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HDFC ERGO General Insurance Company Limited 2312100008984400000

Certificate of Insurance cum Policy Schedule

Policy No. 2312 1000 0898 4400 000

Two Wheeler Package Policy

0 1 A , T I P

Insured Name
Correspondence
Address
Facebook
Mr K SandeepKumar Reddy
SandeepKumar Reddy, H No 2-64/A, Chalakurthy (post),
Peddavoora Mandal, Nalgonda Dist
Twitter RTO
Registration
Address
NALGONDA
SandeepKumar Reddy, Chalakurthy,
Peddavoora, Nalgonda Dist
ANDHRA PRADESH 508202 ANDHRA PRADESH 508202
Mobile 8886812269 Phone - E Mail sandeepkumar.reddy@gmail.com Registration No. AP-24-AJ-1922

%
Period of Insurance From Date & Time 30/01/2014 00:01 hrs To Date & Time 29/01/2015 Midnight Policy Issuance Date 29/01/2014
Seats(Incl.
Make Model - Variant Engine No Chassis No Mfg Yr Body Type CC
of side car)
BAJAJ. PULSAR 180DTSI-SELF START ALLOY JGB1F5986 MD2DHDJZZT0619898 2009 2 OPEN 180

Insured's Declared Vehicle (`) Side Car (`) Non Electrical Acc. (`) Electrical Acc. (`) CNG/LPG Kit (`) Total IDV (`)

Email
Value (IDV) 50,896 0 0 0 0 50,896

Named Persons & Nominee(IMT-15)

Nominee (Owner Driver) Anji Reddy , Father Appointee

Premium Details (`)

Own Damage Premium (a) Liability Premium (b)

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Basic Own Damage: 597 Basic Third Party Liability: 422

PA Cover for Owner Driver of ` 100000 50

Total Basic Premium 597
PA Cover for un-named persons of ` 100000 each(for 2 Person) (IMT-16) 140

Sub Total – Addition 612

Less: No Claim Bonus (20%) 119 Net Liability Premium (b) 612

Total Package Premium (a+b) 1090

Service Tax (Including Education Cess & Higher Education Cess, wherever applicable) 135
Net Own Damage Premium (a) 478 Total Premium 1,225
The total Premium amount is inclusive of NCB 20%

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Geographical Area India Compulsory Deductible (IMT-22) ` 100 Voluntary Deductible (IMT-22A) ` 0

Payment Details: Fund Transfer No. TW1401001061 Dated : 29/01/2014 drawn on HDFC BANK
Previous Policy No. 3005/77222943/00/000 Valid from 30/01/2013 to 29/01/2014 of ICICI LOMBARD GENERAL INSURANCE CO. LTD. No Claim Bonus 0%
Policy Holder declare that no claim has been made in the previous year policy. If declaration found incorrect, benefits under the present policy in respect of own damage section will stand forfeited.

List of Endorsements

Endt No Description Effective Date End Date Premium (In ` )

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. Persons or Class 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 when not used
for the transport of passengers at the time of the accident and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989. 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. 2. Under Section II - 1(ii) of the policy -Damage to Third Party Property- ` 100000 3.P.A.
Cover under Section III for Owner - Driver(CSI): ` 100000 Terms, Conditions & Exclusions: As per the Indian Motor Tariff. A personal copy of the same is available free of cost on request & the same is also
available at our website.

I / We hereby certify that the policy to which the certificate relates as well as the certificate of insurance are issued in accordance with the provision of chapter X, XI of M. V.Act 1988. "The stamp duty of ` 0.50
paid by Demand Draft, vide Receipt/Challan no 30347 dated 10/12/2012 as prescribed in Government Notification Revenue and Forest Department No Mudrank 2004/4125/CR 690/M-1, dated 31/12/2004." Service
Tax Registration No.: AABCH0738EST004. 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 Vehicle Act, 1988 is recoverable from the Insured. See the clause headed "AVOIDANCE OF CERTAIN TERMS AND
RIGHT OF RECOVERY." Disclaimer: The Policy shall be void from inception if the premium cheque is not realized. In the event of misrepresentation, fraud or non-disclosure of material fact, the Company reserves
the right to cancel the Policy from inception.

Policy Issuing Office: Mumbai

For HDFC ERGO General Insurance Company Ltd.

Duly Constituted Attorney

Corporate Off.: 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri(E), Mumbai 400 05 9 . Toll-free No.1800 2 700 700 | Fax 91 22 6638 3699 | care@hdfcergo.com | www.hdfcergo.com
Registered Off.: Ramon House, H.T.Parekh Marg, 169, Backbay Reclamation, Mumbai 400 020, India.

R.chores

ERES
GENERALINSURANCE

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Frequently Asked Questions (FAQs) - MOTOR INSURANCE

WHAT ARE THE MAJOR COVERS OF THE POLICY?
Loss or Damage to the Insured Vehicle caused due to: Liability to Third Parties: Personal Accident Cover:
a) Fire, explosion, self ignition or lightning. Provides cover for any legal liability arising out of the The policy provides for mandatory Personal Accident cover for
b) Burglary, housebreaking or theft use of the vehicle for: owner driver and optional cover for passengers covering
c) All act of God perils like earthquake, flood, cyclone etc a) Accidental death / injury to any third party accidental death and permanent total disability.
d) Accidental external means, terrorism, riot and strike b) Any damage to property owned by third party
WHAT ARE THE MAJOR EXCLUSIONS IN THE POLICY?
a) General aging, wear & tear, mechanical or electrical breakdown, failure, depreciation, g) Loss or damage to bonnet side parts, mudguard, bumpers, lamps, tyres, tubes
any consequential loss headlights, paint work (applicable for all commercial vehicles; unless opted additionally)
b) Damage by a person driving without a valid license h) Loss or damage resulting from overturning arising out of operation as a tool
c) Damage by a person driving under the influence of liquor or drugs (applicable for mobile cranes, drilling rigs, mobile plants, navvies, shovels, grabs,
d) Loss/damage attributable to war, mutiny, nuclear risks rippers unless opted for additionally)
e) Damage to tyres and tubes, unless damaged during an accident i) Loss of or damage to accessories by burglary housebreaking or theft unless the
f) Usage on hire & reward (applicable for all classes expect public commercial vehicles) vehicle is stolen at the same time (applicable to all commercial vehicles & two wheelers)
WHAT DO I DO IN CASE OF A CLAIM?
1. DETAILS TO KEEP HANDY WHILE REGISTERING A CLAIM 3. CLAIMS DOCUMENTS - IN CASE OF ACCIDENTAL DAMAGE TO INSURED
WHAT ARE THE MAJOR COVERS OF THE POLICY?
a) Policy No. VEHICLE
Loss or Damage
b) Regist ration deta to ilsthe/ RC
Insured
copy Vehicle caused due to: Liability to Third Parties: Personal Accident
a) Duly filled and signed claim form & satisfa ctionCover:
voucher
a)
c) Fire, explosion
Drivers details,atself theignition
time oforaccident
lightning. including driving license Provides
number cover for any legal liability b) arising
RegistratioutonofCert
the ificate (RC) The policy provides for mandatory Personal Accident cover for
b) Burgla ry, houseb reaki
d) FIR on a case to case basis ng or theft use of the vehicle for: owner driver
c) Driving license of the person driving atand optional
the time cover
of the forent
accid passengers covering
c)
e) All
Rep act
airofestGod
imaperils
te like earthquake Frequently
, flood, cyclone etc Asked a) Accide Questions
ntal death / injury to(FAQs)
anyd)third party
Policy
- MOTORr estimate
copy , original repaiaccidental
INSURANCE death
, repairand
invopermanent
ice total disability.

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d) Accidental external means, terrorism, riot and strike b) Any damage to property owned e) by third party
Paymen t receipt for non-cashless claims
2. HOW DO I FILE A CLAIM? WHAT ARE THE MAJOR EXCLUSIONS f) Original IN repairTHE invoic e for cashless claims
POLICY?
For Accidental Damage to Insured Vehicle (Own Damage Claims):
a) General aging, wear & tear, mechanical or electrical breakdown, failure, depreciation, g)g) Loss
AMLordocuments
damage tofor amount
bonnet sidemore than
parts, 1 lac (PAN
mudguard, card, 2 passport
bumpers, size tub
lamps, tyres, photo
es ,
a) Call our customer
any consequential loss care Toll-free 1800-2-700-700 if the vehicle meets with an accident residence proof).
headlights, paint work (applicable for all commercial vehicles; unless opted additionally)
b) Provide
Damageyour by apolicy
person number
drivingfor reference
witho ut a validandlicen
register
se the claim h)h) Loss
Formor35 & original
damage NOC from
resulting from financer
overturning incase of total
arising loss
out of where payment
operation as a toolis made
c) IfDamage
your vehicle
by a pe canrson be driving
driven, under
take it the
to the nearestofdealer
influence liquor /orgarage
drugs to insured.for mobile cranes, drilling rigs, mobile plants, navvies, shovels, grabs,
(applicable

Upload your documents to download.

d) Get a repair estimate,fill
Loss/damage attributableuptothe war, claim formnuclear
mutiny, and attach
risksa copy of the registration i) rippers
A copyunless
of policeopted FIR/ panch
for nama is required for TP injury/death/property damage
additionally)
e) Certificate
Damage todriving tyres andlicense ofthe
tubes, person
unless driving at
damaged thetimeof
during the accident
an acciden t i)Additional
Loss of ordocuments
damage to access required ories
forby burglary housebr
commercial eaking or theft unless the
vehicles:
e)
f) IfUsage
the garage
on hireis &within
reward our(applicable
network, you for could avail expect
all classes of cashless
publicclaim facility. Pay
commercial for non
vehicles) vehicle is stolen at the same time (applicable to all commercial vehicles & two wheelers)
a) Spot survey
accident related repairs, depreciation and deductible. We would settle WHATthe rest.
DO I DO IN CASE OF A CLAIM?
b) Load challan
f) If the garage is outside our network, you would have to get the claim reimbursed
1. DETAILS TO KEEP HANDY WHILE REGISTERING A CLAIM c)
3. Fitn ess certi
CLAIMS DOfica te
CUMENTS - IN CASE OF ACCIDENTAL DAMAGE TO INSURED
subsequently.
a) Policy No. d) Ro ute permit
VEHICLE
g) Sign the repairer’s satisfaction voucher and drive off!
b) Registration details / RC copy a) Duly filled and signed claim form & satisfaction voucher
c) Drivers details at the time of accident including driving license number b) Registration Certificate (RC)

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4. CLAIMS DOCUMENTS: IN CASE OF LOSS DUE TO THEFT
d) FIR on a case to case basis g)
c) Original NOC from
Driving license financer
of the personincase
drivingofathypothecation
the time of the/ HPA
accident
a)
e) Duly filled andtesigned claim form & discharge voucher ( after loss settlement ) h)
Repair estima d) Intima
Policytioncoptoy ,RTO
original for repai
theft of vehicle , repair invoice
r estimate
b) Original Registration Certificate (RC) i)
e) Payment receipt for non-cashless claims26, 28,29,30,35)
Duly sign ed RTO trans fer pape rs (Form
c) Ori gin al pol icy
2. HOW DO I FILE A CLAIM? co py j)f) RC extract withinvoic
stolene remark from theims
concerned RTO after the loss
Origi nal repair for cashle ss cla
d)
ForCopy of FIRDamage
lodged attothe neareVehicle
st police station k) AML
Accidental Insured (Own Damage Claims): g) AML documents
documents for for amoun
amountt moremore than
than 11laclac (PAN
(PAN card,
card, 22passport
passport size
size pho to,,
photo
e) All original keys & vehicle invoice copy residence proof).
a) Call our customer care Toll-free 1800-2-700-700 residence proof).
f) No trace report con firmin g that the stolen vehicle isifnot thetracea
vehicle blemeets with an accident l) Deed of sub rogationNOC cumfromindemnity onincase
judicialofstamp papewhere
r.
b) Provide your policy number for reference and register the claim h) Form 35 & original financer total loss payment is made
HOW DO I MAKE CHANGES IN MY POLICY to insured. (ENDORSEMENTS)?
c) If your vehicle can be driven, take it to the nearest dealer / garage

OR
1. Changes related to registration of vehicle or vehicle
d) Get a repair estimate,fill up the claim form and attach a copy of the registrationdetails like: 2. For addition of e lectrical and non electrical accessories/CNG
i) A copy of police FIR/panchnama is required for TP injury/death/property damage & LPG Kit:
Certificate driving license ofthe person driving at thetimeof the accident a) Requestdocuments
Additional letter for therequired
change for commercial vehicles:
a) Correction in registration number/ location / address
e) If the garage is within our network, you could avail of cashless claim facility. Pay for non b) Policy copy
Correction in vehicle make & model / cubic capacity / seating capacity/ engine & chassis a) Spot survey
b) accident related repairs, depreciation and deductible. We would settle the rest. c) Invoice copy (mandatory where value of accessory exceeds ` 20,000/-)
number / year of manufacture b) Load challan
f) If the garage is outside our network, you would have to get the claim reimbursed d) Endorsed Registration Certificate Copy (For CNG/LPG kit)
c) Fitness certificate
subsequently. e) Cheque for additional premium

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Documents Required:
’
d) Route permit
g)
a) Sign the repa
Request irerfors satisfaction
letter the change b) voucher
Policy andcopydrive off!
c) Registration Certificate copy Call us for additional premium details & send relevant documents copy to our corporate
office
4. CLAIMS DOCUMENTS: IN CASE OF LOSS DUE TO THEFT
3. Documents required to change financier details g)4. Original
Changes NOC from financer
/ Correction incaseHolder's
in Policy of hypothecation / HPA
Name / Correspondence Address /

full documents.
a) Duly filled and signed claim form & discharge voucher ( after loss settlement ) h) Intima tionNumbers
to RTO for/ E-mail
theft of idvehicl e other changes:
(Hypothecation/Lease/Hire-Purchase) Contact / any
b) Original Registration Certificate (RC) i) Duly signed RTO transfer papers (Form 26, 28,29,30,35)
a) Request letter for the change E mail us at : care@hdfcergo.com OR
c) Original policy copy j) RC extract with stolen remark from the concerned RTO after the loss
b) Policy copy Call Toll-free: 1800 2 700 700 / 1800 226 226 OR
d) Copy of FIR lodged at the nearest police station k) AML documents for amount more than 1 lac (PAN card, 2 passport size photo,
c) Endorsed Registration Certificate copy Fax your request at: 022 6638 3669
e) All original keys & vehicle invoice copy residence proof).
d) NOC from financier (not mandatory for deletion if RC is endorsed)

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f) No trace report confirming that the stolen vehicle is not traceable l) Deed of subrogation cum indemnity on judicial stamp paper.
HOW DO I RENEW MYHOW POLICY?
DO I MAKE CHANGES IN MY POLICY (ENDORSEMENTS)? HOW DO I RENEW MY POLICY?
1.a) Visit
Changes related to registration
www.hdfcergo.com to renewofinstantly
vehicleonline.
or vehicle details like: 2. For
Call addition :of electrical
Toll-free 1800 2 700and700
non electrical
/ 1800 accessories/CNG & LPG Kit:
226 226
b) SMS"RENEW <POLICY NO> " to 9999 700700 FaxRequest letter: for the
a) 022ch6638
ange3669
a) Visit
c) Correction inest
our near regibr
strat
anchion/ number
your age/ location
nt / address E-Mail : care@hdfcergo.com
b) Policy copy
Correction
d) Send a copyin of
vehicle make &nomodel
the renewal / cubic
tice along capacity
with premium/ seating
chequecapacity/ engineoffice
to our branch & chassis
/ Write to uscopy
at (mandatory
: HDFC where ERGOvalue
General Insurance Company` 20,000/-)
Limited
b) c) Invoice of accessory exceeds
number / year
Corporate officeof manufacture 6th floor, Leela Copy
Business
d) Endorsed Registration Certificate (ForPark,
CNG/LAndheri
PG kit)Kurla Road,
e) Call our toll free number 1800 2 700 700 / 1800 226 226. Andheri(East),
e) Cheque for additional premium Mumbai - 400 059
Documents Required:
a) Request letter for the change b) Policy copy c) Registration Certificate copy Call us for additional premium details & send relevant documents copy to our corporate
Manage Your Portfolio Vi e w y o u r p o l i c y d e ta i l s office Track your claims online whenever the need arises
@ hdfcergo.com / financier det Link multiple policies of yourself and your loved ones Raise service request / complaints & set renewal reminders
3. Documen ts required to change ails 4. Changes / Correction in Policy Holder's Name / Correspondence Address /
Change your personal details on the go Information about branches, garages and hospitals
Smartphones*
(Hypothecation/Lease/Hire-Purchase) Contact Numbers / E-mail id / any other changes:
a) Request letter for the change * supports smart phones based on Blackberry, E mailiPhone,
us at : care@hdfcergo.com OR
Android & Symbian platforms
b) Policy copy
This document is a summary of the benefits offered. The information mentioned above is illustrative Call Toll-free:
and not 1800Information
exhaustive. 2 700 700must
/ 1800 226in226
be read OR
conjunction with the policy wordings.
c) Endorsed Registration Certificate cop y Fax your request at: 022 6638 3669
In case of any conflict between this document and the policy wordings, the terms and conditions mentioned in the policy wordings shall prevail.
d) NOC from financier (not mandatory for deletion if RC is endorsed)

HOW DO I RENEW MY POLICY? HOW DO I RENEW MY POLICY?

a) Visitwww.hdfcergo.com to renew instantly online. Call Toll-free : 1800 2 700 700 / 1800 226 226
b) SMS"RENEW <POLICY NO> " to 9999 700700 Fax : 022 6638 3669
c) Visit our nearest branch / your agent E-Mail : care@hdfcergo.com
d) Send a copy of the renewal notice along with premium cheque to our branch office / Write to us at : HDFC ERGO General Insurance Company Limited
Corporate office 6th floor, Leela Business Park, Andheri Kurla Road,
e) Call our toll free number 1800 2 700 700 / 1800 226 226. Andheri(East), Mumbai - 400 059

Vi e w y o u r p o l i c y d e ta i l s Track your claims online whenever the need arises

Link multiple policies of yourself and your loved ones Raise service request / complaints & set renewal reminders

Share this document

Change your personal details on the go Information about branches, garages and hospitals

This document is a summary of the benefits offered. The information

* supports mentionedbased
smart phones above is
onillustrative and not
Blackberry, exhaustive.
iPhone, Information
Android must be platforms
& Symbian read in conjunction with the policy wordings.
In case of any conflict between this document and the policy wordings, the terms and conditions mentioned in the policy wordings shall prevail.
Manage Your Portfolio
@ hdfcergo.com /

" # $ % &
Smartphones*

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