SBI GENERAL INSURANCE COMPANY LTD (ISO 9001:2015 Certified Company)
BUNDLED TWO-WHEELER INSURANCE POLICY - CERTIFICATE CUM POLICY SCHEDULE
(FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES *,1989)
UIN No: IRDAN144RP0007V02201819 GSTIN:
IRDAI Registration No: 144
Description of Services: Motor Vehicle insurance services
Toll Free No.: 1800-102-1111, 1800-22-1111
Website: www.sbigeneral.in Email: customer.care@sbigeneral.in
Policy & Owner Details Policy Type- New Product Name- Bundled Two-Wheeler Insurance Policy
Policy Number Proposal Number & Date Insured GSTIN Number
POPM2W00100982348 QPM2W001000050642641 & 02/08/2022
Policy Tenure (OD Tenure) Policy Tenure (TP Tenure) Policy Issued On
1 YEAR 5 YEAR 02/08/2022 15:17:35
Period Of Insurance (OD Tenure) Period Of Insurance (TP Tenure)
From: 02/08/2022 15:17:35 02/08/2022 15:17:35 To
To: 01/08/2023 23:59:59 01/08/2027 23:59:59
Insured Name Insured Address
Mr. GOKUL M 1/26, P K VALAVU KADATHUR AGRAHARAM SALEM TK,SALEM DT Salem tamilnadu 636308
Nominee Name Nominee Relationship Appointee Name Relation with Appointee
Mr. MURUGESAN Father - -
CPA Start Date CPA End Date CPA Tenure CPA Sum Insured
02/08/2022 15:17:35 01/08/2023 23:59:59 1 ₹ 1500000
Tax Invoice Number
Vehicle Details
Make Model Variant Cubic Capacity Seating Capacity Body Type
TVS TVS NTORQ 125 RACE EDITION XP TVS NTORQ 125 RACE XP BSVI DISC 125 2 SOLO
RED+BLK -
Manufacturing Year Registration Date Fuel Type RTO Registration Number Chassis Number
2022 02/08/2022 PETROL TN-30 New MD626BK39N2D02100
Engine Number CNG Elec.Accessories Non-Elec.Accessories Carrier Type CNG/LPG Kit
CK3DN2702166 0 0 0 No
Vehicle IDV Hypothecation/Lease/HP* (IMT-7) Hypothecation City Hypothecation Bank Financier Branch Geographical area extension
₹ 93851 HYPOTHECATION 1 Salem HDFC BANK LTD 0 -
Schedule Of Premium (Amount In Rs.)
OWN DAMAGE PREMIUM (A) LIABILITY PREMIUM (B)
Particular Total Particular Total
Basic Own Damage 943.77 Basic Third Party Liability 3851
Non-Elec. Accessories 0 Third Party Liability For Bi-Fuel Kit 0
Elec. Accessories (IMT-24) 0 PA Cover For Owner Driver (IMT-15) 400
CNG / LPG Kit (IMT-25) 0 PA Paid Driver 0
Geographical Extension (IMT-1) 0 PA Cover For Unnamed Persons (IMT-16) 0
Sub Total (Basic Premium) 943.77 Legal liability Paid Driver (IMT-28) 0
ADD ON COVERAGE Legal liability Unnamed Persons (IMT-29) 0
Sub Total (Addons) 0 Geographical Areas Extension (IMT-1) 0
DISCOUNTS Net Liability Premium (B) 4251
AntiTheft Discount (IMT-10) 0 Total Premium (A+B) 5194.94
AA Membership Discount (IMT-8) 0 IGST Premium (18%) 935.06
No Claim Bonus 0 Total GST 935.06
Sub Total (Discounts) 0
Net Own Damage Premium (A) 944 Gross Premium 6130
• Policy insurance is subject to realization of premium/payment. • Consolidated stamp duty paid to state exchequer. The policy is subject to compulsory deductible (IMT-22) of Rs.100. • Geographical Area-India. •
NOTE: You agree to receive the policy document (without enclosing the terms & conditions) from the company and the company will display terms & conditions on its website which can be accessed by you online. * Subject
to IMT Endt. Nos. & Memorandum: 22,7,15.
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 (8) Tuition.
Drivers 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: (a) 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. (b) Under Section II (1)(ii) of the Policy-
Damage to property other than property belonging to the insured or held in trust or in the custody of control of the insured up to the limits specified- (TPPD Sum Insured - ` 1,00,000/-) . (iii) PA cover for owner driver under
section III CSI ₹ 1500000.
No Claim Bonus : No Claim Bonus will only be allowed, provided the policy is renewed within 90 days of the expiry of the previous policy. No Claim Bonus is subject to no claim on the previous policy. Benefits under the policy
stands forfeited if claim is/was made in previous policy.
Geographical Area: Any accidental loss damage and/or liabilty caused sustained or insured within India shall be covered subject to policy Terms and Conditions, unless specially agreed and endorsed.
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.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 Chapter XI of Motor Vehicle Act *, 1988. "As per section 146 of
the motor vehicle act *, 1988 it is mandatory to have your vehicle insured against third party risk". As per section 196 of the above act,driving a vehicle without valid insurance is punishable with fine upto Rs 2000/- or
imprisonment upto 3 months or both. Pre-existing Damages: All types of pre-existing damages or cost of rapair of such damage will be excluded at the time of claim settlement. Updating Registration Number of vehicles within
15 days of policy inception is MANDATORY as per IRDAI. Kindly provide the same to your Agent/Our Call centre/Policy issuing Branch (Applicable for policies booked without Registration No of vehicles).
Grievance Clause: Insured is advised to go through the policy schedule cum certificate of insurance which is issued based on your declaration and if any error/ discrepancy is found in respect of vehicle details, No Claim Bonus
or any other material information, it should be brought to our notice within 15 days of receipt of this policy for necessary correction along with the supporting documents, otherwise it will be deemed correct. In the unfortunate
event of a claim, please call quoting your Policy No. on 1800-102-1111, 1800-22-1111 (toll free) and register your claim immediately within 7 days from the date of loss. You may visit company website at www.sbigeneral.in for
detailed benefits, terms & conditions & exclusions of the policy. You may also reach us at our 24*7 helpline 1800-102-1111, 1800-22-1111 or customer.care@sbigeneral.in in case you desire to have a printed copy of policy
wording or any other assistance required. Our grievance redressal procedure and details about ombudsman is also available in our policy wording and company website. Please note that any misrepresentation, non disclosure
or withholding of material facts will lead to cancellation of policy void ab initio with forfeiture of premium and non consideration of claim, if any. In the event of unsatisfactory response from the Head Grievance Officer, he/she
may, subject to vested jurisdiction, approach the Insurance Ombudsman for the redressal of grievance. Details of Insurance Ombudsman are available at IRDAI website www.irdai.gov.in or on company website
www.sbigeneral.in or on General Insurance Council: http://www.cioins.co.in/ombudsman.html
MISP MISP Code Email/Mobile
GT AUTO AGENCIES PRIVATE LIMITED HIB/TVS/14090 gt.rajvi@gmail.com/98******33
DP DP Code Email/Mobile
RAJESHWARAN GANESAN HIB_001885 gt.rajvi@gmail.com/8973626333
Broker Name & Address: Harita Insurance Broking LLP, Jayalakshmi Estates, No.29, Haddows Road, Nungambakkam, Chennai,TN-600006
Broker Code : 97309
For & On Behalf of
SBI GENERAL INSURANCE COMPANY LTD
Authorized Signatory
For Renewal/Claims assistance - please contact Insurance.Co./HIB through : GT AUTO AGENCIES PRIVATE LIMITED at 8973626333
