The New India Assurance Co. Ltd.
Servicing Office of Insurer : Mumbai Auto Hub, The New India Assurance Company Ltd.,
New India Centre, 17A, Cooperage road, Off Madam Cama Road, Mumbai 400039, Mumbai,
Maharashtra (State Code:27) -400001, PH-022-22708230 Website : http://newindia.co.in
PAN : AAACN4165C . GSTIN: 27AAACN4165C3ZP Insurer's IRDA Registration Number: 190
Tollfree Helpline : 1800209141 Email: [email protected] : U9999
MH1919 GOI 000526
Private Car Package Policy (UIN-IRDAN190RP0042V01100001) CUM RECEIPT
(FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)
Policy No. : 80000031240350125223 Policy Issued On : 07-NOV-2024 (15:30)
Insured Name : MR. VINAY KUMAR SHUKLA
Own Damage Period : 07-NOV-2024(15:30) To 06-NOV-2025 Motor Liability Period : 07-NOV-2024(15:30) To 06-NOV-2025(Midnight)
(Midnight)
Proposal No. & Date : PPVBU19742961, 07-NOV-2024 CPA Cover Period : 07-NOV-2024(15:30) To 06-NOV-2025(Midnight)
Insured Add. : 63/1K/4B SHIVKUTTI , PRAYAGRAJ , UTTAR PRADESH Previous Insurer : UIIC
(State Code:09) -211001 Previous Policy No. : 0209003123P109375214 03-NOV-2023 To 02-NOV-
2024
BROKER DETAILS
IRDA Lic. No. 375 CIN No. U50300MH1997PLC149349
Broker Category Composite Broker Validity 13-MAY-23 To 12-MAY-26
Name & Add. : TATA MOTORS INSURANCE BROKING AND ADVISORY SERVICES LTD, 1ST FLOOR, AFL HOUSE, LOK BHARTI COMPLEX, MAROL MAROSHI
ROAD, ANDHERI (EAST), MUMBAI - 400 059
Make Model Variant Cubic Capacity Manufacturing Year Seating capacity
TATA MOTORS TIAGO TIAGO (P) XT NEW 1199 2021 5
Body Type Registration No. RTO Invoice Date Engine No. Chassis No.
MAT626359MKK686
HATCH BACK UP 70 FX 0016 ALLAHABAD 03-NOV-2021 REVTRN08KYXK96636
29
Non-Elec.
Vehicle IDV CNG/LPG Kit Elec. Accessories Total IDV
Accessories
341,940 0 0 0 341,940
NOMINEE DETAILS
Name of Nominee Age Relationship with Insured Name of Appointee Relationship with Nominee
MR VIVEK SHUKLA 26 BROTHER --N.A-- --N.A--
PAYMENT DETAILS
Premium Paid : 11607 Cheque No. : 113531841142 Cheque Date: 07-NOV-2024
Bank Name : NON CUG HDFC CCAVENUE Bank City :
For & On Behalf of The New India Assurance Co. Ltd.
Dealer Code : G P MOTORS PVT LTD ALLAHABAD - 300380000
Authorized Signatory
In case of any claim or assistance required please contact our help line at 1800 209 0060 and you may also reach us at [email protected]
The New India Assurance Co. Ltd.
Servicing Office of Insurer : Mumbai Auto Hub, The New India Assurance Company Ltd.,
New India Centre, 17A, Cooperage road, Off Madam Cama Road, Mumbai 400039, Mumbai,
Maharashtra (State Code:27) -400001, PH-022-22708230 Website : http://newindia.co.in
PAN : AAACN4165C . GSTIN: 27AAACN4165C3ZP Insurer's IRDA Registration Number: 190
Tollfree Helpline : 1800209141 Email: [email protected] : U9999
MH1919 GOI 000526
Private Car Package Policy (UIN-IRDAN190RP0042V01100001) CUM RECEIPT
(FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)
Policy No. : 80000031240350125223 Policy Issued On : 07-NOV-2024 (15:30)
Insured Name : MR. VINAY KUMAR SHUKLA
Own Damage Period : 07-NOV-2024(15:30) To 06-NOV-2025 Motor Liability Period : 07-NOV-2024(15:30) To 06-NOV-2025(Midnight)
(Midnight)
SCHEDULE OF PREMIUM (AMOUNT IN RS.)
Own Damage Premium (A)
Basic Premium Deductibles
Vehicle 2,183 Voluntary Deductibles (0) (IMT-22A) 0
Non-Elec. Accessories 0 Anti Theft Device (IMT-10) 0
Elec. Accessories (IMT-24) 0 AA Membership (IMT-8) 0
CNG/LPG Kit (IMT-25) 0 No Claim Bonus (0%) 0
Sub Total (Basic Premium) 2,183 Handicapped Discount (0%) 0
Geographical Area Extension (IMT-1) 0 Sub Total (Deductibles) 0
IMT 23 Premium 0
Add On Coverages (Refer Note 5) 3762
Sub Total-Addition 5,945 Net Own Damage Premium (A) 5,945
Liability Premium (B)
Basic Third Party Liability 3416 PA Cover For 0 Persons of Rs. 200000 Each (IMT-16) 0
Third Party Liability For Bi-Fuel Kit 0 PA cover for Paid Driver of Rs. 200000 (IMT–17) 100
Third Party Liability For Geographical Area
0 Legal Liability For Paid Driver (IMT-28) 50
Extension
PA Cover For Owner Driver Of Rs. 1500000 (IMT-
325 Legal Liability for Employees (for 0 persons) (IMT–29) 0
15)
Net Liability Premium (B) 3891
Note: .Warning that in case of dishonour of the premium cheque, this document stands
automatically cancelled 'ab-initio
Total Premium (A+B) 9836
> Consolidated stamp duty paid to state exchequer.
> The policy is subject to compulsory deductible of Rs.1000 (IMT-22) IGST (18%) 1771
> The insurance company will display terms & conditions on its website
http://newindia.co.in which can
be accessed by you online.
>Addon Opted: Engine Protect PVT,NIL Dep - 2 claims,
*Subject to IMT Endt. Nos.& Memorandum:7,22,17,28 Gross Premium Paid 11607
EX-SHOWROOM PRICE : 569900
Addon Unique Identification Number (UIN) Details Add On Premium
Nil Depreciation IRDAN190RP0042V01100001 A0002V03201112 2565
Engine Protect 1197
Hypothecation Details: ICICI BANK LTD - . - PRAYAGRAJ
MISP Name: G P MOTORS PVT LTD ALLAHABAD, MISP PAN No: AADCG3414A, MISP Code: TMIBASL/MISP/AADCG3414A
SAC:997134, Description of Service :Motor Vehicle Insurance Services, Place of Supply :UTTAR PRADESH(State Code:09), Receipt No/Invoice No:23240106936
I/we hereby certify that the policy to which this certificate relates as well as this certificate of insurance are issued in accordance with the provisions of Chapter X and Chapter XI of Motor Vehicle
Act, 1988
For & On Behalf of The New India Assurance Co. Ltd.
Dealer Code : G P MOTORS PVT LTD ALLAHABAD - 300380000
Authorized Signatory
In case of any claim or assistance required please contact our help line at 1800 209 0060 and you may also reach us at [email protected]
The New India Assurance Co. Ltd.
Servicing Office of Insurer : Mumbai Auto Hub, The New India Assurance Company Ltd.,
New India Centre, 17A, Cooperage road, Off Madam Cama Road, Mumbai 400039, Mumbai,
Maharashtra (State Code:27) -400001, PH-022-22708230 Website : http://newindia.co.in
PAN : AAACN4165C . GSTIN: 27AAACN4165C3ZP Insurer's IRDA Registration Number: 190
Tollfree Helpline : 1800209141 Email: [email protected] : U9999
MH1919 GOI 000526
Private Car Package Policy (UIN-IRDAN190RP0042V01100001) CUM RECEIPT
(FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)
Policy No. : 80000031240350125223 Policy Issued On : 07-NOV-2024 (15:30)
Insured Name : MR. VINAY KUMAR SHUKLA
Own Damage Period : 07-NOV-2024(15:30) To 06-NOV-2025 Motor Liability Period : 07-NOV-2024(15:30) To 06-NOV-2025(Midnight)
(Midnight)
The policy covers use of the vehicle for any purpose other than (1) Hire or Reward (2) Carriage of
LIMITATIONS AS TO
goods (other than samples or personal luggage) (3) Organized racing (4) Pace making (5) Speed
USE testing (6) Reliability trials (7) Any purpose in connection with motor trade.
Any person including the insured: Provided that the person driving holds an effective driving license
at the time of the accident and is not disqualified from holding or obtaining such license. Provided
DRIVER’S CLAUSE also that the person holding an effective learners license may also drive the vehicle & that such a
person satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules, 1989.
Under Section II-1(i) of the policy-Death of or bodily injury: Such amount as is necessary to meet the
LIMITS OF LIABILITY
requirements of the Motor Vehicle Act 1988.Under Section II-1 (ii) of the policy-Damage to third
CLAUSE party property is Rs.7.5lakhs PA Cover Under Section III for Owner-Driver is Rs. 1500000
The insured is entitled for a No Claim Bonus (NCB) on the own damage section of the policy, if no
claim is
made or pending during the preceding year(s)-20%, preceding two consecutive years-25%, preceding
NCB Clause three consecutive
years-35%, preceding four consecutive years-45%, preceding five consecutive years-50% of NCB on
OD Premium. NCB is
allowed provided the policy is renewed within 90 days of the expiry date of the previous policy.
The insured is not indemnified if the vehicle is used or driven otherwise than in accordance with the
schedule. Any payment made by the company by reasons of wider terms appearing in the certificate
IMPORTANT NOTICE in order to comply with the Motor Vehicle Act, 1988 is recoverable from the insured. See the clause
headed “AVOIDANCE OF CERTAIN TERMS & RIGHT OF RECOVERY”. For legal interpretation English
version will hold good.
This Schedule, the attached Policy and Endorsements mentioned herein above shall read together
and word or expression to which a specific meaning has been attached in any part of this policy or of
the Schedule shall bear the same meaning wherever it may appear. Any
amendments/modifications/alterations made on this system generated policy document is not valid
NOTE and Company shall not be liable for any liability whatsoever arising from such changes. Any changes
required to be made in the policy once issued would be valid and effective, only after written request
is made to the Company and Company accepts the requested amendments/modifications/alterations
and records the same through separate endorsement to be issued by the company.
In Witness whereoff this policy has been signed at PRAYAGRAJ on 07-NOV-2024 15:30
The New India Assurance Co. Ltd.
Servicing Office of Insurer : Mumbai Auto Hub, The New India Assurance Company Ltd.,
New India Centre, 17A, Cooperage road, Off Madam Cama Road, Mumbai 400039, Mumbai,
Maharashtra (State Code:27) -400001, PH-022-22708230 Website : http://newindia.co.in
PAN : AAACN4165C . GSTIN: 27AAACN4165C3ZP Insurer's IRDA Registration Number: 190
Tollfree Helpline : 1800209141 Email: [email protected] : U9999
MH1919 GOI 000526
Private Car Package Policy (UIN-IRDAN190RP0042V01100001) CUM RECEIPT
(FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)
Policy No. : 80000031240350125223 Policy Issued On : 07-NOV-2024 (15:30)
Insured Name : MR. VINAY KUMAR SHUKLA
Own Damage Period : 07-NOV-2024(15:30) To 06-NOV-2025 Motor Liability Period : 07-NOV-2024(15:30) To 06-NOV-2025(Midnight)
(Midnight)
PRIVATE CAR PACKAGE POLICY: ADD ON COVERS
ENGINE PROTECT COVER
Notwithstanding anything contained to the contrary in the within mentioned policy it is hereby declared and agreed that subject to the
insured having paid the Additional premium as applicable the cover under Section I of the within mentioned policy is hereby extended to
the effect that in the event of any partial loss claim admissible under this policy towards the loss or damage to the vehicle including its
engine and / or its parts due to hydrostatic losses shall be payable. The term hydrostatic loss or damage will include the loss or damage
caused to any parts of engine due to ingress of water in the car or any part of it. Subject to the condition that the above said coverage shall
be applicable only for any two partial loss claims admitted and payable under the policy relating to accidents during the policy period.
NIL Depreciation
In consideration of payment of an additional premium by the Insured, it is hereby agreed and declared that notwithstanding anything to
the contrary contained in the Policy, the Company hereby undertakes to indemnify:
Depreciation on replacement of parts including tyres, tubes, rubber / plastic for Partial Loss Claims.
Midterm inclusion of cover is not permitted.
Total Loss and Constructive Total Loss will be settled on the basis of IDV.
The claims under this Add On Cover will be paid up to maximum of specified number of times or unlimited nos. (as mentioned in Policy
schedule) during the policy period of Own Damage Coverage. This Add On Cover policy will not be valid once the Insured has claimed for
the specified number of times mentioned in the policy schedule.
Subject otherwise to the terms, exceptions, conditions and limitations of this Policy
Note - Only 2 claims can be availed under Nil Depreciation.
