Bajaj Allianz General Insurance Company Limited.
Servicing Office : BAJAJ ALLIANZ GENERAL INSURANCE CO LTD,, 1st FLOOR, INDRA BHAVAN ROAD,,
OPP HOTEL CHINNI INTERNATIONAL, 0, NELLORE, ANDHRA PRADESH (State Code:37) -524001
Private Car Package Policy UIN --IRDAN113RP0025V01200102
Certificate Cum Policy Schedule (FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)
PAN :AABCB5730G GSTIN: 37AABCB5730G1ZW CIN :U66010PN2000PLC015329 IRDAI Reg:113
Policy No: OG-25-1515-1801-00000373 Proposal No. & Date: HIIB9909545, 19-JUL-2024
Policy Issued On: 19-JUL-2024 13:46 HRS Previous Policy No.: OG-24-9910-1801-00075346
Insured Name: MR. KRISHNA MOHAN RAJU B Previous Insurer: Bajaj Allianz General Insurance Company Limited.
Period of Own Damage : 01-AUG-2024 (00:00) To 31-JUL-2025 (1 YEAR)
WARD-1,MALAVYA NAGAR, GUDUR,NELLORE , NELLORE , Period of Liability Cover: 01-AUG-2024 (00:00) To 31-JUL-2025 (1 YEAR)
Insured Address:
ANDHRA PRADESH (State Code:37) -524101
Period of Compulsory 01-AUG-2024 (00:00) To 31-JUL-2025 (1 YEAR)
Personal Accident Cover:
Customer Type PAN GSTIN Name Age (Yr.) Relation
Customer Details Nominee Details
INDIVIDUAL XXXXX6870F NA B SAILAJA 64 SPOUSE
Vehicle Details
Make Model Variant Cubic Capacity Manufacturing Year Seating capacity
HYUNDAI I10 ERA 1.1 BSIV F/L 1086 2011 5
Body Type Registration No. RTO Hypothecation/Lease* Fuel Type VIN/Chassis No.
HATCHBACK AP 26 AL 3427 NELLORE YES PETROL MALAM51BLBM949284
Vehicle IDV Electrical Accessories Non-Electrical Accessories BI Fuel Kit Total IDV Engine No
94,941 0 0 0 94,941 G4HGBM302147
Own Damage Premium (A) Amount(INR) Liability Premium (B) Amount(INR)
Basic Own Damage Premium Basic Third Party Liability Premium 3,416
Vehicle 2,280 Bi-Fuel Kit 0
Non-Elec. Accessories (IMT-24) 0 Geographical Area Extension (IMT-1) 0
Elec. Accessories (IMT-24) 0 Sub Total (Third Party Liability) 3,416
Bi-Fuel Kit (IMT-25) 0 Personal Accident (PA) Cover
Geographical Area Extension (IMT-1) 0 Compulsory PA Cover for Owner Driver Rs 1500000 (IMT-15) 331
IMT 23 Premium 0 PA Cover for 0 Unnamed Passengers Rs 0 Each (IMT-16) 0
Sub Total (Basic Premium) 2,280 PA cover for Paid Driver of Rs 2 Lac (IMT-17) 0
Discount/Deductibles Sub Total PA Cover 331
Voluntary Deductibles (0) (IMT-22A) 0 Legal Liability
Anti Theft Device (IMT-10) 0 Paid Driver (IMT-28) 50
AA Membership (IMT-8) 0 Employees (for 0 persons) (IMT-29) 0
No Claim Bonus (45%) 1,026 Sub Total (Legal Liability) 50
Handicapped Discount (IMT-12) 0 Net Liability Premium (B) 3,797
Sub Total (Deductibles) 1,026 Total Premium (A+B) 5,051
Total Own Damage Premium 1,254 SGST(9%) 455
Add On Coverages 0 CGST(9%) 455
Net Own Damage Premium (A) 1,254 Gross Premium Paid 5,961
Add-on Cover Opted in the Policy:
Notes: 1. Consolidated Stamp Duty of Rs.0.5/- paid towards Insurance Stamps vide Challan No. MH002405964202122M Defaced No. 0001482221202122 dated 05-JUL-21 timing 12:58:03 of General Stamp
Office,Mumbai,India.
2.This policy has been issued upon declaration by the Insured that a valid Pollution Under Control (PUC) Certificate is held on the date of
commencement of the Policy. The insured undertakes to renew and maintain a valid and effective PUC and/or fitness Certificate, as applicable, 3.Geographical Area: India
during the subsistence of the Policy.
5.The policy is subject to compulsory deductible of INR 1000
4. Policy issuance is subject to realization of cheque if premium is paid by cheque
(IMT-22) & Voluntary Deductible of INR 0
6. This policy is to be read in conjunction with the Policy /Add-on wordings T&C available on the insurer website http://www.bajajallianz.com
*Hypothecation Details: HDFC BANK LTD - NELLORE - NELLORE Payment Mode: CUSTOMER ONLINE
Limitations as to use:The policy covers use of the vehicle for any purpose other than (1) Hire or Reward (2) Carriage of goods (other than samples or personal luggage) (3) Organized racing (4) Pace
making (5) Speed testing (6) Reliability trials (7) Any purpose in connection with motor trade.
Driver's Clause: Any person including the insured: Provided that the person driving holds an effective driving license at the time of the accident and is not disqualified from holding or obtaining such
license. Provided also that the person holding an effective learners license may also drive the vehicle & that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules, 1989.
Limits of Liability Clause: Under Section II-1(i) of the policy-Death of 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 is INR 7.5 Lakhs, PA Cover Under Section III for Owner-Driver is INR 15 Lakhs.
No Claim Bonus: The insured is entitled for a No Claim Bonus (NCB) on the own damage section of the policy, if no claim is made or pending during the preceding year(s) - 20%, preceding
two consecutive years - 25%, preceding three consecutive years - 35%, preceding four consecutive years - 45%, preceding five consecutive years - 50% of NCB on OD Premium.
NCB is allowed provided the policy is renewed within 90 days of the expiry date of the previous policy.
Declaration on Tax Invoice We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than the aggregate 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.
Important Notice: The insured is not indemnified if the vehicle is used or driven otherwise than in accordance with the schedule. Any payment made by the company by reasons 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 & RIGHT
OF RECOVERY" For legal interruption, English version will hold good.
Grievance Clause: For resolution of any query or grievance, Insured may check Grievance redressal policy at https://www.bajajallianz.com/about-us/customer-service.html or connect with the respective
servicing office of insurance company. In the event of unsatisfactory response,he/she may approach the insurance ombudsman for the redressal of grievance at www.irdai.gov.in or on website of General
Insurance Council: www.gicouncil.in
HSN/SAC : 997134, Description of Service : Motor Vehicle Insurance Services, Place of Supply : ANDHRA PRADESH(State Code : 37), Insurer Invoice Number : HBZ/HIIB9909545
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 XI of Motor Vehicle Act, 1988.
Insurance Broker Name : Hyundai India Insurance Broking Pvt. Ltd. Scan for Renewal For & On Behalf of
Corporate Office:16th Floor, Building No. 9A, DLF Cybercity, Phase III, Gurugram, (Valid from 90 Days Prior to Expiry) Bajaj Allianz General Insurance Company Limited.
Haryana 122001
Broker Code: 822 (Valid UPTO:30/05/2025) MISP NAME-KUN AUTO COMPANY
CIN No.: U67200HR2021PTC098982 PRIVATE LIMITED
GST: 06AAGCH0310P1ZP MISP CODE-HIIB-MHY-0017
Email ID: connect@hiib.in DP NAME-SATHIYA NARAYANAN P
Contact No: 0124-6833000
Authorized Signatory
For Claims, Policy Servicing & Renewal, Kindly contact (KUN HYUNDAI) at +91-9493935375
