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DOC-20240706-WA0001
DOC-20240706-WA0001
ICICISLombard
Nibhaye Vaade
Dear Sir/Madam,
Thank you for choosing ICICI Lombard General Insurance Company Limited (ICICI Lombard) as your preferred service provider.
Please find enclosed Policy No. 3005/2011488876/00/0000023760, which has been issued based on the below mentioned details:
nsUe0 RVenice
MR. MANTRIPRAGADAAVINASH
Name of insured
Period of insurance-Own Damage |Sep 27, 2023 to Sep 26, 2024
Poriod of insurance-ThirdRarty Sep 27, 2023 to Sep 26, 2028
Period of insurance-PA Owner Driver Sep 27, 2023 to Sep 26, 2024
HONDA MOTORCYCLE l ACTIVA 125 SMART OBD2
Vehicle Make/Model
RTOCity TELANGANA-HYDERABAD
|Vehicle Registration No. NEW
Vehicle Registration Date Sep 27, 2023
Engine No. JK13EG8014273
Chassis No. ME4JK13EJPGO14004
The information provided above is based on the information received from you and accordingly, the policy has been processed. Coverage
of risk is subject to realization of the full premium, post which, insurance coverage under the policy would commence. Incase the premium
is not received by us due to cheque dishonour or any other reason, the insurance cover shall be void ab-initio.
We have issued the policy basis your confirmation that you hold a valid PUC and/or Fitness Certificate, as applicable.
Government of India has mandated electronic toll payments using FASTag to reduce vehicular traffic at toll plazas. Customers are advised
io comply with the direction of the government and get their FASTag from Point of Sale locations at Toll Plazas or from issuer Agency.
Please visit http://www.fastag.org/ for details.
If you require any changes in theor Certificate of Insurance cum Policy Schedule, you are requested to inform us by writing to
Customersupport@icicilombard.com calling our 24 hour toll free helpline on 1800 2666. Absence of any communication within a period of
15 days of the date mentioned on this letter, would mean that the issued policy is in order and as per your proposal.
anio
ORTUN
nceely,
MOT
ral Insurance Company Ltd.
In case of claim, immediately notify CICI Lombard General Insurance Conpany Linited on the
or SMS "CLAIM to 575758
Toll Free Number 1800 2666save the policy details and the contact numbers 1800 2666(Toll Free)
that you
For quick reference during emergencies, we recommand
09223622666(chargeable)
on your easily accessiblenemobile handset. CIN:L67200MH2000PLC129408
Malad(West), Mumbai - 400 064, |IRDAReg. No. 115,
Mailing Address: 401 & 402, 4th floor, Inteface 11, New Linking Road,
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Page 2 of5
cae tat the insured named herein/owner of the vehicle holds aValid Pollution Under Control(PUC) Certificate and/or valid fitness certificate,
Jdate of commencem as aplicable,on the
the policy.Further . ,the c of the Policy
ho Company and undertakes
reserves the right to totake
renew and maintain
appropriate actionainvalid
caseand effective
of any PUCand/or
discrepancy in thefitness certificate,as
PUC or applicable
,during the subsistence of
fitness certificate.
ICICI Lombard General Insurance Company Ltd
In case of claim, immediately notify ICICI Lombard General Insurance Company Limited on the
Toll Free Number 1800 2666 or SMS "CLAIM" to 575758
For quick reference during emergencies, we recommand that you save the policy details and the contact numbers 1800 2666(Toll Free)
09223622666(chargeable)
on your easily accessible mobile handset.
Mailing Address: 401 &402, 4th floor, Interface 11, New Linking Road, Malad(West), Mumbai - 400 064, IRDA Reg. No. 115, CIN:L67200MH2000PLC129408
SA
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Page 4 of 5
cIcombard
ICICILOMBARD GENERAL INSURANCE COMPANY LTD.
IRDA Aegistration No.115
MOTOR INSURANCE PROPOSAL FORM
TWO WHEELER
Proposal Form No. :3005/2014488876/00/0000023760
Motor Proposal Form
Main Features:
1. Own
fire
Damage : This product
self ignition
Protects you Against loss or damage to your motor vehicle,and/or
explosion
accessories,díe to housebreaking riot
lightning theft burglary
strike earthquake flood and allied perils accidental external means emalicious ats terrorist activity transit landslide, rockslide
I1. Third Party Liability : In addition to the coverage noted above,this productcoversyou against lega liability towards third party, in respect of the following:
death of or bodily injury to any person damage to property (as per the pfovision of Motor Vehicle Act.)
We are pleased to inform you that in addition, the product also includes the foloing:
Personal accident benefits for owner driver upto a value of Rs. 15 lakhs Legafliability towards the paiddriver Cover for Rs.1 lakhs for third party property damage
Insured's Additional
Make of Vehicle Model of Vehicle
Year of Cubj Seating Declared
Electrical Non Electrical
Accessories.
Date of
Registration
M£nufacturing Capacity Çapacity Accessories Accessories.
Value (|DV)
HONDA ACTIVA 125 2 Rs. 86831.00 Rs. 0.00 27/09/2023
MOTORCYCLE SMART OBD2| 2023 125 Rs. 0.00 Rs. 0.00
PROHIBITION OF REBATES
(Under Section 41 of Insurance Law)
(Amendment Act 2015) inducement to person to take out or renew or continue an insurance in respect of any kind of risk
1) No person shall allow or offer to allow, either airecuy or nalevuy iuahle or any rehate of the premium shown on the policy, nor shall any person taking out or
relating to lives or property, in India, any rebate of the whole or part of the commiss
renewing or continuing a Policy accept any rebate, except 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 sha liable for a penalty, which may extend to ten lakhs rupees.
file://C:/Users/sada-mgroad/1LPOS%20Motor%20insurance/PolicySchedule.htm] 27-09-2023
( s J e Owner Driver Tyoe of Cover Page 5of 5
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file:///C:/Users/sada-mgroad/lLPOS%20Motor%20Insurance/PolicySchedule.html 27-09-2023