Chola GENERAL INSURANCE

MS
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor "DARE HOUSE", 2, N.S.C. Bose Road, Chennai 600 001. -

Toll free: 1800 208 5544, T: +91(0) 44 4044 5400, F: +91(0) 44 4044 5550
E-mail: customercare@cholams.murugappa.com; website: cholainsurance.com
IRDAI Regn. No.123 PAN AABCC6633K CIN: U66030TN2001PLC047977

POS Motor Two Wheelers - Policy Bundled Schedule cum Certificate of Insurance
-

[UIN: IRDAN123RP0003vo2202122]

Policy cum Certificate Number: 3397/03788074/000/00

Name&Communication Address: DEEPIKA LAKSHMI

Name &Registration Address:
MAHENDRAN
3 NELLUR AMMAN KOIL STREET NEW BALAJ NAGAR SELAIYUR
3 NELLUR AMMAN KOIL STREET NEW BALAJ NAGAR SELAIYUR
KANCHEEPURAM.
KANCHEEPURAM.
,SELAIYUR S.O ,KANCHIPURAM,TAMIL NADU,PIN 600073
SELAIYUR S.O ,KANCHIPURAM ,TAMIL NADU ,PIN 600073 -

Mobile: 8825838478, Landline: 91

Mobile: 8825838478 | Landline: 91- |Mail: a@gmail.com
GSTIN: Customer ID: 101860268396 Geographical Area: India Business/ Profession: Individual

Period of Insurance for OD(Own Damage) : From 19/07/2022 18:29 hours to midnight on 18/07/2023
Period of Insurance for TP(Third Party) : From 19/07/2022 18:29 hours to midnight on 18/07/2027
Period of Insurance for CPA(Compulsory Personal Accident Owner Driver):
From 19/07/2022 18:29 hours to midnight on 18/07/2023
PARTICULARS OF VEHICLE INSURED

Registration
Date of Registration 19/07/2022 Place of Registration TAMBARAM NEW
Mark
Make MAHINDRA Model MOJO Variant BSVI CORALRED

Year of Manutacture 2022 Type of Body STREET Fuel Used PETROL

Cubic Capacity 300 Engine No. UFENDOOO011 Chassis No. MA1KE1C16N1E00021

K.Watts 0 Licensed passenger Carrying Capacity 2

Total Seating Capacity Including Driver

Vehicle Colour
2 Driver

IDV (Insured's Declared Value)

1st Year: 2nd Year 3rd Year: 4th Year: 5th Year:
IDV ()
2,11,000
Non-Electrical Electrical/Electroniclo
For Vehicle (.) 2,11,000
Accessories (z.) Accessories (.)
Value of CNG/LPG Kit (z.) Total Value (.) 2,11,00o Contract No:

A1.0WN DAMAGE

Sum 1st year 2md year 3rd year 4th year 5th year Total
No.of
Insured IMT Premium PremiumPremium Premium Premium Premium
Persons
) ()
Basic OD 2,11,000.00 3783 0* 0* 3783

Electrical or Electronic Accessories 24

Non Electrical or Electronic Accessories

TOTAL 3783 3783

Less:

Bonus Discount(%)

Refer website for policy wordings and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544| SMS CHOLA to 56677|Visit www.cholainsurance.com Email customercare@cholams.murugappa.comn
|Disclaimer: The company may contact you for matters related to your policy or to provide details of products & services offered. To opt out from the facility, please register
under Do Not Call section on our website.
Chola GENERAL INSURANCE
MS
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor "DARE HOUSE", 2, N.S.C. Bose Road, Chennai 600 001.
-

Toll free: 1800 208 5544, T: +91(0) 44 4044 5400, F: +91(0) 44 4044 5550
E-mail: customercare@cholams.murugappa.com; website: cholainsurance.com
IRDAI Regn. No.123 PAN AABCC6633K CIN: U66030TN2001PLC047977

POS Motor Two Wheelers - Policy Bundled Schedule cum Certificate of Insurance
-

[UIN: IRDAN123RPO003Vvo2202122]

Experience Based Discount(%) 1324 1318

GST Discount(5%) 189 0 189

TOTAL PREMIUM(A1) 2270 2276

A2.ADD-ON COVERS

Sum
No.of
1styear 2nd year 3rdyear 4th year 5th year Total
Insured Options Premium Premium Premium Premium Premium Premium
persons
() ) .) )
Full Depreciation Waiver Cover Bundled 1055 1055
TOTAL PREMIUM(A2) 1055 0 1055
B.LIABILITY(TP)

Sum
No.of 13 year 2nd year3rd year 4th year sth year Total
Insured IMT Premium Premium Premium Premium Premium Premiumn
Persons
) ) () ()
Basic TP 1473 1473 1473 1473 1473 7365

Paid Driver 50 50 50 50 50 50
TOTAL PREMIUM(B) 1523 1523 1523 1523 1523 7615
C.PERSONAL ACCIDENT COVERS

Sum
No.of
1st year 2nd year 3rd year ath year 5th year Total
Insured IMT PremiumPremium Premium | Premium Premium Premium
Persons
() () ) ()

Compulsory Personal Accident(CPAJCOver

1500000 325 0* 0* 325
for Owner-Driver
Unnamed PA cover 0 16 0

TOTAL PREMIUM(C) 325 325

TOTAL (A1+A2+B+C) 5173 1523 1523 1523 1523 11271

CGST (9%6)(T.) 1014.50

SGST (9%)(z.) 1014.50

IGST (06(.)

TOTAL CONSIDERATION AFTER TAX 13300

*This refers to NIL OD coverage for the period and NIL CPA COverage for the period_
|LIMITATIONS AS TO USE: The Policy covers use of the vehicle for any purpose other than: a) Hire or Reward b) Carriage of g0ods (Other than samples or personal
luggage) in connection with any trade or business or use for any purpose in connection with motor trade c) Organized racing d) Pace making e) Speed Testing f)
Reliability Trial g) Tuition h) Use only with side car if attached.
DRIVER CLAUSE: Any person including 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 requirements of Rule 3 of the Central Motor Vehicles Rules 1989.

LIMITS OF LIABILITY: Under Section I| - 1() of the Policy Death or bodily injury such amount as is necessary to meet the requirements of the Motor Vehicle Act,
1988. Under Section l 1(ii) of the Policy Damage to Third Party Property- 7. 1,00,000 P.A. Cover for the Owner cum Driver Under Section IV (CSI)- .1500000
- -

Compulsory Deductibles Under Section 1: Rs.100 Per claim

|Voluntary deductibles under Section 1 Rs.0 Per claim

Refer website for policy wordings and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 SMS CHOLA to 56677| Visit www.cholainsurance.com Email customercare@cholams.murugappa.com
|Disclaimer: The company may contact you for matters related to your or to provide details of products & services offered. To opt out from the facility, please register
under Do Not Call section on our website.
Chola GENERAL INSURANCE
MS
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor "DARE HOUSE", 2, N.S.C. Bose Road, Chennai 600 001. -

Toll free: 1800 208 5544, T: +91(0) 44 4044 5400, F: +91(0) 44 4044 5550
E-mail: customercare@cholams.murugappa.com; website: cholainsurance.com
IRDAI Regn. No.123 PAN AABCC6633K CIN: U66030TN2001PLCO47977

POS Motor Two Wheelers - Policy Bundled Schedule cum Certificate of Insurance
-

[UIN: IRDAN123RP0003voz202122]

Subject to I.M.T. Endt. Nos. and Memorandum: 22,7.

Coverage Under this policy is subject to realisation of premium cheque(s). Incase of dishonor of cheque(s), no separate intimation will be given and the policy
stands cancelled from inception.
Product Plan: Two Wheeler package policy with chosen Add-on covers.
Applicable benefits:
The policy wording with detailed terms, conditions, warranties, exclusions and the list of Ombudsman details are available on our website
www.cholainsurance.com.
Date and Signature of the proposal 19/07/2022. In witness where of this policy has been signed in lieu of the Cover Note No. Date:
|Warranties: Warranted that NCB under this Policy is based on representation regarding NCB and absence of claim under the previous Policy.lf the information be
found incorrect or fallse in any aspect,this Policy shall be void ab initio and no benefit shall be payable by the company.
CVAS NEW: To avail the Roadside Assistance Service. Please contact Mafrey on Toll-Free-Number : 1800-209-5354/1800-103-5354.
As per GR 36A,PA for Owner driver refers to the Owner of the insured vehicle holding an effective driving licence.
SI.No. Name of the Nominee Relationship Age of the Nominee oage of share Name of the Guardian Guardian relationship with Nominee
SASHIKUMAR Husband 100
This refers to NIL OD coverage for the period.
No Claim Bonus will only be allowed provided the policy is renewed within 90 days of the expiry date of the previous policy. No claim bonus is applicable at the
end of the policy period.
Note: The Policy Schedule cum Certificate of Insurance is an important document issued based on your declaration. We request you to verify the details and
ensure that everything is in order. In case of any discrepancies, please contact us within 15 days from the date of issuance of policy.
Financier Name & Address:,
Intermediary Name: CHOLA INSURANCE DISTRIBUTION SERVICES PRIVATE LIMITED
Code: 200572295173 Contact No: 9787095340
For Cholamandalam Ms General Insurance Company Limited.

Receipt
Place: CHENNAI
No:202207190010
Receipt
Date:19/07/2022
Date:19/07/2022
Duly Constituted Authority
Business Location: MANNARGUDI CIE
NO-106/1 AND 106/2, 21ST STREET
KAMMALAR STREET, MANNARGUDI
MANNARGUDI H.O TIRUVARUR TAMIL NADU

GST Invoice No: 3397386076835 GSTIN: 33AABCC6633K1Za SAC Code:997134 SAC Description: Motor vehicle insurance services
Consolidated Stamp Duty Paid Vide G.0. Rt No.295, Commercial Taxes and Registration (j1) Department, Tamil Nadu dated30/06/2022.
|/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 the Motor Vehicles Act, 1988.
|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 version will hold good.
Note: UIN for the add-on covers availed under this policy are as mentioned.
Whether tax is payable under reverse charge basis - No.
Cholamandalam MS General Insurance Company Ltd.
Regd.&Head Office:Dare House,2nd Floor,No.2,N.S.C Bose Road, Chennai-600001, India

Product Name Motor Two - Wheelers Policy Bundled

UIN :IRDAN123RP0017V01201819

UIN for Add-on Covers

SI.NO Add on cover Name IRDA BAP UIN UIN

POS-Full Depreciation Waiver Cover for five years IRDAN123RA0079201819
POS-Full Depreciation Waiver Cover for three years IRDAN123RAO046201819
POS-Full Depreciation Waiver Cover Bundled IRDAN123RAO046201819

Refer website for policy wordings and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544| SMS CHOLA to 56677| Visit www.cholainsurance.com Email customercare@cholams.murugappa.com
|Disclaimer: The company may contact you for matters related to your policy or to provide details of products & services offered. To opt out from the facility, please register
under Do Not Call section on our website.
Chola GENERAL INSURANCE
MS
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor "DARE HOUSE", 2, N.S.C. Bose Road, Chennai 600 001.-

Toll free: 1800 208 5544, T: +91(0) 44 4044 5400, F: +91(0) 44 4044 5550
E-mail: customercare@cholams.murugappa.com; website: cholainsurance.com
IRDAI Regn. No.123 PAN AABCC6633K CIN: U66030TN2001PLC047977

POS Motor Two Wheelers - Policy Bundled Schedule cum Certificate of Insurance
-

[UIN: IRDAN123RPO003vo2202122]

POS-Full Depreciation Waiver Cover for four years IRDAN123RA0046201819

POS-Full Depreciation Waiver Cover for two years IRDAN123RA0046201819

nola

Refer website for policy wordings and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 SMS CHOLA to 56677| Visit www.cholainsurance.com | Email customercare@cholams.murugappa.com
|

|Disclaimer: The company may contact you for matters related to your policy or to provide details of products & services offered. To opt out from the facility, please register
under Do Not Call section on our website.