2312200708319303000

HDFC ERGO General Insurance Company Limited

Policy No. 2312 2008 0831 9305 000

Certificate of Insurance cum Policy Schedule
0
Motor Insurance - Comprehensive Policy

0T
Insured Name MR Ravinder Singh RTO Punjab PAN No.

Corr.Address/ Place Ward No.2 Pandita Mohalla

of Supply Shri Chamkaur Sahib,140112
Mobile 9807600736 Phone - E Mail Ravidhiman922@gmail.com Registration No. PB-12-RT-5252

Period of Insurance From Date & Time 24/07/2019 00:01 hrs To Date & Time 23/07/2020 Midnight Policy Issuance Date 24/07/2019

Make Model – Variant Engine No Chassis No Mfg Seats(Incl. Body Type CC

Yr of side car)
Maruti Suzuki Swift HA09EE99N00002 MBLHA10EK99M06709 2009 5 Hatchback 1200

Vehicle (`) Side Car (`) Non Electrical Acc. (`) Electrical Acc. (`) CNG/LPG Kit (`) Total IDV (`)
Insured's Declared
Value (IDV) 300000 0 0 0 0 300000

Named Persons & Nominee (IMT-15)

Nominee for Owner driver Appointee

Premium Details (`)

Own Damage Premium (a) Liability Premium (b)

Basic Own Damage: 165 Basic Third Party Liability: 11720

PA Cover for Owner Driver of `100000 1150

Total Basic 165
Premium

Sub Total – Addition 990

Less: No Claim Bonus 4 year 41 Net Liability Premium (b) 1770

Total - Less 41
Total Package Premium (a+b) 15630

GST 18% : Central Tax 9%(`80.50)+ State Tax 9%(`80.50) 1406

Net Own Damage Premium (a) 124 Total Premium 17036
The total Premium amount is inclusive of NCB 25%

Geographical Area India Compulsory Deductible (IMT- ` 1000 Voluntary Deductible (IMT-22A) ` 0
22)
Fund Transfer No.
HSN
Payment Details: Dated : 21/07/2017 Drawn on BizDirect Invoice No.:200708319303000 9971
Code:
TW1707555181
Previous Policy No. 2312200708319302000Valid from 24/07/2016 to 23/07/2017of HDFC ERGO GENERAL INSURANCE CO.LTD.No Claim Bonus 3
year
If declaration found incorrect, benefits under the present policy in respect of own damage section will stand forfeited.

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 `0.5 paid by Demand Draft, vide Receipt/Challan no 1709262201718 dated 03/07/2017 as prescribed in Government Notification Revenue and
Forest Department No Mudrank 2004/4125/CR 690/M-1,dated 31/12/2004., dated ,31-12-2004." Goods and Service Tax Registration No: 07AABCH0738E1ZZ. 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. Please note that the insured vehicle was pre-
inspected and a report was prepared accordingly. The existing damages to the vehicle as mentioned in the report shall not be paid by the Company. The policy is issued basis the
information provided by you, which is available with the company. In case of discrepancy or non recording of relevant information in the policy, the insured is requested to bring the
same to the notice of the company within 15 days. Goods and Service Tax for this invoice is not payable under reverse charge basis.
Policy Issuing Office : AMBADEEP BUILDING, 14, GROUND FLOOR, KASTURBA GANDHI MARG, NEW DELHI - 110 001 NEW DELHI, 110001. Phone No. : +91-11-
39883600
Policy Issuing Office: Mumbai For HDFC ERGO General Insurance Company Ltd.
 *1*

Agent Name: DM001689 ANKIT SHUKLA Digitally signed by Nagendra SaikumarDate: 2017.07.21 15:30:49 IST Agent Code
21042219 Tel No.: 28561818 Reason: I'm the authorLocation: India
#1# Duly Constituted Attorney

*$*NAGENDRA_SAI#$#

Registered & Corporate Office: 1st Floor, 165-166Backbay Reclamation, H. T. Parekh Marg, Churchgate, Mumbai - 400020. Customer Service Address: 6th Floor, Leela
Business Park, Andheri Kurla Road, Andheri (E), Mumbai - 400 059. Toll Free : 1800-2-700-700(Accessible from India only) | Fax : 91 22 6638 3699 | care@hdfcergo.com |
www.hdfcergo.com. CIN :U66010MH2002PLC134869. IRDAI Reg No.125.

HDFC ERGO General Insurance Company Limited

Frequently Asked Question’s (FAQ’s) - Motor Insurance
WHAT ARE THE MAJOR COVERS UNDER THE POLICY? e. Cheque for additional premium
Loss or Damage to the Insured Vehicle E mail or Call us for additional premium details & send
caused due to: a. Fire, explosion, self ignition relevant documents copy to our customer service office
or lightning. b Burglary, housebreaking
or theft c All act of God perils like earthquake, For Change of financier details
flood, cyclone etc d Accidental external (Hypothecation/Lease/Hire-Purchase) a. Request letter for
means, terrorism, riot and strike Liability to the change
Third Parties: b. Policy copy
Provides cover for any legal liability arising out of the use of c. Endorsed Registration Certificate copy
the vehicle for a Accidental death / injury to any third d. NOC from financier (not mandatory for deletion if RC is endorsed)
party b Any damage to property owned by third party
Personal Accident Cover: For any endorsments on your policy you can contact us through any of the below
The policy provides for a mandatory Personal Accident cover for owner driver and mentioned modes:
optional cover for passengers covering accidental death and permanent total E mail us at : care@hdfcergo.com OR Call Toll-free: 1800 2 700 700 (Accessible
disability from India only)
OR Fax your request at: 022 6638 3669 OR Raise a service request on
WHAT ARE THE MAJOR EXCLUSIONS OF THE POLICY?
Insurance Portfolio
a. General aging, wear & tear, mechanical or electrical breakdown, failure, Organizer (IPO) from www.hdfcergo.com
depreciation, any consequential loss HOW DO I FILE A CLAIM?
b. Damage by a person driving without a valid license
c. Damage by a person driving under the influence of liquor or drugs For Accidental Damage to Insured Vehicle (Own Damage Claims):
¡Call our customer care Toll-free 1800-2-700-700 (Accessible from India only) if the
d. Loss/damage attributable to war, mutiny, nuclear risks
e. Damage to tyres and tubes, unless damaged during an accident vehicle meets with an accident and provide your policy number for reference and
register the claim
f. Usage on hire & reward (applicable for all classes except public commercial
¡Alternatively, you can visit and register on IPO (available on website/Download IPO
vehicles)
app on your smart phone) by providing personal details, link your policy and
g. Loss or damage to bonnet side parts, mudguard, bumpers, lamps, tyres, tubes,
register your claim under "Claims" tab
headlights, paint work (applicable for all commercial vehicles; unless opted
Please keep the following details handy while
additionally)
intimating a claim a.Policy No.
h. Loss or damage resulting from overturning arising out of operation as a tool
b. Registration details/ RC copy
(applicable for mobile cranes, drilling rigs, mobile plants, navvies, shovels, grabs,
c. Drivers details at the time of accident including driving license number
rippers unless opted for additionally)
d. FIR on a case to case basis
i. Loss of or damage to accessories by burglary housebreaking or theft unless the
e. Repair estimate
vehicle is stolen at the same time (applicable to all commercial vehicles & two
wheelers) WHAT IS THE CLAIM PROCESS?
1. If your vehicle can be driven, take it to the nearest dealer / garage.
TRANSFER OF INSURANCE (INCASE VEHICLE IS SOLD)
2. Get a repair estimate, fill up the claim form and attach a copy of the registration
a. No objection letter from the previous insured certificate and driving license of the person driving at the time of the accident.
b. Form 29/30, Sale Deed OR transferred RC copy. In case of smart card, RTO 3. If the garage is within our network, you could avail of cashless claim facility. Pay
transfer fee paid for non accident related repairs, depreciation and deductible. We would settle the
receipt. rest.
c. Differential Premium if any (NCB recovery, PA to Owner - Driver etc) 4. If the garage is outside our network, you would have to get the claim reimbursed
d. NOC from Financier, if applicable. subsequently.
e. Pre-inspection is must if transfer request date is >14 days from the endorsed RC
copy date CLAIMS DOCUMENTS -
f. Break-in loading >45 days ( if applicable) For ACCIDENTAL DAMAGE TO INSURED VEHICLE
a. Duly filled and signed claim form & satisfaction voucher
Additional Documents b. Registration Certificate (RC)
a. Incase of death of Insured - a. Death Certificate b. Legal heir certificate c. Driving license of the person driving at the time of the accident
b. Incase of Employer to Employee transfer - a. Letter from Employer d. Policy copy , original repair estimate, repair invoice
e. Payment receipt for non-cashless claims
WHAT CHANGES CAN BE DONE IN MY POLICY ENDORSEMENT f. Original repair invoice for cashless claims
For Changes related to registration of vehicle or g. AML documents for amount more than 1 lac (PAN card, 2 passport size photo,
vehicle details like a. Correction in registration number/ residence proof)
location / address h. Form 35 & original NOC from financer incase of total loss where payment is made
b. Correction in vehicle make & model/ cubic capacity/ seating capacity/ engine & to insured
chassis number/manufacture year i. A copy of police FIR/panchnama is required for TP injury / death / property
damage
To make above changes, you need following
documents: a. Request letter for the change Additional documents required for commercial
b. Policy copy vehicles:
c. Registration Certificate copy /Invoice Copy for change in vehicle details a. Spot survey b. Load challan c. Fitness certificate
d. Cheque for additional premium if applicable d. Route permit

For addition of electrical and non electrical accessories, CLAIMS DOCUMENTS: IN CASE OF LOSS DUE TO THEFT
CNG & LPG Kit: a. Request letter for the change a. Duly filled and signed claim form & discharge voucher ( after loss settlement )
b. Policy copy b. Original Registration Certificate (RC)
c. Invoice copy (mandatory where value of accessory exceeds ` 20,000/-) c. Original policy copy
d. Endorsed Registration Certificate Copy (For CNG/LPG kit)
d. Copy of FIR lodged at the nearest police station
e. All original keys & vehicle invoice copy
f. No trace report confirming that the stolen vehicle is not traceable
g. Original NOC from financer incase of hypothecation / HPA
h. Intimation to RTO for theft of vehicle
i. Duly signed RTO transfer papers (Form 26, 28,29,30,35)
j. RC extract with stolen remark from the concerned RTO after the loss
k. AML documents for amount more than 1 lac (PAN card, 2 passport size photo,
residence proof)
l. Deed of subrogation cum indemnity on judicial stamp paper

WHAT IS NCB?
NO CLAIM BONUS (NCB):
NCB is provided for every claim free year basis the slab as provided by Tariff.
How can I get No Claim Bonus Reserving Letter?
NCB Reserving letter can be provided only on Sale of vehicle evidenced by
transferred RC copy OR Sale Deed and Form 29 & 30. The OD section of the policy
needs to be transferred to the new owner or cancelled.
HOW DO I RENEW MY POLICY?
a. Visit www.hdfcergo.com to renew instantly d. Send a copy of the renewal notice
along with online premium cheque to our branch office
b. SMS "RENEW <POLICY NO> " to 9999 /Corporate office
700700 e. Call our toll free number 1800 2 700 700
c. Visit our nearest branch / your agent (Accessible from India only)
HOW TO CONTACT US?
Call Toll-free :1800 2 700 700 (Accessible from India only)
Fax :022 6638 3669
E-Mail :care@hdfcergo.com
Write to us at :HDFC ERGO General Insurance Company Limited
(Customer service 6 Floor, Leela Business Park, Andheri Kurla Road,
office) Andheri (East),th Mumbai - 400 059
IPO :Raise a service request on Insurance Portfolio
Organiser (IPO)
Manage Your Portfolio ¡Link multiple policies ¡View/Edit your contact details

Ver.Aug14
@ hdfcergo.com / ¡¡Register Motor claimsView/Email your policy ¡¡Set Renewal RemindersCreate and track your interactions

Smartphones* ¡Track your claim status ¡Locate our network garages/ branches

* supports smart phone based on Blackberry, iPhone, Windows 8 & Android platform.Download IPO mobile application from IPO website post log in
This document is a summary of the benefits offered. The information mentioned above is illustrative and not exhaustive. Information must be 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.