This Document is Digitally Signed

The Oriental Insurance Company Limited

Signer: RAJIV KUMAR GUPTA
Date: Fri, Jun 27, 2025 [Link] IST
Reason: Signing Policy for OICL

MOTOR INSURANCE CERTIFICATE CUM POLICY SCHEDULE

GCCV-PUBLIC CARRIERS OTHER THAN THREE WHEELERS PACKAGE
POLICY - ZONE C
Road Side Assistance included in this policy - Toll free No.
8447642311 *Conditions Apply
UIN NO:IRDAN556RP0079V01200506

Policy No : 233703/31/2026/367 Prev Policy No : -

Cover Note No : - Cover Note Dt :
Insured's Code : 170174483 Issue Office Code : 233703
Insured's Name : SAHIJPAL SINGH S/O SH Issue Office Name : BO TALWANDI ROAD ZIRA (GSTIN:
KULWINDER SINGH (GSTIN: ) 03AAACT0627R3Z7)
Address : R/O VILL PHIDE DISTT FZR Address : NEAR GRAIN MARKET TALWANDI
PREINSPECTION BY ECO VIDE REF ROAD
NO 37805 ZIRA
142047
FEROZEPUR PUNJAB 142050 ZIRA PUNJAB 142047
PAN No : XXXXXX823R Tel /Fax /Email : 01682-250761, 250583, 250761,
8198856500 / 01682-500043 /
[Link]@[Link]
,233703@[Link]
Validated Mobile No /Email: / / 0 / NA CKYC No:
E-Insurance Account No: Lead/Breakin No: /
Agent/Broker Details
[Link] : NG0000000396 ANIL KUMAR BAJAJ
Agent/Broker : BA0000155539 ISHA TIWARI
Address : Friends Enclave, Ferozepur Road, Zira,,FEROZEPUR,PUNJAB,142047
Tel /Fax /Email : 9317244444//bajajenterpriseszira@[Link]

Period of Insurance : FROM 17:02 ON 27/06/2025 TO MIDNIGHT OF 26/06/2026

Collection No & Dt : CSH 2128000487 - 27/06/2025 GST INVOICE NO :032479640 UIN :0
Gross Premium : 57,961 GST : 7,780 Stamp Duty : .5 Total : 65,741
Geographical Area : INDIA Area Extension :

Particulars of Insured Vehicle:

Registration RTO Place Engine/Motor Make - Model Type Of Body G.V.W Year Of Seating Cap Cubic
No. No.&chassis Type Of Fuel Manf. (incl Driver) Capacity
no/VIN

PB 10 FV 7437 Ludhiana - C63588602 TATA SIGNA OTHERS 55000 2017 1+1 5883
MAT704101H3C086 4923.S BS IV DIESEL
46

Particulars of Trailer
Chassis No. Registration No. Manufacturer Make

FASTag ID :
Limitations as to Use:--
The Policy covers use only under a permit within the meaning of the Motor Vehicles (Amendment) Act,2019, or such a

Place : ZIRA
Date : 27/06/2025

Page 1 of 7
 This Document is Digitally Signed

The Oriental Insurance Company Limited

Signer: RAJIV KUMAR GUPTA
Date: Fri, Jun 27, 2025 [Link] IST
Reason: Signing Policy for OICL
Attached to and forming part of policy number 233703/31/2026/367

carriage falling under sub-section (3) of section 66 of the Motor Vehicles (Amendment) Act,[Link] Policy does not cover
use for --- (a) organised racing (b) speed testing.
Persons or classes of persons entitled to drive:-- Any person including insured: PROVIDED that a person driving holds an
effective driving licence at the time of the accident and is not disqualified from holding or obtaining such a licence:PROVIDED
ALSO that the person holding an effective learner's licence may also drive the vehicle when not used for the transport of
goods at the time of the accident and that such a person satisfies the requirements of rule 3 of the Central Motor Vehicles
Rules, 1989.

Limit of Liability:Under Section II-1(i) & (ii) in respect of any one accident: as per the Motor Vehicles (Amendment)
Act,2019.
P.A. Cover under Section III for Owner - Driver (CSI) : Rs. 1500000
*This insurance excludes all pre-existing damages

Insured's Declared Value (IDV)

IDV of IDV of IDV of Non IDV of IDV of external IDV of Any Allied IDV of Total Value
Vehicle/ Trailer Electrical Electrical CNG Kit Body Components Articulated IDV
Chassis Accessories Accessories /Retrofit Trailer

18,00,000 18,00,000

SCHEDULE OF PREMIUM

A. OWN DAMAGE B. LIABILITY

ADD :ADDITIONAL TOWING CHARGES- 500.00 ADD :BASIC TP COVER 44,242.00

GR-47 BASIC TP TOTAL 44,242.00
LESS :ANTI-THEFT DISCOUNT-GR-30 500.00 ADD :PA FOR OWNER DRIVER-GR36A 320.00
ADD :LL-PAID DRIVER, 150.00
BASIC OD COVER 44,226.00
CONDUCTOR,CLEANER-IMT-40
ADD :IMT23-COVERAGE FOR IMT 21 6,768.90 ADD :GEOGRAPHICAL EXTENSION - 100.00
EXCLUSIONS LIABILITY ONLY
BASIC OD TOTAL 13,148.90 TP TOTAL 44,812.00
LESS :SIP DISCOUNT 38,246.00 TOTAL PREMIUM 57,961.00
OD TOTAL 13,149.00 STAMP DUTY 0.50
ADD :CGST_TP 2,655.00
ADD :GEOGRAPHICAL EXTENSION- 400.00
GR4 ADD :CGST_OD 1,235.00
ADD :SGST_TP 2,655.00
MOTOR TOTAL OD 13,149.00
ADD :SGST_OD 1,235.00
TOTAL AMOUNT 65,741.00

Deductibles under Section-I : Compulsory Deductible 1500

Subject to IMT Endorsement Printed herein/attached to : IMT-40 , IMT-21 , IMT-23 , IMT-1 , IMT-3 , IMT-10 , IMT-6
Details of IMT Endorsements are also available on the Company's Web Portal [Link]

Hypothecation Agreement with: TATA MOTORS FINANCE SOLUTIONS LTD

Hire Purchase/Lessor Agreement with: -

Place : ZIRA
Date : 27/06/2025

Page 2 of 7
 This Document is Digitally Signed

The Oriental Insurance Company Limited

Signer: RAJIV KUMAR GUPTA
Date: Fri, Jun 27, 2025 [Link] IST
Reason: Signing Policy for OICL
Attached to and forming part of policy number 233703/31/2026/367

In the event of a claim under the policy exceeding Rs.1lac or a claim for refund of premium exceeding Rs1lac,the insured
will comply with the provisions of the AML policy of the [Link] AML policy is available in all our operating Offices as
well as company's website.

The insurance provided by this policy is governed by the terms,conditions,warranties,exclusions,INDIA MOTOR

TARIFF(2002)endorsements, and OIC add-on cover endorsements as outlined in the prospectus and customer information
sheet. These details can be found on the company's website [Link] or requested from the policy
issuing [Link] can store our policy in [Link] insured is requested to visit our website or nearest office for policy
servicing,claim procedures,and lodging [Link] not resolved,you may approach the insurance ombudsman of your region,a
list of which is available on our website or at any of our offices.
You may also lodge a complaint at IRDAI:[Link]

This Policy is issued on the condition that the insured vehicle has a valid PUC and FASTag ID(Wherever Applicable) and they
must remain valid throughout the period of this insurance.
WARRANTED THAT AT NO TIME THE GROSS LADEN OF WEIGHT OF THE VEHICLE EXCEEDS THE GROSS VEHICLE
WEIGHT MENTIONED IN THE SCHEDULE OF THE POLICY.

Warranted that in case of dishonour of premium cheque(s) the Company shall not be liable under the policy and the policy shall
be void abinitio (from inception).

I/We hereby certify that the policy to which the certificate relates as well as this certificate of insurance are issued in accordance
with the provision of Chapter XI of the Motor Vehicles (Amendment) Act,[Link] Policy does not cover liability for death,bodily
injury or damage as excluded in section 150(2) (ii) and (iii); (b) and (c) of the Motor Vehicles (Amendment) Act,2019.

No claim is admissible if driving license is found fake or is not valid,whether or not in the knowledge of the insured.
In witness whereof the undersigned being authorised by and on behalf of the company has/have herein to set his/their hands at
BO TALWANDI ROAD ZIRA (GSTIN: 03AAACT0627R3Z7) on 27-JUN-25
IMPORTANT NOTICE
The Insured is not Indemnified if the vehicle is used or driven otherwise than in accordance with [Link] payment
made by the Company by reason of wider terms appearing in the Certificate in order to comply with the Motor Vehicles
(Amendment) Act,2019 is recoverable from the Insured. See the Clause headed "AVOIDANCE OF CERTAIN TERMS AND
RIGHTS OF RECOVERY".

Entered By : GURSIMRAN JEET SINGH

Examined By : GURSIMRAN JEET SINGH

Policy Printed By : 066206 IP :

Policy Printed On : 27-JUN-25 [Link]

Digitally Signed
By
Authorised Signatory

This is an electronically generated digitally signed document(Policy Schedule).The stamp duty has been centrally
deposited with the appropriate authority or stamp defaced & retained in the office.

In case of any query regarding the Policy please call Toll Free No. 1800 11 8485 and 011 33208485.
CIN: U66010DL1947GOI007158 All the Amounts mentioned in this policy are in Indian Rupees
IRDA Regn. No. 556 - Now you can buy and renew selected policies online at [Link]
and through other digital platforms including Whatsapp (Send "Hi" to 9560711200)

Place : ZIRA
Date : 27/06/2025

Page 3 of 7
 This Document is Digitally Signed

The Oriental Insurance Company Limited

Signer: RAJIV KUMAR GUPTA
Date: Fri, Jun 27, 2025 [Link] IST
Reason: Signing Policy for OICL
Attached to and forming part of policy number 233703/31/2026/367
THE ORIENTAL INSURANCE COMPANY LIMITED
REG OFFICE: ORIENTAL HOUSE, P.B. NO. 7037, A-25/27, ASAF ALI ROAD, NEW DELHI - 110 002
CUSTOMER INFORMATION SHEET
Sl. Title Description
No.
GCCV Package Policy
1. Product Name

Unique Identification UIN NO:IRDAN556RP0079V01200506

2. Number (UIN) allotted
by IRDAI
The Insured Declared Value (IDV) of the Vehicle will be deemed to be the Sum Insured for
StructureBasis of Sum the purpose of this policy which is fixed at the commencement of each policy period for the
3. Insured (IDV) insured [Link] is an Indemnity based (with deductions for depreciation and policy
excess) package product covering both Accidental Own Damages to the insured's vehicle
& Third Party liability arising out of use of the vehicle. It also covers personal accident for
owner-driver.
The schedule of depreciation for fixing IDV of the vehicle :-

% OF DEPRECIATION
FOR FIXING IDV
AGE OF VEHICLE
Not exceeding 6 months 5%
Exceeding 6 months but not exceeding 1 year 15%
Exceeding 1 year but not exceeding 2 years 20%
Exceeding 2 years but not exceeding 3 years 30%
Exceeding 3 years but not exceeding 4 years 40%
Exceeding 4 years but not exceeding 5 years 50%
IDV of vehicles beyond 5 years of age and of obsolete models of the vehicles ( i.e. models
which the manufacturers have discontinued to manufacture) is to be determined on the
basis of an understanding between the insurer and the insured. IDV shall be treated as the
'Market Value' throughout the policy period without any further depreciation for the
purpose of Total Loss (TL) / Constructive Total Loss (CTL) claims. The insured vehicle
shall be treated as a CTL if the aggregate cost of retrieval and / or repair of the vehicle,
subject to terms and conditions of the policy, exceeds 75% of the IDV of the vehicle.
1. Indemnity- Repair or TL/CTL basis
2. Benefit basis in case of CPA( only if opted for)

1. Vehicle registered in the name of the insured.

4. Interests Insured 2. Third Party Liability arising out of use of the vehicle.
3. Personal Accident cover for Owner and/or driver and passengers
(only if opted for)

Sum Insured/ Insured Section I-- LOSS OF OR DAMAGE TO THE VEHICLE INSURED
5.
Declared Value (IDV) The schedule of age-wise depreciation as shown in above Column no. 3 is
applicable for the purpose of Total Loss/Constructive Total Loss (TL/CTL) claims only.
Section II-- LIABILITY TO THIRD PARTIES
Legal Liability to Third parties (TP) for Death, personal injury and property damage
resulting from accident to insured vehicle
Section - III:

Place : ZIRA
Date : 27/06/2025

Page 4 of 7
 This Document is Digitally Signed

The Oriental Insurance Company Limited

Signer: RAJIV KUMAR GUPTA
Date: Fri, Jun 27, 2025 [Link] IST
Reason: Signing Policy for OICL
Attached to and forming part of policy number 233703/31/2026/367

PERSONAL ACCIDENT COVER FOR OWNER-DRIVER

(applicable only when opted for)
Nature of injury/ Scale of compensation
(i) Death 100%
(ii) Loss of two limbs or sight of two eyes or one limb and sight of
one eye 100%
(iii) Loss of one limb or sight of one eye 50%
(iv) Permanent total disablement from injuries other than named above 100%
The compensation shall be payable under only one of the items (i) to (iv) above in
respect of the accident occurred whilst operation of vehicle by owner-driver arising out
of any one occurrence and the total liability of the insurer shall not in the aggregate
exceed the sum of Rs.15 lakhs during any one period of insurance.

6. Policy Coverage OD Cover (Section I): The Company will indemnify the insured against loss or damage
to the vehicle insured hereunder and/or its accessories whilst thereon
i. by fire, explosion, self -ignition or lightning;
ii. by burglary, housebreaking, or theft;
iii. by riot and strike;
iv. by earthquake (fire and shock damage);
v. by flood, typhoon, hurricane, storm, tempest, inundation, cyclone, hailstorm, frost;
vi. by accidental external means;
vii. by malicious act;
viii. by terrorist activity;
ix. whilst in transit by road, rail, inland- waterway lift elevator or air;
x. by landslide, rockslide.
Subject to a deduction for depreciation based on age of the vehicle, at the rates
mentioned below in respect of parts replaced:-
1. For all rubber/ nylon/ plastic parts, tyres and tubes, batteries and air bags -50%
2. For fiber glass components - 30%
3. For all parts made of glass - Nil
4. Rate of depreciation for all other parts including wooden parts will be as per the
following schedule depending on Age of Vehicle:
No. Age of Vehicle Depreciation rate

i. Not exceeding 6 months NIL

ii. Exceeding 6 months but not exceeding 1 year 5%
iii. Exceeding 1 year but not exceeding 2 years 10%
iv. Exceeding 2 years but not exceeding 3 years 15%
v. Exceeding 3 years but not exceeding 4 years 25%
vi. Exceeding 4 years but not exceeding 5 years 35%
vii. Exceeding 5 year but not exceeding 10 years 40%
viii. Exceeding 10 years 50%
5. Rate of Depreciation for Painting: In the case of Painting, the depreciation rate of 50%
shall be applied only on the material cost of total painting charges. In case of a
consolidated bill for painting charges, the material component shall be considered as
25% of total painting charges for the purpose of applying the depreciation.
Road Side Assistance Cover (Integrated with OD Cover, no extra premium
charged)
TP Cover (Section II): Third party liability arising out of use of the insured
vehicle.
Add-on covers
(Available only when
* Nil Depreciation
7.

Place : ZIRA
Date : 27/06/2025

Page 5 of 7
 This Document is Digitally Signed

The Oriental Insurance Company Limited

Signer: RAJIV KUMAR GUPTA
Date: Fri, Jun 27, 2025 [Link] IST
Reason: Signing Policy for OICL
Attached to and forming part of policy number 233703/31/2026/367

opted for & extra * Return to Invoice

applicable premium is * Consumables
paid) * EMI Protect
Deductible applicable
The Company shall not be liable for deductible amount as stated in Policy schedule, in
8. Loss Participation each and every claim under Section - I (loss of or damage to the vehicle insured) of this
Policy.
Refer 'Excess' clause as per policy.
The Company shall not be liable to make any payment in respect of
What are the major (a) consequential loss, depreciation, wear and tear, mechanical or electrical breakdown,
9. exclusions? failures or breakages nor for damage caused by overloading or strain of the insured
vehicle nor for loss of or damage to accessories by burglary, housebreaking or theft unless
such insured vehicle is stolen at the same time.
(b) damage to Tyres and Tubes unless the vehicle insured is damaged at the same
time in which case the liability of the company shall be limited to 50% of the cost of

For Details, Pl. Refer policy document.

Special Conditions, General Exceptions and warranties are as stated in policy wordings.
10. Special Conditions and In case of Theft of vehicle, immediate notice should be given to insurance company
Warranties along-with FIR. Notice should be given to RTO about the theft of vehicle. Further, insured
is advised to follow theft claim guidelines obtained from claim settling office.
In case of Death of Registered Owner of vehicle, the policy will not lapse immediately but
will remain valid for 3 months from the date of death of Registered Owner or expiry of the
policy whichever is earlier. RC should be transferred in the name of legal heir within these
3 months or a new policy can be obtained by the legal heir.
Claim should be notified immediately through online intimation, email to the address
11. Claim Intimation and mentioned in policy or through any other means.
settlement Due diligence should be taken by Insured upon occurrence of loss as mentioned in
conditions of the policy.
Post intimation, surveyor will be deputed to assess the loss.
In case of major losses, spot survey is essential and if there is no spot survey,
appropriate claim amount may be deducted if the liability is admitted.
Claim will be indemnified in any one of the methods;
1) Repair basis - Indemnity with deduction for consumables ,depreciation
& excess applicable- under cashless or reimbursement mode to Insured
2) Total Loss/CTL basis- Based on the Net of Salvage loss/ Total loss basis after
deduction of Wreck value and Excess.
3) Cash Loss basis
Cashless Claim Process:
* In Cashless settlement, when repair of vehicle is done in authorized workshop, Insured
and Workshop sign the satisfaction note accepting this mode of settlement. Amount of
claim admissible is paid to the workshop and balance is borne by Insured.
* After completion of repairs, Insurer will give clearance to release the vehicle from the
workshop once all the documents are received and the liability is admitted
* In case of claim, please obtain necessary guidance from policy issuing office regarding
12 Claim Service designated SVC i.e. claim settling office.
* Surveyor appointment will be done within 24hrs of receiving intimation
* Surveyor / In house Loss Assessor shall reach the place of survey within 24 hours of
intimation of claim
* Settlement Advice together with discharge voucher is sent within 7 days from the date of
receipt of all documents.
The following are the Basic Claim documents to be submitted by the insured:
Basic Documents:

Place : ZIRA
Date : 27/06/2025

Page 6 of 7
 This Document is Digitally Signed

The Oriental Insurance Company Limited

Signer: RAJIV KUMAR GUPTA
Date: Fri, Jun 27, 2025 [Link] IST
Reason: Signing Policy for OICL
Attached to and forming part of policy number 233703/31/2026/367

* Motor Claim Form - claim form may be downloaded from OICL website.
* KYC documents
* Copy of Registration Certificate of the Insured vehicle.
* Copy of Driving License of person driving at the time of loss.
* Copy of permit, load challan, fitness , GR etc.
* FIR in case of TP Injury/Death Case.
For cashless garage network visit: [Link]
Claimant to be assisted by the cashless workshop partner to intimate the claim to the
claim center.

13 1. Policy can be cancelled by the policyholder any time during the term of the policy.
Cancellation
2. The Company can cancel the policy on grounds of established fraud by giving a prior
notice of 7 days to the policyholder. In this case, no refund of premium shall be done.
3. The Company will not cancel the Statutory Motor Third Party Policy except in case of
double insurance or total loss of insured vehicle.
4. The Company shall--
i. refund proportionate premium for unexpired policy period, if the term of the policy is upto
one year & no claim(s) is made during the term of the policy.
ii. refund premium for the unexpired policy period, in respect of policy with the term more
than one year and risk coverage for such policy years has not commenced.

1. Company Officials :
14. Policy Servicing
Website: [Link]
2. Toll Free Number: 1800 11 8485
3. Policy Issuing Office - as mentioned in your Policy Schedule for any assistance.
* [Link]
15. Grievances * E-mail - csd@[Link]
Complaints/ TAT * IRDAI Integrated Grievance Management System [Link]
* Insurance Ombudsman - Contact details of the Insurance Ombudsman have been
provided in Annexure 1 of the policy document.
* Ombudsman Website - [Link]
* TAT: Decision on claim within 7 days of receipt of Survey report.
Surveyor to be appointed within 24 hrs of claim intimation.
Surveyor to submit report within 15 days of appointment.
16. * Insured is at obligation to disclose all material information in the Proposal form.
Obligations of the * In the event of misrepresentation, mis-description or non-disclosure of any material fact
Policyholder by the Insured, the Policy shall be void
* To intimate any change to the material information affecting the policy.
* Any change in the ownership of the vehicle, any kind of modification in the vehicle/RC
which might enhance the risk is considered as material information and should be informed
to insurance company for necessary endorsement on policy.
For all above, Insured can contact our policy issuing office, details of which are mentioned
in the policy schedule.
Legal Disclaimer Note: The information must be read in conjunction with the policy document. In case of any conflict between
the CIS and the policy document, the terms and conditions mentioned in the policydocument shall prevail.
Declaration by the Policy Holder:
I have read the above and confirm having noted the details.

Place :
Date : Signature of Policy Holder

Place : ZIRA
Date : 27/06/2025

Page 7 of 7