CERTIFICATE VEHICLE

Certificate Number EA0000007760 Vehicle Registration Number JH-10-CS-1754

Plan Name SERVICE BEYOND ASSISTANCE Manufacturer TVS

PLUS(15 LAC)
Model RAIDER
Certificate issue Date 2024-05-04 13:17:45
Engine Number AF9GP2515791
RSA Start Date 2024-05-11 00:00:00
Chassis Number MD625AF93P2G17621
RSA End Date 2025-05-10 23:59:59

PERSONAL DETAILS

First Name JITU Address 1 ASHOKNAGAR

Last Name KUMAR Address 2 MERHA NIRSHA CUM CHIRKUNDA

Mobile No 9693838824 State JHARKHAND

Email ID City DHANBAD

PAYMENT DETAILS

Plan Ammount(Rs.) 470

Tax Ammount(18% IGST in Rs.) 85

Total Ammount (Rs.) 555

CHANNEL PARTNER: TVS

INDICOSMIC CAPITAL Europ Assistance

Address: Star Hub #2, 7th Floor, Near ITC Maratha Hotel, Sahar, Andheri (E),
Address: Office No. 101, BABA House, Andheri Kurla Road, Next to WEH Metro
Mumbai – 400 059, India
Station, Andheri East, Mumbai: 400093, Maharashtra (India)

EMAIL : info@indicosmic.com EMAIL :

CUSTOMER CARE NO: 18002587111

Emergency SOS Doctor Consultation

For any medical emergency while riding your TVS bike you may call us to take Doctor tele consultation Free of cost. Incase of an accident the pillion passenger
also would be covered for free Tele doctor consultation. Incase third party is effected due to accident he / she would also be covered for free Tele doctor
consultation. FOR EMERGENCY DOCTOR CONSULTATION CALL ON: 022-69635223

To renew policy kindly scan the below QR code: To Register Service Claim kindly scan the below QR code:

Estimated Arrival Time

Within City Out of City Hilly area
60 120 180
Coverage
The territorial scope of the Roadside Assistance Services
provided by IIL shall be only eligible to customers having a valid
RSA policy. The scope of services is up to 25 km from incident to
authorized TVS workshop.
Fuel Assistance
In the event Covered Vehicle runs out of fuel or stops due to
contaminated fuel, IIL will provide support by arranging up to 2
liters of fuel. The supply of fuel will be based on availability. IIL will
bear the labor cost and conveyance charges. Fuel charges shall
be borne by Customer. This service will not be applicable if the
vehicle is at Customer residence This service is based on local
availability of fuel.
Rundown of Battery
In the event the Covered Vehicle having a breakdown due to
rundown of battery, IIL shall support by arranging vehicle
technician to jump start the vehicle with appropriate means. IIL will
bear the labor cost and conveyance charges.
Towing Assistance
In the event that a Covered Vehicle is immobilized due to
electrical or mechanical failure, IIL shall arrange towing of the
Covered Vehicle to the nearest authorized outlet. These services
shall be provided using equipment/s deemed most suitable by IIL.
Towing upto 25 km from incident to nearest tvs service center is
free.
Emergency Assistance
Medical co-ordination for occupants of the vehicle as a result of
accidents.
Flat Tyre
In the event that the Covered Vehicle has a puncture or tyre burst,
IIL shall support the Customer in replacing the flat tyre with spare
tyre. The technician will repair the same at the location of
breakdown.In case of unavailability of spare tyre, IIL will try to
repair the faulty tyre. This service is based on the availability of
tyre repair shop near the breakdown location. All the cost related
to rendering such service will be charged to customers.
Accommodation Assistance
Arranging for hotel accommodation in case breakdown is reported
outside customer’s home city. Co-ordination is free and all the
related accommodation cost will be borne by the customer.
Arrangement of Rental Vehicle
Arranging rental vehicle in case breakdown is reported outside
customer’s home city Co-ordination is free, all the related rental
vehicle cost will be borne by the customer.
Mobile charging
IIL towing vehicle shall provide Mobile portable chargers incase
demanded by the customer.
Helmet Assist
IIL shall provide assistance in arranging the helmet which shall be
payable by customer beforehand and making it available at
customer location.This service is applicable only under “service
beyond assistance” program
Toll Free
24 X 7 multi lingual support
Onsite support for Minor repairs
In the event the Vehicle covered under this Agreement (Covered
Vehicle) having a breakdown due to minor mechanical/ electrical
fault, IIL shall support by arranging vehicle technician to the
breakdown location. IIL will bear the labor cost and conveyance
charges. Cost of spare parts if required to repair the vehicle on the
spot (Outside coverage area) to obtain such material & spare
parts will be borne by the Customer.
Key Assistance*
If the Covered Vehicle's key is miss placed we will organize to
pick up the spare key from the house of the Customer, or we will
support the Customer to tow the Vehicle to the Customer
residence. Validation of the vehicle ownership information on
record will be required prior to attempting this service.
Coverage in North East and J&K Coverage In Islands
Due to the extreme geographical conditions in North Eastern
States and Jammu & Kashmir SLAs will not be applicable for
services rendered in these territories. IIL shall arrange assistance
on best efforts base in this territories. IIL will not provide RSA
services in Islands.
Urgent Message Relay
Relay of Urgent message to family / friends in case of medical
emergency.
Taxi Assistance
In the event that a Covered Vehicle is immobilized due to the
breakdown or accident and On-site preliminary support to make
the vehicle roadworthy, is not possible, IIL shall arrange and bear
the expense for transferring the Covered Vehicle to the nearest
authorized outlet upto 25 km. To help the Customer continue with
his journey, IIL will arrange taxi support to the Customer as per
availability. SLAs will not be applicable for taxi assistance and IIL
does not guarantee the quality of taxi services.
Outward / Forward Journey
Arranging for Outward / Forward Journey in case breakdown is
reported outside customer’s home city Co-ordination is free, all
the related travel cost will be borne by the customer.
Water and other refreshments for stranded customers
On a best effort basis IIL shall make available a bottle of packed
drinking water/refreshments for every attending customer
Delivery of basic spares
Covered customers can demand to get spare part from TVS
motors authorized spare part retailer/dealer. However, this service
shall be subject to availability of required spares in that location.
This service is applicable only under “service beyond assistance”
program
Document Assist
If the Covered Vehicle is immobilized within 25 kilometers from the
Users residence, IIL will organize to pick up the RC card and other
documents from the house of the Customer
* Vehicle should in good working condition. RSA would not cover for any pre-existing issues in the vehicle before the RSA policy purchase date.All consumables would
be charged back to the customer. Cost of accommodation, Taxi, rental vehicle needs to be paid by the customer. Toll fees and border charges if applicable shall be
borne by the customer
 Niva Bupa Health Insurance Company
Limited.
Details of Personal Accident Cover
Master Policy Holder Name: INDICOSMIC INFOTECH LTD

Group Master Policy Holder Name.: Indicosmic Infotech Ltd

Master Policy Number: 50697000202400
Issuing Office: D-5 SECTOR 59 Noida Gautambuddha Nagar Uttar Pradesh 201307
Beneficiary Name: JITU KUMAR
Beneficiary’s Address: ASHOKNAGARMERHA NIRSHA CUM CHIRKUNDA
Beneficiary ID No: EA0000007760
Certificate No: EA0000007760
Customer Contact No: + 91-11-30902000
Certificate Inception date: From - 2024-05-11 13:17:45 Expiry date: 2025-05-10 23:59:59

Name of the Member Date of Gender Nominee Name Nominee Nominee Email ID and Mobile Benefits Sum Insured
Covered Birth/Age Age Relationship with no. (if any)
Member
JITU KUMAR 2002-01-01 MALE DAYANAND 17 BROTHER Accidental death / Permanent INR 1500000
RAM Total Disablement (PTD)
Broker Name: Global India Insurance Brokers Pvt. Ltd. Broker Email: info@giib.co.in Broker contact No.: 022-26820489
Details of GPA Policy
If the Insured person sustains any bodily injury during the policy period which directly and independently of all other causes result in death/ disablement stated below within 12
months from the date of accident resulting solely and directly from Accident then the Company shall pay to the insured the sum set in the schedule to the Insured person’s nominee
,beneficiary or legal representative. This certificate is effective only if the vehicle is registered in the name of insured person as on date of accident.
Important Notes:
1 The personal accident coverage is applicable only to the owner of the vehicle for which Road Side Assistance service or any other assistance service has been provided by
the Indicosmic Infotech Ltd.
2 The said personal accident cover is active only whilst the owner is driving or travelling in the said vehicle including mounting into/dismounting from the said vehicle.
3 Death or permanent total disability claims due to any other incidence would not be covered
4 The policy is valid for 365 days from the policy risk start date
5 You are covered up to age of 70 years only, any claim above age of 70 under this certificate will not be processed / settled
Insurance cover in brief: Please refer to policy for detail information on coverage, exclusion and other terms and conditions.
1. Death only INR (1500000)
2. PTD INR (1500000)
Important Exclusions in brief: The insurance cover herein does not cover death, injury or disablement resulting from:
a) Services on duty with any armed forces.
b) Intentional self injury, suicide or attempted suicide, insanity, venereal diseases or the influence of intoxicating drug.
c) Medical or surgical treatment.
d) Aviation other than as a passenger (fare-paying or otherwise) in any duly licensed standard type of aircraft anywhere in the world.
e) Nuclear radiation or nuclear weapons related accident.
f) War & warlike operation, the act of foreign enemy, civil war & similar risk.
g) Child birth, pregnancy or other physical cause peculiar to the female sex.
h) Whilst committing any breach of law with criminal intent.
Claim Procedure: An indicative document list in case of claim is as given below.

Claims assistance
Requirement Claims
1. In case of hospitalization, notify us within 48 hours of admission, do call our
care lines : 1860-500-8888, or an email customercare@nivabupa.com
2. Pay directly to the hospital. Collect all relevant documents* (invoices,
medical reports, discharge certificate, etc.) in originals
3. Send these documents along with filled & signed claim form (available on
Website), ID proof, Address proof, Aadhar Card and Age proof to the
address given above
4. A decision will be taken on the documents they will be either approved,
rejected, or a query will be raised as per Policy T&C
5. If approved, the claim will be settled and reimbursed as per Policy T&C
Important Terms & Conditions (T&C)
L1. Niva Bupa request you to refer to the detailed Terms and Conditions (T&C) available with
the Group Master Policiyholder. You may also refer the T&C on our Website.
L2. Free Look Provision: You can review the T&C within the number of days Specified
overleaf and request cancellation of the Certificate of Insurance in case of objections to
any T&C. we will refund the premium as Specified in the T&C provided that no claim has
been registered under the cover.
L3. Grievance Redressal: In case of any query or complaint/grievance, you may approach our
office at the below mentioned address. In case you are not satisfied with our resolution,
you may register a complaint in the integrated grievance Management System (IGMS) of
IRDAI or approach the Insurance Ombudsman. Details about the IGMS and Ombudsman
are available on our Website.

Registered Office: C-98, Lajpat Nagar 1, Delhi-110024| Corporate Office: 14th Floor, Capital Cyberscape
Golf Course Extension Road Sector-59, Gurugram-122011(Haryana) | Website: www.nivabupa.com
Tel.:+ 91-11-30902000, Fax No.: + 91- 011-30902010
IRDAI Registration No. 145|CIN: U66000DL2008PLC182918

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