Alok Ramesh Pandey

Date: 05/01/2024
S.no: Vertical Recipient :
C O Alok Pandey I 20 EmpyreanTownship Kothewada Outer Ring Raod Gumgaon Nagpur Nagpur Pincode - 441122Nagpur Pin Code :
441122
Motor Insurance Renewal – Private Car Package Policy No. : 2311101184173201000
Due Date : 26/03/2024 Premium Payable : ` 13594.00
If a Claim is registered post 05/01/2024 the revised premium payable will be ` 14,802.00 due to withdrawal of NCB.

Dear Customer,

BOSG Recipient:
You are our valued customer and we thank you for choosing HDFC ERGO as your preferred insurance partner. We would like to remind you that your Motor
Insurance Policy is due for renewal on 26-Mar-2024. We request you to renew your policy before expiry date for continuity of benefits of your existing policy.
VEHICLE DETAILS
Make Model - Variant Engine No. Chassis No. Mfg Yr Seats Body Type CC

MAHINDRA XUV 500-W10 R FWD SPJ4B21918 MA1YU2SPVJ6B14830 2018 7 6 2179

Dispatch Location:
Registration No. RTO Location GVW Financing Institution
MH-40-BE-8170 NAGPUR
If you find any error in the above details, kindly intimate the same to us along with a copy of the Registration Certificate of your vehicle.

Insured's Declared Vehicle (`) Trailer (`) Non Electrical Acc. (`) Electrical Acc. (`) CNG/LPG Kit (`) Total IDV (`)
Value (IDV) 787,903 0 0 0 787,903

Branch name:8TH FLOOR, A WING, SHRI RAM TOWER, KINGSWAY SADAR 440001 MAHARASHTRA
PREMIUM COMPUTATION
Own Damage Premium (a) Liability Premium (b)
Own Damage (OD) including applicable Third Party Liability (TP) is charged as prescribed by IRDAI 7,897
3,073
loading/discounting/NCB @ 25% Other Liability (optional coverages) 225
Personal Accident for owner driver and optional coverage 325
Total Package Premium (a+b) 11,520
GST as applicable 2,074
Total Premium Payable (excluding Add on Cover) 13,594
Addon Cover: Total Premium Payable (Including Add on cover)
Total Premium Payable (Including add on cover) QR Code
Online Contact Us SMS Courier Scan for instant Renewal
Renewal
Options

Visit "Renew - Renew your

Call on 022 - 6234 6234 / SMS "Renew” to Send duly filled renewal slip with
HDFC Ergo policy" on
0120 - 6234 6234 and 9999700700 & receive call premium cheque to customer
hdfcergo.com. Fill details &
renew instantly within 24 hours service address
Visit nearest branch & Pay via Cheque/DD/Cash/Credit Card : 8TH FLOOR, A WING, SHRI RAM TOWER, KINGSWAY
SADAR 440001 MAHARASHTRA
Customer Service Address : D-301, 3rd Floor, Eastern Business District ( Magnet Mall), LBS Marg, Bhandup
(West).MUMBAI - 400078. Maharashtra. For instant renewal Call 022 - 6234 6234 / 0120 - 6234 6234

IMD Code:
RENEWAL SLIP
Motor Insurance Renewal – Private Car Package Policy No. 2311101184173201000
Coverage Opted for: Basic Policy

Issue Cheque/DD in favour of HDFC ERGO General Insurance Company Ltd. Please mention your policy number on the reverse.

Cheque No. Cheque Date Cheque Amount Name of Bank & Branch

In case of any change in your correspondence address / contact details, please update & help us serve you better
Address
City State Pin Code
Phone Mobile Email
Nominee Details - Name, Age & Relationship
For PA to named Passenger
(Not applicable for commercial vehicle)
Owner Driver

In case of more than one named passenger, please provide in the above format on a separate sheet.
Terms & Conditions: This renewal letter is generated on the basis of information of Claims, if any, in respect to your current policy as on 05/01/2024. if any additional claim is reported other than
the above mentioned, this offer letter stands withdrawn and the Company reserves the right to increase the renewal premium. In addition to the above, in case you have availed No Claim Bonus
benefit, you will be required to reimburse the same. In case you do not agree to pay the revised premium, the Company reserves the right to cancel the policy, if already issued, and return the
balance amount.Coverage will be effective on realisation of premium amount.
Goods and Services Tax Reg. No. 27AABCL5045N1Z8 The Taxes will be charged as per the direction issued by Government / Regulatory Authority from time to time. The description of the add
on plans are illustrative and not exhaustive, To know more about the detailed description, terms and conditions you may refer to the policy wordings. The terms and conditions mentioned in the
Policy will supersede in case of any confict.

Customer Signature_________________________________
To,
Alok Ramesh Pandey
Serial No. :
C O Alok Pandey I 20 EmpyreanTownship Kothewada Outer Ring Raod
Gumgaon Nagpur Nagpur Pincode - 441122 Date : 05/01/2024
Nagpur
Nagpur
Pin Code : 441122
231110118417320100005012024
Mumbai (Corporate) - Leela Business Park -