The Oriental Insurance Company Limited
MOTOR INSURANCE CERTIFICATE CUM POLICY SCHEDULE
PRIVATE CAR PACKAGE POLICY - ZONE B
Policy No : 211200/31/2019/142560 Prev Policy No : -
Cover Note No : - Cover Note Dt :
Insured's Code : 90338392 Issue Office Code : 211200
Insured's Name : Mr SUBHEESHNATH (GSTIN: ) Issue Office Name : DO II NEW DELHI (GSTIN:
07AAACT0627R1Z1)
Address : ATHIRA NIVAS, Address : 16/20, WEA, FIRST FLOOR,NEAR SHASTRI
PADANTHAZA,CHENDAYAD, PANOOR PARK,
PADAM SINGH ROAD, KAROL BAGH
KANNUR NEW DELHI
KERALA 670692 NEW DELHI DELHI 110005
Tel /Fax /Email : / / 7203903879 / subheeshnath@gmail.com Tel /Fax /Email : 011-28750963, 28758823, 28753268 / 011-
28750844 /
mandakini.balodhi@orientalinsurance.co.in
Local Servicing Office Code : 211200
Local Servicing Office Details : DO 2 NEW DELHI,16/20, WEA, FIRST FLOOR,NEAR SHASTRI PARK,,PADAM SINGH ROAD,
KAROL BAGH,NEW DELHI,,,011-28750963, 28758823,
Agent/Broker Details
Dev.Off.Code :
Agent/Broker : BF0000004776 POLICY BAZAAR 1
Address : PLOT 119, SECTOR 44, GURGAON-122001,
HARYANA,GURGAON,HARYANA,122001
Tel /Fax /Email : 18002088787//crtmotor@policybazaar.com
Period of Insurance : FROM 00:00 ON 20/10/2018 TO MIDNIGHT OF 19/10/2019
Collection No & Dt : 3 2005141855 - 15/10/2018 GST INVOICE NO :071711096025 UIN :0
Gross Premium : 5,591 GST : 1,006 Stamp Duty : .5 Total : 6,597
Geographical Area : IND Area Extension :
Particulars of Insured Vehicle:
Registration Mark Engine No. & Type Of Body Cubic Year Of Seating Capacity
& Place Chassis No. Make - Model Capacity Manf. (including Driver)
MP 04 CN 3779 K10BN7385346 MARUTI-WAGON R SALOON 998 2014 4 + 1
VXI+
BHOPAL MA3EWDE1S00767
855
Limitations as to use:
1 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) c) Organized racing d) Pace making e) Speed testing f) Reliability Trials g) Use in connection with Motor
Trade
Driver :
Any person including the 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.
Limit of Liability:
Under Section II-I(1) in respect of any one accident: as per Motor Vehicles Act, 1988.
Under Section II-I(ii) in respect of any one claim or series of claims arising out of one event is Rs. 750000
P.A. Cover under Section III for Registered Owner Cum Driver (CSI) : Rs. 1500000
Place : NEW DELHI
Date : 15/10/2018
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The Oriental Insurance Company Limited
Attached to and forming part of policy number 211200/31/2019/142560
28753268,9818491955,mandakini.balodhi@orientalinsurance.co.in
Insured's Declared Value
For the Vehicle For Trailers Non Electrical Electrical Value of CNG Total Value
Accessories Accessories LPG Kit
2,65,050 0 0 0 2,65,050
SCHEDULE OF PREMIUM
A. OWN DAMAGE B. LIABILITY
BASIC OD COVER 8,055.00 BASIC TP COVER 1,850.00
MOTOR OD BASIC - NEW 8,055.00 BASIC TP TOTAL 1,850.00
BASIC OD TOTAL 8,055.00 ADD :PA FOR OWNER DRIVER-GR36A 750.00
ADD :ADD-ON COVER NIL DEPRECIATION 1,551.00 TP TOTAL 2,600.00
POLICY
LESS :Discount 3,625.00 TOTAL PREMIUM 5,591.00
OD TOTAL 5,981.00 STAMP DUTY 0.50
LESS :NO CLAIM BONUS-GR27 2,990.50 ADD :IGST 1,006.00
MOTOR TOTAL OD 2,991.00 TOTAL AMOUNT 6,597.00
* NCB discount - 50 %
Deductibles under Section-I : Compulsory Deductible 1000
Subject to IMT Endorsement Printed herein/attached to : IMT-22 , OIC-1:Nil Depreciation Cover
Details of IMT Endorsements are also available on the Company¿s Web Portal www.orientalinsurance.org.in
Hypothecation Agreement with: STATE BANK OF INDIA
Hire Purchase/Lessor Agreement with: -
In the event of a claim under the policy exceeding Rs.1lac or a claim for refund of premium exceeding Rs1lac,the insured will comply with
the provisions of the AML policy of the Company.The AML policy is available in all our operating Offices as well as company's website.
The insurance under this policy is subject to conditions, clauses, warranties, exclusions, IMTs and OIC endorsements mentioned herein
above which are available on Company's website: www.orientalinsurance.org.in or on demand from the policy issuing office.
Warranted that in case of dishonour of premium cheque(s) the Company shall not be liable under the policy and the policy shall be void
abinitio (from inception).
Claim is not admissible if Driving License is found fake or is not valid whether or not in the knowledge of the insured.
I/We hereby certify that the policy to which the certificate relates as well as this certificate of insurance are issued in accordance with the provision of
Chapter X and Chapter XI of Motor Vehicles Act, 1988.
In witness whereof the undersigned being authorised by and on behalf of the company has/have herein to set his/their hands at DO II NEW DELHI
(GSTIN: 07AAACT0627R1Z1) on 15-OCT-18
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 MVAct, 1988 is
recoverable from the Insured. See the Clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY".
Place : NEW DELHI
Date : 15/10/2018
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The Oriental Insurance Company Limited
Attached to and forming part of policy number 211200/31/2019/142560
For and on behalf of
The Oriental Insurance Company Limited
Entered By : POLICY BAZAR
Examined By : POLICY BAZAR
Shri. Balwant Singh
Policy Printed By PREMIA IP General Manager
Policy Printed On 15-OCT-18 15:45:37 MAC Authorised Signatory
This is an electronically generated document (Policy Schedule).The Policy document duly stamped will be sent by post.
In case of any query regarding the Policy please call Toll Free No. 1800 11 8485 and 011 33208485.
CIN: U66010DL1947GOI007158 All the Amounts mentioned in this policy are in Indian Rupees
IRDA Regn. No. 556 - Now you can buy and renew selected policies online at www.orientalinsurance.org.in
Place : NEW DELHI
Date : 15/10/2018
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