12/2/24, 12:38 PM Policy Schedule Certificate Motor
Motor Commercial Vehicle Package Policy - For Goods Carrying Vehicles
(See Rule 51 of Central Motor Vehicles Rules, 1989 of Motor Vehicles Act,1988.)
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LTD.
ADDRESS: BHUBANESHWAR OFFICE GST Invoice No.: 3379556594072
Ground Floor, No A/167, Saheed Nagar, DATE: 02/12/2024
Bhubaneswar - 751007 PAN: AABCC6633K
SAHEED NAGAR S.O SAC Code: 997134
CITY: KHORDA STATE: ORISSA SAC Description: Motor vehicle insurance services
GSTIN: 21AABCC6633K7ZP
Business Location: BHUBANESHWAR OFFICE Cover Note No: -
Policy Number: 3379/04175101/000/00 Customer Code: 190000020386905 Policy Type: Package - Goods Carrying Vehicle
Name&Communication Address: Name and Registration Address:
DEEPAK KUMAR NAYAK
AT - GOTHAPUR , PO - BELAGACHHIA , PS - BARANGA , AT - GOTHAPUR , PO - BELAGACHHIA , PS - BARANGA ,
CUTTACK, CUTTACK,
BARANG S.O,CUTTACK BARANG S.O,CUTTACK
ORISSA,PIN- 754005 Mobile-- ORISSA,PIN- 754005 Mobile--
Period of Insurance: from 05/12/2024 00:00 hours to midnight on Business or Geographical Area: No
04/12/2025 Profession: Individual Extension
Certificate Number: 3379/04175101/000/00 Issue Date: 02/12/2024
PARTICULARS OF THE VEHICLE INSURED
Date of Registration: 13/11/2019 Place of Registration: CUTTACK Registration Mark: OD-0-5AU-1109
Make: ASHOK LEYLAND Model: DOST PLUS - LX HSD BSVI Variant: LX HSD BSVI Vehicle Colour: - Year of Mfg: 2019
Type of Body: OPENBODY Fuel Used: DIESEL Engine No: EKH031488P Chassis No: MB1AA22E5KRB81774
Cubic [Link] Gross Vehicle GVW as per Public/Private Registration Contract
Capacity: 2750 : - Weight(GVW): 2750 RC: 0 Carrier: PUBLIC Mark(Trailer): - No: -
Licensed Passenger Carrying Capacity: 2 Driver 1 Cleaner: 0 Conductor: 0 Total Seating Capacity Including Driver: 3 Chassis No.(Trailer): -
IDV (Insured Declared Value)
Value of Chassis (Rs): 433000 Value of Body (Rs): 0 For Vehicle (Rs): 433000 For Trailer (Rs): 0 Non-Electrical Accessories (Rs): 0
Electrical/Electronic Accessories (Rs): 0 Value of CNG/LPG Kit (Rs): 0 Total Value (Rs): 433000
A. OWN DAMAGE B. LIABILITY
SI No. of Person IMT Premium (Rs) SI No. of Person IMT Premium (Rs)
Basic OD 433,000.00 7,664.00 Basic TP 16,049.00
IMT 23 7,664.00 23 1,150.00 Paid Driver 1 40 50.00
TOTAL 8,814.00 Legal Liability to 40 50.00
Own Damage Premium 8,814.00 TOTAL 16,149.00
Experience Based Discount (80%) 7,051.20 TOTAL PREMIUM(B) 16,149.00
TOTAL(A) 1,763.00 [Link] ACCIDENT COVERS
[Link]-ON COVERS(BENEFITS) TOTAL PREMIUM(C) .00
Benefit
Option No.
No. TOTAL (A+B+C+E) 17,912.00
ADD-ON COVERS PREMIUM 0.00 TOTAL CONSIDERATION 17,912.00
Add-On Covers Discount .00 CGST 1,128.00
TOTAL ADD-ON-COVERS PREMIUM (D) 0.00 SGST 1,128.00
[Link] CHARGES (NON PREMIUM) IGST 0.00
Chola value added services 0.00 AMOUNT COLLECTED 20,168.00
TOTAL OTHER CHARGES (NON PREMIUM) (E) 0.00
LIMITATIONS AS TO USE: The Policy covers use of the vehicle for any purpose other than: a)Organised Racing. b)Use while drawing a Trailer,except the towing(other than for reward) of any one disabled mechanically
propelled vehicle. c)Pace Making. d)Reliability Trial. e)Speed Testing. f)Use for carrying passengers in vehicles;except employees not exceeding the number permitted in the registration document and coming under the purview of
Workmen's Compensation Act 1923.
[Link] per Sec 147 of MV Act issued policy the premium received only to an extent of liability fixed by IRDA/Central Govt
[Link] 150 (2) (b) that the policy is void on the ground that it was obtained by, nondisclosure of any material fact or by representation of any fact which was, false in some material particular;
[Link]
ii.(c) that there is non-receipt of premium as required under section 64VB of, the Insurance Act, 1938.
[Link] Application for compensation shall be entertained unless it is made within 6 Months from the date of occurrence of the Accident
[Link] Sum shall be payable by an Insurer incase a person driving the vehicle does not have a valid driving license or is under the influence of Alcohol or Drug.
DRIVER CLAUSE: Any person including 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 when not used for the transport of goods at the time of the accident and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles
Rules 1989.
LIMITS OF LIABILITY:Under Section II-1 (1) of the Policy - Death or bodly 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 - Rs.750000 P.A. Cover for the Owner cum Driver Under Section III (CSI)- Rs..00 Deduction Under Section 1: Rs.500 Additional compulsory deductibles under Section 1 Rs.0.00
Additional Imposed deductibles under Section 1 Rs.0
Subject to I.M.T. Endt. Nos. and Memorandum: 23,21,40 .
Coverage Under this policy is subject to realisation of premium cheque(s). Incase of dishonor of cheque(s). No separate intimation will be given and the policy stands cancelled from inception.
Product Plan:
Applicable benefits:-
The policy wordings with detailed terms, conditions,warranties exclusions and the list of Ombudsman details are available on our website [Link].
Date and Signature of the proposal 02/12/2024.
Warranties: -
Warranted that NCB under this Policy is based on representation regarding NCB and absence of claim under the previous Policy. If the information be found incorrect or false in any aspect, this Policy shall be void ab initio and no
benefit shall be payable by the company. It is warranted that separate value for Chassis and body including cabin has to be declared for insurance failing which assessment of own damage claims will get prejudiced
This policy has been issued upon declaration by the Assured that a valid Pollution Under Control (PUC) Certificate is held on the date of commencement of the Policy
lt is hereby warranted the coverage under this Policy commences only from the Risk Start time and Date as mentioned in the Policy schedule. No Liability shall attach under this Policy in respect of any Accident/Loss prior to the
time and date of commencement of Period of insurance
No Claim Bonus will only be allowed provided the policy is renewed within 90 days of the expiry date of the previous policy.
CVAS NEW :
As per GR 36A-PA for Owner driver refers to the Owner of the insured vehicle holding an effective drving licence.
Nominee Details:
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12/2/24, 12:38 PM Policy Schedule Certificate Motor
Financier Name & Address:
Intermediary Name: GIRNAR INSURANCE
POSP Name:
BROKERS PRIVATE LIMITED
POSP PAN
Code: 202077721536
No.:
POSP
Contact No: 7551196989
Aadhaar No.:
Note: The Motor Policy Schedule cum Certificate of Insurance is an important document issued based on your declaration. We request you to verify the details and ensure that everything is in order. In case of any discrepancies,
please contact us within 15 days from the date of issuance of policy.
For Cholamandalam MS General Insurance Company Ltd.
Place: CHENNAI Date:02/12/2024 Receipt No: Receipt Date:
@CholaSign1
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) Duly Constituted Attorney(s)
of rule 48, we are not required to prepare an invoice in terms of the provisions of the said sub-rule and also as per Notification No. 13/2020-CT dated 21-03-2020. This policy
schedule shall be in lieu of Tax Invoice and hence no separate GST invoice required In compliance with Rule 54(2) of CGST Rules, 2017.
Consolidated Stamp Duty Paid Vide G.O Rt No , Commercial Taxes and Registration (j1) Department, Tamil Nadu dated
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 the Motor Vehicles Act, 1988.
IMPORTANT NOTICE: The insured is not indemnified if the vehicles 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 Information/Claims: Contact Toll Free Helpline at 1800 208 5544: sms "CHOLA" to 56677 For CARE contact 1800 103 5354;
E-mail: customercare@[Link]: [Link]
Note:UIN for this product and the related add on covers availed under this policy are as mentioned in the attached sheet ,which forms part of the Policy Schedule.
Whether tax is payable under reverse charge basis - No.
Cholamandalam MS General Insurance Company Ltd.
Regd.&Head Office:Dare House, 2nd Floor, No.2, N.S.C Bose Road, Chennai-600 001, India
CIN: U66030TN2001PLC047977 | IRDAI Reg. No. 123
Motor Commercial Vehicle
Product
: Package Policy - For Goods
Name
Carrying Vehicles
IRDAN123RP0003V03100001
UIN :
NA
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