Tata AIG General Insurance Company Ltd.

Transcription

1 Tata AIG General Insurance Company Ltd. Date: 22/04/2011 Policy No.: Mr. MANOJ SHARMA. GALI NO-4-B, SWATANTRA NAGAR, NARELA, DELHI , DELHI Work Phone: 1 Client Id: Dear Mr. MANOJ SHARMA., It is my pleasure to welcome you to the Tata AIG family. Your Policy number is The insurance coverage that you have opted for is Scooter/Motor Cycle Insurance. The details of your coverages and the other guidelines regarding your policy can be had from the policy document and the guide to our products that is enclosed with this. Please do file these documents for future reference. I am sure that you will benefit from the best that we have to offer. You and your family are offered security and convenience by us through a host of benefits under the policy that you have opted for, security in the feeling that your assets are protected and convenience in accessing us as your insurer. The most striking feature of this accessibility being the 24 - hour help line for all our policyholders. Please do call us at this number in case you require any clarifications or services. It is our promise to be there for you in your time of need. We shall work on providing you with many more benefits that will stand by our commitment to provide you with nothing but the best. We thank you for choosing us for your requirements and promise you a pleasant experience called insurance. Sincerely yours,. Branch: Chennai Page 1 of 5

2 Tata AIG General Insurance Company Ltd. RECEIPT Receipt No.: W Receipt Date: 19/04/2011 Received with thanks from ICM Insurance Brokers Pvt. Ltd (ID: ) (Insured: Mr. MANOJ SHARMA. (ID: )) a sum of Rs. 50, ( Rupees Fifty Thousand and Paise 00 Only ) vide Cheque no dated 18/04/2011 drawn on I.C.I.C.I. BANKING CORPORATION LTD.,BESANT NAGAR branch towards RP01 Sr. No. Policy No. Total Premium (Rs.) Utilised from Receipt (Rs.) , , , , , , , , Branch: Chennai Page 2 of 5 DE: icminsup TIME STAMP: 22/04/2011 FU: icmins2f

3 Excess: 28, REVENUE STAMP Note: 1. This is a computer generated receipt and does not require a signature. 2. This receipt is issued subject to realisation of the cheque. 3. Upon issuance of this receipt, all previously issued temporary receipts, if any, related to this policy, are considered null and void. 4. Any excess amount will be adjusted against subsequent policy applications, or will be refunded on demand. Service Tax Registration No : Insurance/Tata/Mumbai-I/1542/ RP01 Branch: Chennai Page 3 of 5 DE: icminsup TIME STAMP: 22/04/2011 FU: icmins2f

4 Agent/Broker Producer Name - Agent/Broker License Code - Certificate & Policy No Effective time and date of commencement of Insurance Date of Expiry Midnight on 22/04/2012 Place of Registration NORTH WEST ZONE Name and address of the Insured Name: MANOJ SHARMA. Address : GALI NO-4-B, SWATANTRA NAGAR, NARELA, DELHI , DELHI Registration No. Make & Model Body Type Mfg. Year DL8SAN5296 HERO HONDA CD DELUXE CAST IDV of vehicle(rs.) IDV of Side Car(Rs.) Tata AIG General Insurance Company Ltd. Certificate of Insurance and Policy Schedule Form 51 of the Central Motor Vehicle Rules, 1989 ICM Insurance Broker DB388/07 Agent/Broker Contact No.- Bi-Fuel/CNG/LPG Kit(Rs.) Policy Type From 00:01 Hours on 23/04/2011 Package Policy-Scooter/Motor Cycle Insurance Premium (incl.s.tax) Rs Insured's Business/Profession PROFESSIONAL Geographical Area INDIA Under Hire Purchase/Hypothecation/Lease with CC Seating Capacity Engine No. Chassis No IDV of non-built-in Accessories(Rs.) Electrical Non-Electrial Total Insured Declared Value (Rs.) 24, , SCHEDULE OF PREMIUM Own Damage Basic Rs Liability to Public Risk Rs Less : 35.00% for NCB Rs Add: Compulsory PA Cover for Owner-Driver Rs.1,00,000 Rs A. TOTAL OWN DAMAGE PREMIUM (rounded off) Rs B. TOTAL LIABILITY PREMIUM Rs COMPREHENSIVE PREMIUM(A+B) Rs NET PREMIUM Rs Add : 10.30% Service Tax Rs TOTAL PREMIUM Rs Drivers Clause : Persons or classes of persons entitled to drive : Any person including the insured: Provided that a person driving holds an effective driving licence at the time of the accident and is not disqualified from holding or obtaining such a licence. Provided also that the person holding an effective Learner's Licence may also drive the vehicle and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 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) Organised racing d) Pace Making e) Speed testing f) Reliability Trials g) Any purpose in connection with Motor Trade. Limits of Liability: 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, Subject to : A. Indian Motor Tariff Endorsement No. (IMT) Under Section II-1 (ii) of the policy (Damage to Third Party Property ) : Rs /- P.A. Cover for Owner - Driver under Section III: CSI : Rs /- 22 Deductible under Section - I Compulsory Deductible : Rs. 50.0/- Voluntary Deductible : Rs. 0/- Imposed Excess : Rs. 0.0/- I/We hereby certify that the Policy to which this Certificate relates as well as this Certificate of For Tata AIG General Insurance Company Ltd. Insurance are issued in accordance with the provisions of Chapter X and XI of Motor Vehicles Act, In witness whereof this Policy has been signed at MUMBAI on 19/04/ Receipt(s): W Service Tax Registration No : Insurance/Tata/Mumbai-I/1542/ The stamp duty of Rs /-(Rupees zero and Paise 50 Only) paid in cash or demand draft or by pay order, vide Receipt/Challan no dated the 25/10/2010. DA17 Branch: Chennai Page 4 of 5

5 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 Vehicles Act, 1988 is recoverable from the Insured. See the clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY". This Schedule, the attached Policy and Endorsements mentioned herein above shall read together and word or expression to which a specific meaning has been attached in any part of this Policy or of the Schedule shall bear the same meaning wherever it may appear. Any amendments/modifications/ alterations made on this system generated policy document is not valid and Company shall not be liable for any liability whatsoever arising from such changes. Any changes required to be made in the policy once issued, would be valid and effective, only after written request is made to the Company and Company accepts the requested amendments/modifications/alterations and records the same through separate endorsement to be issued by the Company. DA17 Branch: Chennai Page 5 of 5