THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)
POLICY SCHEDULE CUM CERTIFICATE OF INSURANCE
Commercial Vehicle Package Policy Enhanced Covers
UIN Number - IRDAN190RP0044V01100001
Policy Number :42040931230300002475
POLICY ISSUING OFFICE: BUSINESS CHANNEL/CPSC User: CLAIM CONTACT:
SULTANPUR BRANCH OFFICE (420409), NAME: Lucknow Non Suit Claim Hub (429001)
2ND FLOOR, MUSKAN TOWER , NEAR Efficient Insurance Brokers Pvt. Ltd. - ADDRESS: 6TH FLOOR, JIVAN BHAVAN II, NAVAL
GABHADIYA OVER-BRIDGE , MAJORGANJ, (2D10670573), KISHORE ROAD, HAZRATGANJ, 226001 , , , UTTAR
SULTANPUR , PHONE NUMBER: / / PRADESH , 226001.
UTTAR PRADESH , 228001. LAND/FAX NUMBER:/ PHONE NUMBER: 05222619922 /
PHONE NUMBER:05362359566 EMAIL:shraddha.efficient@gmail.com / MOBILE NUMBER:
FAX NUMBER:NA / NA Email: ch429001@newindia.co.in
Email:nia.420409@newindia.co.in
INSURED DETAILS
Insured's Name ANAND KUMAR Customer ID PO93841939 (PAN No :NA)
Insured's Address 02 RAJENDRA NAGAR SIKANDRA KANPUR DEHAT,,, Contact Number / / XXXXXX2571
KANPUR DEHAT ,UTTAR PRADESH, 209715
Email sunil.sachan44@gmail.com
GSTIN NA
POLICY DETAILS
Period of cover 25/12/2023 12:00:01 AM to 24/12/2024 11:59:59 PM Receipt Number 42040981230000003123 -
22/12/23
Previous Insurer THE NEW INDIA ASSURANCE COMPANY LTD. Previous Policy Number 42040931220300002243
VEHICLE DETAILS
Geographical Area / Zone: India/C Year of manufacture: 2020
Type of Commercial A - Goods Carrying Sub Type: Other than 3 wheeler -
Vehicles: Public Carrier
Name of the Financier: TATA MOTORS FINANCE LTD Chassis no./Engine no.: MAT808014L1P10668/D02
102M64133856
Type of fuel: Diesel Cubic capacity ( cc): 0
Type of body: Open Gross Vehicle Weight 47500
(GVW):
Make/Model: TATA MOTOR/TATA LPT 4825 TRUCK Registration no. UP-77-AT-9378
Seating capacity including 2 Variant: LPT 4825 COWL/6800 BS-VI
Driver:
Automobile Association none Colour: AS PER RC
membership:
Cover Note No/Cover / Name of registration Kanpur - Rural
Note Issue Date: authority:
FASTag ID:
INSURED DECLARED VALUE (Rs)
Vehicle Trailer Non-Elec Acc Electrical Acc Bi-fuel kit Total Value
3240000 0 0 0 0 3240000
ENHANCED COVER
Nil Depreciation Add On Cover
SCHEDULE OF PREMIUM
Own Damage Liability
Signature Not
Verified
Digitally signed
by JAGATJAYEE Policy No. : 42040931230300002475Document generated by 39792 at 2023/12/22 14:26:12.
PANIGRAHI
Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Date: 2023.12.22
14:26:12 IST Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own grievance redressal mechanism; you may also
approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website http://newindia.co.in.
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THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)
Basic OD Premium 8388 Basic TP Premium 44242
(+)Additional premium for GVW above 12000KG 1437.75 (+)Compulsory PA Premium for Owner Driver(Sum 275
(-)Calculated NCB Discount(35%) 3955.01 Insured Rs 1500000)
(+)Loading for Inclusion of IMT 23 1473.92 (+)LL to paid driver conductor cleaner employed for 100
(+)Nil Depreciation Cover Premium 28301.12 oprn
(+)Premium for enhancement cover 28301.12 (+)LL under WCA for carriage of more than six 250
employees(excluding the Driver)(5)
Calculated OD Premium 34173 Calculated TP Premium 44867
Total OD Premium (Rs) 34173 Total TP Premium (Rs) 44867
Net Premium (Rs) 79,040
GST (Rs) 11,574
Total Payable (Rs) 90,614
Total Payable in Rs(in words): RUPEES NINETY THOUSAND SIX HUNDRED FOURTEEN ONLY
GSTIN(Issuing Office) 09AAACN4165C4ZM
SAC 997134 (Motor vehicle insurance services)
Limitation as to use:The Policy covers use only under a permit within the meaning of the Motor Vehicles Act, 1988 or such a carriage falling
under Sub-section 3 of Section 66 of the Motor Vehicles Act, 1988.The Policy does not cover use FOR a)Organised racing b) Pace Making c)
Reliability Trials d) Speed Testing
Limits of Liability:Limit of the amount the Company's Liability Under Section II 1(i) in respect of any one accident: as per the Motor Vehicles
Act, 1988. Limit of the amount of the Company's Liability Under Section II 1(ii) in respect of any one claim or series of claims arising out of one
event: Up to Rs. 7,50,000
For individual covers (OD) in RS:3240000 Compulsory excess in Rs:1500
Imposed excess in Rs:0 Voluntary excess in Rs:0
Persons or classes of persons entitled to drive: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 requirement of Rule 3 of the Central Motor Vehicles
Rules, 1989.
PA cover for Owner Driver
Name of Nominee Age of Nominee Relationship with the Name of the Appointee (if Relationship to the
Insured Nominee is a minor) Nominee
NA NA NA N N
PA cover for named persons
Name CSI Opted(Rs.) Nominee Relationship
NA NA NA NA
Premium and GST Details
Rate of Tax Amount in INR
Premium Rs34798
SGST 9 3132
CGST 9 3132
IGST 0 0
Premium Rs44242
SGST 6 2655
CGST 6 2655
IGST 0 0
In witness where of this policy has been signed at SULTANPUR BRANCH OFFICE on this 22/12/2023
WARRANTED THAT IN CASE OF DISHONOUR OF THE PREMIUM CHEQUE, THIS DOCUMENT STANDS AUTOMATICALLY CANCELLED ABINITIO
This policy is subject to the Terms, conditions and exceptions applicable to Package/Liability policy attached/available on the web site
http://newindia.co.in; IMT Endorsement Number(s) printed herewith attached 21,23,39A,40,7.
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 Vehicles Act, 1988 is recoverable from the
Policy No. : 42040931230300002475Document generated by 39792 at 2023/12/22 14:26:12.
Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own grievance redressal mechanism; you may also
approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website http://newindia.co.in.
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THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)
insured: see clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY". It is clarified that in case the declaration regarding
the ncb or other previous policy details made by the insured, is found to be incorrect, all the benefits (including claim) under section-1 of this
policy, will stand forfeited.
Anti Money Laundering Clause: In the event of a claim under the policy exceeding Rs 1lakh or a claim for refund of premium exceeding Rs 1
lakh, the insured will comply with the provisions of AML policy of the company. The AML policy is available in all our operating offices as
well as Company website.
I/We hereby certify that the policy to which this Certificate For and on behalf of The New India Assurance Company Limited
relates as well as this Certificate of Insurance are issued in
accordance with the provisions of Chapter X and XI of M.V. Act,
1988.
Date of Issue: 22/12/2023
Duly Constituted Attorney(s)
NIL DEPRECIATION ADD ON COVER UNDER COMMERCIAL VEHICLE PACKAGE POLICY
(Endorsement Wording for Add on cover - Nil Depreciation)
UIN Number - IRDAN190RP0044V01100001/A0009V01202021
ENDORSEMENT ATTACHED TO AND FORMING PART OF POLICY NO. 42040931230300002475
Additional Premium: Rs.28302
In consideration of payment of an additional premium by the Insured, it is hereby agreed and declared that notwithstanding anything to
the contrary contained in the Policy, the Company hereby undertakes to indemnify:
1.Depreciation on replacement of parts including tyres, tubes, rubber / plastic for Partial Loss Claims.
2.Exclusion and depreciation under IMT 21 & IMT 23 respectively (wherever applicable).
3.Midterm inclusion of cover is not permitted.
4.Total Loss and Constructive Total Loss will be settled on the basis of IDV.
5.Depreciation waiver is applicable for two claims only.
The Company shall not be liable to make any payment in respect of:
1.Replacement of accessories, extra fittings and/or any internal improvements in the Insured Vehicle unless specifically covered in IDV.
2.Any damage occurred due to overturning in case of Miscellaneous D vehicle, unless covered under the policy by IMT 47.
Subject otherwise to the terms, exceptions, conditions and limitations of this Policy.
For and on behalf of The New India Assurance Company Limited
Date of Issue: 22/12/2023
Duly Constituted Attorney(s)
Policy No. : 42040931230300002475Document generated by 39792 at 2023/12/22 14:26:12.
Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own grievance redressal mechanism; you may also
approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website http://newindia.co.in.
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THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)
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.
Tax Invoice No : 42040923E0003790
IRDA Registration Number: 190
NIA PAN NUMBER: AAACN4165C
Policy No. : 42040931230300002475Document generated by 39792 at 2023/12/22 14:26:12.
Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own grievance redressal mechanism; you may also
approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website http://newindia.co.in.
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