Policy
Policy
Registered and Head Office: Bajaj Allianz House, Airport Road, Yerwada, Pune
Dear ARJUN N,
We wish to inform you that the contract under policy number 'OG-22-1701-1825-00001766' 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 : ARJUN N
2. Proposer Address : FLAT E-1020, AMBER BLOCK,, BRIGADE LAKE FRONT APT,BROOKFIELD,
ITPL MAIN ROAD,
-, BANGALORE, BANGALORE, KARNATAKA-560037
3. Proposer Mobile Number : 7760295811
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
KA03NK644 SEP/2021 BMW 2 SERIES 220i Sport 1998 Petrol 2021 5
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.)
0140Y317 WBA37AK09M 32,87,607.00 0 0 0 32,87,607.00
YD07752
C. Coverage opted
1. Period of Insurance
For Own Damage Section From 27-SEP-2021 11:04(Hrs) To 26-SEP-2022 Midnight
For Third Party Liability Section From 27-SEP-2021 11:04(Hrs) To 26-SEP-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 : 0 %.
20. About the last insurance company
(i) Insurance Provider : NA.
(ii) Previous Policy No : NA , Previous Policy Expiry Date : NA
21. Whether your vehicle is Hypothecated and if so the details of Pledgee whose name is registered by us : Yes.
Name of Pledgee : BMW INDIA FINANCIAL SERVICES PVT LTD.
22. Add on Cover(s) optedm2 : Yes, Plan Name:Depreciation Shield_ And Consumable_Expenses_ And Vehicle
Replacement_Advantage Plan Description: consumable expenses , depreciation shield , vehicle replacement advantage ,
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:
Please note Cover Note No. PIMS328365/ 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 : Bagichelp@bajajallianz.co.in
Website : www.bajajallianz.com
Contact our policy servicing branch at: Golden Heights,4th Floor,, No.1/2,59th C Cross, 4th M Block,Rajajinagar, ,
BANGALORE-560010 PH:080-67195000.
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
UIN : IRDAN113RP0007V01201819
Policy Number: OG-22-1701-1825-00001766 Customer ID: 228131401
Particulars of Vehicle Insured:
Registration Number Place of Registration Engine Number Chassis Number Make & Model
KA03NK6444 INDIRANAGAR 0140Y317 WBA37AK09MYD07 BMW - 2 SERIES
752
Invoice No 308177504/2
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
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 :PRIYANKA T - Relationship :Spouse
Subject to Warranties/ 22, 7, 16 & Plan Name:Depreciation Shield_ And Consumable_Expenses_ And Vehicle Replace-
IMT-Endorsements/ ment_Advantage & Plan Description: consumable expenses , depreciation shield , vehicle re-
Add on Package placement advantage ,
Additional Details Coinsurance Details: - . Transaction Id: -
Premium Details Receipt No. 1701-02734352, Date 27-SEP-21 ** 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.2,000.00
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.
For & On Behalf of
Bajaj Allianz General Insurance Company Ltd.
Stamp
Duty Rs.
0.5
Authorized Signatory
This document is digitally signed, hence counter signature / stamp is not required.
Consolidated Stamp Duty of Rs.0.5/- paid towards Insurance Stamps vide Challan No. MH014271630202021M Defaced No. 0000144047202122 dated 12-APR-21 timing 13:29:05 of
General Stamp Office,Mumbai,India.
Principal Location : Golden Heights, 4th Floor, No.1/2, 59th C Cross, 4th M Block, Rajajinagar, BANGALORE - 560010
PH:080-67195000 | Services Accounting Code : 997134 - Motor vehicle insurance services. No reverse charge is payable on these services.
RECEIPT
Authorised Signatory
S3 - DEPRECIATION SHIELD
(UIN No. IRDAN113RP0007V01201819/A0009V01201819)
A. Endorsement Wordings
In consideration of payment of additional premium, it is hereby agreed and declared that this Policy extends to cover the
depreciation amount, partly or fully, on assessed damaged parts allowed for replacement during repairs in the event of a
Partial Loss to the Insured Vehicle .
In the event You have opted for co-payment, Your contribution shall be to the extent agreed by You as shown in the
Schedule for the depreciation amount on the assessed parts for each and every Partial Loss claim.
The benefits under 'Depreciation Shield' would be available only if the Insured Vehicle is repaired at Our authorized
workshops. In case You have opted to repair the Insured Vehicle at a non-authorized workshop, Our liability will be
restricted to 90% of the assessed total claim amount under this cover.
B. Conditions
(A) Claims made by You against Us under 'Depreciation Shield' are subject to the terms and conditions set forth
under the Motor Insurance Policy. (B) In case of transfer of ownership of the Insured Vehicle , the cover under
'Depreciation Shield' shall expire. (C) The benefits under 'Depreciation Shield' can be utilized for a maximum of
two times during the Policy Period
C. Exclusions
In addition to the exclusions mentioned 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)
Depreciation pertaining to any part/ sub part/ accessories not approved for replacement by Us under Motor Insur-
ance Policy. (3) Loss or damage to tyres and/or battery of the Insured Vehicle . (4) Consequential loss of any
kind arising out of claims lodged under 'Depreciation Shield'. (5) 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
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 Alli-
anz General Insurance Company Limited. (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 cov-
er is extended (5) Insured Vehicle : The vehicle insured by Us under the Motor Insurance Policy and as shown
on the Schedule .(6) Policy Period: The period between and including the commencement date and expiry date as
shown in the Motor Insurance Policy Schedule . (7) Schedule : The Schedule and any Annexure or Endorse-
ment to it which sets out Your personal details and the insurance cover in force. (8) Own Damage Claim: The
claims raised by You against Us for loss or damage to the Insured Vehicle due to the perils mentioned under Sec-
tion 1 of Motor Insurance Policy. (9) Total Loss/ Constructive Total Loss: A loss under the Motor Insurance
Policy where the aggregate cost of retrieval and/ or repair of the Insured Vehicle , subject to terms and conditions
of the Policy, exceeds 75% of the IDV of the Insured Vehicle . (10)Partial Loss: Any loss falling into a category
other than (A) the loss mentioned under Sr. No. 9 above and (B) theft of the Insured Vehicle
B. Conditions
(1)Claims made by You against Us under 'Vehicle Replacement Advantage' 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 under 'Vehicle Re-
placement Advantage' shall expire (3) In order to declare the Insured Vehicle a Total Loss/ Constructive Loss, the estim-
ates for the aggregate cost of retrieval and/or repair have to be approved by Ourauthorized workshops
C. Exclusions
In addition to the exclusions mentioned 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)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 (3)Any con-
sequential loss arising out of claims lodged under 'Vehicle Replacement Advantage' (4) Any claims pertaining to ac-
cessories, unless the same are additionally insured and endorsed into the Motor Insurance Policy 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.(1)You, Your, Yourself: The person or persons We insure as set out in the
Schedule (2) We, Our, Us: Bajaj Allianz General Insurance Company Limited (3) Accident, Accidental: A sudden, un-
intended and fortuitous external and visible event (4) Policy Period: The period between and including the commence-
ment date and expiry date as shown in the Motor Insurance Policy Schedule (5) Insured Vehicle: The vehicle insured
by Us under the Motor Insurance Policy (6) IDV: Insured's Declared Value (Sum Insured) of the Insured Vehicle un-
der the Motor Insurance Policy (7) Total Loss/ Constructive Total Loss: A loss under the Motor Insurance Policy
where the aggregate cost of retrieval and/or repair of the Insured Vehicle, subject to terms and conditions of the Policy,
exceeds 75% of the IDV of the Insured Vehicle (8) Policy Period: The period between and including the start and end
dates as shown in the Motor Insurance Policy Schedule (9) Schedule: The Schedule and any Annexure or Endorsement
to it which sets out Your personal details and the type of insurance cover in force (10) 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 Mo-
tor Insurance Policy
S17:CONSUMABLE EXPENSES
(UIN No. IRDAN113RP0007V01201819/A0020V01201819)
A. Endorsement Wordings
In consideration of payment of additional premium, it is hereby agreed and declared that if the Insured Vehicle is
damaged by a covered peril mentioned under the own damage section of the Motor Insurance Policy and needs to be
repaired, We will cover cost of consumables required to be replaced/ replenished during the repair of the damaged
vehicle. Consumable for the purpose of this cover shall include engine oil, gear box oil, power steering oil, coolant, AC
gas oil, brake oil, AC refrigerant, battery electrolyte, windshield washer fluid, radiator coolant, nut & bolt, screw, oil fil-
ter, fuel filter, bearings, washers, clip, wheel balancing weights , and items of similar nature excluding fuel.
B. Conditions
(a) This cover is applicable if it is shown on Your schedule. (b) Claims made by You against Usunder 'CONSUM-
ABLE EXPENSES' are subject to the terms and conditions set forth under the Motor Insurance Policy. (c)In case
of transfer of ownership of the Insured Vehicle , the cover under 'CONSUMABLE EXPENSES' shall expire.
(d) The benefits under under 'CONSUMABLE EXPENSES' would be available only if the Insured Vehicle is re-
paired at Our authorized workshops.
C. Exclusions
In addition to the exclusions mentioned 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) Consumables pertaining to any part/ sub part/ accessories not approved for replacement by Us under
Motor Insurance Policy. (3)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.
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)Authorized workshop / garage / service station - A motor vehicle repair workshop / garage / service station author-
ized by us. (2)Insured Vehicle: The vehicle insured by Us under the Motor Insurance Policy and as shown on the Sched-
ule. (3)Policy/ Motor Insurance Policy: Motor Package Policy issued by Us to which this cover is extended.
(4)Schedule: The Schedule and any Annexure or Endorsement to it which sets out Your personal details and the insur-
ance cover in force. (5)We, Our, Us: Bajaj Allianz General Insurance Company Limited. (6)You, Your, Yourself: The
person or persons We insure as set out in the Schedule.