THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)
POLICY SCHEDULE CUM CERTIFICATE OF INSURANCE
Commercial Vehicle Package Policy
UIN Number - IRDAN190RP0044V01104582
Policy Number :61360131230100004859
POLICY ISSUING OFFICE: BUSINESS CHANNEL/CPSC User: CLAIM CONTACT:
KOTHAGUDEM BO (613601), NAME: SHAIK AMJAD MIYA 9848134098 - Khammam Non Suit Claim Hub (619006)
D.NO: 5-15-93/94, OPP: URDU GHAR, M.G. (2D5602735) ADDRESS: KHAMMAM D.O.; 9-3-143, 1st Floor , Old
ROAD, KOTHAGUDEM, KHAMMAM DIST. Mr. Mohammad Haseen Pasha - Club Road, Khammam, Telangana 507001 , , ,
TELANGANA STATE , , , (NIAAG00063059), TELANGANA , 507001.
TELANGANA , 507101. PHONE NUMBER: / / 9160085536 PHONE NUMBER: 08742228269 /
PHONE NUMBER:08744241233 LAND/FAX NUMBER:/ MOBILE NUMBER:
FAX NUMBER:NA / NA EMAIL: / md.haseen5@gmail.com Email: ch619006@newindia.co.in
Email:nia.613601@newindia.co.in
INSURED DETAILS
Insured's Name AKKALA RAJESHWARI Customer ID POA7965976 (PAN No :NA)
Insured's Address W/O NARESH, Contact Number / / XXXXXX2546
H NO: 9-3-94,3RD LINE,
SUBASH NAGAR COLONY,
0123456789,,
BHADRADRI ,TELANGANA
Email
GSTIN NA
POLICY DETAILS
Period of cover 06/01/2025 23:59:59 PM to 05/01/2026 11:59:59 PM Receipt Number 61360181230000001573 -
06/01/25
Previous Insurer Not applicable Previous Policy Number NA
VEHICLE DETAILS
Geographical Area / Zone: India/B Year of manufacture: 2013
Type of Commercial C - Passenger Carrying Sub Type: C1-Four Wheeler(Carrying
Vehicles: <=6)
Name of the Financier: NA . Chassis no./Engine no.: MAT445117DVG51363/
275IDI06.GWYSE3022
Type of fuel: Diesel Cubic capacity ( cc): 702
Type of body: Sedan Gross Vehicle Weight 0
(GVW):
Make/Model: TATA MOTOR/MAGIC Registration no. AP-15-TV-3371
Seating capacity including (6+1) Variant: TATA ACE MAGIC HT 7S
Driver:
Automobile Association none Colour: WHITE
membership:
Cover Note No/Cover / Name of registration RTA BHADRADRI
Note Issue Date: authority:
FASTag ID:
INSURED DECLARED VALUE (Rs)
Vehicle Trailer Non-Elec Acc Electrical Acc Bi-fuel kit Total Value
200000 0 0 0 0 200000
SCHEDULE OF PREMIUM
Own Damage Liability
Basic OD Premium 2748 Basic TP Premium 6040
(+)Add Legal liability to passangers 6972
(+)LL to paid driver conductor cleaner employed for
Signature Not
Policy No. : 61360131230100001698Document generated by AG_MOHAM59 at 2025/01/06 13:15:36.
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.
Page 1 of 3
THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)
oprn 50
Calculated OD Premium 2748 Calculated TP Premium 13062
Total OD Premium (Rs) 2748 Total TP Premium (Rs) 13062
Net Premium (Rs) 12,810
GST (Rs) 2,846
Total Payable (Rs) 14,656
Total Payable in Rs(in words): RUPEES FOURTEEN THOUSAND SIX HUNDRED FIFTY-SIX ONLY
GSTIN(Issuing Office) 36AAACN4165C3ZQ
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 e) Use whilst drawing a trailer except the towing (other than for reward) of any one disabled Mechanically
propelled vehicle.
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:280000 Compulsory excess in Rs:500
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 none none
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 Rs 13,810
SGST 9 923
CGST 9 923
IGST 0 0
In witness where of this policy has been signed at KOTHAGUDEM BO on this 06/01/2025
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 22,35,40,7.
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
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,
Policy No. : 61360131230100001698Document generated by AG_MOHAM59 at 2025/01/06 13:15:36.
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.
Page 2 of 3
THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)
1988.
Date of Issue: 06/01/2025
(Mr. KORRA SHOBAN)
[Sr. Branch Manager]
Duly Constituted Attorney(s)
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 : 61360123P0002866
IRDA Registration Number: 190
NIA PAN NUMBER: AAACN4165C
Policy No. : 61360131230100001698Document generated by AG_MOHAM59 at 2025/01/06 13:15:36.
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.
Page 3 of 3
