THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)
[B]
POLICY SCHEDULE CUM CERTIFICATE OF INSURANCE
Commercial Vehicle Package Policy
UIN Number - IRDAN190RP0044V01100001
Policy Number :71020331250100003530
POLICY ISSUING OFFICE: BUSINESS CHANNEL/CPSC User: CLAIM CONTACT:
THIRUVOTTIYUR BRANCH (710203), NAME: DIRECT BUSINESS - (2D3902844) CHENNAI (710001)
NO:142,143 &144, T.H.ROAD, , JEEVAN Mr. Karimulla A - (NIAAG00090674), ADDRESS: Macmillan House,2nd Floor, "B" Block
PALLAVA BUILDING,GROUND FLOOR, , PHONE NUMBER: / / 9840938718 21,Patullos Road,Chennai 600002 , , , TAMIL NADU ,
TONDIARPET, CHENNAI , LAND/FAX NUMBER:/ 600002.
TAMIL NADU , 600081. EMAIL:ksdmoideen2015@gmail.com / PHONE NUMBER: 04428888700 /
PHONE NUMBER:04423456759 MOBILE NUMBER:
FAX NUMBER:NA / NA Email: ch71@newindia.co.in
Email:nia.710203@newindia.co.in
INSURED DETAILS
Insured's Name SUDHAKARAN V Customer ID POC4439947 (PAN No
:OKFKS6433D)
Insured's Address NO 73, PONNERI MAIN ROAD, KRISHNAPURAM, Contact Number / / XXXXXX0618
PONNERI, TIRUVALLUR.,,,
PONNERI ,TAMIL NADU, 601204
Email
GSTIN NA
POLICY DETAILS
Period of cover 19/07/2025 09:58:51 AM to 17/07/2026 11:59:59 PM Receipt Number 71020381250000002450 -
19/07/25
Previous Insurer THE NEW INDIA ASSURANCE COMPANY LTD. Previous Policy Number 71020331240300000723
VEHICLE DETAILS
Geographical Area / Zone: India/A Year of manufacture: 2022
Type of Commercial A - Goods Carrying Sub Type: Other than 3 wheeler -
Vehicles: Public Carrier
Name of the Financier: KOTAK MAHINDRA BANK LTD Chassis no./Engine no.: MAT808017N3H21890/B6
7B6A250D02122H6422754
9
Type of fuel: Diesel Cubic capacity ( CC): 0
Type of body: Open Gross Vehicle Weight 47500
(GVW):
Make/Model: TATA MOTOR/TATA SIGNA 4830.T TRUCK Registration no. TN-05-CJ-5344
Seating capacity including 2 Variant: SIGNA 4830.T 6730/COWL
Driver: BS-VI
Automobile Association none Colour: TITANIUM WHITE
membership:
Cover Note No/Cover / Name of registration Chennai - North East
Note Issue Date: authority:
FASTag ID:
INSURED DECLARED VALUE (Rs)
Vehicle Trailer Non-Elec Acc Electrical Acc Bi-fuel/CNG/LPG kit Total Value
4700000 0 0 0 4700000
SCHEDULE OF PREMIUM
Own Damage Liability
Basic OD Premium 12345 Basic TP Premium 44242
Signature Not
Verified
Digitally signed
by DHIRAJ Policy No. : 71020331250100003530Document generated by 39175 at 2025/08/07 19:24:53.
KUMAR
Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Date: 2025.08.07
19:24:53 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 https://newindia.co.in.
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THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)
(+)Additional premium for GVW above 12000KG 1437.75 0
(+)Loading for Inclusion of IMT 23 2067.35 (+)LL to paid driver conductor cleaner employed for
(+) Additional OD Premium for Bi-Fuel/CNG/LPG 0 oprn 100
Calculated OD Premium 15850 Calculated TP Premium 44342
Total OD Premium (Rs) 15850 Total TP Premium (Rs) 44342
Net Premium (Rs) 60,183
GST (Rs) 8,178
Total Payable (Rs) 68,361
Total Payable in Rs(in words): RUPEES SIXTY-EIGHT THOUSAND THREE HUNDRED SIXTY-ONE ONLY
GSTIN(Issuing Office) 33AAACN4165C4ZV
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:4700000 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
none 0 none NA NA
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 Rs60183
SGST 9 284
CGST 9 284
IGST 0 0
Premium Rs0
SGST 0 0
CGST 0 0
IGST 0 0
In witness where of this policy has been signed at THIRUVOTTIYUR BRANCH on this 07-AUG-25
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 policy attached/available on the web site
http://newindia.co.in; IMT Endorsement Number(s) printed herewith attached 21,23,37,38.
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
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.
Policy No. : 71020331250100003530Document generated by 39175 at 2025/08/07 19:24:53.
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 https://newindia.co.in.
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THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)
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: 07/08/2025
Duly Constituted Attorney(s)
IRDA Registration Number: 190
NIA PAN NUMBER: AAACN4165C
Policy No. : 71020331250100003530Document generated by 39175 at 2025/08/07 19:24:53.
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 https://newindia.co.in.
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