Insurance Purchase Statement

Mentioned below are the transaction details for your New India Assurance policy purchased on Coverfox.com. A policy
document will be issued against these details.

Personal Details Policy Details

Name: Sameer Khan Policy No.: 13130031210100038454

Mobile: +91 90*****053 Policy Type: Comprehensive

Email: kh*****com Policy Purchase 06/12/2021

Date:
Address: 6th Kharwa Lane 15 Navneet Bhavan, 3rd
Floor Room50, Mumbai, Maharashtra, Policy Start Date: 10/12/2021
400004
Policy End Date: 09/12/2022

Total Premium: 1496.0

Payment Date: 06/12/2021

Vehicle Details

HERO MOTOCORP KARIZMA DOUBLE DISC BRAKE 223 (Petrol) Registration No.: MH-01-BC-4070

Engine No.: MC38ECCGA01869 Chassis No.: MBLMC38EDCGA01924

Registration Date: 08/02/2012 Financier: NA

Category: Private

Coverage

Vehicle IDV: 19829.0 Owner Driver Cover: NA

Value of CNG/LPG Kit: NA Passenger Cover (per 0

passenger):
Electrical Accessories: NA
Voluntary Deductible: 0
Non Electrical NA
Accessories:

No Claim Bonus: 20%

Note:
Your new policy details will be updated within next 30 days on mParivahan.
This is only a transaction confirmation receipt and cannot be used for filing claims.
Have questions, suggestions or complaints? Connect with our Customer Service Unit:
Toll free no.: 1800 209 9930 (Mon to Sat, 9am-9pm) Email: help@coverfox.com

Coverfox Insurance Broking Pvt. Ltd. : Unit D4131-4139, 4th floor, Oberoi Garden Estates, Near Chandivali Studio, Andheri East,
Mumbai - 400072
IRDAI Direct Broker Code : IRDA/ DB 556/ 13, Valid till: 26/12/2022