THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)
POLICY SCHEDULE CUM CERTIFICATE OF INSURANCE
Two Wheeler Package Policy
UIN Number - IRDAN190RP0043V01100001
Policy Number :31030031220100030933
POLICY ISSUING OFFICE: BUSINESS CHANNEL/CPSC User: CLAIM CONTACT:
N BLOCK,CONNAUGHT CIRCUS (310300), NAME: N BLOCK,CONNAUGHT CIRCUS (310300)
BOMBAY LIFE BUILDING, N-34, CONNAUGHT Policybazaar Insurance Broker Pvt Ltd - OR
CIRCUS, NEW DELHI , , , (BR00000972), CUSTOMER CARE NUMBER: 1800-209-1415
DELHI , 110001. PHONE NUMBER:18002585970 / /
PHONE NUMBER:23723521 LAND/FAX NUMBER:/
FAX NUMBER:NA / NA EMAIL:
[email protected] /
Email:
[email protected] INSURED DETAILS
Insured Name Dinen Surchowdhury Customer ID PO96601456 (PAN No :NA)
Insured Address st 28 , qrs no 3/D ,,chittaran jan,, Contact Number / / XXXXXX9673
AMLADEHI ,WEST BENGAL, 713331
Email [email protected]
GSTIN NA
CHANNEL PARTNER CONTACT DETAILS
Channel Partner Name Email Address(s) Contact Number(s)
Policy Bazaar [email protected] 1800-258-5970
POLICY DETAILS
Period of cover 23/04/2022 12:00:01 AM to 22/04/2023 11:59:59 PM Receipt Number 31030081220000025181 -
22/04/22
Previous Insurer THE NEW INDIA ASSURANCE COMPANY LTD. Previous Policy Number 31030031210100045977
VEHICLE DETAILS
Registration Number WB-44-B-8530 Chassis no./Engine Number MD2DHDJZZUCD28898/DJ
GBUD85042
Make / Model BAJAJ/PULSAR Variant: PULSAR 180 DTSI
Year of manufacture 2011 Type of body / Type of Fuel
Colour As per RC Book Cubic capacity(cc) 180cc
/Wattage(kW):
Seating capacity including 2 Name of registration WEST BENGAL
Driver authority
Geographical Area / Zone India Name of the Financier
Cover Note No/Cover Note / Automobile Association none
Issue Date: membership
INSURED DECLARED VALUE (in Rs)
Vehicle Trailer Non-Elec Acc Electrical Acc Bi-fuel kit Total Value
20453 0 0 0 0 20453
SCHEDULE OF PREMIUM
Own Damage Liability
Basic OD Premium 252 Basic TP Premium 1193
(-)Calculated NCB Discount(25%) 62.88
Calculated OD Premium 189 Calculated TP Premium 1193
Total OD Premium 189 Total TP Premium 1193
Net Premium in Rs 1382
GST in Rs 249
Total Payable in Rs 1631
Total Payable in Rs(in words): RUPEES ONE THOUSAND SIX HUNDRED THIRTY-ONE ONLY
Signature Not
Verified
GSTIN(Issuing Office) 07AAACN4165C1ZT
Digitally signed
SACby SRINIVASAN 997134 (Motor vehicle insurance services)
VAIDESWARAN
Limitation
Date: as to use:The Policy covers use of the vehicle for any purpose other than: a)Hire or Reward b)Carriage of goods (other than
2022.04.22
10:51:54 IST
samples or personal luggage) c)Organized racing d)Pace making e)Speed testing f) Reliability Trials g)Any purpose in connection with Motor
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THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)
Trade
Limits of Liability:Limit of the amount the Company's Liability Under Section II 1(i) in respect of any one accident: as per the Motor Vehicles
Act, 1988. Limit of the amount of the Company's Liability Under Section II 1(ii) in respect of any one claim or series of claims arising out of one
event: Up to Rs. 1,00,000
For individual covers (OD) in RS:20453 Compulsory excess in Rs:100
Imposed excess in Rs:0 Voluntary excess in Rs:0
Persons or classes of persons entitled to drive:Any person including the insured provided that a person driving holds an effective driving
license at the time of the accident and is not disqualified from holding or obtaining such a license. Provided also that the person holding an
effective Learner's License may also drive the vehicle and that such a person satisfies the requirement of Rule 3 of the Central Motor Vehicles
Rules, 1989.
PA cover for Owner Driver
As per the declaration given,the Insured has opted out of CPA cover under this policy.
PA cover for named persons
Name CSI Opted(Rs.) Nominee Relationship
none 0 NA NA
Premium and GST Details
Rate of Tax Amount in INR
Premium Rs 1382.00
SGST 0 0
CGST 0 0
IGST 18 249
In witness where of this policy has been signed at N BLOCK,CONNAUGHT CIRCUS on this 22/04/2022WARRANTED THAT IN CASE OF
DISHONOUR OF THE PREMIUM CHEQUE, THIS DOCUMENT STANDS AUTOMATICALLY CANCELLED ABINITIO This policy is subject to the Terms,
conditions and exceptions applicable to Package/Liability policy attached/available on the web site http://newindia.co.in; IMT Endorsement
Number(s) printed herewith attached 22.
Important notice:
The insured is not indemnified, if, the vehicle is used or driven otherwise than in accordance with this schedule. Any payment made by the
company by reason of wider terms appearing in the certificate in order to comply with the Motor Vehicles Act, 1988 is recoverable from the
insured: see clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY". It is clarified that in case the declaration regarding
the ncb or other previous policy details made by the insured, is found to be incorrect, all the benefits (including claim) under section-1 of this
policy, will stand forfeited.
Anti Money Laundering Clause: In the event of a claim under the policy exceeding Rs 1lakh or a claim for refund of premium exceeding Rs 1
lakh, the insured will comply with the provisions of AML policy of the company. The AML policy is available in all our operating offices as well
as Company website.
I/We hereby certify that the policy to which this Certificate relates For and on behalf of The New India Assurance Company Limited
as well as this Certificate of Insurance are issued in accordance
with the provisions of Chapter X and XI of M.V. Act, 1988.
Date of Issue: 22/04/2022
(MS. RASHMI LUCY BARWA)
[SRDivisional Manager]
Duly Constituted Attorney(s)
Tax Invoice No : 31030022P0026163
IRDA Registration Number: 190
NIA PAN NUMBER: AAACN4165C
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