Smart Drive Two Wheeler Insurance Policy CERTIFICATE OF INSURANCE CUM SCHEDULE
Date: 4/11/2017
Name of Policy Holder : MR .N VIGNESHKUMAR Policy No : S5287581
Communication Address : 71/1 ANNA NAGAR PEELAMEDU -641004 Policy Type : Two Wheeler-Comprehensive
: -641004 TAMIL NADU Insurance Policy
Total Premium : 2311
Contact No.: 9994612452 Intermediary Details:
Email ID: vigneshnmech@gmail.com Name : BHARTI AXA DIRECT A/C-SM1N Policy Start Date : 10/11/2017 00:00 hrs
Policy End Date : 9/11/2018 Midnight
Under Hypothecation/ Hire purchase/ Telephone no.: 080 - 49123900
Lease with : Code : T1000446
Your Vehicle Details
Vehicle Reg.no.: NEW Year of Manufacture : 2016 Make / Model:HONDA MOTORS / CB HORNET Fuel Type : P
Insured Declared Value of the Seating Capacity(Including Chassis / Engine No : ME4KC238KG8006300 / Cubic Capacity : 160
Vehicle(IDV) : 69183 Driver) : 2 KC23E80103667
Your Premium Details(in Rs)
OWN DAMAGE (A) THIRD PARTY (B)
Basic Premium for vehicle 1218 Basic Third Party Premium 887
Accessories Sum Insured (IMT 24) (0) 0 TPPD -0
CNG/LPG (IMT 25) Sum Insured(0) 0 PA to Owner Driver 50
Basic Own Damage Premium 1,218 Unnamed PA Cover to Passengers (IMT 16) Sum Insured (0) 0
Voluntary Deductible 0 Legal Liability to Paid Driver (IMT 28) 0
No Claim Bonus (20%) -244 Bi-Fuel Kit 0
Load/Discount -195
Handicap 0
AAI Discount 0
AntiTheft 0
Additional Covers:
Depreciation Cover
Hospital Cash Cover
Roadside Assistance Cover
Ambulance Cover
Medical Cover
Invoice Price Cover (Rs. )
Key Replacement Cover
No Claim Bonus Same Slab
Hydrostatic Lock Cover
Engine and GearBox Protection Cover
Consumables Cover
Total Own Damage Premium (Rs.) (A) 779 Total Third Party Premium (Rs.) (B) 937
Net Premium (A+B) 1958
GST @18% 352
TOTAL PREMIUM OF YOUR VEHICLE (Rs.) 2311
YOUR NOMINEE DETAILS
Nominee Name: VASUHI V Nominee Age: Insurer’s relationship with Appointee Name: Insurer’s relationship with
62 Nominee: Mother appointee:
In case of a claim, you may reach us at 080 - 49123900 or email us at claims@bharti-axagi.co.in.
Please intimate us if you wish to change any of the above information or if incorrect.
This policy is booked via IP at Sat Nov 04 14:01:06 SGT 2017
We thank you for the patronage and confidence you have placed in us. We look forward to serve you again.
Best Regards,
Rohit Kohli
Vice President - Operations
Limitations as to use: The Policy covers use of the vehicle for any purpose other than: (a) Hire or Reward (b) Carriage of goods (other than samples of personal luggage)(c)
Organized Racing (d) Pace Making (e) Speed Testing (f) Reliability Trial (g) Any purpose in connection with Motor Trade. Driver's Clause: Persons or Classes of person 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 requirements of
Rule 3 of the Central Motor Vehicles Rules, 1989. Limits of Liability: 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 Vehicles Act, 1988. Under Section II-1 (ii) of the policy (Damage to Third Party Property) Rs. 7.5 lakhs. Under Section III: P.A cover to owner driver (CSI):
Rs.2,00,000. PA cover to unnamed passenger Rs. 0. Deductible under Section-I: Compulsory Deductible IMT 22: Rs. 100 . Voluntary Deductible IMT 22 (A): Rs. 0
Subject to Indian Motor Tariff Endorsement (nos.)
Under HP / HYP / Lease (IMT 5,6,7) with:
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 XI of
Motor Vehicles Act, 1988. In witness of this Policy has been signed at _________________ on _________________
Transaction no. : JHMP5785099701 Service Tax Registration no.: AADCB2008DST001 For Bharti AXA General Insurance Co. Ltd.
Stamp duty paid to the account of The District Registrar of Stamps (Acc Head 0030-02-103-0-01), Bangalore Karnataka.
Tax Invoice will be followed after the Policy Certificate
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's Act, 1988 is recoverable
from the insured. See the clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY".The Schedule, the attached Policy and
Endorsements mentioned herein above shall read together and word or expression to which a specific meaning has been attached in any part of
this Policy or of the Schedule shall bear the same meaning wherever it may appear. Any amendments/modifications/alterations made on this
system generated policy document is not valid and Company shall not be liable for any liability whatsoever arising from such changes. Any changes
required to be made in the policy once issued, would be valid and effective, only after written request is made to the company and Company
accepts the requested amendments/modifications/alterations and records the same through separate endorsement to be issued by the
Company.Insurance is the subject matter of solicitation. For redressal of your grievance, if any, you may approach any one of the offices- 1.Policy
issuing office 2.Corporate Office. In case, you are not satisfied with our own grievance redressal mechanism; you may also approach Insurance
Ombudsman. Details of Insurance Ombudsman offices are available at IRDA website: www.irda.gov.in , or on the website of General Insurance
Council: www.gicouncil.in or on the company website www.bharti-axagi.co.in
