Bajaj Allianz General Insurance Company Ltd.

Registered and Head Office: Bajaj Allianz House, Airport Road, Yerwada, Pune

Transcript of Proposal for Private Car Package Policy

Dear ATIBHA VERMA,

We wish to inform you that the contract under policy number 'OG-23-1302-1801-00003366' has been finalized based on the
information and declaration given by you, the transcript whereof is mentioned below. You are requested to reconfirm the same.
In case of any disagreement or objection or any changes with respect to information mentioned below, we request you to
please revert back within a period of 15 days from date of your receipt of this, failing which it will be deemed that you are
satisfied with the correctness of the details mentioned below. Kindly note that as the contents and declarations contained in this
transcript is the basis on which we have issued the policy to you, we advise you to please ensure that you have
provided/disclosed and or not withheld any material facts/information and declarations, as Policy becomes Void ab initio if
material facts are not provided/disclosed and or withheld and in such case no claim, if any, will be considered by us apart from
forfeiture of the premium.
Details provided by you:

A. Proposer details
1. Proposer Name : ATIBHA VERMA
2. Proposer Address : 115/160 ASHIRVAD APPARTMRNT DARBHANGA COLONY,
ALLAHABAD, , ALLAHABAD, UTTAR PRADESH-211001
3. Proposer Mobile Number : 6307926405
4. Proposer Residential Number : NA
5. Proposer e-mail id : NA
6. Proposer Profession : NA

B.Vehicle Details
Registration Month / Year Vehicle Vehicle Vehicle Sub Cubic Capa- Fuel Type Year of Man- Seating Ca-
Number of Regn Make Model Type city/Kilowatt ufacture pacity
UP70BL2343 FEB/2010 TATA NANO CX 624 Petrol 2010 4

Engine Number Chassis Number Vehicle IDV (in Electrical Non-Electrical CNG/LPG Unit Total IDV (in
Rs.) Accessories Accessories (Extra fitted) Rs.)
IDV (in Rs.) IDV (in Rs.) IDV (in Rs.)
33392 25773 73,479.00 0 0 0 73,479.00
 C. Coverage opted

1. Period of Insurance : From 10-FEB-2023 00:01(Hrs)

To 09-FEB-2024 Midnight
2. Is your vehicle fitted with external LPG/CNG kit : No.
3. Electrical Accessories cover Opted (If Applicable) : No.
4. Non - Electrical Accessories cover Opted (If Applicable): : No.
5. Is Voluntary Excess opted : No.
Amount of voluntary excess opted : Rs.NA.
6. Whether PA cover is opted for owner-driver : Yes.
7. Is any additional compulsory deductible imposed and agreed upon : No.
Amount of additional compulsory deductible imposed : NA.
8. Whether geographical area extension is opted : No.
Details of Countries to which geographical area extension cover is given : NA.
9. Is LL to person for Paid driver/Operation/Maintenance opted : No.
10. Whether PA cover is opted for paid driver other than owner driver : No.
Sum Insured for Paid Driver : Rs.NA.
12. Is TPPD restricted to statutory limit of Rs.6,000? : No.
13. Pre Existing damages in the vehicle : NA.
14. 1 Premium for Liability coverage, quoted and agreed upon is :
15. 1 Premium for OD coverage, quoted and agreed upon is :
16. Do you have valid PUC certificate of the vehicle : NA
17. Do you have valid Fitness certificate of the vehicle : NA
18. Total Premium (excluding Goods and Service Tax (GST)) for Liability and OD coverages, quoted and agreed upon is
:
19. NCB (No Claim Bonus) claimed by you and granted by us based on your declaration of no claim during your previous
previous policy : -50 %.
20. About the last insurance company
(i) Insurance Provider : Bajaj Allianz General Insurance Co Ltd..
(ii) Previous Policy No : OG-22-1316-1801-00000544, Previous Policy Expiry Date :09-FEB-23
21. Whether your vehicle is Hypothecated and if so the details of Pledgee whose name is registered by us: No.
Name of Pledgee : NA.
22. Add on Cover(s) optedm2 : Yes, Plan Name:24x7 Spot Assistance And Accidental Medical Expenses Plan Description:
24x7 spot assistance , , accidental medical expenses cover with sum insured Rs..00
Please call us on 1800 103 5858 for any emergency.

23. To support our Go Green initiative, send policy copy link on registered mobile number / email id: NO
Please note Cover Note No. / issued to you basing on the above information.
In case of Disagreement or objection or any changes with respect to information and contents mentioned hereinabove, please
contact our toll free number & register your objections/changes/disagreement to the contents of this transcript or you may also
send us email or written correspondence at the following details within a period of 15 days from date of your receipt of this
transcript along with Policy:
I/We hereby unconditionally allow the Company to share all my / our information being collected in this proposal form or
through telephonic / email / web-inputs means or other means, as updated from time to time within group entities.
Toll free Number : 1800-102-5858,1800-209-5858
Email address : [email protected]
Website : www.bajajallianz.com
Contact our policy servicing branch at: Bajaj Allianz General Insurance Co.Ltd, 15/54 B 2nd Floor, Virendra Smriti Complex,
Civil Lines, KANPUR NAGAR-208001 PH:0512-2338277.
INSURANCE ACT, 1938 SECTION 41 - PROHIBITION OF REBATES
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 an insurance in respect of any kind of 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 a policy
accept any rebate, except such rebate as may be allowed in accordance with the published prospectus or tables of the insurer.
ANY PERSON IN BREACH OF COMPLYING WITH THE PROVISIONS OF THIS SECTION SHALL BE PUNISHABLE
WITH FINE WHICH MAY EXTEND TO RUPEES TEN LAKH.Bajaj Allianz General Insurance Co Ltd
  

BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LIMITED

Regd. Office & Head Office: GE Plaza, Airport Road, Yerwada,Pune-411006(India)
IRDAI Registration No. 113
Corporate Identity Number: U66010PN2000PLC015329
Certificate of Insurance ( PRIVATE CAR PACKAGE POLICY)

UIN : IRDAN113RP0025V01200102
Policy Number: OG-23-1302-1801-00003366 Customer ID: 42794799
Particulars of Vehicle Insured:
Registration Number Place of Registration Engine Number Chassis Number Make & Model
UP70BL2343 ALLAHABAD 33392 25773 TATA - NANO

Sub Type Year of Mfg NCB % CC Seating Capacity

CX 2010 -50 624 4

Name of Registration Authority : ALLAHABAD

Name and Address of Insured : ATIBHA VERMA
: 115/160 ASHIRVAD APPARTMRNT DARBHANGA
COLONY, ALLAHABAD, , ALLAHABAD, UTTAR
PRADESH-211001
Geographical Area : India
Business or Profession : NA
Effective date of commencement of Insurance for the purpose of act:
Policy Inception Date: From 00:01 O' Clock on 10-FEB-2023
Policy Expiry Date: Midnight on 09-FEB-2024
Persons or Class of Persons entitled to drive:
Any person including the insured:
a) 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.
b) 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.
IMT-Endorsements/Add on Package
22, 29 & Plan Name:24x7 Spot Assistance And Accidental Medical Expenses & Plan Description: 24x7 spot assistance , ,
accidental medical expenses cover with sum insured Rs..00
Limitations as to Use:
The Policy covers use 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
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.
Policy issuing office and correspondence address for communication by holder of Certificate of Insurance for claim,
service request, notice, summons, etc:
Bajaj Allianz General Insurance Co.Ltd, 15/54 B 2nd Floor, Virendra Smriti Complex, Civil Lines, KANPUR
NAGAR-208001 PH:0512-2338277
Date of issue :07-FEB-2023
For & On Behalf of
Bajaj Allianz General Insurance Company Ltd.
Now carry your m-policy on your mobile. Click here to download. https://bagic.page.link/YNv5k3

For help and more information:

Contact our 24 Hour Call Centre at 1800-102-5858, 1800-209-5858, Toll Free: 30305858( chargeable, add area code before this number in case of mobile call) Email us at
[email protected] or Visit our Website www.bajajallianz.com
Corporate Identification Number U66010PN2000PLC015329
Latest Schedule - 08-Feb-2023 11:27:47 AM- Silent_Printing (Web) (0)
Authorized Signatory
  

BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LIMITED

(A Company incorporated under Indian Companies Act, 1956 and licensed by Insurance Regulatory and Development Authority of
India [IRDA] vide Reg No.113)
Regd. Office: Bajaj Allianz House, Airport Road, Yerwada,Pune-411006(India)
PRIVATE CAR PACKAGE POLICY SCHEDULE
UIN : IRDAN113RP0025V01200102
Policy issuing office and Correspondence address for communication by policyholder for claim, service request, notice, summons, etc:
Bajaj Allianz General Insurance Co.Ltd, 15/54 B 2nd Floor, Virendra Smriti Complex, Civil Lines, KANPUR NAGAR-208001
PH:0512-2338277
INSURED DETAILS POLICY DETAILS
Insured Name ATIBHA VERMA Policy Number OG-23-1302-1801-00003366
115/160 ASHIRVAD APPARTMRNT Policy Issued on 07-FEB-2023 21:21 PM
Insured DARBHANGA COLONY, ALLA-
HABAD, , ALLAHABAD, UTTAR PRA- From : 10-FEB-2023 00:01 (Hrs)
Address DESH-211001
Policy Period To : 09-FEB-2024 Midnight
Geographical India
Area Cover Note
/
Customer ID Details
42794799
Previous Policy No OG-22-1316-1801-00000544
Bank Reference
No 1 47469986/13
Invoice No
GSTIN / UIN NA Company GST No 09AABCB5730G1ZV
Place of Supply/ 09 - Uttar Pradesh
State Code/Name Company PAN AABCB5730G

Make & Mod-

Registration Number Place of Registration Engine Number Chassis Number SubType
el
UP70BL2343 ALLAHABAD 33392 25773 TATA - NANO CX
Year Of Manufactur- Trailer Registra-
NCB % CC/KW Seating Capacity Hypothecation Details
ing tion Number
-50 624 4 2010 -,-
Non electrical Electrical/Elec- Value of CNG/
Vehicle IDV Value For Trailers Total Value
accessories tronic accessories LPG kit
73,479.00 0 0 0 0 73,479.00
Own Damage Premium(Rs.) Liability Premium(Rs.)
Own Damage Premium 1,410.00 Basic Third Party Liability 2,094.00
Special Discount 0.00 PA Cover for Owner-Driver - SI - Rs.1500000 331.00
Total OD Premium - A 1,410.00 LL to employee other than paid driver/cleaner 50.00
Total Premium (Net Premium) (A+B) 3,884.00 (IMT 29)
State GST (9%) 350.00 Total Act Premium - B 2,475.00
Central GST (9%) 350.00
Final Premium ( Rupees Four Thousand Five Hundred 4,584.00
Eighty Four Only )
**Note: The above Total OD Premium is inclusive of all applicable Loading /Discounts viz (Automobile association membership, Voluntary Excess,
Anti Theft, Handicap Person, Driver Tuition, Fiber Glass, CNG/LPG Unit, Geographical Extension, Imported Vehicle Etc. wherever Applicable)

As per the GST regulations, the amount of GST will not be refunded if the policy / endorsement is cancelled after 30th September of the next financial year
I/We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than the aggregate turnover notified under
sub-rule (4) of rule 48, we are not required to prepare an invoice in terms of the provisions of the said sub-rule.

Agency Code BAG10036846 Contact No. 0/9936290680

Agency Name KUNAAL . SHARMA
For help and more information:
Contact our 24 Hour Call Centre at 1800-102-5858, 1800-209-5858, Toll Free: 30305858( chargeable, add area code before this number in case of mobile call) Email us at Ba-
[email protected] or Visit our Website www.bajajallianz.com
Corporate Identification Number U66010PN2000PLC015329
Latest Schedule - 08-Feb-2023 11:27:47 AM- Silent_Printing (Web) (0)
  

E-Mail ID. [email protected]

Limitation as to Use The Policy covers use of the vehicle for any purpose other than : Hire or reward, Carriage of
goods( other than samples or personal luggage),Organised racing,Pace making, Speed testing,
Reliability trials. Any purpose in connection with Motor Trade.
Driver Any person including the insured provided that a person driving holds an effective driving li-
cense 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
when not used for the transport of goods/passengers at the time of the accident and that such a
person satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules, 1989.
Limits of Liability Under section II-I(i) of the policy -> Death of or bodily injury : Such amount is necessary to meet
there requirements of the Motor Vehicles Act,1988. Under section II-I(ii) of the policy -> Dam-
age to Third Party Property : Rs. 7,50,000.00
Existing Damage Details
Nominee Details Name :NA - Relationship :NA
Subject to Warranties/ 22, 29 & Plan Name:24x7 Spot Assistance And Accidental Medical Expenses & Plan Descrip-
IMT-Endorsements/ tion: 24x7 spot assistance , , accidental medical expenses cover with sum insured Rs..00
Add on Package
Additional Details Coinsurance Details: - . Transaction Id: -
Premium Details Receipt No. 1302-00567928, Date 07-FEB-23 ** If Premium paid through Cheque, the Policy is
void ab-initio in case of dishonour of Cheque.
Excess Details Compulsory Excess: Additional Excess: Rs.0 Voluntary Excess: Rs..00
Rs.1,000.00
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.
Warranted that insured named herein or owner of the vehicle insured holds a valid Pollution Under Control (PUC) and / or Fitness Certificate on the date of
commencement of the Policy. If the PUC and/or Fitness Certificate is not found to be valid on the date of commencement of the Policy, the Company reserves
its right to consider the policy void ab initio.
For & On Behalf of
Bajaj Allianz General Insurance Company Ltd.

Stamp
Duty Rs.
0.25

Authorized Signatory
This document is digitally signed, hence counter signature / stamp is not required.
Consolidated Stamp Duty of Rs.0.25/- paid towards Insurance Stamps vide Challan No. MH002223565202223M Defaced No. 0001502897202223 ORDER NO.CSD/371/2022/2472 OR-
DER DATED 10.06.2022DEFACED DATE dated 10-JUN-22 timing 11:08:23 of General Stamp Office,Mumbai,India.

Principal Location : Bajaj Allianz General Insurance Co.Ltd, 15/54 B 2nd Floor, Virendra Smriti Complex, Civil Lines, KANPUR
NAGAR - 208001 PH:0512-2338277 | Services Accounting Code : 997134 - Motor vehicle insurance services. No reverse charge is payable
on these services.
 Bajaj Allianz General Insurance Company Ltd.
Bajaj Allianz General Insurance Co.Ltd, 15/54 B 2nd Floor, Virendra Smriti Complex, Civil Lines, KAN-
PUR NAGAR - 208001
Contact No:Contact No: 0512-2338277,0512-2338278; Fax No: 0512-2530529

RECEIPT

Receipt Number 1302-00567928

Receipt Date 07/02/2023
Business Channel ML

Received with thanks from ATIBHA VERMA

(Customer ID : 42794799 ) a total sum of Rupees Four Thousand Five Hundred Eighty Four
Only by,

Instrument Instrument No. Instrument Bank Name Branch Name Amount

Type Date
Credit Card 97210928 07/02/2023 NA NA 4,584

Total Amount Rs. 4,584.00

Issuance of this receipt does not amount to acceptance of the risk by Bajaj Allianz General In-
surance Company Limited. The insurance cover for the risk shall be as per the terms and con-
ditions of the Insurance Policy if and when issued.
* Cheque/DD/PO receipt is valid subject to realisation of the instrument.

For & on behalf of

Bajaj Allianz General Insurance Company Ltd.

Authorised Signatory

Regd.Office: Bajaj Allianz House,Airport Road, Yerwada, Pune - 411006

 PRIVATE CAR PACKAGE POLICY: ADD ON COVERS(Plan Name:24x7 Spot Assistance And Accidental Medical
Expenses): POLICY WORDINGS

S1 - 24x7 SPOT ASSISTANCE

(UIN No. IRDAN113RP0025V01200102/A0024V01200910)
A. Endorsement Wordings
In consideration of the payment of additional premium, it is hereby agreed and declared that You shall be entitled to one or
more of the below mentioned benefits depending on the plan opted by You and as shown on the Schedule :
(A) Flat Battery: In the event of the Insured Vehicle being immobilized due to a flat battery, We will make al-
ternative arrangements to make the Insured Vehicle mobile again provided the event has occurred within 100
kilometers from the center point of the city of Your residence and the Insured Vehicle has not reached a work-
shop/repairer. (B) Spare Keys: In the event of You losing keys of the Insured Vehicle , We will arrange for the
pick up and delivery of spare keys to the spot where the Insured Vehicle is located provided the event has oc-
curred within 100 kilometers from the center point of the city of Your residence and the Insured Vehicle has not
reached a workshop/repairer. (C) Flat Tyre: In the event of the Insured Vehicle being immobilized due to flat
tyres, We will arrange for the refill of the flat tyres and/or replacement of the flat tyres with a usable spare tyre to
make the Insured Vehicle mobile again provided the event has occurred within 100 kilometers from the center
point of the city of Your residence and the Insured Vehicle has not reached a workshop/repairer . (D) Minor Re-
pairs: In the event of the Insured Vehicle being immobilized due to mechanical and/or electrical breakdown, We
will arrange for minor mechanical and/or electrical repairs to make the Insured Vehicle mobile again provided
the event has occurred within 100 kilometers from the center point of the city of Your residence and the Insured
Vehicle has not reached a workshop/repairer. (E) Towing Facility: In the event of the Insured Vehicle getting im-
mobilized as a result of Accident and/or breakdown, We shall arrange for towing away of the Insured Vehicle
from the spot of immobilization to Our nearest preferred workshop provided the event has occurred within 100
kilometers from the center point of the city of Your residence. (F) Urgent Message Relays: In the event of the In-
sured Vehicle getting immobilized as a result of Accident and/or breakdown, We will send urgent message on
Your request to the specified persons through available means of communication (G) Medical Co-ordination: In
the event of the Insured Vehicle meeting with an Accident, You can call Us on our Toll Free Number, mentioned
on the Schedule , to obtain details regarding the nearest medical center that can provide emergency relief services.
(H) Fuel Assistance: In the event of the Insured Vehicle being immobilized due to an empty fuel tank and/or con-
taminated fuel, We will either arrange for supply of 3 litres of petrol or diesel on chargeable basis and/or towing
of the Insured Vehicle to Our nearest preferred workshop provided the event has occurred within 100 kilometers
from the center point of the city of Your residence and the Insured Vehicle has not reached a workshop/repairer.
(I) Taxi Benefits: In the event of the Insured Vehicle meeting with an Accident/breakdown, We will arrange for a
free travel of the occupants of the Insured Vehicle to a single destination within a vicinity of 50 kilometers from
the spot of immobilization through a taxi or any other transportation service provided the event has occurred with-
in 100 kilometers from the center point of the city of Your residence and the Insured Vehicle has to be towed
away to Our nearest preferred workshop. Any travel beyond 50 kilometers can be covered on payment of addi-
tional amount as specified by Us. In the unlikely event of We being unable to arrange for this service, We may re-
quest You to arrange for a taxi to transfer the occupants of the Insured Vehicle on Your own and submit the bills
for a pre-communicated amount for re-imbursement to Us. (J) Accommodation Benefits: In the event of the In-
sured Vehicle meeting with an Accident/breakdown, We will provide occupants of the Insured Vehicle with a
hotel accommodation for one day provided the event has occurred beyond 100 kilometers from the center point of
the city of Your residence but within 100 kilometers of another covered city and the time to repair the Insured
Vehicle will exceed 12 hours from the time of reporting the incident.
The accommodation benefits would be offered subject to a per day limit of Rs. 2,000 per occupant and a maxim-
um total limit of Rs. 16,000 for all the occupants of the Insured Vehicle through out the Policy Period. In the un-
likely event of We being unable to arrange for this service, We may request You to arrange for a hotel accom-
modation for the occupants of the Insured Vehicle on Your own and submit the bills for a pre-communicated
amount for re-imbursement to Us. (K)Legal Advice: In the event of the Insured Vehicle meeting with an Acci-
dent, You shall be entitled for a free legal advice from a legal advisor over the phone for a maximum duration of
30 minutes. Subsequent to the expiry of the specified period of 30 minutes, You may continue with the same legal
advisor on direct payment basis
B. Conditions
(1) . In case of transfer of ownership of the Insured Vehicle , the cover under '24x7 Spot Assistance' shall expire.
(2) The benefits under '24x7 Spot Assistance' can be utilized for a maximum of 4 times during the Policy Period
except for 'Fuel Assistance', 'Taxi Benefits', 'Accommodation Benefits' and 'Legal Advice' for which the aggregate
utilization limit is 2 times during the Policy Period
C. Exclusions
(1) Where the Insured Vehicle can be safely transferred on its own power to nearest dealer/workshop. (2) Any
Accident, loss, damage and/or liability caused, sustained or incurred whilst the Insured Vehicle is being used oth-
erwise than in accordance with the limitations as to use. (3) Any liability of whatsoever nature directly or indir-
ectly caused by or contributed to by or arising from ionising radiations or contamination by radioactivity from any
nuclear fuel or from any nuclear waste from the combustion of nuclear fuel. For the purpose of this exception,
combustion shall include any self-sustaining process of nuclear fission. (4) Any Accident, loss, damage and/or li-
ability directly or indirectly or proximately or remotely occasioned by contributed to/by or traceable to or arising
out of or in connection with war, invasion, the act of foreign enemies, hostilities or warlike operations (whether
before or after declaration of war), civil war, mutiny rebellion, military or usurped power or by any direct or indir-
ect consequences of any of the said occurrences. (5) Any loss or damage caused due to riots, strikes and Act of
 PRIVATE CAR PACKAGE POLICY: ADD ON COVERS(Plan Name:24x7 Spot Assistance And Accidental Medical
Expenses): POLICY WORDINGS

God perils like flood, earthquake etc. (6) Claims pertaining to theft losses. (7) Any consequential loss arising out
of claims lodged under '24x7 Spot Assistance' .(8) Where a loss is covered under Motor Insurance Policy or any
other type of insurance policy with any other insurer or manufacturer's warranty or recall campaign or under any
other such packages at the same time.(9) Replacement cost of battery and/or any associated repair cost. (10) Cost
of supply of parts or replacements elements or consumables. (11)Repair cost of tyre and/or parts or replacement
cost of any part of consumable at a third party workshop/repairer. (12)Any taxes, levy and expenses incurred in
excess of the limit described under the plan opted by You . (13)Loss of valuables and personal belongings kept in
the Insured Vehicle . (14) Any loss or damage to the Insured Vehicle arising out of participation in a motor ra-
cing competition or trial runs. (15)Where it is proved that You have abused the benefits under '24x7 Spot Assist-
ance'. (16)Any loss or damage caused due to pre- existing damages. (17)Any loss or damage arising out of inter-
vention of Government Authorized Agencies, Police Authorities or Law Enforcing Agencies . (18)Any loss or
damage resulting from the use of Insured Vehicle against the recommendations of the owners manual and/or
manufacturer's manual. (19)Any loss resulting from Your deliberate or intentional and/or unlawful or criminal act
(20)Benefits under 'Taxi Benefits' and 'Accommodation Benefits' for occupants in excess of the seating capacity
as per the registration certificate of the Insured Vehicle . (21)Additional cost incurred in towing the Insured
Vehicle to a dealer/workshop as specified by You instead to Our specified nearest authorized workshop. (22)Ser-
vices organized without Our prior consent for the various assistance services. (23)If You or Your personal repres-
entative is already at a garage for delivery of the Insured Vehicle or at the place of recovery in case of theft
(24)Mechanical and/or electrical breakdowns that require replacement of spare parts and/or specialized tools/
equipments that are usually available only in automotive workshops
If You do not agree whether any of these exclusions apply to Your claim, You agree to accept the burden of proving that
they do not apply.
D. Definitions
The words and phrases listed have special meanings We have set below whenever they appear in bold type and initial
capitals. Please note that references to the singular or to the masculine also include references to the plural or to the fe-
male the context permits and if appropriate.
(1) You,Your,Yourself: The person or persons We insure as set out in the Schedule . (2) We, Our, Us: Bajaj Al-
lianz General Insurance Company Limited and/or the Service Provider with whom Bajaj Allianz General Insur-
ance Company Limited has entered into a contract to provide the benefits under this cover to You . (3) Accident,
Accidental: A sudden, unintended and fortuitous external and visible event. (4) Policy/Motor Insurance Policy:
Private Car Package Policy issued by Us to which this cover is extended. (5) Insured Vehicle : The vehicle in-
sured by Us under the Motor Insurance Policy. (6) Policy Period: The period between and including the com-
mencement date and expiry date as shown in the Motor Insurance Policy Schedule . (7) Schedule : The Sched-
ule and any Annexure or Endorsement to it which sets out Your personal details and the type of insurance cover
in force

S15: ACCIDENTAL MEDICAL EXPENSES COVER

(UIN No. IRDAN113RP0025V01200102/A0005V01201213)

A. Endorsement Wordings
In consideration of payment of additional premium, it is hereby agreed and declared that if You/Your family members
(named in the Schedule) are Hospitalized on advice of a Doctor because of an Accidental Bodily Injury sustained dur-
ing the Policy Period while travelling in the Insured Vehicle, then We will reimburse You, the reasonable and custom-
ary medical expenses incurred up to a maximum Sum Insured as shown in the Schedule for this Cover aggregate in any
one Policy Period. The medical expenses reimbursable would include: i) the reasonable charges that You/Your family
members (named in the Schedule) necessarily incur on the advice of a Doctor for In-patient Care in a Hospital for ac-
commodation; nursing care; the attention of medically qualified staff; undergoing medically necessary procedures and
medical consumables. ii) Ambulance charges for carrying You/Your family members (named in the Schedule) from the
site of accident to the nearest hospital, subject to a limit of Rs. 1,000 per claim.
B. Conditions
(1) Claims made by You against Us under #Accidental Medical Expenses Cover# are subject to the conditions set
forth under the Motor Insurance Policy (2)In case of transfer of ownership of the Insured Vehicle , the cover un-
der #Accidental Medical Expenses Cover# shall expire
C. Exclusions
In addition to the exclusions mentioned under under Motor Insurance Policy, We will not be liable to indemnify You
for the following events:
1. Where the Own Damage Claim made by You against Us under the Motor Insurance Policy is not payable. 2.
Accidental Bodily Injury that You/Your family members (named in the Schedule) meet with: a) Through suicide,
attempted suicide or self inflicted injury or illness b) While under the influence of liquor or drugs c) Arising or
resulting from You/Your family members (named in the Schedule) committing any breach of law with criminal
intent d) Whilst engaging in aviation or ballooning, whilst mounting into, dismounting from or travelling in any
balloon or aircraft other than as a passenger (fare paying or otherwise) in any duly licensed standard type of air-
craft anywhere in the world. e) Whilst participating as the driver, co-driver or passenger of a motor vehicle during
motor racing or trial runs f) As a result of any curative treatments or interventions that You/Your family members
(named in the Schedule) carry out or have carried out on your body g) Arising out of participation in any naval,
 PRIVATE CAR PACKAGE POLICY: ADD ON COVERS(Plan Name:24x7 Spot Assistance And Accidental Medical
Expenses): POLICY WORDINGS

military or air force operations whether in the form of military exercises or war games or actual engagement with
the enemy, whether foreign or domestic 3. Consequential losses of any kind, be they by way of loss of profit, loss
of opportunity, loss of gain, business interruption, market loss or otherwise, or any claims arising out of loss of a
pure financial nature such as loss of goodwill or any legal liability of any kind whatsoever 4. Any injury/dis-
ablement/death directly or indirectly arising out of or contributed to any pre-existing condition 5. Venereal or
sexually transmitted diseases 6. HIV (Human Immunodeficiency Virus) and/or any HIV related illness including
AIDS (Acquired Immune Deficiency Syndrome) and/or mutant derivatives or variations thereof however caused
7. Pregnancy, resulting childbirth, miscarriage, abortion, or complications arising out of any of these 8. War
(whether declared or not), civil war, invasion, act of foreign enemies, rebellion, revolution, insurrection, mutiny,
military or usurped power, seizure, capture, arrest, restraint or detainment, confiscation or nationalisation or re-
quisition of or damage by or under the order of any government or public local authority 9. Nuclear energy, radi-
ation If You do not agree whether any of these exclusions apply to Your claim, You agree to accept the burden of
proving that they do not apply.
D. Claims Process
1) Making a Claim If You/Your family members (named in the Schedule) meet with any Accidental Bodily Injury that
may result in a claim, then as a condition precedent to Our liability: a) You or someone claiming on behalf must inform
Us in writing immediately and in any event within 30 days b) You must immediately consult a Doctor and follow the ad-
vice and treatment that he recommends c) You must take reasonable steps to lessen the consequence of Bodily injury d)
You must have Yourself examined by Our medical advisors if We ask for this e) You or some one claiming on behalf
must promptly give Us documentation and other information We ask for to verify the claim or Our obligation to make
payment for it f) In the event of Your/Your family members (named in the Schedule) death, someone claiming on de-
ceased#s behalf must inform Us in writing immediately and send Us a copy of the post- mortem report within 30 days
Note: Waiver of conditions (a) and (f) may be considered in extreme cases of hardship where it is proved to Our satisfac-
tion that under the circumstances in which You/Your family members (named in the Schedule) were placed, it was not
possible for You or any other person to give notice or file claim within the prescribed time limit. 2) Claim Settlement a)
You agree that We need only make payment when You or someone claiming on behalf has provided a claim to Our satis-
faction b) We will make payment to You or to Your Assignee. If there is no Assignee, We will pay to Your legal heir, ex-
ecutor or validly appointed legal representative as per succession certificate and any payment We make in this way will
be a complete and final discharge of Our liability to make payment
E. Definitions
The words and phrases listed have special meanings We have set below whenever they appear in bold type and initial
capitals. Please note that references to the singular or to the masculine also include references to the plural or to the fe-
male the context permits and if appropriate. 1. Accident, Accidental: A sudden, unintended and fortuitous external and
visible event 2. Assignee: The person named in the proposal or Schedule to whom the benefits under the cover are as-
signed by You/Your family members (named in the Schedule) 3. Bodily Injury: Physical bodily harm or injury but not
any mental sickness, disease or illness 4. Doctor: A person who holds a recognized qualification in allopathic medicine,
is registered by the medical council of any State of India in which he operates and is practicing within the scope of such
license. 5. Hospital: means any institution in India established for the indoor care and treatment of disease and injury,
which: a) Is registered and licensed as a hospital or nursing home with the appropriate local authorities and is under the
supervision of a registered medical practitioner OR b) Complies with minimum criteria of: i) At least 15 inpatient beds
(10 in Class C towns) ii) Fully equipped OT of its own where surgical operations are carried out iii) Fully qualified nurs-
ing staff under employment round the clock iv) Qualified doctors in charge round the clock but shall not include any es-
tablishment which is a place of rest, a place for the aged, a place for drug-addicts or a place for alcoholics, a hotel or sim-
ilar place 6. Hospitalized/Hospitalization: Your/Your family members (named in the Schedule) required stay of as an in-
patient in a Hospital within India for medically necessary treatment following and due to an insured event 7. In-patient
Care: The treatment for which You/Your family members (named in the Schedule) have to stay in a Hospital for more
than 24 hours for a covered event 8. Insured Vehicle: The vehicle insured by Us under the Motor Insurance Policy 9.
Own Damage Claim: The claims raised by You against Us for loss or damage to the Insured Vehicle due to the perils
mentioned under Section 1 of Motor Insurance Policy 10. Policy/Motor Insurance Policy: Private Car Package Policy is-
sued by Us to which this cover is extended 11. Policy Period: The period between and including the commencement date
and expiry date as shown in the Motor Insurance Policy Schedule 12. Schedule: The Schedule and any Annexure or En-
dorsement to it which sets out Your personal details, the type of insurance cover in force and the Sum Insured 13. Sum
Insured: The amount stated in the Schedule, which is the maximum amount We will pay for claims made by You irre-
spective of the number of claims You make in respect of Yourself/Your family members (named in the Schedule) 14.
You, Your, Yourself: The person or persons We insure as set out in the Schedule 15. We, Our, Us: Bajaj Allianz General
Insurance Company Limited