Policy
Policy
Registered and Head Office: Bajaj Allianz House, Airport Road, Yerwada, Pune
A. Proposer details
1. Proposer Name : KALPANA BEHERA
2. Proposer Address : ROXYLANE BADAMBADI, TELENGA BAZAR,CUTTACK SADAR
, TELENGA BAZAR, CUTTACK, ODISHA-753009
3. Proposer Mobile Number : 7381918028
4. Proposer Residential Number : NA
5. Proposer e-mail id : KALPANAB67497@GMAIL.COM
6. Proposer Profession : NA
B.Vehicle Details
Registration Month / Year Vehicle Vehicle Vehicle Sub Cubic Capa- Fuel Type Year of Man- Seating Ca-
Number of Regn Make Model Type city/Kilowatt ufacture pacity
NEW MAR/2025 BAJAJ CHETAK 3502 4 Battery 2025 2
Engine Number Chassis Number Vehicle IDV (in Electrical Non-Electrical CNG/LPG Unit Total IDV (in
Rs.) Accessories Accessories (Extra fitted) Rs.)
IDV (in Rs.) IDV (in Rs.) IDV (in Rs.)
E30ASM71817 MD2B35300SA 1,20,000.00 0 0 0 1,20,000.00
M39196
C. Coverage opted
1. Period of Insurance
For Own Damage Section From 26-MAR-2025 11:23(Hrs) To 25-MAR-2026 Midnight
For Third Party Liability Section From 26-MAR-2025 11:23(Hrs) To 25-MAR-2030 Midnight
2. Is your vehicle fitted with external LPG/CNG kit : No.
3. Electrical Accessories cover Opted (If Applicable) : No.
4. Non - Electrical Accessories cover Opted (If Applicable): : No.
5. Is Voluntary Excess opted : No.
Amount of voluntary excess opted : Rs.NA.
6. Whether PA cover is opted for owner-driver : Yes.
7. compulsory deductible : Rs.100.00
8. Is any additional compulsory deductible imposed and agreed upon : Yes.
Amount of additional compulsory deductible imposed : Rs.
9. Whether geographical area extension is opted : No.
Details of Countries to which geographical area extension cover is given : NA.
10. Is LL to person for Paid driver/Operation/Maintenance opted : No.
11. Whether PA cover is opted for paid driver other than owner driver : No.
Sum Insured for Paid Driver : Rs.NA.
13. Is TPPD restricted to statutory limit of Rs.6000? : Yes.
14. Pre Existing damages in the vehicle : NA.
15. 1 Premium for Liability coverage, quoted and agreed upon is :
16. 1 Premium for OD coverage, quoted and agreed upon is :
17. Do you have valid PUC certificate of the vehicle : NA
18. Do you have valid Fitness certificate of the vehicle : NA
19. Total Premium (excluding Goods and Service Tax (GST)) for Liability and OD coverages, quoted and agreed upon is
:
20. NCB (No Claim Bonus) claimed by you and granted by us based on your declaration of no claim during your previous
previous policy : 0 %.
21. About the last insurance company
(i) Insurance Provider : .
(ii) Previous Policy No : NA , Previous Policy Expiry Date : NA
22. Whether your vehicle is Hypothecated and if so the details of Pledgee whose name is registered by us : Yes.
Name of Pledgee : KOTAK MAHINDRA PRIME LTD.
23. Add on Cover(s) optedm2 : Yes, Plan Name:24x7_Spot Assistance And Drive Assure Silver Ev Plan Description: 24x7
spot assistance , consumable expenses , electric vehicle/ hybrid system protection cover , depreciation shield ,
Please call us on 1800 103 5858 for any emergency.
24. To support our Go Green initiative, send policy copy link on registered mobile number / email id: YES
Please note Cover Note No. / issued to you basing on the above information.
In case of Disagreement or objection or any changes with respect to information and contents mentioned hereinabove, please
contact our toll free number & register your objections/changes/disagreement to the contents of this transcript or you may also
send us email or written correspondence at the following details within a period of 15 days from date of your receipt of this
transcript along with Policy:
I/We hereby unconditionally allow the Company to share all my / our information being collected in this proposal form or
through telephonic / email / web-inputs means or other means, as updated from time to time within group entities.
Toll free Number : 1800-102-5858,1800-209-5858
Email address : Bagichelp@bajajallianz.co.in
Website : www.bajajallianz.com
Contact our policy servicing branch at: Plot no-9/10,, 1st floor and 2nd floor, Satyanagar, Bhubaneswar, KHORDA-751007
PH:0674-2570498.
INSURANCE ACT, 1938 SECTION 41 - PROHIBITION OF REBATES
No person shall allow or offer to allow either directly or indirectly, as an inducement to any person to take out or renew or
continue an insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the
commission payable or any rebate of the premium shown on the policy, nor shall any person taking out or renewing a policy
accept any rebate, except such rebate as may be allowed in accordance with the published prospectus or tables of the insurer.
ANY PERSON IN BREACH OF COMPLYING WITH THE PROVISIONS OF THIS SECTION SHALL BE PUNISHABLE
WITH FINE WHICH MAY EXTEND TO RUPEES TEN LAKH.Bajaj Allianz General Insurance Co Ltd
Limitations as to Use:
The Policy covers use for any purpose other than
a) Hire or Reward, b) Carriage of goods (other than samples or personal
luggage), c) Organized racing, d) Pace Making, e) Speed testing, f)
Reliability Trials, g) Any purpose in connection with Motor Trade
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 provi-
sions of Chapter X and Chapter XI of M.V. Act, 1988.
Policy issuing office and correspondence address for communication by holder of Certificate of Insurance for claim,
service request, notice, summons, etc:
Plot no-9/10,, 1st floor and 2nd floor, Satyanagar, Bhubaneswar, KHORDA-751007 PH:0674-2570498
Date of issue :26-MAR-2025
For & On Behalf of
For help and more information:
Contact our 24 Hour Call Centre at 1800-102-5858, 1800-209-5858, Toll Free: 30305858( chargeable, add area code before this number in case of mobile call) Email us at
Bagichelp@bajajallianz.co.in or Visit our Website www.bajajallianz.com
Corporate Identification Number U66010PN2000PLC015329
Latest Schedule - 27-Mar-2025 21:24:25 PM- Silent_Printing (Web) (NA)
Bajaj Allianz General Insurance Company Ltd.
Authorized Signatory
Invoice No 450416872/1
As per the GST regulations, the amount of GST will not be refunded if the policy / endorsement is cancelled after 30th September of the next financial year
I/We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than the aggregate turnover noti-
fied 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.
Limitation as to Use The Policy covers use of the vehicle for any purpose other than : Hire or reward, Carriage of
goods( other than samples or personal luggage),Organised racing,Pace making, Speed testing,
Reliability trials. Any purpose in connection with Motor Trade.
Driver Any person including the insured provided that a person driving holds an effective driving li-
cense 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
when not used for the transport of goods/passengers at the time of the accident and that such a
person satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules, 1989.
Limits of Liability Under section II-I(i) of the policy -> Death of or bodily injury : Such amount is necessary to meet
there requirements of the Motor Vehicles Act,1988. Under section II-I(ii) of the policy -> Dam-
age to Third Party Property : Rs. 1,00,000/- for Motorized Two Wheelers and Rs.7,50,000 for
others or Rs.6,000/-,where the proposer / insured opts to limits the TPPD liability to the statutory
limit of Rs.6,000/-
No Claim Bonus
Existing Damage Details NA
Nominee Details Name :SHREYESH VISHAL - Relationship :Son
Subject to Warranties/ 10, 20, 7, 22, & Plan Name:24x7_Spot Assistance And Drive Assure Silver Ev & Plan Descrip-
IMT-Endorsements/ tion: 24x7 spot assistance , consumable expenses , electric vehicle/ hybrid system protection cov-
Add on Package er , depreciation shield ,
Additional Details Coinsurance Details: - . Transaction Id: -
Premium Details Receipt No. 2403-00520570, Date 24-MAR-25 ** If Premium paid through Cheque, the Policy is
void ab-initio in case of dishonour of Cheque.
Excess Details Compulsory Excess: Rs.100.00 Additional Excess: Rs. Voluntary Excess: Rs..00
Theft Excess: Rs.0
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 Vehicle Act,
1988 is recoverable from the Insured. See the clause headed AVOIDANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY.
It is mandatory to keep your policy with updated contact (Mobile No., Email ID and PAN Card) and bank account details, to process any of
your service requests faster and hassle-free in future.
You can update the same through Caringly yours App {Link}, WhatsApp Service { Say Hi on WhatsApp - +91 75072 45858}, Contact our
24-Hour Call Center at 1800-209-5858, 1800-102-5858, Give a Missed Call on 8080945060, SMS WORRY to 575758, Email ba-
gichelp@bajajallianz.co.in, website {http://www.bajajallianz.com}, contact your agent or nearest branch.
For & On Behalf of
Bajaj Allianz General Insurance Company Ltd.
Stamp
Duty Rs.
0.50
Authorized Signatory
This document is digitally signed, hence counter signature / stamp is not required.
Consolidated Stamp Duty of Rs. 0.50/- paid for insurance policy stamps vide Order No. CSD/19/2025/816 dated 01-MAR-25 of General Stamp Office, Mumbai, India.
Principal Location : Plot no-9/10, 1st floor and 2nd floor, Satyanagar, Bhubaneswar, KHORDA - 751007 PH:0674-2570498 | Services Ac-
counting Code : 997134 - Motor vehicle insurance services. No reverse charge is payable on these services.
S3 - DEPRECIATION SHIELD
A. Endorsement Wordings
(UIN No. IRDAN113RP0008V01201819/A0024V01201819)
In consideration of payment of additional premium, it is hereby agreed and declared that this Policy extends to cover the
depreciation amount, partly or fully, on assessed damaged parts allowed for replacement during repairs in the event of a
Partial Loss to the Insured Vehicle .
In the event You have opted for co-payment, Your contribution shall be to the extent agreed by You as shown in the
Schedule for the depreciation amount on the assessed parts for each and every Partial Loss claim.
The benefits under 'Depreciation Shield' would be available only if the Insured Vehicle is repaired at Our authorized
workshops. In case You have opted to repair the Insured Vehicle at a non-authorized workshop, Our liability will be
restricted to 90% of the assessed total claim amount under this cover.
B. Conditions
(1) Claims made by You against Us under 'Depreciation Shield' are subject to the terms and conditions set forth
under the Motor Insurance Policy. (2) In case of transfer of ownership of the Insured Vehicle , the cover under
'Depreciation Shield' shall expire. (3) The benefits under 'Depreciation Shield' can be utilized for a maximum of
two times during the Policy Period
C. Exclusions
In addition to the exclusions mentioned under Motor Insurance Policy, We will not be liable to indemnify You for the
following events:
(1) Where the Own Damage Claim made by You against Us under the Motor Insurance Policy is not payable (2)
Depreciation pertaining to any part/ sub part/ accessories not approved for replacement by Us under Motor Insur-
ance Policy. (3) Loss or damage to tyres and/or battery of the Insured Vehicle . (4) Consequential loss of any
kind arising out of claims lodged under 'Depreciation Shield'. (5) Where a loss is covered under Motor Insurance
Policy or any other type of insurance policy with any other insurer or manufacturer's warranty or recall campaign
or under any other such packages at the same time
If You do not agree whether any of these exclusions apply to Your claim, You agree to accept the burden of proving that
they do not apply.
D. Definitions
The words and phrases listed have special meanings We have set below whenever they appear in bold type and initial
capitals. Please note that references to the singular or to the masculine also include references to the plural or to the fe-
male the context permits and if appropriate.
(1) You,Your,Yourself: The person or persons We insure as set out in the Schedule .(2) We, Our, Us: Bajaj Alli-
anz General Insurance Company Limited. (3) Accident, Accidental: A sudden, unintended and fortuitous external
and visible event.(4) Policy/Motor Insurance Policy: Two Wheeler Package Policy issued by Us to which this
cover is extended (5) Insured Vehicle : The vehicle insured by Us under the Motor Insurance Policy and as
shown on the Schedule .(6) Policy Period: The period between and including the commencement date and expiry
date as shown in the Motor Insurance Policy Schedule . (7) Schedule : The Schedule and any Annexure or En-
dorsement to it which sets out Your personal details and the insurance cover in force. (8) Own Damage Claim:
The claims raised by You against Us for loss or damage to the Insured Vehicle due to the perils mentioned under
Section 1 of Motor Insurance Policy. (9) Total Loss/ Constructive Total Loss: A loss under the Motor Insur-
ance Policy where the aggregate cost of retrieval and/ or repair of the Insured Vehicle , subject to terms and con-
ditions of the Policy, exceeds 75% of the IDV of the Insured Vehicle . (10)Partial Loss: Any loss falling into a
category other than (A) the loss mentioned under Sr. No. 9 above and (B) theft of the Insured Vehicle
S17:CONSUMABLE EXPENSES
(UIN No. IRDAN113RP0008V01201819/A0023V01201819)
A. Endorsement Wordings
In consideration of payment of additional premium, it is hereby agreed and declared that if the Insured Vehicle is
damaged by a covered peril mentioned under the own damage section of the Motor Insurance Policy and needs to be
repaired, We will cover cost of consumables required to be replaced/ replenished during the repair of the damaged
vehicle. Consumable for the purpose of this cover shall include engine oil, gear box oil, power steering oil, coolant, AC
gas oil, brake oil, AC refrigerant, battery electrolyte, windshield washer fluid, radiator coolant, nut & bolt, screw, oil fil-
ter, fuel filter, bearings, washers, clip, wheel balancing weights , and items of similar nature excluding fuel.
B. Conditions
(a) This cover is applicable if it is shown on Your schedule. (b) Claims made by You against Usunder 'CONSUM-
ABLE EXPENSES' are subject to the terms and conditions set forth under the Motor Insurance Policy. (c)In case
of transfer of ownership of the Insured Vehicle , the cover under 'CONSUMABLE EXPENSES' shall expire.
(d) The benefits under under 'CONSUMABLE EXPENSES' would be available only if the Insured Vehicle is re-
paired at Our authorized workshops.
C. Exclusions
In addition to the exclusions mentioned under Motor Insurance Policy, We will not be liable to indemnify You for the
following events: (1)Where the Own Damage Claim made by You against Us under the Motor Insurance Policy is
not payable. (2) Consumables pertaining to any part/ sub part/ accessories not approved for replacement by Us under
Motor Insurance Policy. (3)Where a loss is covered under Motor Insurance Policy or any other type of insurance
policy with any other insurer or manufacturer's warranty or recall campaign or under any other such packages at the
same time.
D. Definitions
The words and phrases listed have special meanings We have set below whenever they appear in bold type and initial
capitals. Please note that references to the singular or to the masculine also include references to the plural or to the fe-
male the context permits and if appropriate.
(1)Authorized workshop / garage / service station - A motor vehicle repair workshop / garage / service station author-
ized by us. (2)Insured Vehicle: The vehicle insured by Us under the Motor Insurance Policy and as shown on the Sched-
ule. (3)Policy/ Motor Insurance Policy: Motor Package Policy issued by Us to which this cover is extended.
(4)Schedule: The Schedule and any Annexure or Endorsement to it which sets out Your personal details and the insur-
ance cover in force. (5)We, Our, Us: Bajaj Allianz General Insurance Company Limited. (6)You, Your, Yourself: The
person or persons We insure as set out in the Schedule.
EXCLUSIONS:
In addition to the exclusions mentioned underMotor Insurance Policy, We will not be liable to indemnify You for
the following events:
(1) For any loss to any accessories/attachments not supplied along with the Insured Vehicle as Original Equip-
ment fitments.(2) Any damage that results from operating methods other than those mentioned in the owners
manual or use beyond the limitations as specified by manufacturer such as maximum load passenger capacity,
speed and other performance modifications. (3) Where reasonable care (as prescribed by OEM) has not been taken
by You to protect the loss or damage to the Insured Vehicle (4) Goodwill compensation and costs incurred in the
recall campaigns of the manufacturer.(5)Any damage that results from neglect of the periodic maintenance as spe-
cified by manufacturer or not carried out at an authorized dealer/service center of the manufacturer.(6)Any dam-
age that results from storage, transportation and wear and tear (7)Any claims for repair/replacement of parts
covered under theManufacturer's Warranty Period.(8)Any loss or damage caused willfully/ knowingly or by
negligence of the Insured or his Employees/ Family Members(9)Any loss or damage arising due to poor work-
manship.(10)Any expenses incurred on towing, transportation cost, safeguarding and/or repair and replacement la-
bour charges arising out of loss of or damage admissible under this cover.(11)Caused through cyber risks; loss,
damage, destruction, distortion or loss of use, reduction in functionality, cost, expense of whatsoever nature result-
ing therefrom, regardless of any other cause or event contributing concurrently or in any other sequence to the
loss.(12)Loss of use/dead battery on account of untimely charging or over discharge(13)Any loss after the vehicle
has been serviced/handled by unauthorized service centre or personnel.(14)Loss or damage including corrosion
due to delay in intimating Us or delay in retrieval of the Insured Vehicle from the water logged area(15)Any
Third Party Liability
GENERAL CONDITIONS
(1) Claims made by Youagainst Us under this cover are subject to the conditions set forth under the Motor Insur-
ance Policy(2) Claims made by You against Us under this cover would be admissible if there is evidence that
theInsured Vehicle stopped in water logged area resulting into damage to theElectric Vehicle Drive System due
to water ingression(3)Health of Traction Battery (HOTB)shall be maintained by the Insured as per manufactur-
ers schedule of battery health (4)Number of claims to be Policy Period shall be limited to a maximum of two
claims(5)No cover is provided for child parts of internal combustion engine of Hybrid Vehicles under this add-on.
In order to cover the child parts of internal combustion engine separate add-on covering the same needs to be op-
ted by the Insured.(6) In case of Hybrid vehicles, this cover shall only be applicable to the components specified
in the insuring clause and Insured must opt for Engine Protector Cover separately to cover the internal combustion
engine components of the hybrid vehicle.
DEFINITIONS
The words and phrases listed have special meanings Wehave set below whenever they appear in bold type and initial
capitals. Please note that references to the singular or to the masculine also include references to the plural or to the
female the context permits and if appropriate.
(1)Accident, Accidental: A sudden, unintended and fortuitous external and visible event (2)Battery Manage-
ment System (BMS): A Battery Management System (BMS) is an electronic system that managesInsured
Vehicle Battery, such as by protecting the battery from operating outside its safe operating area, monitoring its
state, calculating secondary data, reporting that data, controlling its environment, authenticating it and / or balan-
cing it.The BMS also controls the charging and discharging, as well as recharging of the battery by redirecting the
recovered energy (i.e., from regenerative braking) back into theInsured Vehicle Battery. Inverter,converter and
the cooling systems form part of the BMS. For the purposes of thisPolicye ,it means the original BMS provided by
the Manufacturer along with new purchase of theInsured Vehicle without any modifications, or the original BMS
that has been replaced by the original equipment manufacturer following some fortuitous event.(3)Battery Elec-
tric Vehicle (BEV): Battery Electric Vehicle (BEV), a pure electric vehicle, only electric vehicle, fully electric
vehicle or all electric vehicle is a type of electric vehicle that exclusively uses chemical energy stored in re-
TWO WHEELER POLICY - BUNDLED : ADD ON COVERS(Plan Name:24x7_Spot Assistance And Drive Assure Sil-
ver Ev): POLICY WORDINGS
chargeable battery packs, with no secondary source of propulsion (e.g. hydrogen fuel cell, internal combustion en-
gine, etc.) Battery Electric Vehicle derive all power from battery packs and thus have no internal combustion en-
gine, fuel cell, or fuel tank.(4)Electric Vehicle Drive Systemmeans (i). Drive Motor/Electric Motor which con-
verts electric energy into mechanical energy. (ii). DC/DC step down converter (iii). Electric Generator (iv).Power
Electronics Controllers(5)Hybrid Electric Vehicle means Insured Vehiclespowered by an internal combustion
engine in combination with auxiliary electric motors that use energy stored in Traction Batteryfor propelling the
vehicle.(6) Health of Traction Battery (HOTB): Means the measurement of condition of the Battery compared
with that of the manufacturer's specification for the said Battery Type. It is generally expressed in percentage
terms, ranging between 0% to 100%. 100% means that battery's condition is fully meeting the manufacturer's spe-
cifications. The typical factors considered in these calculations are (the list below is inclusive but not
exhaustive):.Internal Resistance or conductance.Battery Capacity.Voltage.Self-discharge.Age of the battery(7)In-
sured Vehicle:The vehicle insured by Us under the Motor Insurance Policy (8) Policy/ Motor Insurance
Policy:Two Wheeler Policy - Bundled Policy issued by Us to which this cover is extended. (9) Policy Period:The
period between and including the commencement date and expiry date as shown in the Motor Insurance Policy
Schedule (10). Schedule:The Schedule and any Annexure or Endorsement to it which sets out Your personal de-
tails and the type of insurance cover in force (11). Traction Battery: A rechargeable battery used to power the
electric motor(s) of Battery Electric Vehicle (BEV) or Hybrid Electric Vehicle (HEV). Traction Battery
does not include (SLI) Battery used for starting, lighting, and ignition of the Vehicle (12). You, Your, Yourself,
Insured:The person or persons Weinsure as set out in Schedule (13). We, Our, Us: Bajaj Allianz General In-
surance Company Limited
Subject otherwise to all other terms conditions and exclusions of the within mentioned Policy.