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
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IRDAI Regn. No.123 PAN AABCC6633K CIN: U66030TN2001PLC047977

Motor Two ‐ Wheelers Policy Bundled ‐ Schedule cum Certificate ofInsurance

[UIN: IRDAN123RP0003V02202122]

Policy cum Certificate Number: 3456/04060872/000/00

Name & Communication Address: MR VIR BAHADUR Name & Registration Address:
G-123 VIJAY VIHAR PHASE-2 RAJA PUR KALAN DELHI - 110085 G-123 VIJAY VIHAR PHASE-2 RAJA PUR KALAN DELHI - 110085
Mobile: 9953871288|Landline: 91‐ |Mail: rajeev0987garg@gmail.com Mobile: 9953871288|Landline: 91‐

GSTIN: Customer ID: 101966470699 Geographical Area: India Business / Profession: Individual

Period of Insurance for OD(Own Damage) : From 26/05/2023 12:54 hours to midnight on 25/05/2024
Period of Insurance for TP(Third Party) : From 26/05/2023 12:54 hours to midnight on 28/03/2028
Period of Insurance for CPA(Compulsory Personal Accident Owner Driver):
From 26/05/2023 12:54 hours to midnight on 25/05/2028
PARTICULARS OF VEHICLE INSURED
Registration
Date of Registration 25/05/2023 Place of Registration ROHINI NEW
Mark
Make TVS Model NTORQ 125 Variant SQUAD EDITION BSVI
Year of Manufacture 2023 Type of Body SCOOTER Fuel Used PETROL
Cubic Capacity 125 Engine No. N3600371 Chassis No. MD626AK31N3L01069
K.Watts 0 Licensed passenger Carrying Capacity 2

Total Seating Capacity Including Driver 2 Driver 0

Vehicle Colour ‐
IDV (Insured's Declared Value)
1st Year: 2nd Year: 3rd Year: 4th Year: 5th Year:
IDV ( .)
94,962 0 0 0 0
Non‐Electrical Electrical/Electronic
For Vehicle ( .) 94,962 0 0
Accessories ( .) Accessories ( .)
Value of CNG/LPG Kit ( .) 0 Total Value ( .) 94,962 Contract No: ‐

Sum A1.OWN1DAMAGE
st
year 2nd year 3rd year 4th year 5th year Total
No.of
Insured IMT Premium Premium Premium Premium Premium Premium
Persons
( .) ( .) ( .) ( .) ( .) ( .) ( .)

Basic OD 94,962.00 1622 0* 0* 0* 0* 1622

Electrical or Electronic Accessories 24 0 0 0 0 0 0
Non Electrical or Electronic Accessories 0 0 0 0 0 0
TOTAL 1622 0 0 0 0 1622

Less:

Bonus Discount(%) 0
Experience Based Discount(%) 811 0 0 0 0 811
TOTAL PREMIUM(A1) 811 0 0 0 0 811

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.
 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

Motor Two ‐ Wheelers Policy Bundled ‐ Schedule cum Certificate of Insurance

[UIN: IRDAN123RP0003V02202122]

A2.ADD‐ON COVERS

Sum
No.of 1st year 2nd year 3rd year 4th year 5th year Total
Insured Options Premium Premium Premium Premium Premium Premium
persons
( .) ( .) ( .) ( .) .) ( .) ( .)

TOTAL PREMIUM(A2) 0 0 0 0 0 0
B.LIABILITY(TP)

Sum
No.of 1st year 2nd year 3rd year 4th year 5th year Total
Insured IMT Premium Premium Premium Premium Premium Premium
Persons
( .) ( .) ( .) ( .) ( .) ( .) ( .)

Basic TP 771 770 770 770 770 3851

Paid Driver 0 0 0 0 0 0
TPPD Discount 20 250.00
TOTAL PREMIUM(B) 771 770 770 770 770 3601
C.PERSONAL ACCIDENT COVERS

Sum
No.of 1st year 2nd year 3rd year 4th year 5th year Total
Insured IMT Premium Premium Premium Premium Premium Premium
Persons
( .) ( .) ( .) ( .) .) ( .) ( .)

Compulsory Personal Accident(CPA)cover

0 0 0* 0* 0* 0* 0
for Owner‐Driver

Unnamed PA cover 0 16 0 0 0 0 0 0
TOTAL PREMIUM(C) 0 0 0 0 0 0
TOTAL (A1+A2+B+C) 1582 770 770 770 770 4412
CGST (9%)( .) 397
SGST (9%)( .) 397
IGST (0%)( .) 0
TOTAL CONSIDERATION AFTER TAX 5206
* 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 goods (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 II ‐ 1(i) of the Policy ‐ Death or bodily injury such amount as is necessary to meet the requirements of the Motor Vehicle Act, 1988. Und
Voluntary deductibles under Section 1 Rs.0 Per claim
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 cancel
Product Plan: Two Wheeler package policy with chosen Add‐on covers.
Applicable benefits:

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.
 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

Motor Two ‐ Wheelers Policy Bundled ‐ Schedule cum Certificate of Insurance

[UIN: IRDAN123RP0003V02202122]
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 26/05/2023. 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.If the information be
found incorrect or false in any aspect,this Policy shall be void ab initio and no benefit shall be payable by the company.
As per GR 36A,PA for Owner driver refers to the Owner of the insured vehicle holding an effective driving licence.
Sl.No. Name of the Nominee Relationship Age of the Nominee %age of share Name of the Guardian Guardian relationship with Nominee

* 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: TATA CAPITAL FINANCIAL SERVICES LTD
Intermediary Name: LANDMARK INSURANCE BROKERS PVT LTD
Code: 200951842473 Contact No: 9687630986
For Cholamandalam MS General Insurance Company Limited.
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Receipt
45 1 898 67 9 878 679 650
c

Place: CHENNAI
67 9 555 62 8 499 538 435
c
48 8 399 46 7 376 467 292
c 313
292l
h

No:
308 214 170 -164 re

0.44G
1.2 w
110.4 rg
287 31 8 m
287 430 299 479 40 6 5 5

Digitally signed by:

KANCHIPURAM
Date:26/05/2023 Receipt SRIDHAR HARISH
Date:
Duly Constituted Authority
Business Location: CANNAUGHT PLACE
NO. 39, SECOND FLOOR, SAMYAKTOWER,OPP. METRO PILLARNO. 120,
PUSA ROAD, NEW DELHI ‐ 110 005
KAROL BAGH S.O CENTRAL DELHI DELHI

GST Invoice No: 3397409674999 | GSTIN: 07AABCC6633K5ZH | SAC Code:997134 | SAC Description: Motor vehicle insurance services
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 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 OFRECOVERY".
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 : IRDAN123RP0017 V01201819

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.