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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: HUBLI BRANCH OFFICE GST Invoice No.: 3379573239472
I FLOOR, KALBURGI SQUARE, DESAI CROSS, DATE: 15/03/2025
DESHPANDE NAGAR, HUBLI - 580029 PAN: AABCC6633K
HUBLI TRAFFIC ISLAND S.O SAC Code: 997134
CITY: DHARWARD STATE: KARNATAKA SAC Description: Motor vehicle insurance services
GSTIN: 29AABCC6633K5ZB
Business Location: HUBLI BRANCH OFFICE Cover Note No: -
Policy Number: 3379/04305689/000/00 Customer Code: 190000023438965 Policy Type: Package - Goods Carrying Vehicle
Name&Communication Address: Name and Registration Address:
SUBHANASAB H ONTI
S/O HUSENASAB VARD 4 B C M HOSTEL HATTIR #2229 S/O HUSENASAB VARD 4 B C M HOSTEL HATTIR #2229
MUNDARGI,, MUNDARGI,,
MUNDARGI S.O,GADAG MUNDARGI S.O,GADAG
KARNATAKA,PIN- 582118 Mobile-8123816330 KARNATAKA,PIN- 582118 Mobile-8123816330
Period of Insurance: from 15/03/2025 19:57 hours to midnight on Business or Geographical Area: No
14/03/2026 Profession: Individual Extension
Certificate Number: 3379/04305689/000/00 Issue Date: 15/03/2025
PARTICULARS OF THE VEHICLE INSURED
Date of Registration: 27/11/2015 Place of Registration: GADAG Registration Mark: KA-26-A-5638
Make: ASHOK LEYLAND Model: DOST - LS BSVI Variant: LS BSVI Vehicle Colour: - Year of Mfg: 2015
Type of Body: OPENBODY Fuel Used: DIESEL Engine No: TFH031870P Chassis No: MB1AA22E4FRT15063
Cubic [Link] Gross Vehicle GVW as per Public/Private Registration Contract
Capacity: 1478 : - Weight(GVW): 2805 RC: 0 Carrier: PUBLIC Mark(Trailer): - No: -
Licensed Passenger Carrying Capacity: 2 Driver 2 Cleaner: 0 Conductor: 0 Total Seating Capacity Including Driver: 3 Chassis No.(Trailer): -
IDV (Insured Declared Value)
Value of Chassis (Rs): 325000 Value of Body (Rs): 75000 For Vehicle (Rs): 400000 For Trailer (Rs): 0 Non-Electrical Accessories (Rs): 0
Electrical/Electronic Accessories (Rs): 0 Value of CNG/LPG Kit (Rs): 0 Total Value (Rs): 400000
A. OWN DAMAGE B. LIABILITY
SI No. of PersonIMT Premium (Rs) SI No. of PersonIMT Premium (Rs)
Basic OD 400,000.00 7,248.00 Basic TP 16,049.00
IMT 23 7,248.00 23 1,087.00 Paid Driver 1 40 50.00
TOTAL 8,335.00 Legal Liability to 1 40 50.00
Own Damage Premium 8,335.00 LL to Paid Driver 1
Experience Based Discount (80%) 6,668.00 TOTAL 16,149.00
TOTAL(A) 1,667.00 TOTAL PREMIUM(B) 16,149.00
[Link]-ON COVERS(BENEFITS) [Link] ACCIDENT COVERS
Benefit PA for owner driver 1,500,000.00 550.00
Option No.
No. TOTAL PREMIUM(C) 550.00
ADD-ON COVERS PREMIUM 0.00
Add-On Covers Discount .00 TOTAL (A+B+C+E) 18,366.00
TOTAL ADD-ON-COVERS PREMIUM (D) 0.00 TOTAL CONSIDERATION 18,366.00
[Link] CHARGES (NON PREMIUM) CGST 1,169.00
Chola value added services 0.00 SGST 1,169.00
TOTAL OTHER CHARGES (NON PREMIUM) (E) 0.00 IGST 0.00
AMOUNT COLLECTED 20,704.00
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.1,500,000.00 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 15/03/2025.
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.
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:
Financier Name & Address:
Intermediary Name: AFRID
POSP Name:
LALSAB WALIKAR
POSP PAN
Code: 290000019564278
No.:
POSP
Contact No: 6363780878
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:15/03/2025 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 Duly Constituted Attorney(s)
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 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.
In the event of a claim under Compulsory personal accident cover (CPA), the intimation of the claim to the Insurer shall be within 30 days of its occurrence
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
Product
Name :
UIN :
