AutoSecureTwoWheelerPackagePolicy

CertificateOfInsuranceandPolicyScheduleForm51oftheCenterMotorVehicleRules,1989

AgentName:KARTHICK.
AgentLicenseCode:9083725AgentContactNo:9840851086
Certificate&Policy
No.:
EndorsementNo.:

015511706000

PeriodofInsuranceFrom:

TN20AU5923
IDVofVehicle
()
14,607.00

Midnighton28/01/2016
To

EffectiveFrom:

InsuredName&Address:
MRPHINEHASG
NO36,
ANBAZHANSTREET
MANALI
CHENNAI600068
CHENNAI
TAMILNADU
Phone:
RegistrationNo.

09:39Hrson29/01/2015

Occupation:
GeographicalArea:
RegistrationAuthority:
HPA/Hyp/Leaseto:

SELFEMPLOYED
India
Tiruvallur
N/A

LoanNo.:

Make&Model
HERO
HONDASPLENDOR
PLUS
IDVofSideCar
()
0.00

EngineNo.

ChassisNo.

CC

Mfg.Year

BodyType

Seating
Capacity

16457

19954

97

2006

MOTORCYCLE

BiFuel/CNG/LPG
Kit( )
0.00

IDVofnonbuiltinAccessories( )
Electrical
NonElectrical
0.00
0.00

TotalInsuredDeclared
Values(IDV)( )
14,607.00

SCHEDULEOFPREMIUM

A.OWNDAMAGE
PremiumonVehicleandnonelectricalaccessories
A.TOTALOWNDAMAGEPREMIUM
C.TOTALADDONPREMIUM

B.LIABILITY
231.37 Basic
231.37 Add:CompulsoryPACoverforOwnerDriver 1,00,000
0.00 Less:IncreaseinPropertyDamageAmountUnlimited 6,000(IMT20)

464.00
50.00
50.00

B.TOTALLIABILITYPREMIUM(Roundoff)

464.00

COMPREHENSIVEPREMIUM(A+B+C)

695.37

NETPREMIUM

695.00

Add:12.36%ServiceTax
TOTALPREMIUM

86.00
781.00

DriversClause:Personsorclassesofpersonsentitledtodrive:Anypersonincludingtheinsured.Providedthatapersondrivingholdsaneffectivedrivinglicenseat
thetimeoftheaccidentandisnotdisqualifiedfromholdingorobtainingsuchalicense.ProvidedalsothatthepersonholdinganeffectiveLearner'sLicensemayalso
drivethevehicleandthatsuchapersonsatisfiestherequirementsofRule3oftheCentralMotorVehiclesRules,1989.
LimitationsastoUse:ThePolicycoversuseofthevehicleforanypurposeotherthan:a)HireorRewardb)Carriageofgoods(otherthansamplesorpersonal
luggage)c)Organizedracingd)PaceMakinge)Speedtestingf)ReliabilityTrialsg)AnypurposeinconnectionwithMotorTrade
LimitsofLiability:UnderSectionII1(i)ofpolicy(Deathoforbodilyinjury):Suchamountasis I/weherebycertifythatthePolicytowhichthisCertificate
necessarytomeettherequirementsoftheMotorVehiclesAct,1988.
relatesaswellasthisCertificateofInsuranceareissuedin
UnderSectionII1(ii)ofpolicy(ThirdPartyPropertyDamage): 6,000.00
accordancewithprovisionsofChapterXandXIofMotor
VehiclesAct,1988.
UnderSectionIII:PAtoOwnerDriverCSI: 1,00,000.00
InwitnesswhereofthisPolicyhasbeensignedatTAMBARAMon
Nominee:NAAge:33Relationship:OTHERS
29/01/2015
UnderSectionI:(Deductibles)CompulsoryDeductible: 100.00,VoluntaryDeductible:
ReceiptNo.(s):103011000221439Dated:29/01/2015
0.00,
ForTataAIGGeneralInsuranceCompanyLTD.
ImposedExcess: 0.00
Subjectto:A)IMTEndorsementNo.:20,22
ServiceTaxRegistrationNo:AABCT3518QST004
StampDuty 0.50paidvideChallanNo:MH001053052201415Edated05/06/2014

AtriChakraborty
NationalHeadOperations&Systems

TheInsuredisnotindemnifiedifthevehicleisusedordrivenotherwisethaninaccordancewiththisSchedule.AnypaymentmadebytheCompanybyreasonofwiderterms
appearingintheCertificateinordertocomplywiththeMotorVehiclesAct,1988isrecoverablefromtheInsured.Seetheclauseheaded"AVOIDANCEOFCERTAINTERMS
ANDRIGHTOFRECOVERY".
Note:ThisSchedule,theattachedPolicyandEndorsementsmentionedhereinaboveshallreadtogetherandwordorexpressiontowhichaspecificmeaninghasbeen
attachedinanypartofthisPolicyoroftheScheduleshallbearthesamemeaningwhereveritmayappear.Anyamendments/modifications/alterationsmadeonthissystem
generatedpolicydocumentisnotvalidandCompanyshallnotbeliableforanyliabilitywhatsoeverarisingfromsuchchanges.Anychangesrequiredtobemadeinthepolicy
onceissued,wouldbevalidandeffective,onlyafterwrittenrequestismadetotheCompanyandCompanyacceptstherequestedamendments/modifications/alterationsand
recordsthesamethroughseparateendorsementtobeissuedbytheCompany.

Insuranceisthesubjectmatterofthesolicitation.Formoredetailsonriskfactors,termsandconditions,pleasereadsalesbrochurecarefullybeforeconcludingasale.
TATAAIGGeneralInsuranceCompanyLtd.Regd.Office:15thfloor,TowerA,PeninsulaBusinessPark,GanpatraoKadamMarg,OffSenapatiBapatMarg,LowerParel,Mumbai400013.
IRDARegistrationNo.108,CINNo:U85110MH2000PLC128425
Website:www.tataaiginsurance.in24X7TollfreeHelpline18002667780Email:customersupport@tataaig.com
2ndFloor,SamsonTowers,403L,PantheonRoad,Egmore,Chennai600008
Tel:04466220222,Fax: