COMPREHENSIVE POLICY

Certificate of Insurance cum Policy Schedule

Summary

Renault Kwid Valid from Valid till (midnight)

GA03R7883 23 MAR 23 22 MAR 24
Car owner Owner number Owner email
BHUSHAN SAGARKAR XXXXXX7009 [email protected]
Plan Policy price Car value
Comprehensive ₹ 4521.80 ₹ 169613.0
Please refer overlay for more details

WELCOME! We’re happy to have you at Acko, and promise to be there for you always. You’re now a part of the
Acko Advantage program, which takes care of everything if your car ever runs into trouble. Just call us
immediately on 1800 266 2256 when things go wrong and we’ll take it from there.

Acko Non-Acko
Advantage* Advantage
Free car pick-up
from home,
office or accident
site

Repairs at our
network of
expert garages.

Car drop at your

doorstep.

Cashless and
hassle-free
processing.

*Only applicable in selected cities provided you call us immediately - Ahmedabad | Bangalore | Chennai | Delhi | Hyderabad | Kolkata | Mumbai |
Pune

Please Note: Previous Policy document is required in case of claim within 30 days of Acko Policy Start Date.

If you are a workshop or garage staff

Please call Acko for quick settlements on 1800 209 9910 [ GST# for workshop Invoice 27AAOCA9055C1ZJ ]
Acko Ge ne ral Insurance Ltd.
Unit No. 301, 3rd Floor, F Wing, Lotus Corporate Park, Goregaon (E), Mumbai- 400063
Email: [email protected] | Phone: 18 00 266 2256 | www.acko.com
Product: Private Car Package Policy | CIN : U66000MH2016PLC28 738 5
IRDAI Reg No. 157 | HSN: 997134 | GST: 27AAOCA9055C1ZJ
UIN: IRDAN157RP0007V02201718 /A0009V012018 19/IRDAN157RP
0024V012018 19/A0004V01201920 Page 1 of 6
What’s Covered
A snapshot of all the coverages in this policy.

Accide nts Fire T he f t

Damages to the car due to an accident. In case your car catches fire, resulting If your car is stolen, we will pay you the
from self-ignition, explosion or lightning. value as per policy of your car.

C alamitie s T hird - Party Lo sse s C o nsumable s

Damage due to natural or man made Death, injury or property damage to any Covers the cost of consumables like nut,
causes like earthquake, riots, etc. third party arising from your car. bolt, lubricant etc. consumed during car
repair due to accident.

Engine Pro te ct C ar C ar Owne r C o ve r

Covers repairs or replacement of internal Death and disability cover for the car
parts of the engine or gearbox and owner.
differential assembly arising out of water
ingression, hydrostatic lock, or leakage
of coolant/lubricating oil.

What’s Not Covered

A snapshot of all the coverages that are not covered in this policy.

No n-Accide nt Damage C o nse que ntial Lo ss & Nucle ar Risk & War Ille gal Driving
Like depreciation, wear & C o ntractual Liability Damages to your car due to Damage due to the car driven by a
tear, breakdown, failures & Indirect damage or liability nuclear risk, war & mutiny person without a valid driving
breakages, and deductibles. arising due to your car license or under influence of
accident. liquor/drugs.

T yre , T ube s & Engine C ar Re vie w Exce ptio n C o mme rcial usage o f the
Not included unless the tyre, Pre-existing Damages as C ar
tubes & engine are damaged found on vehicle inspection. If the Car is registered as
due to an accident. Private vehicle & if it is used
for commercial purpose than
the losses or liability due to
accident during such usage is
not covered in this policy.

Car Review Exceptions

We found the following exceptions in your Car Review which we unfortunately won't be able to cover.

The info rmatio n pro vide d he re in abo ve is fo r the purpo s e o f illus tratio n o nly. Fo r mo re de tails o n ris k facto rs , te rms ,
co nditio ns and e xclus io ns , ple as e re ad the po licy wo rdings ( https ://www.ack o .co m/do wnlo ad ) care fully.
Page 2 of 6
 COMPREHENSIVE POLICY
Private Car Package Policy

POLICY DET AILS VEHICLE DET AILS

Insured Name: BHUSHAN SAGARKAR Registration Number: GA03R78 8 3
Address/Pincode: 403521 Make/Model: Renault Kwid
Period of Insurance: 23 Mar 23 00:00 hrs to 22 Mar 24 23:59 Purchase Year: 2017
hrs Engine CC: 799
Policy Issuance Date: 21 Mar 23
Policy Number: DCCR008 258 65400/00
INSURED DECLARED VALUE (IDV)
Ve hicle IDV (₹) Acce sso rie s (₹) Bif ue l K it (₹) T o tal IDV (₹)

169613 0.0 0 169613.0

PREMIUM DET AILS (₹)

Own Damage Pre mium (A) Liability Pre mium (B)

Basic Own Damage ₹ 118 1.02 Basic Third Party Liability ₹ 2094.00

NCB Discount ₹ (236.20) PA for Owner Driver ₹ 399.00

Consumables ₹ 38 .03

Engine Protect ₹ 356.19

Net Own Damage Premium (A) ₹ 1339.03 Net Liability Premium (B) ₹ 2493.00

Total Package Premium ₹ 38 32.03

IGST (18 %) 68 9.77

Total Premium ₹ 4521.8 0

Geographical Area: India Voluntary Deductible: ₹0 Hypothecation: NA

No-Claim Bonus: 20% Compulsory Deductible: ₹ 1000
L i m i tati o n s As T o U se: The Po licy co ve rs us e o f the ve hicle fo r any purpo s e o the r than: a) Hire o r Re ward b) Carriage o f go o ds (o the r than s ample s o r pe rs o nal
luggage ) c) Organize d racing d) Pace mak ing e ) Spe e d te s ting f) Re liability Trials g) Any purpo s e in co nne ctio n with Mo to r Trade . Perso n s o r Cl ass o f Perso n s
en ti tl ed to d ri ve: Any pe rs o n ((including the ins ure d), pro vide d that a pe rs o n driving ho lds a valid driving lice ns e at the time o f the accide nt and is no t dis qualifie d
fro m ho lding o r o btaining s uch a lice ns e . Pro vide d als o that the pe rs o n ho lding a valid le arne r's lice ns e may als o drive the ve hicle and that s uch a pe rs o n s atis fie s the
re quire me nts o f Rule 3 o f the Ce ntral Mo to r Ve hicle s Rule s , 198 9. L i m i ts o f L i ab i l i ty. 1. Unde r Se ctio n II-1 (i) o f the po licy - De ath o f o r bo dily injury - Such amo unt as
is ne ce s s ary to me e t the re quire me nts o f the Mo to r Ve hicle s Act, 198 8 . 2 . Unde r Se ctio n II - 1(ii) o f the po licy -Damage to Third Party Pro pe rty - Rs . 7 5 0 0 0 0 3 . P. A.
Co ve r unde r Se ctio n III fo r Owne r - Drive r (CSI): Rs . 15 0 0 0 0 0 T erm s, Co n d i ti o n s & Exc l u si o n s: As pe r the Indian Mo to r Tariff. A pe rs o nal co py o f the s ame is available
fre e o f co s t o n re que s t & the s ame is als o available at o ur we bs ite .
I / We he re by ce rtify that the po licy to which the ce rtificate re late s as we ll as the ce rtificate o f ins urance are is s ue d in acco rdance with the pro vis io n o f chapte r X, XI o f
Mo to r Ve hicle s Act, 198 8 . Stamp Duty o f Rs * * /- is paid as pro vide d unde r Article 4 7 o f Indian Stamp Act, 18 99 and include d in Co ns o lidate d Stamp Duty Paid to the
Go ve rnme nt o f Maharas htra Tre as ury vide Orde r o f Addl. Co ntro lle r o f Stamps , Mumbai at Ge ne ral Stamp Office , Fo rt, Mumbai - 4 0 0 0 0 1., vide this Orde r No .
(LOA/CSD/3 93 /2 0 2 2 /Validity Pe rio d Dt. 15 /0 7 /2 0 2 2 To Dt. 3 1/12 /2 0 2 3 / 2 912 Date :0 1/0 7 /2 0 2 2 ). GSTN: 2 7 AAOCA90 5 5 C1ZJ. IMPO RT ANT NO T ICE: The Ins ure d is no t
inde mnifie d if the ve hicle is us e d o r drive n o the rwis e than in acco rdance with this Sche dule . Any payme nt made by the Co mpany by re as o n o f wide r te rms appe aring in
the Ce rtificate in o rde r to co mply with the Mo to r Ve hicle s Act, 198 8 is re co ve rable fro m the Ins ure d. Se e the claus e he ade d " AVOIDANCE OF CERTAIN TERMS AND RIGHT
OF RECOVERY” in the po licy wo rdings . Di sc l ai m er: The Po licy s hall be vo id fro m ince ptio n if the pre mium che que is no t re alize d. In the e ve nt o f mis re pre s e ntatio n,
fraud o r no n-dis clo s ure o f mate rial fact, the Co mpany re s e rve s the right to cance l the Po licy. Ple as e no te that the ins ure d ve hicle was pre -ins pe cte d and a re po rt was
pre pare d acco rdingly. The e xis ting damage s to the ve hicle as me ntio ne d in the re po rt s hall no t be paid by the Co mpany. The po licy is is s ue d bas is the info rmatio n
pro vide d by yo u, which is available with the co mpany. In cas e o f dis cre pancy/no n re co rding o f re le vant info rmatio n in the po licy, the ins ure d is re que s te d to bring the
s ame to the no tice o f the co mpany within 15 days . This Po licy is to be re ad in co njunctio n with the Po licy wo rdings (https ://www.ack o .co m/do wnlo ad) available o n the
we bs ite o f the Co mpany. On re ne wal, the be ne fits pro vide d unde r the po licy and/o r te rms and co nditio ns o f the po licy including pre mium rate may be s ubje ct to
change .

INT ERMEDIARY DET AILS

Policy Issuing Office: Direct - Mumbai Intermediary Name: Direct
Phone Number: NA Intermediary Code: NA

Acko Ge ne ral Ins urance Ltd .

Unit No . 301, 3rd Flo o r, F Wing, Lo tus C o rpo rate Park , Go re gao n (E), Mumbai- 40006 3
Email: he llo @ack o .co m | Pho ne : 1800 26 6 2256 | www.ack o .co m
Pro duct: Private C ar Pack age Po licy | C IN : U6 6 000MH2016 PLC 287385
IRDAI Re g No . 157 | HS N: 9 9 7134 | GS T: 27AAOC A9 055C 1ZJ
UIN: IRDAN157RP0007V02201718/A0009 V01201819 /IRDAN157RP0024 Fo r Ack o Ge ne ral Ins urance Ltd.
V01201819 /A0004V012019 20 Duly C o ns titute d Atto rne y
Page 3 of 6
 PREMIUM RECEIPT

Received with thanks from BHUSHAN SAGARKAR a sum of ₹ 4521.80 towards premium on Car Insurance
Policy

INSURED DET AILS

Name of Insured: BHUSHAN SAGARKAR
Period of Insurance: 23 Mar 23 00:00 hrs to 22 Mar 24 23:59
hrs
Policy Number: DCCR008 258 65400/00
Payment Date: 21 Mar 23

PREMIUM DET AILS (₹)

Gross Premium ₹38 32.03

IGST (18 %) ₹ 68 9.77

Total Premium ₹4521.8 0

We he re by de clare that tho ugh o ur aggre gate turno ve r in any pre ce ding financial ye ar fro m 2017-18 o nwards is mo re than the aggre gate turno ve r no tifie d
unde r s ub-rule (4) o f rule 48 o f C GS T Rule s 2017, we are no t re quire d to pre pare an invo ice in te rms o f the pro vis io ns o f the s aid s ub-rule .

T ERMS & CONDIT IONS:

Issuance of this receipt does not amount to acceptance of the risk by Acko General Insurance Limited. The insurance cover for the risk shall be
as per the terms and conditions of the Insurance Policy if and when issued. * Cheque/DD/PO receipt is valid subject to realization of the
instrument.

Acko Ge ne ral Insurance Ltd.

Unit No. 301, 3rd Floor, F Wing, Lotus Corporate Park, Goregaon (E), Mumbai- 400063
Email: [email protected] | Phone: 18 00 266 2256 | www.acko.com
CIN : U66000MH2016PLC28 738 5 | IRDAI Reg No. 157 | HSN: 997134 | GST: 27AAOCA9055C1ZJ
UIN: IRDAN157RP0007V02201718 /A0009V012018 19/IRDAN157RP For Acko General Insurance Ltd.
0024V012018 19/A0004V01201920 Duly Constituted Attorney
Page 4 of 6
 PROPOSAL FORM

Dear BHUSHAN SAGARKAR,

We wish to inform you that the Insurance policy number DCCR00825865400/00 has been issued on the
basis of the information and declaration given by you, the transcript whereof is mentioned below.

Please be informed that this Policy shall be construed to be void ab initio/invalid in the event we find that you have not
disclosed material or correct information required for the purpose of providing the below insurance cover and in case of any
claim arising under the policy in such a scenario, we shall be under no obligation whatsoever to settle such claim to you and the
premium paid by you under this policy shall stand fully forfeited.

POLICY DET AILS PREVIOUS POLICY DET AILS

Policy Number: DCCR008 258 65400/00 Previous Policy Expired: Not Expired
Period of Insurance: 23 Mar 23 00:00 hrs to 22 Mar 24 23:59 Previous Policy Insurer: Acko General Insurance
hrs Previous Policy Type: Package
Policy Issuance Date: 21 Mar 23

CAR DET AILS CAR OWNER DET AILS

Car Number: GA03R78 8 3 Name: BHUSHAN SAGARKAR
Make/Model: Renault Kwid Email Address: [email protected]
Type: Private Mobile Number: XXXXXX7009
Fuel Type: petrol NCB: 20%
Registration Year: 2017 Address/Pincode: 403521
Registration Month: Jan
Insured Declared Value (IDV): 169613
Accessories (IDV): 0.0

Acko Ge ne ral Insurance Ltd.

Unit No. 301, 3rd Floor, F Wing, Lotus Corporate Park, Goregaon (E), Mumbai- 400063
Email: [email protected] | Phone: 18 00 266 2256 | www.acko.com
CIN : U66000MH2016PLC28 738 5 | IRDAI Reg No. 157 | HSN: 997134 | GST: 27AAOCA9055C1ZJ
UIN: IRDAN157RP0007V02201718 /A0009V012018 19/IRDAN157RP For Acko General Insurance Ltd.
0024V012018 19/A0004V01201920 Duly Constituted Attorney
Page 5 of 6
 PROPOSAL FORM

COVER DET AILS

Add-o ns/ Othe rs Include d Exclude d

PA Cover -

Consumables -

Zero Depreciation -

Engine Protect Car -

T ERMS & CONDIT IONS:

“I/We desire to insure with Acko General Insurance Limited in respect of the vehicle described in this proposal form and confirm that the
statements contained in this application are my/our true and accurate representations. I/We undertake that if any of the statements are found
to be false or incorrect, the benefits under this policy would stand forfeited. I/We agree that this application and declaration shall be promissory
and shall be the basis of the contract between me/us and Acko General Insurance Limited. I/We agree to the Company taking appropriate
measures to capture the voice log for all such telephonic transactions carried out by me/us as required by the procedures/regulations internal or
external to the Company and shall not hold the Company responsible or liable for relying/using such recorded telephonic conversation. In the
event of nonrealization of the cheque or non-receipt of the amount of premium by the Company the policy shall be deemed cancelled ‘ab-initio’
and the Company shall not be responsible for any liabilities of whatsoever nature under this Policy.” I/We agree to receive ‘Certificate of
Insurance or Policy Schedule’ only and shall access the policy terms, conditions and exclusions on the company’s website.

PROHIBIT ION OF REBAT ED (SECT ION 4 1) OF T HE INSURANCE ACT - 1938 (AS AMENDED)
1. No person shall allow or offer to allow, either directly or indirectly as an inducement to any person to take out or renew or continue and
insurance in respect of any kind or risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any
rebate of the premium shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate expect such
rebate as may be allowed in accordance with the prospectus or tables of the Insurer.
2. Any person making default in complying with the provisions of this section shall be liable for a penalty which may extend to 10 lakh rupees.

Acko Ge ne ral Insurance Ltd.

Unit No. 301, 3rd Floor, F Wing, Lotus Corporate Park, Goregaon (E), Mumbai- 400063
Email: [email protected] | Phone: 18 00 266 2256 | www.acko.com
CIN : U66000MH2016PLC28 738 5 | IRDAI Reg No. 157 | HSN: 997134 | GST: 27AAOCA9055C1ZJ
UIN: IRDAN157RP0007V02201718 /A0009V012018 19/IRDAN157RP For Acko General Insurance Ltd.
0024V012018 19/A0004V01201920 Duly Constituted Attorney
Page 6 of 6