70177345

It's Time to Renew Your (STANDALONE MOTOR THIRD PARTY INSURANCE - TWO WHEELER) Insurance
Intermediary Code : 200865646919 Date : 28-03-2024
Intermediary Name : POLICYBAZAAR INSURANCE BROKERS PRIVATE Customer Id : 1017617331750002
LIMITED GSTIN Number :

Dear SAMEEMA NISTHAR,

We wish to inform you that your captioned Policy is falling due for renewal on: 17/05/2024
Please pay the renewal amount of *Rs. 784/- Your Policy
Expires on
17/05/2024
If there is any revision in Motor Third Party (TP) rates, the difference in premium due to the revised rates will be payable by
the policyholder immediately, and if such revised premium is not paid then the motor insurance policy will not be valid.

You can pay your premium in any of the following ways

Visit our website or login to Pulz App Visit our website to find our Nearest Branch

Call us on: 1800-22-4030,1800-200-4030 Epay link shared on your registered mobile number and
Email us: contactus@universalsompo.com email id.
Our customer service team will help you to get answer of your Daily Renewal SMS for 30 days so that you may not miss the
queries. renewal date.
The Premium Payable for the renewal, may be remitted to us before the expiry of this Policy to maintain continuity of your insurance.

The renewal coverage is based on your current claim status, as on 25/03/2024 which may alter in case of any claim lodged on us after this date.

For any changes/ corrections in the policy and/ or to discuss the rates/ terms/ conditions/ coverage before renewing the Policy to know about other products offered
by Universal Sompo General Insurance Co. Ltd, please contact our executive/ your Insurance Agent or our Call Centre.

You may alternatively courier the premium instrument and Renewal Notice duly signed to the following address:
Universal Sompo General Insurance Co. Ltd. (Renewal Section)
Unit No 601/602, A wing, 6th Floor, Reliable Tech Park, Cloud City Campus, Gut No. 31
Thane-Belapur Road, Airoli Navi Mumbai-400708 Maharashtra

Thanking you for placing your trust and confidence in Universal Sompo General Insurance Co. Ltd. and always assuring you of our best attention.

Version No. Version Date

1 25/03/2024

Authorized Signatory
Your Renewal Details
Make and Model HONDA ACTIVA 110 CC Manufacturing Year 2012
Registration Number KL-25-D-2066 Engine Number JC44E2097020
Chassis Number ME4JC448EC8986233 CNG/LPG Kit Value 0/0
Electrical Accessories Value 0 Non-Electrical Accessories Value 0
No Claim Bonus 0% Amount 0
(Insured Declared Value)
NCB Recovery Amount 0 CPA 0
Cover SA_TP Car is financed/mortgaged
Policy Number 2320/70177345/00/000 Online Policy Number USGI/WEBAG/0951768/00/B00
Special conditions

Nominee Details of compulsary PA for owner driver

Name Age Relationship
For any correction in above details, Please feel free to write back to us at contactus@universalsompo.com
Scan this QR Code to pay your renewal premium Scan to download USGI Pulz App
Name.........................................................................

Insured Signature.....................................................

Place.........................................................................

My Updated Mobile No.............................................

Toll Free No:1800-22-4030, 1800-200-4030 | www. universalsompo.com Renewal Section:Unit No. 601 & 602, 6th Floor, Reliable Tech Park, Cloud City Campus,
Gut No. 31, Thane-Belapur Road, Airoli, Navi Mumbai 400708 Maharashtra
 2320
Inland Letter Card

To,
SAMEEMA NISTHAR
CHARUVILA PUTHEN VEEDU ANAKUL AM PO
CHANNAPETTA
503 KOLLAM - 691311
KERALA
Mobile No.8281508147

If undelivered, please return to:

Renewal Section: Unit No. 601 & 602, 6th Floor, Reliable Tech Park, Cloud City Campus, Gut No. 31, Thane-Belapur Road, Airoli, Navi Mumbai - 400 708

24/7 Assistance | For any help please contact: Customer Care 1800224030, 18002004030 | Email: contactus@universalsompo.com

Regd. Office: Ackruti Star, Unit No.103, 1st Floor, MIDC, Gautam Nagar, Andheri (E), Mumbai - 400093, Maharashtra. | CIN# U66010MH2007PLC166770. | Email:
contactus@universalsompo.com. | Insurance is the subject matter of solicitation. | For more details on risk factors, terms and conditions please read policy documents carefully
before concluding a sale. UIN : IRDAN134RP0001V01202122 IRDAI Registration No. 134

Cheque/DD/EFT (Drawn on Universal Sompo General Insurance Co. Ltd) ___________________________________Dated ______________

Drawn on Bank: ______________________________________________________________________________________________________________

For Amount Rs. ____________________________________________________________________________________________________________

My Mobile / Telephone Number is: ___________________________________________ EmailId________________________________________

My PAN Card Number is: _________________________________________________________________________________________________

Points to note:

In the event of a claim being reported, subsequent and prior to current policy expiry date, then the No Claim Bonus (NCB) would be withdrawn.

If the policy is not renewed within 90 days past the policy expiry date, the No Claim Bonus (NCB) would be withdrawn.

Renewal Premium mentioned is inclusive of all taxes and discounts (if any).

You may also send your premium cheque/DD in favour of Universal Sompo General Insurance Company Limited before renewal due date.

Note : This Renewal Notice is issued subject to Third Party Upward premium revision by IRDAI w.e.f. 1st April 2022 which has not been declared as yet;

The revised premium will be notified as per the Final Notification from the Government.