1

Product Code: 3001

1 UIN: IRDAN115RP0001V02201920
0 Ref. No. W360729147 Date: Oct 20, 2024

Insured Details Partner Details

Name Partner Name
POLICYBAZAAR INSURANCE BROKERS
PARDEEP SAINI
PRIVATE LIMITED
Address Partner Code
HOUSE NO 290/B-2, SHIV COLONY (NEAR BITNA ROAD), PINJORE, DISTRICT - PANCHKULA,
DB79719
HARYANA, PANCHKULA, HARYANA - 134102
Mobile Number: Partner Mobile Number:
98******21 9999999999
Policy No Partner Email:
3001/O/364810441/00/000

Hello PARDEEP SAINI, we have your car covered!

Here is your Stand-Alone Own Damage Private Car Insurance Policy.

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Product Code: 3001
1 UIN: IRDAN115RP0001V02201920
0

Why go to our network garages?

Are you wondering why you should choose our partner garages to get your car repaired? We will help you make the decision easy, or else you'll miss out on the super
benefits that you get at our network garages!

Firstly, our partner garages offer cashless repairs. Which means you don't have to spend out of pocket. We directly settle your bill, and you can take possession of your
car once it's fixed. Some of the other great benefits that you receive at our partner garages include -

√ Pick up arrangement from your doorstep or accident spot

√ Quick vehicle survey through InstaSpect on our IL Take Care app
√ Service quality assurance for six months on repairs
√ Use of original parts in case of any replacement needed
√ Safety measures including sanitisation of high touch-points and car wash
All this comes at no added cost to you!

So the next time you need to make a car insurance claim, don't fret. Just give us a call or use our app to file the claim. Call us first, and we'll take care of everything!
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Product Code: 3001
1 UIN: IRDAN115RP0001V02201920
0

Dear PARDEEP SAINI,

Thank you for choosing ICICI Lombard General Insurance Company Limited to insure your vehicle. We are delighted to welcome you in the ever growing family of ICICI
Lombard. Please find enclosed Policy No. 3001/O/364810441/00/000.
ZD
We have included all the information and details provided by you including your declaration regarding the add-ons available in this policy. Please read this section along
with the Important details thoroughly .

Previous year policy add-ons: ZD

we further declare that the information fumished are true and no matenal information, which may be relevant has been winheld or not disclosed in case any of the
information is found false, during verification at a later date the company would have the night to cancel the polay or the company would have the night to cancel the policy
and not be ented to any benefits/coverages under the said policy

We have taken care to include all the information provided by you in the policy document. Please read this section along with the "Important details" thoroughly.

Let us walk you through the features of your policy.

What’s covered?
Basic Covers

Add on covers

The chart below (including icons) illustrates the salient features of your policy in general and is for your easy
understanding. Please refer detailed policy document (schedule along with policy wordings) for coverage, benefits,
exclusions and terms & conditions of your policy.
0 4376 0 0 0 0 499 0 1945

What'’s not covered

Unique Identification Number (UIN) Details

IRDAN115RP0001V01201920/A0035V01201819
IRDAN115RP0001V01201920/A0036V01201819
IRDAN115RP0001V01201920/A0010V01201920 IRDAN115RP0021V01202122/A0021V01202223
Zero Depreciation Return to Invoice Key Protect Telematics (pay-as-you-use)
IRDAN115RP0001V01201920/A0035V0 IRDAN115RP0001V01201920/A0036V0 IRDAN115RP0001V01201920/A0010V0 IRDAN115RP0021V01202122/
1201819 1201819 1201920 A0021V01202223

Coverages, add-on, exclusions metioned above are indicative. For more detials on risk factors, terms condition
and exclusions, please read the policy wordings available at www.icicilombard.com.
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Product Code: 3001
1 UIN: IRDAN115RP0001V02201920
0

Policy Certificate
Stand-Alone Own Damage Private Car Insurance Policy

Your Policy Details

Name Contact no Email

PARDEEP SAINI 98******21 PA***************@GMAIL.COM
Address Policy No E-Policy No
HOUSE NO 290/B-2, SHIV COLONY (NEAR BITNA ROAD), PINJORE, DISTRICT - PANCHKULA, 3001/O/364810441/00/000 EC2311W20241020173957652
HARYANA, PANCHKULA, HARYANA - 134102 9101
Policy Issued On Covernote No
Oct 20, 2024 364810441
Vehicle Registration No Vehicle Registration Date
HR49J6326 Feb 01, 2024
Tenure Period of Insurance - Own Damage
1 Year Oct 27, 2024 00:00 to Midnight of Oct 26, 2025
Nominee Name Relationship Age RTO Location Hypothecated To
- - 0 HARYANA-KALKA -
Named Passenger's Relationship Age GSTIN Number (Customer) Invoice Number
Nominee
- - 0 1010242095009
Servicing Branch Name Servicing Branch Address
New Delhi Fourth Parsavnath Capital Tower Bhai Veer Singh Marg, New Delhi New Delhi 110001

Previous Policy Details

Bundled Package Policy
Previous Policy No Previous Policy Period Previous Insurer Name Previous Policy Type
13897088 27-10-2023 to 26-10-2024 IFFCO TOKIO Bundled Package Policy
Previous Year NCB Claims Made Under Previous Policy
0 0

Third Party Insurance Details

Third Party Policy No. Third Party Insurance Period Third Party Insurer Name
13897088 Oct 27, 2023 to Oct 26, 2026 IFFCO TOKIO
This policy covers only Own Damage Risk with no other liability in connection with Private Car vehicle including third party cover and is issued basis following : Third Party
Policy No. -13897088 valid from Oct 27, 2023 to Oct 26, 2026, Insured by IFFCO TOKIO

Politically Exposed Person (PEP)/close relative of PEP: No

Vehicle and IDV Details

Registration No. Make Model Type of Body CC/KW Mfg Yr Seating Capacity Chassis No. Engine No.
HR49J6326 MARUTI BREZZA ZXI PLUS Private Car SUV 1462 2024 5 MA3RYHK1SPJ299789 K15CN7237393
Vehicle IDV (`) Trailer (`) Non Electrical Accessories (`) Electrical / Electronic Accessories (`) CNG / LPG Unit (`) Total IDV (`)
972417 0 0 0 0 972417
Odometer Odometer captured Date Opening KM for PAYU Total KM covered No. of KM carry Opening KM for PAYU from previous year
Reading forward
1914 20/10/2024 1965 5000 0 0
1

Premium Break-up

Own Damage Premium (A) (`)

Basic OD Premium 4654
Zero Depreciation (ZD -) 4376
Return to Invoice 1945
Key Protect of ` 50000 499
Telematics (pay-as-you-use) -2847
Sub-Total 8627
Savings - You have saved the following amount on your premium
No Claim Bonus 20% 931
Total Own Damage Premium (A) 7696
IGST ` 1385.28
% 18
Total Tax Payable in ` 1385
Total Premium Payable In ` 9081

Geographical Area: No Extension Applicable IMT Clauses: 22

Compulsory Deductible: ` 1000 Voluntary Deductible: ` 0

Premium Collection No. 1218965206 Premium Amount 9081 Receipt Date 20-10-2024
GSTIN Reg.No 07AAACI7904G1ZP HSN/SAC code 997134/GENERAL INSURANCE SERVICES
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Product Code: 3001
1 UIN: IRDAN115RP0001V02201920
0
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.
Features of Add-on Covers:
1 Return to Invoice Coverage: Sum Insured under this add-on, determined as the difference between the Insured's Declared Value (IDV) and the total actual expenses
incurred towards acquisition of a new vehicle of same make and model, as specified in the on-road price listed by the manufacturer/ dealer upon the occurrence of
Total Loss including Theft/ Constructive Total Loss as defined in the Policy
2 Zero Depreciation Coverage : Zero Depreciation covers only the depreciation on the replaced parts. Consumables and HydroStatic Lock are not coverd under Zero
Depreciation unless opted as separate add-on.
3 Telematics (Pay-As-You-Use) : Section I -Own Damage, Fire & Theft cover would be available only till the time opted kilometres are not exhausted.
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Product Code: 3001
1 UIN: IRDAN115RP0001V02201920
0

Important Details
This page contains information regarding risk assumption clauses, changes, additions, and grievance redressal.
We suggest giving it a thorough read.

Limitations as to Use: The Policy covers use of the vehicle for any purpose other than: Hire or Reward, Carriage of goods (other than samples of personal luggage), Organised
racing, Pace Making, Reliability trails or Speed testing, any purpose in Connection with Motor Trade.

Driver's Clause: 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

Important Notice: The insured i s not indemnified if the vehicle i s 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". In consideration of the premium for this extension being calculated at a pro-rata proportion of the annual premium, it is hereby
declared and agreed by the insured that upon expiry of this extension, this policy shall be renewed for a period of twelve months, failing which the difference between the
extension premium now paid on pro rata basis and the premium at short period rate shall become payable by the insured. For Legal interpretation, English version will hold
good.

Important Points:
a. Any accidental loss, damage and/or liability caused, sustained or incurred, while vehicle not being registered permanently will not be covered.
b. Any minor scratches to the vehcile, paint fading, wear and tear arising out of normal use and requiring touch-up or minor repair under routine maintenance will not be
covered.
c. Any liability of whatsoever nature caused by, contributed by or arising due to the vehicle being driven by a person without having valid driving license will not be covered.
d. In case of total loss / constructive total loss / Total theft of the vehicle, the claim will be settled at invoice price i.e amount paid by the insured / policyholder at the time of
purchasing the vehicle, excluding subsidy amount, if included in the invoice, or the Insured declared value (IDV) whichever is lower, subject to terms and conditions of the
policy and admissibility of claims.
( Please visist www.icicilombard.com for the policy wordings, for complete details on terms and conditions governing the coverage and NCB

FASTag: Government of India has mandated electronic toll payments using FASTag to reduce vehicular traffic at toll plazas. Customers are advised to comply with the
direction of the government and get their FASTag from Point of Sale locations at Toll Plazas or from Issuer Agency. Please visit http://www.fastag.org/ for details.

PUC: We have issued the policy basis your confirmation that you hold a valid PUC and/or Fitness certificate, as applicable. Warranted that the insured named herein/owner of
the vehicle holds a valid Pollution Under Control (PUC) Certificate and/or valid fitness certificate, as applicable, on the date of commencement of the Policy and undertakes to
renew and maintain a valid and effective PUC and/or fitness Certificate, as applicable, during the subsistence of the Policy. Further, the Company reserves the right to take
appropriate action in case of any discrepancy in the PUC or fitness certificate.

Changes Required: If you require any changes in the Certificate of Insurance cum Policy Schedule, you can do so via an endorsement. You are requested to inform us by
writing to customersupport@icicilombard.com, visiting our website, or calling our 24 hour toll free helpline on 1800 2666. In case of any discrepancy with respect to the policy,
please revert within 15 days from the policy start date. Absence of any communication within a period of 15 days of the date mentioned on this letter, would mean that the
issued policy is in order and as per your proposal.

Grievance Redressal: For resolution of any query or grievance you may contact us on our toll free no. 1800 2666, or visit any of our branch offices. You can also write to us at
customersupport@icicilombard.com. For detailed grievance redressal mechanism please visit the "Grievance Redressal" section on our website www.icicilombard.com.
The Company reserves the right to cancel this Policy immediately upon becoming aware of any mis-representation, fraud, non-disclosure of material facts or non-cooperation
by or on behalf of the Insured; the Company is not obliged to refund the premium paid under this Policy
In case of total loss / constructive total loss / Total theft of the vehicle, the claim will be settled at invoice price i.e amount paid by the insured / policyholder at the time of
purchasing the vehicle, excluding subsidy amount, if included in the invoice, or the Insured declared value (IDV) whichever is lower, subject to terms and conditions of the
policy and admissibility of claims.
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 XI of Motor
Vehicle Act, 1988. In witness whereof, this Policy has been signed at Mumbai on this date of Oct 20, 2024 in lieu of Covernote no. 364810441. The stamp duty of ` 0.5 paid
vide deface no. CSD372024252885 dated Jul 15, 2024.

Disclaimer: The information provided above i s based on the information received from you and accordingly, the policy has been processed. Coverage of risk is subject to
realisation of the full premium, post which, insurance coverage under the policy would commence. In case the premium is not received by us due to cheque dishonour or any
other reason, the insurance cover shall be void ab-initio.

Disclaimer:The information provided is merely illustrative and shall not be construed to be an evidence of existence of a contract of insurance. This document is to be read in
conjunction with the policy wordings and shall be considered null and void without the same. Please visit www.icicilombard.com for policy wordings and complete details on
terms and conditions governing the coverage and NCB.
-
This policy i s underwritten on the basis of the information provided by you and as detailed in this document. On renewal, the benefits provided under the policy and/or terms
and conditions of the policy including premium rate may be subject to change.
*Quality assurance of 6 months or 6000 km (whichever comes early) is available only at our preferred partner garages. #Approval would be subject to physical survey of the
vehicle wherever deemed necessary. The insurer reserves the right to conduct a physical survey in accordance with the regulatory prescriptions. The policy is valid subject to
realisation of cheque. We accept premium only via legally recognized modes. In case of dishonour of premium cheque, the company shall not be liable under the policy and
the policy shall be void ab-initio.

Update your bank details in your policy: Updating your bank details with us would help facilitating future transactions. Bank details can be easily updated using "IL - Take
care" App.
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Product Code: 3001
1 UIN: IRDAN115RP0001V02201920
0

Policy Issuing Office: ICICI Lombard General Insurance Company Limited, ICICI LOMBARD HOUSE, 414, Veer Savarkar Marg, Near Siddhi Vinayak Temple, Prabhadevi, Mumbai 400 025.

Agent/Partner Details
DB79719
Here are the details of your agent

Agency Code : DB79719

Agency Name : POLICYBAZAAR INSURANCE
BROKERS PRIVATE LIMITED
Agent's Contact No : 9999999999 D:/CLICK/images/Gaurav_Arora.png
Contact Person :

Click here or scan the QR code to view the Customer Information Sheet (CIS). It provides an overview
of the policy features, service and claim processes, as well as other important terms.

Signature Not Verified

Digitally signed by DS ICICI
LOMBARD GENERAL
INSURANCE CO LTD 1
Date: 2024.10.20 17:42:47 IST