Customer Care Number

1800-22-1111 (MTNL/BSNL user)

1800-102-1111 (for other users)
[email protected]

Private Car Certificate cum Policy Schedule - Package Policy

(UIN No. IRDAN144RP0005V03201112)
Important Note: 1) The Validity of this Certificate of Insurance cum Schedule is subject to realization of the premium cheque. 2) This Insurance Policy cover is valid subject to availability of Complete and
Correct Registration Number within 15 days from the Date of Commencement of this Policy. 3) This insurance policy cover is valid subject to Warranties, Terms and Conditions of the policy.
Policy / Certificate No : PBMC000000140840
Policy Issue Date : 08/09/2022
Customer ID : NA
Policy Effective From : 05-10-2022 00:00 Hours To 04-10-2023 Midnight
Name : Mr. Ravi
Geographical Area : India
Address : 503 r eklavya tower Ranchi JH 834001
Policy Servicing Branch : Mumbai
Contact No. : 9905660677 Intermediary Name &
: Policybazaar Insurance Brokers Private Limited - 65359
Code
Email Id : [email protected]
Intermediary Contact No. :

Vehicle Details Insured’s Declared Values Amount (Rs)

Vehicle Make Model & Variant MARUTI SUZUKI, VITARA BREZZA & ZDI PLUS Vehicle IDV 477,659.00
Year of Mfg. 2017 Trailer/Side Car 0
Registration no JH01CQ0838 Electrical/Electronic Accessories 0.00
RTO Location Name Ranchi Non Electrical Accessories 0.00
Engine No D13A5519464 CNG/LPG Kit (Rs) 0.00
Chassis No. MA3NYFB1SHJ290617 Total IDV (Rs) 477,659.00
Cubic Capacity 1248 Type of Body
Fuel Type Diesel
Seating Capacity Including Driver 5
LIMITATION AS TO USE: As per Motor Vehicle Rules, 1989, 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.
DRIVERS CLAUSE : 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 Vehicle Rules, 1989.
LIMITS OF LIABILITY : a. Under Section II-1(i) of the Policy-Death of or bodily injury to any person so far as it is necessary to meet the requirements of the Motor Vehicle Act, 1988. b. Under Section II (1)(ii)
of the Policy-Damage to property other than property belonging to the insured or held in trust or in the custody or control of the insured up to the limits specified Upto Rs.7,50,000.00/-. c. PA Cover for owner-
driver under Section-III CSI - Rs. 1500000 /-.
DEDUCTIBLE UNDER SECTION-I : (i) Compulsory deductible Rs. 1000.00/- (ii) Voluntary deductible Rs. 0.00/-
SPECIAL CONDITION : Warranted all damages existing prior to inception of risk are excluded from the scope of policy.
NO CLAIM BONUS:The Insured is entitled for a No Claim Bonus (NCB) on the Own Damage section of the Policy, if no claim is made or pending during the preceding year(s), as follows: The preceding year –
20%; Preceding two consecutive years – 25%; Preceding three consecutive years – 35%; Preceding four consecutive years – 45%; Preceding five consecutive years – 50%.The No Claim Bonus will
only be allowed provided the Policy is renewed within 90 days of the expiry date of the previous policy.
Premium Computation Table
Own Damage - Section I Amount (Rs) Liability - Section II Amount (Rs)
Own Damage Premium for Vehicle & Accessories (Amount will be including all Basic Liability 3,416.00
7,621.05
tariff covers & discounts & Other Loading / Discount) CNG/LPG Bi-fuel Kit 0.00
Basic Road side Assistance 0.00
Depreciation reimbursement 5,254.25
Return to Invoice 0.00 Additional Covers
Engine Guard 0.00 PA cover - Owner Driver 0.00
Cover for Consumable 0.00 PA cover – Unnamed Passengers (SI/Person) 0.00
Electrical Accessories 0.00 Legal Liability Cover
Non Electrical Accessories 0.00 Legal Liability to paid driver 0.00
Bi-fuel Kit 0.00 TPPD - Third Party Property Damage Discount 0.00
Voluntary Discount 0.00 Total Third Party Liability Premium (B) 3,416.00
NCB Details TOTAL POLICY PREMIUM (A+B) 12480.77
No Claim Bonus 50% 3,810.53 GST 2,246.00
Total Own Damage Premium (A) 9064.77 Total Premium Collected 14,727.00
Premium Collection details : Receipt No.: PB57755100, Receipt Date: 08/09/2022
Hire Purchase/ Lease /Hypothecated with : ,
Subject to I.M.T Endorsement Nos. :IMT 22-GR 27
Subject to SBIG Add-On Endorsement Nos.:SBIG 16,Break In Insurance - Pre – Existing damages - Warranted all damages existing prior to inception of
risk are excluded from the scope of policy.
Nominee Details : Name :Rupa Anand, Age :27, Relation :Spouse
Warranty: Warranted that the insured named herein/owner of the vehicle holds a valid Pollution Under Control (PUC) Certificate and/or valid fitness
certificate, as applicable, on the date of commencement of the Policy and undertakes to renew and maintain a valid and effective PUC and/or fitness
Certificate, as applicable, during the subsistence of the Policy. Further, the Company reserves the right to take appropriate action in case of any
discrepancy in the PUC or fitness certificate. For and on behalf of SBI General Insurance Co. Ltd
For claims, Please contact us at Toll Free number
MTNL/BSNL users – 1800-22-1111, Other users – 1800-102-1111For complete Coverage & Policy Wording, kindly visit our website -
www.sbigeneral.in
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 M.V. Act, 1988.
Authorized Signatory
Policy Servicing Office : SBI General Insurance Company Ltd.9th Floor, A & B Wing, Fulcrum Building, Sahar Road, Andheri (East), Mumbai 400099.

Consolidated Stamp Duty Rs. 0.50 paid towards Insurance Policy Stamps vide Order No. CSD/360/2019/917/19 Dated: 2019-03-13 14:27:47.0 of General Stamp Office, Mumbai
Subject to I.M.T Endorsement Nos. :IMT 22-GR 27
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 Vehicle Act, 1988 is recoverable from the Insured. See the clause headed “AVOIDANCE OF CERTAIN
TERMS AND RIGHT OF RECOVERY”. For legal interpretation English version will be good.
Disclaimer: Please examine this Policy including attached Schedules / Annexure if any. In the event of any discrepancy please contact the office of the Company immediately, it being noted that this Policy
shall be otherwise considered as being entirely in order. Please find claims settlement & grievance redressal procedure available on www.sbigeneral.in S

SBI General Insurance Company Limited

Registered and Corporate office : 9th Floor, A & B Wing, Fulcrum Building, Sahar Road, Andheri (East), Mumbai 400099,IRDA of India Reg.No.144
 Customer Care Number
1800-22-1111 (MTNL/BSNL user)
1800-102-1111 (for other users)
[email protected]

Customer Service & Grievance Procedure : The Grievance Redressal Cell of the Company looks into complaints from policyholders. If the Insured has a grievance that the Insured wishes the Company to
redress, the Insured may approach the person nominated as ‘Grievance Redressal Officer’ with the details of their grievance. Process of Service Registration * Call us at our Toll Free - 1800 22 1111 / 1800
102 1111 Monday to Saturday (8 am - 8 pm). * Fax us at 1800 22 7244 / 1800 102 7244 * Email us at [email protected] * Visit us at any of our Branches. Process of Grievance Redressal Step 1: *
Call us at our Toll Free - 1800 22 1111 / 1800 102 1111 Monday to Saturday (8 am - 8 pm). * Fax us at 1800 22 7244 / 1800 102 7244. * Email us at [email protected] * Visit us at any of our
Branches. If you are not happy with the resolution provided, please follow step 2. Step 2: * Please email your concerns to Head - Customer Care at [email protected] Step 3: * If you are
dissatisfied with the resolution provided in the Steps as indicated above on your Complaint, you may send your ‘Appeal’ addressed to the Chairman of the Grievance Redressal Committee. The Committee will
look into the appeal and decide the same expeditiously on merits. You can write to Head – Compliance, Legal & CS on the id - [email protected] Step 4: * If your issue remains unresolved you may approach
IRDA by calling on the Toll Free no. 155255 or you can register an online complaint on the website http://igms.irda.gov.in * If after having followed the above steps you are not happy with the resolution and
your issue remains unresolved, you may approach the Insurance Ombudsman for Redressal. List of Ombudsman offices with contact details are attached for ready reference. For updated status, Please
refer to website www.irdaindia.gov.in
Names of Ombudsman and Addresses of Ombudsman Centers
Gujarat, Dadra & Nagar Haveli,Daman and Diu AHMEDABAD - Shri/Smt........ Rajasthan
Office of the Insurance Ombudsman, JAIPUR - Shri/Smt........
Jeevan Prakash Bldg, 6th Floor, Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg,
Tilak Marg, Relief Road, Jaipur - 302 005.
Ahmedabad – 380 001. Tel.: 0141 - 2740363
Tel.: 079 - 25501201 / 02 / 05 / 06 Email: [email protected]
Email: [email protected]
Karnataka Kerala,Lakshadweep,Mahe-a part of Pondicherry, ERNAKULAM - Shri/Smt........
BENGALURU - Shri/Smt........ Office of the Insurance Ombudsman,
Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground 2nd Floor, Pulinat Bldg.,
Floor, 19/19, 24th Main Road, Opp. Cochin Shipyard, M. G. Road, Ernakulam - 682 015.
JP Nagar, Ist Phase, Tel.: 0484 - 2358759 / 2359338
Bengaluru – 560 078. Fax: 0484 - 2359336
Tel.: 080 - 26652048 / 26652049 Email: [email protected]
Email: [email protected]
Madhya Pradesh Chattisgarh. West Bengal,Sikkim,Andaman & Nicobar Islands. KOLKATA - Shri/Smt........
BHOPAL - Shri/Smt........ Office of the Insurance Ombudsman,
Hindustan Bldg. Annexe, 4th Floor,
Office of the Insurance Ombudsman, 4, C.R. Avenue,
Janak Vihar Complex, 2nd Floor, KOLKATA - 700 072.
6, Malviya Nagar, Opp. Airtel Office, Near New Market, Bhopal – 462 003. Tel.: 033 - 22124339 / 22124340
Tel.: 0755 - 2769201 / 2769202 Fax : 033 - 22124341
Fax: 0755 - 2769203 Email: [email protected]
Email: [email protected]
Orissa Districts of Uttar Pradesh :Laitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot,
BHUBANESHWAR - Shri/Smt........ Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun,
Office of the Insurance Ombudsman, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti,
62, Forest park, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur,
Bhubneshwar – 751 009. Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur,
Tel.: 0674 - 2596461 /2596455 Chandauli, Ballia, Sidharathnagar.
Fax: 0674 - 2596429 LUCKNOW - Shri/Smt........
Email: [email protected] Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore
Road, Hazratganj, Lucknow - 226 001.
Tel.: 0522 - 2231330 / 2231331
Fax: 0522 - 2231310
Email: [email protected]
Punjab,Haryana,Himachal Pradesh,Jammu & Kashmir,Chandigarh. CHANDIGARH - Goa, Mumbai Metropolitan Region excluding Navi Mumbai & Thane MUMBAI - Shri/Smt........
Shri/Smt........ Office of the Insurance Ombudsman,
Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe,
S.C.O. No. 101, 102 & 103, 2nd Floor, Batra Building, Sector 17 – D, Chandigarh – 160 017. S. V. Road, Santacruz (W), Mumbai - 400 054.
Tel.: 0172 - 2706196 / 2706468 Fax: 0172 - 2708274 Tel.: 022 - 26106552 / 26106960 Fax: 022 - 26106052
Email: [email protected] Email: [email protected]
Tamil Nadu,Pondicherry Town andKaraikal (which are part of Pondicherry). CHENNAI - State of Uttaranchal and the following Districts of Uttar Pradesh:Agra, Aligarh, Bagpat,
Shri/Smt........ Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kanooj, Mainpuri, Mathura, Meerut,
Office of the Insurance Ombudsman, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad,
Fatima Akhtar Court, 4th Floor, 453, Gautambodhanagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj,
Anna Salai, Teynampet, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur.
CHENNAI – 600 018. NOIDA - Shri/Smt........
Tel.: 044 - 24333668 / 24335284 Office of the Insurance Ombudsman, Bhagwan Sahai Palace
Fax: 044 - 24333664 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar,
Email: [email protected] U.P – 201 301.
Tel.: 0120-2514250 / 2514252 / 2514253 Email: [email protected]
DELHI - Shri/Smt........ Bihar,Jharkhand.
Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, PATNA - Shri/Smt........
New Delhi – 110 002. Office of the Insurance Ombudsman, 1st Floor,Kalpana Arcade Building,, Bazar Samiti
Tel.: 011 – 2323481 / 23213504 Email: [email protected] Road, Bahadurpur, Patna 800 006.
Tel.: 0612-2680952
Email: [email protected]
Assam,Meghalaya,Manipur,Mizoram,Arunachal Pradesh,Nagaland and Tripura. GUWAHATI - Maharashtra,Area of Navi Mumbai and Thane,excluding Mumbai Metropolitan Region.
Shri/Smt........ PUNE - Shri/Smt........
Office of the Insurance Ombudsman, Office of the Insurance Ombudsman,
Jeevan Nivesh, 5th Floor, Jeevan Darshan Bldg., 3rd Floor,
Nr. Panbazar over bridge, S.S. Road, Guwahati – 781001(ASSAM). C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030.
Tel.: 0361 - 2132204 / 2132205 Tel.: 020-41312555
Fax: 0361 - 2732937 Email: [email protected]
Email: [email protected]
Andhra Pradesh,Telangana,Yanam and part of Territory of Pondicherry HYDERABAD -
Shri/Smt........
Office of the Insurance Ombudsman,
6-2-46, 1st floor, "Moin Court",
Lane Opp. Saleem Function Palace, A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004.
Tel.: 040 - 65504123 / 23312122
Fax: 040 - 23376599
Email: [email protected]
Address and contact number of Governing Body of Insurance Council
Secretary General Governing Body of Insurance Council,Jeevan Seva Annexe, 3rd Floor (Above MTNL),S. V. Road, Santacruz (W), Mumbai – 400 054,Tel: 022-6106889,Fax: 022-6106980, 6106052,Email:
[email protected] Integrated Grievance Management System
IRDA has launched the Integrated Grievance Management System (IGMS). IGMS is a grievance redress monitoring tool for IRDA. Policyholders who have grievances should register their complaints with the
Grievance Redress Channel of the Insurance Company first. If policyholders are not able to access the insurance company directly for any reason, IGMS provides a gateway to register complaints with
insurance companies. Complaints shall be registered with insurance companies first and only if need be, be escalated them to IRDA (Consumer Affairs Department). Website:
http://www.policyholder.gov.in/Integrated_Grievance_Management.aspx Toll Free Number of IRDA Grievance Call Centre: 155255, Timings: 8 AM to 8 PM -- (Monday to Saturday)
SBI General Insurance Company Limited
Registered and Corporate office : 9th Floor, A & B Wing, Fulcrum Building, Sahar Road, Andheri (East), Mumbai 400099,IRDA of India Reg.No.144