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Tata AIG Motor Policy Schedule_3184_6202343437-00
Tata AIG Motor Policy Schedule_3184_6202343437-00
De ar M r SR I N I VAS JAYAR AM ,
We l come to Tata AI G Ge n e r al I n su r an ce Compan y Li mi te d fami l y & we th an k you for ch oosi n g ou r pol i cy for you r motor ve h i cl e i n su r an ce . You r Pol i cy N o.
6 2 0 2 34 34 37 h as be e n i ssu e d base d on th e i n for mati on an d de cl ar ati on pr ovi de d by you . You ar e r e qu e ste d to vi si t ou r we bsi te www. tataaig. co m for fu l l
pol i cy wor di n gs
Addr e ss : N O - 10, J J CR OWN ,1 ST F LOOR , 13TH M AI N ,, N E AR I N DI AN M ake /M ode l : VOLK SWAGE N / TAI GUN
BAN K ,SAR ASWATH I N AGAR , VTC,, PO, VI JAYAN AGAR , BAN GALOR E N OR TH ,,
Var i an t : H I GH LI N E 1.0 TSI AT
BAN GALOR E - 560040,
K AR N ATAK A, F u e l Type : PE TR OL
I N DI A E n gi n e N u mbe r /Batte r y N u mbe r : DTB168 216 /
Pe r i od of I n su r an ce OD cove r pe r i od : 25 De c '23(00:00 H r s) to 24 De c Ch assi s n u mbe r : M E XJ23CW7R T010723
'24(M i dn i gh t)
E n gi n e /Batte r y Capaci ty (CC/ K W) : 999
TP cove r pe r i od : 25 De c '23(00:00 H r s) to 24 De c '26(M i dn i gh t)
Se ati n g Capaci ty (i n cl u di n g dr i ve r ) : 5
CPA to Own e r dr i ve r cove r Pe r i od : 25 De c '23(00:00 H r s) to 24 De c
'26(M i dn i gh t) M fg Ye ar : 2023
Cu stome r I D : N A Tr ai l e r R e gn N o. / Ch assi s N o. : N A
Zon e : A
Pr oposal N o : PR /23/62028 30250
Al te r n ate Pol i cy N o : N A
Own Dam age Pre m ium on Ve hicle & Acce ssorie s Third Party Pre m ium
Agent Name : SSS RISK MANAGEMENT Agent Contact Number : 7795061618 (or
Agent License code : 759
AND INSURANCE BROKERS PVT LTD Landline)
D rive rs Claus e : Pe r son s or cl asse s of pe r son s e n ti tl e d to dr i ve : An y pe r son i n cl u di n g th e i n su r e d. Pr ovi de d th at a pe r son dr i vi n g h ol ds an e ffe cti ve
dr i vi n g l i ce n se at th e ti me of th e acci de n t an d i s n ot di squ al i fi e d fr om h ol di n g or obtai n i n g su ch a l i ce n se . Pr ovi de d al so th at th e pe r son h ol di n g an
e ffe cti ve Le ar n e r 's Li ce n se may al so dr i ve th e ve h i cl e an d th at su ch a pe r son sati sfi e s th e r e qu i r e me n ts of R u l e 3 of th e Ce n tr al M otor Ve h i cl e s R u l e s,
198 9.
Limitatio ns as to us e : Th e Pol i cy cove r s u se of th e ve h i cl e for an y pu r pose oth e r th an : a) H i r e or R e war d oth e r th an for th e pu r pose of dr i vi n g tu i ti on s b)
Car r i age of goods (oth e r th an sampl e s or pe r son al l u ggage ) c) Or gan i z e d r aci n g d) Pace M aki n g e ) Spe e d te sti n g f) R e l i abi l i ty Tr i al s g) An y pu r pose i n
con n e cti on wi th M otor Tr ade
Warrante d that th e i n su r e d n ame d h e r e i n /own e r of th e ve h i cl e h ol ds a val i d Pol l u ti on Un de r Con tr ol (PUC) Ce r ti fi cate , as appl i cabl e , on th e date of
comme n ce me n t of th e Pol i cy an d u n de r take s to r e n e w an d mai n tai n a val i d an d e ffe cti ve PUC an d/or fi tn e ss Ce r ti fi tate , as appl i cabl e , du r i n g th e
su bsi ste n ce of th e Pol i cy.
Limits o f Liability Un de r Se cti on I I -1 (i ) of pol i cy (De ath of or bodi l y i n j u r y) : Su ch amou n t as i s n e ce ssar y to me e t th e r e qu i r e me n ts of th e M otor Ve h i cl e s
Act, 198 8
Unde r S e ctio n II- 1 (ii) of pol i cy (Th i r d Par ty Pr ope r ty Damage ) :₹ 7,50,000
Unde r S e ctio n III: PA to Own e r Dr i ve r CSI :₹ 15,00,000
N o mine e de tails :
N ame o f the N o mine e : M AN JULA SR I N I VAS N omi n e e Age : 4 2 R e l ati on sh i p of th e N omi n e e wi th th e I n su r e d : S po us e
N u mbe r of cl ai ms cove r e d u n de r De pr e ci ati on R e i mbu r se me n t Cove r : 2 Basi s of cl ai m se ttl e me n t u n de r Tyr e Se cu r e Cove r : N A
Th i s Pol i cy doe s n ot cove r pr e -e xi sti n g damage s as pe r I n spe cti on Ph otogr aph s an d R e por t. I n spe cti on Le ad n o: N A
D e ductible unde r S e ctio n - I : ₹ 1000(Compu l sor y De du cti bl e ₹ 1,000, Vol u n tar y De du cti bl e : ₹ 0, I mpose d E xce ss : 0.00) F r an ch i se e : N A
D e ductible unde r Engine S e cure : N A Add- o n Co ve r : R e pai r of Gl ass, R u bbe r & Pl asti c Par ts,De pr e ci ati on R e i mbu r se me n t,Loss of pe r son al
be l on gi n gs,E me r ge n cy tr an spor t an d h ote l e xpe n se s,K e y R e pl ace me n t,R oad Si de Assi stan ce
N o Claim Bo nus : Th e i n su r e d i s e n ti tl e d for a N o Cl ai m Bon u s (N CB) on th e own damage se cti on of th e pol i cy, i f n o cl ai m i s made or pe n di n g du r i n g th e
pr e ce di n g ye ar (s), as fol l ows: Th e pr e ce di n g ye ar 20%, pr e ce di n g two con se cu ti ve ye ar s 25%, pr e ce di n g th r e e con se cu ti ve ye ar s 35%, pr e ce di n g fou r
con se cu ti ve ye ar s 45%, pr e ce di n g fi ve con se cu ti ve ye ar s 50% of N CB on OD Pr e mi u m. N CB wi l l on l y be al l owe d pr ovi de d th e pol i cy i s r e n e we d wi th i n 90
days of th e e xpi r y date of th e pr e vi ou s pol i cy.
Su bj e ct to: (A) I M T E n dor se me n t N o. : 28 ,32,22 GSTI N :29AABCT3518 Q1ZS-K AR N ATAK A Se r vi ce Accou n ti n g Code : 997134
TATA AI G Au to Se cu r e e n dor se me n t N o. (TA): 08 , 01, 09, 10, 15, 19
P o licy S e rvicing Of f ice : BAN GALOR E , 2N D F LOOR , JP & DE VI JAM BUK E SWAR AR CADE , N O.69 M I LLE R S R OAD, BAN GALOR E 560052 Te l . N o : 8 0662728 29
Receipt
R e ce ipt N o . : P D 30 0 0 0 5 4 6 0 9 4 3 R e ce ipt D ate : 2 4 /12 /2 0 2 3 P o licy N o . : 6 2 0 2 34 34 37 0 0 0 0
Uti l i z e d fr om th e r e ce i pt
Sr . N o. Pol i cy N u mbe r M ode of Payme n t Total Pr e mi u m (₹ ) Bal an ce (₹ )
for pol i cy (₹ )
1 6 2 0 2 34 34 37 0 0 0 0 che que 2 4 8 18 . 0 0 2 4 8 18 . 0 0 0. 00
Name o f t h e In s u r e r : NA Name o f t h e In s u r e r : NA
1. Pol i cy N u mbe r : N A 1. Pol i cy N u mbe r : N A
2. Date of e xpi r y: N A 2. Date of e xpi r y: N A
3. Type of cove r : N A 3. Type of cove r : T P /CP A
4. Addr e ss of th e I n su r e r : N A 4. Addr e ss of th e I n su r e r : N A
5. Cl ai m i n Pr e vi ou s Pol i cy Pe r i od: N O 5. Cl ai m i n Pr e vi ou s Pol i cy Pe r i od: N A
6. N CB i n pr e vi ou s pol i cy: N A 6. N CB i n pr e vi ou s pol i cy: N A
7. N CB Cl ai me d: N A 7. N CB Cl ai me d: N A
8 . Pe r i od of i n su r an ce 8 . Pe r i od of i n su r an ce
OD cove r pe r i od: N A (0 0 :0 0 H rs ) to N A(Midnight) TP cove r pe r i od: N A (0 0 :0 0 H rs ) to N A (Midnight)
TP cove r pe r i od: N A(0 0 :0 0 H rs ) to N A(Midnight)
1. AR AI M e mbe r sh i p N u mbe r : N A
2. Th i r d Par ty Pr ope r ty Damage Cove r r e str i cte d to ₹ 6,000/ on l y: N o
3. I s Vol u n tar y De du cti bl e opte d: N o
4. Amou n t of De du cti bl e opte d: N A
5. Ve h i cl e i s fi tte d wi th An ti Th e ft De vi ce appr ove d by AR AI : N o
6. Add-on Cove r s opte d: R e pair o f G las s , R ubbe r & P las tic P arts , D e pre ciatio n R e imburs e me nt, Lo s s o f pe rs o nal be lo ngings , Eme rge ncy trans po rt and
ho te l e xpe ns e s , Ke y R e place me nt, R o ad S ide As s is tance
De claration for No Claim Bonus (If NCB Confirm ation is not subm itte d but NCB claim e d)
I /We de cl ar e th at th e r ate of N CB cl ai me d by me /u s i s cor r e ct an d th at N O CLAI M h as ar i se n i n th e e xpi r i n g Pol i cy Pe r i od (Copy of Pol i cy e n cl ose d). I /We
fu r th e r u n de r take th at i f th i s de cl ar ati on i s fou n d i n cor r e ct al l be n e fi ts u n de r th e Pol i cy i n r e spe ct of Own Damage Se cti on I of th e Pol i cy wi l l stan d for fe i te d.
I h e r e by gi ve my con se n t to r e ce i ve on e page i n su r an ce pol i cy.
AML Guide line s :
I /we h e r e by con fi r m th at al l pr e mi u ms pai d / payabl e i n fu tu r e wi l l be fr om bon afi de sou r ce s an d n ot pai d ou t of pr oce e ds of cr i me an d th at su ch
pr e mi u ms ar e n ot di spr opor ti on ate to my/ou r i n come .
I / we u n de r stan d th at th e Compan y h as th e r i gh t to cal l for docu me n ts to e stabl i sh sou r ce s of fu n ds an d to can ce l th e i n su r an ce pol i cy i n case .
I / we ar e fou n d gu i l ty by an y compe te n t cou r t of l aw u n de r an y of th e statu te s, di r e ctl y or i n di r e ctl y gove r n i n g th e pr e ve n ti on of mon e y l au n de r i n g l aw i n
I n di a.
I / we ar e n ot Pol i ti cal l y E xpose d Pe r son s * n or ar e th e i r cl ose r e l ati ve s. I / we sh al l ke e p th e compan y i n for me d i f we su bse qu e n tl y be come a Pol i ti cal l y
E xpose d Pe r son .
“Pol i ti cal l y E xpose d Pe r son s” sh al l h ave th e me an i n g assi gn e d to i t u n de r su b cl au se (xi i ) of 3(b) of Ch apte r I of M aste r Di r e cti on - K n ow You r Cu stome r (K YC)
Di r e cti on , 2016 i ssu e d by R e se r ve Ban k of I n di a (R BI ), as ame n de d fr om ti me to ti me .
Disclaimer : Insurance is the subject matter of solicitation. For more details on benefits, ex clusions, limitations, terms & conditions, please refer sales brochure/ policy wordings carefully, before concluding a sale. Purchase of Tata AIG General Insurance Company Limited
products are purely on voluntary basis. #Add On covers can only be purchased with the base product and on payment of an additional premium.
Prohibition of R ebates - S ection 41 of Insurance Act, 1938 as amended by Insurance Laws I Amendment) Act, 2015. 1. No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take out or renew or continue an insurance in respect of any
kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate, ex cept such rebate as may be
allowed in accordance with the published prospectuses or tables of the insurer. 2. Any person making default in complying with the provisions of this section shall be liable for a penalty which may ex tend to ten lakh rupees.
Grievance R edressal Procedure : As per Regulation 17 of IRDA of India (Protection of Policyholders Interests) Regulation, 2017.
S ection 6 4 VB of the Insurance Act 19 38 : Commencement of risk cover under the policy is subject to receipt of premium by Tata AIG General Insurance Company Limited.
Bundled Auto S ecure - Private Car Policy (1 Year Term for Own Damage & 3 years for Third Party) - UIN : IRDAN108 RP0006V022018 19 • Repair of Glass, Rubber & Plastic Parts - UIN : IRDAN108 RP0006V022018 19/A0033V012018 19 (TA 08 ) . Depreciation Reimbursement - UIN :
IRDAN108 RP0006V022018 19/A0029V012018 19 (TA 01) . Loss of personal belongings - UIN : IRDAN108 RP0006V022018 19/A0034V012018 19 (TA 09) . Emergency transport and hotel ex penses - UIN : IRDAN108 RP0006V022018 19/A0035V012018 19 (TA 10) . Key Replacement - UIN :
IRDAN108 RP0006V022018 19/A0036V012018 19 (TA 15) . Road S ide Assistance - UIN : IRDAN108 RP0006V022018 19/A0041V012018 19 (TA 19)
Tata AIG General Insurance Company Limited
Registered Office : Peninsula Business Park, Tower A, 15th Floor, G.K. Marg, Lower Parel, Mumbai - 400013.Maharashtra, India • 24X7 Toll Free No : 18 00 266 778 0 • Email : customersupport@tataaig.com • website : www.tataaig.com • IRDA of India Registration No: 108 • CIN:
U8 5110MH2000PLC128 425
TAGIC/PS /MRPC/Jan 22/06 Ver1 /All 2536