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Motor Two - Wheelers Package Policy
UIN IRDAN123RP0002V02200203
(See Rule 51 of Central Motor Vehicles Rules, 1989 of Motor Vehicles Act,1988.)
GST Invoice No.:3361548725811 CHOLAMANDALAM MS GENERAL INSURANCE COMPANY
DATE: 04/11/2024 LTD.
PAN: AABCC6633K ADDRESS: VIJAYAWADA BRANCH OFFICE
SAC Code: 997134 DOOR NO.- 40-1-48/1, 2ND FLOOR, BEHIND KOTAK MAHINDRA
SAC Description: Motor vehicle insurance services BANK,
MG ROAD, VIJAYAWADA- 520010. (AP) DIST - KRISHNA
VENKATESWARAPURAM S.O
CITY: KRISHNA STATE: ANDHRA PRADESH
GSTIN: 37AABCC6633K5ZE
Business Location: NUZIVEED CIE Cover Note No: 0
Policy Number:3361/00639224/000/07 Customer Code:102049742911 Policy Type: Package - Two Wheeler Policy
Name & Communication Address: Name and Registration Address:
S/O JAKRAIAH D-NO 12-1-73 NARASARAOPETA GUNTUR
NAGARAJU BIRUDU ,NARASARAOPET H.O,GUNTUR,ANDHRA PRADESH PIN - 522601
S/O JAKRAIAH D-NO 12-1-73 Mobile- 9848347004,Landline- -
NARASARAOPETA GUNTUR
,NARASARAOPET
H.O,GUNTUR,ANDHRA PRADESH,PIN -
522601
Mobile- 9848347004,Landline- -
Certificate Number: 3361/00639224/000/07 Geographical Area: India
Period of Insurance: From 06/11/2024 00:00 hours to midnight on
Business or Profession: Individual
05/11/2025
PARTICULARS OF THE VEHICLE INSURED
Date of Registration:08/08/2016 Place of Registration:NARASARAOPET Registration Mark:AP-07-CW-3526
Make: HERO Model: GLAMOUR Variant: CASR DRUM SELF Vehicle Colour: - Year of Mfg: 2016
Type of Body: Two wheeler Fuel Used: PETROL Engine No: JA06EJG9E10716 Chassis No: MBLJA06AMG9E10545
Cubic Capacity:125 [Link]:- 0 Gross Vehicle Weight(GVW):- Public/Private Carrier:- Registration Mark(Trailer):- Contract No:-
Licensed passenger Carrying Total Seating Capacity Including Chassis No.
Driver:0 Cleaner:- Conductor:-
Capacity:2 Driver:2 (Trailer):-
IDV (Insured Declared Value)
Value of Body For Vehicle For Trailer Non-Electrical Accessories
Value of Chassis (Rs): 0.00
(Rs): 0.00 (Rs): 30,178.00 (Rs): 0.00 (Rs): 0.00
Electrical/Electronic Value of CNG/LPG Kit Total Value Odometer reading Anticipated distance to be
Accessories (Rs): 0.00 (Rs): 0.00 (Rs): 30,178.00 (kms): travelled (kms):
[Link] DAMAGE [Link]
[Link] Premium [Link] Premium
SI IMT SI IMT
Person (Rs) Person (Rs)
Basic OD 30,178.00 531.00 Basic TP 714.00
TOTAL 531.00 TOTAL 714.00
Less: Vintage Car Discount-TP 0
Bonus Discount(50%) 266.00 TOTAL PREMIUM(B) 714.00
Sub Total:(discounts) 266.00 [Link] ACCIDENT COVERS
Total -266.00 PA for owner driver 15,00,000.00 500.00
Own Damage TOTAL PREMIUM(C) 500.00
265.00
Premium TOTAL (A+B+C+E) 1,452.00
Experience Based TOTAL PACKAGE
27.00 1,452.00
Discount PREMIUM
TOTAL(A) 238.00 CGST (9%) 130.50
Chola value added services 0.00 SGST (9%) 130.50
CVAS New 0.00 IGST (0%) 0.00
Pay As You Use Discount
AMOUNT COLLECTED 1,713.00
Pay As You Use Loading
[Link] CHARGES(NON PREMIUM)
Break In Loading 0.00
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TOTAL-OTHER CHARGES(NON
.00
PREMIUM)(E)
LIMITATIONS AS TO USE: 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) in connection with any trade or business or use for any purpose in connection
with motor trade c) Organized racing d) Pace making e) Speed Testing f) Reliability Trial g) Tuition h) Use only with side car if
attached.
[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 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(i) of the Policy - Death or bodily 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.1,00,000.00 P.A. Cover for the Owner cum Driver Under Section III (CSI)- Rs.15,00,000.00
Deduction Under Section 1: Rs.100
Additional compulsory deductibles under Section 1 Rs.0
Additional Imposed deductibles under Section 1 Rs.0
Subject to I.M.T. Endt. Nos. and Memorandum: 22,7 .
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 wording with detailed terms, conditions, warranties, exclusions and the list of Ombudsman details are
available on our website [Link].
Date and Signature of the proposal 04/11/2024. In witness where of this policy has been signed in lieu of the Cover Note No.:-
Date:-
Warranties: Warranted that NCB under this Policy is based on representation regarding NCB and absence of claim under the
previous [Link] 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. 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 lnsurance
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.
As per GR 36A - PA for Owner driver refers to the Owner of the insured vehicle holding an effective driving licence.
No Claim Bonus is applicable at the end of the policy period.
Financier Name & Address: SHRIRAM TRANSPORT FINANCE LTD,VIJAYAWADA
Intermediary Name: CHOLA INSURANCE DISTRIBUTION SERVICES PRIVATE LIMITED
Code: 200572295173 Contact No: 9502406056
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.
Place: Receipt Receipt For Cholamandalam MS General Insurance
Date:04/11/2024
CHENNAI No:1087617074 Date:04/11/2024 Company Ltd. @CholaSign1
We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 Duly Constituted Attorney
onwards is more than the aggregate turnover notified under sub-rule (4) of rule 48, we are not (s)
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.526,Commercial Taxes and Registration (j1)
Department, Tamil Nadu dated02/09/2024.
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.
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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 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 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-600001, India
CIN: U66030TN2001PLC047977 | IRDAI Reg. No. 123
Product Name : Motor Two - Wheelers Package Policy
IRDAN123RP0002V02200203
UIN :
NA
[Link] 11/4/2024
