Private Car Package Policy: Certificate of Insurance Cum Policy Schedule
Private Car Package Policy: Certificate of Insurance Cum Policy Schedule
Private Car Package Policy: Certificate of Insurance Cum Policy Schedule
Policy Year Policy Period For the Vehicle (`) Trailer (`) Non Electrical Acc. (`) Electrical Acc. (`) CNG/LPG Kit (`) Total IDV (`)
Year 1 From 31/08/2020 To 30/08/2021 410563 0 0 0 0 410563
Own Damage Policy Period Liability Policy Period
From Date & Time 31/08/2020 00:01 hrs To Date & Time 30/08/2021 Midnight From Date & Time 31/08/2020 00:01 hrs To Date & Time 30/08/2021 Midnight
Premium Details (`)
Own Damage Premium(a) (`) Liability Premium(b) (`)
Basic Own Damage: 5777 Basic Third Party Liability: 2072
Total Basic Premium 5777 PA Cover for Owner Driver of 1500000 ( CPA Cover Policy Period From Date 31/08/2020 325
To Date 30/08/2021 )
Less: No Claim Bonus (25%) 1444 Net Liability Premium (b) 2397
Total - Less 1444 Total Package Premium (a+b) 12272
Add on Coverages GST 18% : Central Tax 9%( `1104.5) State Tax 9%( `1104.5) 2209
Zero Depreciation (IRDAN125A0021V01201415) 2874
Engine and Gear box Protection (IRDAN125A0004V01201213) 821
No Claim bonus Protection 821
Return to Invoice (IRDAN125A0013V01201213) 1026
Total - Add on 5542
Net Own Damage Premium (a) 9875 Total Premium 14481
Geographical Area India Compulsory Deductible (IMT-22) 1,000 Voluntary Deductible (IMT-22A) 0
Payment Details
Cheque / DD / Fund Transfer No. 1122008625522 Dated : 07/08/2020 Drawn on BizDirect
Previous Policy No. 215700/31/2020/93153 Valid 31/08/2019 to 30/08/2020 of THE ORIENTAL INSURANCE CO. LTD. NCB 20%
Policy Holder declare that no claim has been made in the previous year policy. If declaration found incorrect, benefits under the present policy in respect of own damage section will stand forfeited.
Nominee for Owner driver Reshma Fernandes Spouse Appointee
Hypothecated(IMT-7) with: HDFC BANK LIMITED
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 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): `
200000 Terms, Conditions & Exclusions: As per the Indian Motor Tariff. A personal copy of the same is available free of cost on request and the same is also available at our website.
Warranted that the Assured named herein/owner of the vehicle insured holds a valid Pollution Under Control (PUC) Certificate on the date of commencement of the Policy. If the PUC is not found valid on the date
of commencement of the Policy, the Company reserves its right to repudiate the Own Damage claim made under the Policy.
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 0.50 paid
b y Demand Draft, vide Receipt/Challan no. CSD/36/2019/2289/19 dated 27-05-2019 as prescribed in Government of Maharashtra Order No. Mudrank Mudrank-2017/CR.97/M-1, dated the 09th January 2018,dated
31/12/2004. IMPORTANT NOTICE: The Insured i s 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 i s 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 in full is not realised by the company. 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 i s issued basis the information provided b y you, which i s 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.
Branch : LEELA BUSINESS PARK, 6TH FLR, ANDHERI - KURLA RD, MUMBAI, 400059. Phone No. : +91-22-66383600
Goods and Service Tax Registration No: 27AABCL5045N1Z8 HSN Code 997134
For HDFC ERGO General Insurance Company Ltd
#1#
HDFC ERGO General Insurance Company Limited (Formerly HDFC General Insurance Limited) UIN : HDE-MO-P14-40-V02-14-15 | IRDAI Reg No.146 | CIN : U66030MH2007PLC177117
Registered & Corporate Office: Customer Service Address: Customer Service no : 022 - 6234 6234 / 0120 - 6234 6234
1st Floor, HDFC House, 165/166 Backbay Reclamation, D 301, 3rd Floor, Eastern Business District (Magnet Mall), Telephone: 022 6638 3600 Fax : 022 6638 3699
H.T.Parekh Marg, Mumbai - 400 020 LBS Marg, Bhandup (West), Mumbai - 400 078 Email : care@hdfcergo.com
HDFC ERGO General Insurance Company Limited
2311100832426600000
Motor Insurance - Proposal Form cum Transcript Letter For Private Car Package
HDFC ERGO General Insurance Company Limited (Formerly HDFC General Insurance Limited) UIN : HDE-MO-P14-40-V02-14-15 | IRDAI Reg No.146 | CIN : U66030MH2007PLC177117
Registered & Corporate Office: Customer Service Address: Customer Service no : 022 - 6234 6234 / 0120 - 6234 6234
1st Floor, HDFC House, 165/166 Backbay Reclamation, D 301, 3rd Floor, Eastern Business District (Magnet Mall), Telephone: 022 6638 3600 Fax : 022 6638 3699
H.T.Parekh Marg, Mumbai - 400 020 LBS Marg, Bhandup (West), Mumbai - 400 078 Email : care@hdfcergo.com