This document is an insurance policy certificate for a Tata Altroz vehicle owned by Mr. Diwakar Nath Jogi. It provides own damage coverage from December 20, 2020 to December 19, 2021, and motor liability coverage until December 19, 2023. The insured address is in Jabalpur, Madhya Pradesh. The total premium paid is Rs. 23,106 with Mrs. Shyam Nath Jogi listed as the nominee.
This document is an insurance policy certificate for a Tata Altroz vehicle owned by Mr. Diwakar Nath Jogi. It provides own damage coverage from December 20, 2020 to December 19, 2021, and motor liability coverage until December 19, 2023. The insured address is in Jabalpur, Madhya Pradesh. The total premium paid is Rs. 23,106 with Mrs. Shyam Nath Jogi listed as the nominee.
This document is an insurance policy certificate for a Tata Altroz vehicle owned by Mr. Diwakar Nath Jogi. It provides own damage coverage from December 20, 2020 to December 19, 2021, and motor liability coverage until December 19, 2023. The insured address is in Jabalpur, Madhya Pradesh. The total premium paid is Rs. 23,106 with Mrs. Shyam Nath Jogi listed as the nominee.
This document is an insurance policy certificate for a Tata Altroz vehicle owned by Mr. Diwakar Nath Jogi. It provides own damage coverage from December 20, 2020 to December 19, 2021, and motor liability coverage until December 19, 2023. The insured address is in Jabalpur, Madhya Pradesh. The total premium paid is Rs. 23,106 with Mrs. Shyam Nath Jogi listed as the nominee.
Servicing Office of Insurer: Plot No 10 Second Floor, Alankar Palace, MP Nagar,, Zone II, Bhopal, Madhya Pradesh - 462011, , Madhya Pradesh (State Code:23) -462011, PH-- Website: www.icicilombard.com PAN: AAACI7904G . GSTIN: 23AAACI7904G1ZV Insurer's IRDA Registration Number: 115 Tollfree Helpline Email: CIN : U67200MH2000PLC129408 BUNDLED - PRIVATE CAR POLICY-CERTIFICATE CUM POLICY SCHEDULE (UIN- IRDAN115RP0006V01201819) (FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)
Policy No. 3001/TMP-100049961/00/000 Policy Issued On 20-DEC-2020 (19:15)
Insured Name MR. DIWAKAR NATH JOGI Own Damage Period 20-DEC-2020(19:15) To 19-DEC-2021(Midnight) Motor Liability Period 20-DEC-2020(19:15) To 19-DEC-2023(Midnight)
Proposal No. & Date PPVBU9749643, 20-DEC-2020 CPA Cover Period 20-DEC-2020(19:15) To 19-DEC-2023(Midnight) Insured Add. S/O MR. L. P. NATH JOGI LIG 50, INFRONT OF POWER HOUSE, DHANWANTRI NAGAR, GARHA JABALPUR DIST-, JABALPUR , MADHYA PRADESH (State Code:23) -482001 Previous Insurer NA Previous Policy No. NA Broker Details IRDA Lic. No.: 375, CIN No.: U50300MH1997PLC149349 Broker Category: Composite Broker, Validity: 13-MAY-20 To 12-MAY-23 Name & Add.: TATA MOTORS INSURANCE BROKING AND ADVISORY SERVICES LTD, 1ST FLOOR, AFL HOUSE, LOK BHARATI COMPLEX, MAROL MAROSHI ROAD, ANDHERI (EAST), MUMBAI 400 059, INDIA
Make Model Sub Model Cubic Capacity Manufacturing Year Seating capacity
TATA MOTORS ALTROZ XE 1.2 P 1199 2020 5
Body Type Registration No. RTO Invoice Date Engine No. Chassis No.
Vehicle IDV CNG/LPG Kit Elec. Accessories Non-Elec. Accessories Total IDV
664,050 0 0 0 664,050
Schedule of Premium (Amount in Rs.)
Own Damage Premium (A) Basic Premium Deductibles Vehicle 6,357 Voluntary Deductibles (0) (IMT-22A) 0 Non-Elec. Accessories 0 Anti Theft Device (IMT-10) 0 Elec. Accessories (IMT-24) 0 AA Membership (IMT-8) 0 CNG/LPG Kit (IMT-25) 0 No Claim Bonus (0%) 0 Sub Total (Basic Premium) 6,357 Handicapped Discount (0%) 0 Geographical Area Extension (IMT-1) 0 Sub Total (Deductibles) 0 IMT 23 Premium 0 Add On Coverages (Refer Note 5) 2325 Sub Total-Addition 8682 Net Own Damage Premium (A) 8682 Liability Premium (B) Basic Third Party Liability 9534 PA Cover For 5 Persons of Rs. 40000 Each (IMT-16) 300 Third Party Liability For Bi-Fuel Kit 0 PA cover for Paid Driver of Rs 2,00,000 (IMT± 0 Third Party Liability For Geographical Area Extension 0 Legal Liability For Paid Driver (IMT-28) 150 PA Cover For Owner Driver Of Rs. 1500000 (IMT- 914 Legal Liability for Employees (for 0 persons) (IMT± 0 15) Net Liability Premium (B) 10898
Note: 1.Warning that in case of dishonour of the premium cheque, this document stands automatically cancelled 'ab-initio Total Premium (A+B) 19580 .2.Consolidated stamp duty paid to state exchequer. CGST (9%) 1763 3.The policy is subject to compulsory deductible of Rs.1000 (IMT-22) SGST (9%) 1763 5.Add-on: NIL DEP ALTROZ(Nil Depreciation-1 Year:2325) 6.The insurance company will display terms & conditions on its website www.icicilombard.com which can be accessed by you online. *Subject to IMT Endt. Nos.& Memorandum:7,22,16,28 Gross Premium Paid 23,106
Nominee Details Name of Nominee Age Relationship with Insured Name of Appointee Relationship with Nominee MRS. SHYAM NATH 58 MOTHER --N.A-- --N.A-- JOGI Payment Details : Cheque No.: 109042400289, Cheque Date: 20-DEC-2020, Bank Name: NON CUG HDFC CCAVENUE, Bank City: Hypothecation Details: STATE BANK OF INDIA - JABALPUR BRANCH - JABALPUR MISP Name: SUNIL AUTOMOTIVES, MISP PAN No: ACRFS6325D, MISP Code: TMIBASL/MISP/ACRFS6325D SAC:997134, Description of Service :Motor Vehicle Insurance Services, Place of Supply :MADHYA PRADESH(State Code:23), Receipt No/Invoice No:181220274242 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 Motor Vehicle Act, 1988 For & On Behalf of ICICI Lombard General Insurance Co. Ltd.
Authorized Signatory In case of any claim or assistance required please contact our help line at 1800 209 0060 and you may also reach us at [email protected] ICICI Lombard General Insurance Co. Ltd. Servicing Office of Insurer: Plot No 10 Second Floor, Alankar Palace, MP Nagar,, Zone II, Bhopal, Madhya Pradesh - 462011, , Madhya Pradesh (State Code:23) -462011, PH-- Website: www.icicilombard.com PAN: AAACI7904G . GSTIN: 23AAACI7904G1ZV Insurer's IRDA Registration Number: 115 Tollfree Helpline Email: CIN : U67200MH2000PLC129408 BUNDLED - PRIVATE CAR POLICY-CERTIFICATE CUM POLICY SCHEDULE (UIN- IRDAN115RP0006V01201819) (FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)
Policy No. 3001/TMP-100049961/00/000 Policy Issued On 20-DEC-2020 (19:15)
Insured Name MR. DIWAKAR NATH JOGI Own Damage Period 20-DEC-2020(19:15) To 19-DEC-2021(Midnight) Motor Liability Period 20-DEC-2020(19:15) To 19-DEC-2023(Midnight)
Limitations as to use: The policy covers use of the vehicle for any purpose other than (1) Hire or Reward (2) Carriage of goods (other than samples or personal luggage) (3) Organized racing (4) Pace making (5) Speed testing (6) Reliability trials (7) Any purpose in connection with motor trade.
Driver¶s Clause: Any person including the insured: Provided that the person driving holds an effective driving license at the time of the accident and is not disqualified from holding or obtaining such license. Provided also that the person holding an effective learners license may also drive the vehicle & that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules, 1989.
Limits of Liability Clause: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 Vehicle Act 1988.Under Section II-1 (ii) of the policy-Damage to third party property is Rs.7.5lakhs PA Cover Under Section III for Owner-Driver is Rs. 1500000 For resolution of any query or grievance you may contact us on toll free no. 1800 2666, or visit any of our branch offices. You can also write to us at www.icicilombard.com.
Important Notice: The insured is not indemnified if the vehicle is used or driven otherwise than in accordance with the schedule. Any payment made by the company by reasons 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 ³AVOIDANCE OF CERTAIN TERMS & RIGHT OF RECOVERY´For legal interpretation English version will hold good.
Note: 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. In Witness whereoff this policy has been signed at CHHINDWARA on 20-DEC-2020 19:15 ICICI Lombard General Insurance Co. Ltd. Servicing Office of Insurer: Plot No 10 Second Floor, Alankar Palace, MP Nagar,, Zone II, Bhopal, Madhya Pradesh - 462011, , Madhya Pradesh (State Code:23) -462011, PH-- Website: www.icicilombard.com PAN: AAACI7904G . GSTIN: 23AAACI7904G1ZV Insurer's IRDA Registration Number: 115 Tollfree Helpline Email: CIN : U67200MH2000PLC129408 BUNDLED - PRIVATE CAR POLICY-CERTIFICATE CUM POLICY SCHEDULE (UIN- IRDAN115RP0006V01201819) (FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)
Policy No. 3001/TMP-100049961/00/000 Policy Issued On 20-DEC-2020 (19:15)
Insured Name MR. DIWAKAR NATH JOGI Own Damage Period 20-DEC-2020(19:15) To 19-DEC-2021(Midnight) Motor Liability Period 20-DEC-2020(19:15) To 19-DEC-2023(Midnight)
PRIVATE CAR PACKAGE POLICY: ADD ON COVERS
Nil Depreciation
In consideration of the payment of an additional premium by the Insured, it is hereby agreed and declared that notwithstanding anything to the contrary contained in the Policy, the Company hereby undertakes to deduct no amounts for depreciation in case of parts replaced on account of damage to the vehicle insured and/or to its accessories, arising out of any peril as covered under the Policy, however this endorsement shall be applicable to the first two claims during the policy period and any subsequent claim shall be subject to a deduction for depreciation at the rates mentioned in the policy terms and conditions
