MOTOR SECURE - COMMERCIAL VEHICLE (PASSENGER/GOODS)

COMPREHENSIVE POLICY
CERTIFICATE OF INSURANCE CUM POLICY SCHEDULE - Form 51 of the Central Motors Vehicles Rules, 1989
Policy Servicing Office : Off Code-24,Future Generali India Insurance Co Ltd, 2nd Floor, Baleshwar Square, Opp. ISCON Temple, S. G. Highway, Ahmedabad,
Gujarat, 380054.
Policy and Certificate Number : 20800030901/00/000000 Period of Insurance : From 00:00 hrs of 05/01/2022 To midnight of 04/01/2023.
Insured : Kaveri R Covernote No 8987878 :Dated: 02 Jan 2022 Zone: A
Address : 42/75, Main Road, Pulikuthi Po, Uthamapalayam Intermediary Name/Code : Girish Ramanathan / 60021761
TK, Theni, 625515. Email Id : irss.girish@gmail.com

INSURED MOTOR VEHICLE DETAILS AND PREMIUM COMPUTATION

Registration No., Make/Model of Vehicle Year of Engine No. Chassis No. Cubic Seating Type of Body
RTA Location Manufacture Capacity Capacity
TN57S6315 TATA MOTORS LTD / SFC 407 2010 497SPTC35NQZ6375 MAT35716698P 2956 13 Passenger
THENI TN60 32 36227 Carrying Van

INSURED'S DECLARED VALUE

For Vehicle-Rs. For Non-Electrical Accessories-Rs. For Trailers-Rs. For Electrical/Electronic Accessories-Rs. For Bi-Fuel Kit (CNG/LPG)-Rs. Total Value-Rs.
3,75,000 - - - - 3,75,000
SCHEDULE OF PREMIUM
A-OWN DAMAGE Rs. B-LIABILITY Rs.
Basic Premium on Vehicle 12,060.44 Basic Premium Including Premium for TPPD 18,340.00
**NCB 0.00 Add : Bi-Fuel Kit (CNG/LPG) 0.00
**Less : 0.00 Add : Compulsory PA to Owner-Driver - Rs. 2 lacs 100.00
Add : PA to persons other than Owner/Driver 250.00
No. of persons 5 P.A. Limit - Rs. 100000 per person
Add : Legal Liablity to Paid Driver/Cleaner/Employees 50.00
No. of persons 1
Total Liability Premium (B) 18,740.00
Total Own Damage Premium (A) (rounded off) 12,060.44 Total Premium for the Policy Period 30,800.44
Total Annual Premium (A+B) 12,060.44 Goods and Service Tax (Including Cess) 5,544.08
Total Premium (rounded off) 36,344.52
Subject to Endorsement Nos. 22 ,25 ,16 ,28 ,15 ,07 Hypothecation Agreement with:- Nil

LIMITATIONS AS TO USE – As per Motor Vehicle Rules, 1989 :- The Policy covers DRIVERS CLAUSE :- Any person including the insured: Provided that a person driving
use of the vehicle for any purpose other than: a) Organized racing, b) Pace making, c) holds an effective driving license at the time of the accident and is not disqualified from
Speed testing, d) Reliability Trials, e) Any purpose in connection with Motor Trade 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
requirements of Rule 3 of the Central Motor Vehicles Rules, 1989.
Limits of Liability
Under Section II-I (i) : Death of or bodily injury - Under Section II-I (ii) : Damage to Third Party Property-Rs. Under Section III : PA Owner – Compulsory
Such amount as is necessary to meet the requirements 750000/- in respect of any one claim or series of claims arising Driver as per premium computation Deductible Under
of Motor Vehicles Act, 1988 out of one event. table Sec I - Rs. 1,000.00
SPECIAL CONDITIONS – ADDITIONAL EXCESS –
The nominee for Compulsory PA to owner driver cover is 01) LEGAL HEIR, aged: 21 Years, Relationship: Legal Executor, Nomination %: 100%
IMPORTANT - 1. All other Terms, Conditions and Exclusions as per attached Policy Wordings. 2. In case of payment by cheque, in the event of dishonor of cheque for any reason
whatsoever, insurance cover provided under this document automatically stands cancelled from the inception irrespective of whether a seperate communication is sent or not.
**We have granted you No Claim Bonus, in good faith, based on your declaration. In case it is found later that the declaration is not correct, the Own Damage cover for your vehicle
under the Policy will stand cancelled ab initio. You shall not be entitled to any refund or claims under the policy. Kindly, therefore, revalidate your declaration and arrange to remit the
difference in premium, if the declaration is incorrect.
I/We hereby certify that the Policy to which this Certificate relates as well as this Certificate of Insurance are issued in accordance with the provisions of chapter X and chapter XI of
M.V. Act, 1988.
Receipt No : Z5022487 For NAVI GENERAL INSURANCE CO. LTD.
Date of Issue : 25/04/2015
Place of Issuance : Mumbai*
*Address as mentioned below.
This policy is not valid unless it is countersigned by an authorised signatory

For registration of your Motor claims SMS MOTORCLAIM to 9222211100 (Standard SMS charges applicable) (Authorised Signatory)
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”. For legal interpretation English verison will be good.
For full details on coverage, terms, conditions and exclusions, please refer the standard policy wordings attached with this schedule.
The stamp duty of Rs. 0.50 paid by GRAS DEFACE NO.0003288260201415, dated 2/01/2022.Mudrank 2004/4125/CR/690/M-1,dated 31/12/2004.

Corporate & Registered Office: 6th Floor, Tower - 3, Indiabulls Finance Center, Senapati Bapat Marg, Elphinstone Road, Mumbai-400013, Maharashtra
Email: care@naviinsurance.com, Website: www.naviinsurance.com
IRDA Regn. No 132, CIN - U66030MH2006PLC165287, Service Tax Registration Number: AABCF0191RSD002
 Annexure
Forming part of policy number:- 20800030901/00/000000
Motor Add-on Cover
Serial No. Add-on Description Premium Amount - Rs.
0001 Plan 1 36,344.52

Total Premium 36,344.52

-
Forming part of policy number:- 20800030901/00/000000
Motor Add-on Cover Details
Zero Depreciation Cap
Theft Or Loss Of Keys
Loss Of Personal Belongings - Maximum payable amount Laptop: Rs. 50,000 ;Maximum payable amount Mobile: Rs. 25,000
Road Side Assistance – Not Applicable
Please refer the attached detailed policy wordings for the above mentioned coverages.

Corporate & Registered Office: 6th Floor, Tower - 3, Indiabulls Finance Center, Senapati Bapat Marg, Elphinstone Road, Mumbai-400013, Maharashtra
Email: care@naviinsurance.com, Website: www.naviinsurance.com
IRDA Regn. No 132, CIN - U66030MH2006PLC165287, Service Tax Registration Number: AABCF0191RSD002