COMPREHENSIVE POLICY

Summary

T ata Nano Valid from Valid till (midnight)

TN07BL13 00 21 J UL 21 20 J UL 22

Car owner Owner number Owner email

BHASKAR VAKKALAGADDA XXXXXX6436 vXXXXXXXXXXXXXXXXXr@ hotmail.com
Plan Policy price Car value
Comprehensive (Super Saver), ₹ 2871.30 ₹ 79791.0
Voluntary Deductible

Comprehensive Super Saver plan is a reduced price plan under the condition that during claims, you notify us first
and have your car repaired at one of our network garages. Please note that if you choose to take your car to any
other garage before notifying us, an additional Rs.5000 deductible will be applied during settlement.

WELCOME! We're happy to have you at ACKO and promise to be there for you always. Now, you are also a part of the
Acko Advantage program, which takes care of everything if your car ever runs into trouble. To intimate a claim,
simply log in to acko.com or call us on 1800 266 2256.

Acko Non-Acko
Advantage* Advantage

Free car pick-up from home,

office or accident site

Repairs at our network of

expert garages.

3-day repair guarantee.

Cab voucher** worth Rs.

500/day if there's a repair
delay.

Car drop at your doorstep.

Cashless and hassle-free

processing.

*Only applicable in selected cities provided you call us immediately - Ahmedabad | Bangalore | Chennai | Delhi | Hyderabad | Kolk ata | Mumbai | Pune
**Cab vouchers available in the cities mentioned above. Please refer the T erms & Conditions for more details

Please Note: Previous Policy document is required in case of claim within 30 days of Acko Policy Start Date.

If you are a workshop or garage staff

Please call Acko for quick settlements on 1800 209 9910 [ GST# for workshop Invoice 27AAOCA9055C1ZJ ]
Ack o General Ins urance Ltd.
Unit No. 301, 3rd Floor, E Wing, Lotus Corporate Park , Goregaon (E), Mumbai- 4 00063
Email: hello@ack o.com | T oll Free: 1800 266 2256 | www.ack o.com
Product: Private Car Pack age Policy | CIN : U66000MH2016PLC287385
IRDAI Reg No. 157 | HSN: 997134 | GST : 27AAOCA9055C1ZJ
UIN: IRDAN157P0007V01201718, A0004 V01201920, A0038V01201920 Page 1 of 6
What's Covered
A snapshot of all the coverages in this policy.

Accidents Fire Theft

Damages to the car due to an accident. In case your car catches fire, resulting from If your car is stolen, we will pay you the value
self-ignition, explosion or lightning. as per policy of your car.

Calam ities Third - Party Los s es Cons um ables

Damage due to natural or man made causes Death, injury or property damage to any third Covers the cost of consumables lik e nut,
lik e earthquak e, riots, etc. party arising from your car. bolt, lubricant etc. consumed during car
repair due to accident.

Engine Protect Car

Covers repairs or replacement of internal
parts of the engine or gearbox and
differential assembly arising out of water
ingression, hydrostatic lock , or leak age of
coolant/lubricating oil.

What's Not Covered

A snapshot of all the coverages that are not covered in this policy.

Non-Accident Dam age Cons equential Los s & Nuclear R is k & War Illegal Driving
Lik e depreciation, wear & tear, Contractual Liability Damages to your car due to Damage due to the car driven by a
break down, failures & Indirect damage or liability nuclear risk , war & mutiny person without a valid driving license
break ages, and deductibles. arising due to your car accident. or under influence of liquor/drugs.

Tyre, Tubes & Engine Car R eview Exception Com m ercial us age of the Car Voluntary deductible
Not included unless the tyre, Pre-existing Damages as found If the Car is registered as Private T he policyholder will bear Rs. 5000 in
tubes & engine are damaged on vehicle inspection. vehicle & if it is used for the event of a claim not availed at
due to an accident. commercial purpose than the Ack o partner garages, over and above
losses or liability due to the aforementioned exclusions.
accident during such usage is
not covered in this policy.

T h e in fo rma tio n pro vide d h e re in a bo ve is fo r th e purpo se o f illustra tio n o n ly. Fo r mo re de ta ils o n risk fa cto rs, te rms,
co n ditio n s a n d e xclusio n s, ple a se re a d th e po licy wo rdin gs ( h ttps://www.a ck o .co m/do wn lo a d ) ca re fully.
Page 2 of 6
 COMPREHENSIVE POLICY
Private Car Package Policy

POLICY DETAILS VEHICLE DETAILS

Insured Name: BHASKAR VAKKALAGADDA Registration Number: T N07BL1300
Address/Pincode: 600097 Mak e/Model: T ata Nano
Period of Insurance: 21 Jul 21 (00:00 hrs) to 20 Jul 22 (23:59 hrs) Registration Year: 2011
Policy Issuance Date: 06 Jul 21 Registration Month: Mar
Policy Number: DCAR004 06204 4 75/00 Engine CC: 624
Seating Capacity: 4
Engine Number: 273MPFI05AYYK06252
Chassis No: MAT 612252BKA06779

INSURED DECLARED VALUE (IDV)

Vehicle IDV (₹ ) Acces s ories (₹ ) Bifuel Kit (₹ ) Total IDV (₹ )

79791 0.0 0 79791.0

PREMIUM DETAILS (₹)

Own Dam age Prem ium (A) Liability Prem ium (B)

Basic Own Damage ₹ 329.14 Basic T hird Party Liability ₹ 2072.00

NCB Discount ₹ (14 8.11)

Consumables ₹ 12.72

Engine Protect ₹ 167.56

Net Own Damage Premium (A) ₹ 361.31 Net Liability Premium (B) ₹ 2072.00

T otal Pack age Premium ₹ 24 33.31

IGST (18%) 4 38.00

T otal Premium ₹ 2871.302

Geographical Area: India Hypothecation: NA Voluntary Deductible: ₹ 5000*

No-Claim Bonus: 4 5% Compulsory Deductible: ₹ 1000
*T he policyholder will bear Rs. 5000 over and above the standard charges in the event of a claim not availed at Ack o partner garages
L i mi ta ti o ns As T o Us e: T h e Po licy co ve rs use o f th e ve h icle fo r a n y purpo se o th e r th a n : a ) Hire o r Re wa rd b) Ca rria ge o f go o ds (o th e r th a n sa mple s o r pe rso n a l
lugga ge ) c) O rga n ize d ra cin g d) Pa ce ma k in g e ) Spe e d te stin g f) Re lia bility T ria ls g) A n y purpo se in co n n e ctio n with Mo to r T ra de . P ers o ns o r Cl a s s o f P ers o ns enti tl ed
to d ri ve: A n y pe rso n ((in cludin g th e in sure d), pro vide d th a t a pe rso n drivin g h o lds a va lid drivin g lice n se a t th e time o f th e a ccide n t a n d is n o t disqua lifie d fro m h o ldin g
o r o bta in in g such a lice n se . Pro vide d a lso th a t th e pe rso n h o ldin g a va lid le a rn e r's lice n se ma y a lso drive th e ve h icle a n d th a t such a pe rso n sa tisfie s th e re quire me n ts
o f Rule 3 o f th e Ce n tra l Mo to r Ve h icle s Rule s, 1989. L i mi ts o f L i a b i l i ty. 1. Un de r Se ctio n II-1 (i) o f th e po licy - De a th o f o r bo dily in jury - Such a mo un t a s is n e ce ssa ry to
me e t th e re quire me n ts o f th e Mo to r Ve h icle s A ct, 1988. 2. Un de r Se ctio n II - 1(ii) o f th e po licy -Da ma ge to T h ird Pa rty Pro pe rty - Rs. 7 50000 3. P. A . Co ve r un de r Se ctio n
III fo r O wn e r - Drive r (CSI): Rs. 1500000 T erms , Co nd i ti o ns & Exc l us i o ns : A s pe r th e In dia n Mo to r T a riff. A pe rso n a l co py o f th e sa me is a va ila ble fre e o f co st o n
re que st & th e sa me is a lso a va ila ble a t o ur we bsite .
I / We h e re by ce rtify th a t th e po licy to wh ich th e ce rtifica te re la te s a s we ll a s th e ce rtifica te o f in sura n ce a re issue d in a cco rda n ce with th e pro visio n o f ch a pte r X, XI o f
Mo to r Ve h icle s A ct, 1988. " T h e sta mp duty o f Rs. 0.50 pa id by e le ctro n ic me dium vide GRA S De fa ce n o . 0003845130202021 da te d 15/12/2020 a s pre scribe d in
Go ve rn me n t No tifica tio n Re ve n ue & Fo re st De pa rtme n t No . Mudra n k - 2017 /C.R.97 /M-1, da te d 09/01/2018. GST N: 27 A A O CA 9055C1ZJ. I MP O R T ANT NO T I CE: T h e
In sure d is n o t in de mn ifie d if th e ve h icle is use d o r drive n o th e rwise th a n in a cco rda n ce with th is Sch e dule . A n y pa yme n t ma de by th e Co mpa n y by re a so n o f wide r te rms
a ppe a rin g in th e Ce rtifica te in o rde r to co mply with th e Mo to r Ve h icle s A ct, 1988 is re co ve ra ble fro m th e In sure d. Se e th e cla use h e a de d " A VO IDA NCE O F CERT A IN
T ERMS A ND RIGHT O F RECO VERY" in th e po licy wo rdin gs. Di s c l a i mer: T h e Po licy sh a ll be vo id fro m in ce ptio n if th e pre mium ch e que is n o t re a lize d. In th e e ve n t o f
misre pre se n ta tio n , fra ud o r n o n -disclo sure o f ma te ria l fa ct, th e Co mpa n y re se rve s th e righ t to ca n ce l th e Po licy. T h e po licy is issue d ba sis th e in fo rma tio n pro vide d by
yo u, wh ich is a va ila ble with th e co mpa n y. In ca se o f discre pa n cy/n o n re co rdin g o f re le va n t in fo rma tio n in th e po licy, th e in sure d is re que ste d to brin g th e sa me to th e
n o tice o f th e co mpa n y with in 15 da ys. T h is Po licy is to be re a d in co n jun ctio n with th e Po licy wo rdin gs (h ttps://www.a ck o .co m/do wn lo a d) a va ila ble o n th e we bsite o f th e
Co mpa n y. O n re n e wa l, th e be n e fits pro vide d un de r th e po licy a n d/o r te rms a n d co n ditio n s o f th e po licy in cludin g pre mium ra te ma y be subje ct to ch a n ge .

INTERMEDIARY DETAILS
Policy Issuing Office: Direct - Mumbai Intermediary Name: Direct
Phone Number: N/A Intermediary Code: N/A

Ack o General Ins urance Ltd.

Unit No. 301, 3rd Floor, F Wing, Lotus Corporate Park , Goregaon (E), Mumbai- 4 00063
Email: hello@ack o.com | T oll Free: : 1800 266 2256 | www.ack o.com
Product: Private Car Pack age Policy | CIN : U66000MH2016PLC287385
IRDAI Reg No. 157 | HSN: 997134 | GST : 27AAOCA9055C1ZJ For ACKO General Insurance Ltd.
UIN: IRDAN157P0007V01201718, A0004 V01201920, A0038V01201920 Duly Constituted Attorney
Page 3 of 6
 RECEIPT

Received with thanks from BHASKAR VAKKALAGADDA a sum of ₹ 2871.30 towards premium on Car Insurance Policy

INSURED DETAILS
Name of Insured: BHASKAR VAKKALAGADDA
Address/Pincode: 600097
Period of Insurance: 21 Jul 21 (00:00 hrs) to 20 Jul 22 (23:59 hrs)
Policy Number: DCAR004 06204 4 75/00
Payment Date: 06 Jul 21

PREMIUM DETAILS (₹)

Gross Premium ₹24 33.31

IGST (18%) ₹ 4 38.00

T otal Premium ₹2871.30

TERMS & CONDITIONS:

Issuance of this receipt does not amount to acceptance of the risk by Acko General Insurance Limited. The insurance cover for
the risk shall be as per the terms and conditions of the Insurance Policy if and when issued. * Cheque/DD/PO receipt is valid
subject to realization of the instrument.

Ack o General Ins urance Ltd.

Unit No. 301, 3rd Floor, F Wing, Lotus Corporate Park , Goregaon (E), Mumbai- 4 00063
Email: hello@ack o.com | T oll Free: : 1800 266 2256 | www.ack o.com
CIN : U66000MH2016PLC287385 | IRDAI Reg No. 157 | HSN: 997134 | GST : 27AAOCA9055C1ZJ For ACKO General Insurance Ltd.
UIN: IRDAN157P0007V01201718, A0004 V01201920, A0038V01201920 Duly Constituted Attorney
Page 4 of 6
 PROPOSAL FORM

Dear BHASKAR VAKKALAGADDA,

We wish to inform you that the Insurance policy number DCAR00406204475/00 has been issued on the basis of the
information and declaration given by you, the transcript whereof is mentioned below.

Please be informed that this Policy shall be construed to be void ab initio/invalid in the event we find that you have not
disclosed material or correct information required for the purpose of providing the below insurance cover and in case of any
claim arising under the policy in such a scenario, we shall be under no obligation whatsoever to settle such claim to you and
the premium paid by you under this policy shall stand fully forfeited.
The vehicle shall be repaired at Acko's partner garages only. In case of any vehicle repaired outside the partner garages,
policyholders will have to bear the voluntary deductible of Rs. 5000/-. In case of a dispute the decision lies with Acko General
Insurance.

POLICY DETAILS PREVIOUS POLICY DETAILS

Policy Number: DCAR004 06204 4 75/00 Previous Policy Expired: Not Expired
Period of Insurance: 21 Jul 21 (00:00 hrs) to 20 Jul 22 (23:59 hrs) Previous Policy Insurer: United India Insurance Co. Ltd.
Policy Issuance Date: 06 Jul 21

CAR DETAILS CAR OWNER DETAILS

Car Number: T N07BL1300 Name: BHASKAR VAKKALAGADDA
Mak e/Model: T ata Nano Email Address: vXXXXXXXXXXXXXXXXXr@hotmail.com
Fuel T ype: petrol Mobile Number: XXXXXX64 36
Registration Year: 2011 Pincode: 600097
Registration Month: Mar
Insured Declared Value (IDV): 79791
Accessories (IDV): 0.0
Engine Number: 273MPFI05AYYK06252
Chassis Number: MAT 612252BKA06779

Ack o General Ins urance Ltd.

Unit No. 301, 3rd Floor, F Wing, Lotus Corporate Park , Goregaon (E), Mumbai- 4 00063
Email: hello@ack o.com | T oll Free: 1800 266 2256 | www.ack o.com
CIN : U66000MH2016PLC287385 | IRDAI Reg No. 157 | HSN: 997134 | GST : 27AAOCA9055C1ZJ For ACKO General Insurance Ltd.
UIN: IRDAN157P0007V01201718, A0004 V01201920, A0038V01201920 Duly Constituted Attorney
Page 5 of 6
 PROPOSAL FORM

COVER DETAILS

Add-ons / Others Included Excluded

PA Cover -

Consumables -

Zero Depreciation -

Engine Protect Car -

Voluntary Deductible (₹ 5000*) -

T he policyholder will bear Rs. 5000 over and above the standard charges in the event of a claim not availed at Ack o partner garages

TERMS & CONDITIONS:

"I/We desire to insure with Ack o General Insurance Limited in respect of the vehicle described in this proposal form and confirm that the statements contained
in this application are my/our true and accurate representations. I/We undertak e that if any of the statements are found to be false or incorrect, the benefits
under this policy would stand forfeited. I/We agree that this application and declaration shall be promissory and shall be the basis of the contract between
me/us and Ack o General Insurance Limited. I/We agree to the Company tak ing appropriate measures to capture the voice log for all such telephonic
transactions carried out by me/us as required by the procedures/regulations internal or external to the Company and shall not hold the Company responsible
or liable for relying/using such recorded telephonic conversation. In the event of nonrealization of the cheque or non-receipt of the amount of premium by the
Company the policy shall be deemed cancelled 'ab-initio' and the Company shall not be responsible for any liabilities of whatsoever nature under this
Policy." I/We agree to receive 'Certificate of Insurance or Policy Schedule' only and shall access the policy terms, conditions and exclusions on the
company's website.

Ack o General Ins urance Ltd.

Unit No. 301, 3rd Floor, F Wing, Lotus Corporate Park , Goregaon (E), Mumbai- 4 00063
Email: hello@ack o.com | T oll Free: 1800 266 2256 | www.ack o.com
CIN : U66000MH2016PLC287385 | IRDAI Reg No. 157 | HSN: 997134 | GST : 27AAOCA9055C1ZJ For ACKO General Insurance Ltd.
UIN: IRDAN157P0007V01201718, A0004 V01201920, A0038V01201920 Duly Constituted Attorney
Page 6 of 6