSURANCE COMPANY LTD. Previous Policy Number 61280031200100000189

VEHICLE DETAILS
Registration Number AP-28-BM-5999 Chassis no./Engine Number 254723/1393708
Make / Model MARUTI/DZIRE Variant: VDI
Year of manufacture 2012 Type of body / Type of Fuel Saloon/Diesel
Colour PEARL MET ARCTIC Cubic capacity(cc) 1248cc
/Wattage(kW):
Seating capacity including 5 Name of registration Rangareddy
Driver authority
Geographical Area / Zone India Name of the Financier
Cover Note No/Cover Note / Automobile Association none
Issue Date: membership
INSURED DECLARED VALUE (in Rs)
Vehicle Trailer Non-Elec Acc Electrical Acc Bi-fuel kit Total Value
214233 0 0 0 0 214233

SCHEDULE OF PREMIUM
Own Damage Liability
Basic OD Premium 2534 Basic TP Premium 3221
(-)(#)Calculated Discount for Anti-Theft Devices 63.35 (+)Legal Liability Premium for Other Employees(1) 50
(-)(#)Total NCB Discount(25%) 605.2
(+)Additional Loading on OD Premium -50
Calculated OD Premium 1816 Calculated TP Premium 3271
Total OD Premium 1816 Total TP Premium 3271
Net Premium in Rs 5087

Policy No. : 61280031210100000828Document generated by 22090 at 2021/06/14 12:28:02.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own grievance redressal mechanism; you may also
approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website http://newindia.co.in.
Página 1 de 3

Page 2 of 6
 THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

GST in Rs 916
Total Payable in Rs 6003
Total Payable in Rs(in words): RUPEES SIX THOUSAND THREE ONLY
GSTIN(Issuing Office) 36AAACN4165C3ZQ
SAC 997134 (Motor vehicle insurance services)
Limitation 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
Limits of Liability:Limit of the amount the Company's Liability Under Section II 1(i) in respect of any one accident: as per the Motor Vehicles
Act, 1988. Limit of the amount of the Company's Liability Under Section II 1(ii) in respect of any one claim or series of claims arising out of one
event: Up to Rs. 7,50,000
For individual covers (OD) in RS:214233 Compulsory excess in Rs:1000
Imposed excess in Rs:0 Voluntary excess in Rs:0
Persons or classes of persons entitled to drive:Any person including the 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 requirement of Rule 3 of the Central Motor Vehicles
Rules, 1989.
PA cover for Owner Driver
Name of Nominee Age of Nominee Relationship with the Name of the Appointee (if Relationship to the
Insured Nominee is a minor) Nominee
none 0 none none none
PA cover for named persons
Name CSI Opted(Rs.) Nominee Relationship
none 0 NA NA
Premium and GST Details
Rate of Tax Amount in INR
Premium Rs 5087.00
SGST 9 458
CGST 9 458
IGST 0 0

In witness where of this policy has been signed at MALAKPET DO on this 14/06/2021WARRANTED THAT IN CASE OF DISHONOUR OF THE
PREMIUM CHEQUE, THIS DOCUMENT STANDS AUTOMATICALLY CANCELLED ABINITIO This policy is subject to the Terms, conditions and
exceptions applicable to Package/Liability policy attached/available on the web site http://newindia.co.in; IMT Endorsement Number(s)
printed herewith attached 10,22.
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 of wider terms appearing in the certificate in order to comply with the Motor Vehicles Act, 1988 is recoverable from the
insured: see clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY". It is clarified that in case the declaration regarding
the ncb or other previous policy details made by the insured, is found to be incorrect, all the benefits (including claim) under section-1 of this
policy, will stand forfeited.
I/We hereby certify that the policy to which this Certificate relates For and on behalf of The New India Assurance Company Limited
as well as this Certificate of Insurance are issued in accordance
with the provisions of Chapter X and XI of M.V. Act, 1988.
Date of Issue: 14/06/2021
Duly Constituted Attorney(s)

Tax Invoice No : 61280021E0003161

IRDA Registration Number: 190

Policy No. : 61280031210100000828Document generated by 22090 at 2021/06/14 12:28:02.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own grievance redressal mechanism; you may also
approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website http://newindia.co.in.
Página 2 de 3

Page 3 of 6
 THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

Policy No. : 61280031210100000828Document generated by 22090 at 2021/06/14 12:28:02.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own grievance redressal mechanism; you may also
approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website http://newindia.co.in.
Página 3 de 3

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THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

COLLECTION RECEIPT CUM ADJUSTMENT VOUCHER

Issuing Office : MALAKPET DO (612800)
Address : FLAT NO. 101, 1ST FLOOR, TIRUMALA TOWERS, JUDGES COLONY, MALAKPET, HYDERABAD - 500036
I ST FLOOR, TIRUMALA TOWERS
JUDGES COLONY, MALAKPET,500036
Hyderabad
Phone : 04024557149
Email : nia.612800@newindia.co.in
Fax : 04024554484
Collection Number : 61280081210000001191
Collection Date : 14/06/2021
Business Source Code : DE00003209
PAN No of Payer :

Received with thanks from JAIPAL REDDY B.

The amount received/Adjusted is towards -

Policy No. A/C Description Amount` A/C Code Sub A/C Code
61280031210100000828 Bank-612800 6003.00 9100.612800 BA00004720-612800-9100
Total = ` 6003.00

Your Payment/Adjustment Details are as under -

Mode Amount ` Cheque Cheque Date Drawee Bank Drawee Branch Reference No. Scroll/BG/A
No. PD Balance
RTGS 6003.00 1165127 14-JUN-21 HDFC BANK lakdikapul 6128002110014251 N.A.
203
66
Total = ` 6003.00

Utilization details of the Collected Amount :

Premium GST Stamp Duty Excess Amount
5087.00 916.00 0.00 0
Sl no. Agency Code Agency Name Department Code
1 NIAC3895346 CH. USHA RANI 31

For The New India Assurance Company Limited

Revenue Stamp
__________
| |
| |
| |
| |
|__________|
Date of Issue: 14/06/2021

Cashier's Initial Authorized Signatory

Note -
1.Please note the Policy Number, Collection Number and date in all future correspondence. .
2.NIA shall not be liable for any claim arising out of sales made during the period between the due date and date of payment of the
installment if the premium paid has been exhausted by turnover declarations/if there is insufficient premium balance.

Tax Invoice No : 61280021E0003161

IRDA Registration Number: 190

Policy No. : 61280031210100000828Document generated by 22090 at 14/06/2021 12:27:58 Hours.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.

Page 5 of 6
THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

IMT.10. INSTALLATION OF ANTI-THEFT DEVICE

(Not applicable to Motor Trade Policies)

In consideration of certification by ............ that an Anti-Theft device approved by Automobile Research Association of India
(ARAI), Pune has been installed in the vehicle insured herein a premium discount of ` 63.354054 is hereby allowed to the
insured.

It is hereby understood and agreed that the insured shall ensure at all times that this Anti- theft device installed in the vehicle
insured is maintained in efficient condition till the expiry of this policy.

Subject otherwise to the terms, exceptions, conditions and limitations of the policy

IMT.22. COMPULSORY DEDUCTIBLE

(Applicable to Private Cars, three wheelers rated as private cars, all motorized two wheelers, taxis, private car type vehicle
plying for public/private hire, private type taxi let out on private hire)

Notwithstanding anything to the contrary contained in the policy it is hereby understood and agreed that the insured shall
bear under Section 1 of the policy in respect of each and every event (including event giving rise to a total loss/constructive
total loss) the first ` 1000 (or any less expenditure which may be incurred) of any expenditure for which provision has been
made under this policy and/or of any expenditure by the insurer in the exercise of his discretion under Condition no 3 of this
policy.

If the expenditure incurred by the insurer shall include any amount for which the insured is responsible hereunder such
amount shall be repaid by the insured to the insurer forthwith.

For the purpose of this Endorsement the expression "event" shall mean an event or series of events arising out of one cause
in connection with the vehicle insured in respect of which indemnity is provided under this policy.

Subject otherwise to the terms conditions limitations and exceptions of this Policy.

IMT. 29. LEGAL LIABILITY TO EMPLOYEES OF THE INSURED OTHER THAN PAID DRIVER AND/OR CONDUCTOR AND/OR
CLEANER WHO MAY BE TRAVELLING OR DRIVING IN THE EMPLOYER'S CAR {Private Cars only/ Motorised two wheelers (not for
hire or reward)}

In consideration of the payment of an additional premium `50/- per employee insured notwithstanding anything to the
contrary contained in the policy it is hereby understood and agreed that the insurer will indemnify the insured against the
insured's liability at Common Law and Statutory Liability under the Fatal Accidents Act, 1855 for compensation (including
legal costs of any claimant) for death of or bodily injury to any employee (other than paid drivers) of the within named insured
being carried in or upon or entering in or getting on to or alighting from or driving the vehicle insured.

Provided that in the event of an accident whilst the vehicle insured is carrying more than 1 employees of the insured
(including the driver) the insured shall repay to the insurer a rateable proportion of the total amount payable by the insurer by
the reason of this endorsement in respect of accident in connection with such vehicle insured.

Subject otherwise to the terms, conditions limitations and exceptions of this Policy.

Tax Invoice No : 61280021E0003161

IRDA Registration Number: 190

Policy No. : 61280031210100000828Document generated by 22090 at 14/06/2021 12:27:58 Hours.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.

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