CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED

Registered Office: 2nd Floor, "DARE House", 2, N.S.C. Bose Road,Chennai-600 001.
Toll free: 1800 200 5544, T: +91 (0) 44 3044 5400, F: +91 (0) 44 3044 5550
E: customercare@cholams.murugappa.com; website: www.cholainsurance.com
PAN: AABCC6633K GSTIN: 33AABCC6633K1ZQ CIN: U66030TN2001PLC047977
IRDA Registration. No.123

E-Quote - Chola Standalone Own Damage Policy for Private Car

[UIN No. IRDAN123RP0002V01201920]

This is only a quote and not a valid policy certificate

Chola MS quotation number :

QINSD2CDirect1340700986722

Please Note:

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The coverage hereunder is only for Own Damage of the vehicle insured under this policy. No other
a
fic
liability in connection
with the vehicle including Third party liability for Personal injury / Property
damage is payable under this
Policy
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ce
il cy
Customer Details
po
l id
va
Insured Name :
Sohil Dal
Mobile Number :
7990353681

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o
Email ID :
sohildal777@gmail.com

n
ndVehicle Details
a
Transaction Type:
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Roll Over IDV: 10,96,602
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City where car is registered: quBHAVNAGAR(BHAVNAGAR)
Policy End Date: 19/12/2023 23:59 Date of First Registration : 30/12/2021
Fuel Type: DIESEL
Manufacture Name:
y a HYUNDAI Cubic Capacity: 1493
Model / Variant
n l CRETA - 1.5 CRDI MT E

i so
h is Premium Break-Up

T
A.OWN DAMAGE PREMIUM (RS.) ADD-ON COVERS (BENEFITS) PREMIUM (RS.)
Waiver of depreciation 100% Benefit No.
Basic OD 34993 4387
Option No.
TOTAL 34993 Chola Value Added Services Cover 99
Consumables cover 1120

DISCOUNT
Hydrostatic lock cover 1150
6999
No Claim Bonus(NCB) 20% Key replacement cover 333

Personal belonging cover 175

SubTotal : (discounts) 6999
TOTAL ADD-ON COVERS PREMIUM (B) 7264

CPA Premium (C) 0

TOTAL-OTHER SERVICE CHARGES(NON
OWN DAMAGE PREMIUM 27994
PREMIUM)(D)
Detariff Discount (75%)
20996 TOTAL PREMIUM (A+B+C+D) 14262
GST Discount (0%)
0
GST (18%) 2568
TOTAL OWN DAMAGE PREMIUM (A) 6998 PREMIUM PAYABLE 16830
Declaration::
I / We desire to insure with Cholamandalam MS General Insurance Company Limited ("Company") and in this regard
hereby declare
that the statements made by me / us in the proposal form are true and complete to the best of my / our
knowledge
and belief. I / We hereby agree that this declaration shall form the basis of the contract between me / us and
the company. I / We also declare that if alteration /addition is carried out after the submission of this proposal,
the same
shall be conveyed to the Company immediately. I / We have understood the covers being offered under
this policy and am
/ are aware of the applicable terms and conditions. I / We are aware the mere remittance of
payment does not guarantee
acceptance of this risk, which decision shall be made by the Company. I / We agree
to the Company taking appropriate
measures to capture the voice log for all such telephonic transaction carried
out by me / us in accordance with procedures
/ regulations, internal or external. This cover is valid in India
only unless specifically confirmed by the company.

Declaration for No Claim Bonus (NCB)* (if NCB confirmation is not submitted but NCB claimed)
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a
I/We declare that the rate of NCB claimed by me/us is correct and that NO CLAIM has arisen in the expiring Policy Period

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(Copy of Policy enclosed).I/We further undertake that if this declaration is found incorrect, all benefits under
the Policy in
ti
respect of Section - 1 (own damage) of the Policy will stand forfeited.
e r
c
yor offer to allow, either directly or
i c
anl insurance in respect of any kind
or risk
Section 41 of Insurance Act, 1938 - Prohibition of rebates: 1.No person shall allow
indirectly as an in ducement to any person to take out or renew or continueo
p commission payable or
any rebate of the
l d
relating to lives or property in India, any rebate of the whole or part of the
i continuing a policy
accept any rebate except
such rebate as may be allowed in accordance with the prospectus oratables of the Insurer.
2. Any person making default in
premium shown on the policy, nor shall any person taking out or renewing or
v
t a
complying with the provisions of this section shall be punishable with fine,
which may extend to five hundred rupees.

o
ndoes not require signature.
d
an
Note: This is an electronically generated document and

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