Bundled Auto Secure - Two Wheeler Policy (1 Year Term for Own Damage & 5 Years for Third
Party)
Issued at
Policy No. Tata AIG General Insurance Co. Ltd. HERO INSURANCE BROKING INDIA PVT LTD.
319577889/000000/00 15th floor,Tower A,Peninsula Business IRDA Registration No.: 649
Park Ganpatrao Kadam Marg,Off Senapati Toll-Free No.: 1800 102 4376
Bapat Marg Lower Parel 264, Okhla Ind. Estate, Phase-III, Delhi-110020
Tel:18002667780
[email protected]
Insured Business/Profession Address of The Insured TP Valid From TP Valid To
W/O MUSTAFA ALI 17-4-593,
07-03-2025
Ms ASGAR ALI Housewife FALAKNUMA ,FALAKNUMA Midnight of 06-03-2030
TELANGANA 500053 16:21:19
Vehicle Regn No. Engine No. Chassis No. Make & Model Year of Mfg Cubic GSTIN No.
Capacity (Customer)
Hero MotoCorp
New JA07AFPGC00483 MBLJAW376PGC00351 Glamour xtec 2023 100
DRSC FI
Declared Value Side Car IDV Non-Electrical Electrical CNG/LPG/Bi-Fuel Total IDV
(IDV) of Vehicle Accessories IDV Accessories IDV
IDV
71869.00 NA 0.00 0.00 0.00 71869
Place of Regn. Body Type HP/Lease/Hire- Branch Office Seating Capacity Premium
Purchase Agreement of
With HP/Lease/Hire-
Purchase
Hyderabad Solo NIL --- 2 5993.00
Section A B. Liability Premium Computation (Section II) in Rs.
Basic OD Premium : 491.00
Basic Third Party Liability : 3851.00
Non-Electrical-Fitting Premium : 0.00
TPPD Discount : 0.00
Electronic & Electrical Accessories : 0.00
Total : 3851.00
Bi-Fuel Kit : 0.00
CNG/LPG/Bi-Fuel Kit : 0.00
Geographical Extension : 0.00
Geographical Extension : 0.00
ND Cover : 287.00
Add
Less : Compulsory PA Cover (Owner Driver) : 450.00
Handicapped Discount : 0.00 Optional PA Cover(Un Named Passenger) : 0.00
For Anti-Theft Discount : 0.00 Optional PA Cover(Unnamed Hirer/Driver(IMT18)) : 0.00
NCB : 0.00 Legal Liability Cover (Paid Drivers, Cleaners) : 0.00
Total Own Damage Premium(A) : 778.00 Legal Liability Cover (Per Licensed Passenger) : 0.00
Total Liablity Premium (B) : 4301.00
Total Premium (A + B) : 5079.00
For any other extra : 0.00
CGST @ 9.00% : 457.00
SGST @ 9.00% : 457.00
Gross Premium : 5993.00
1.RegistrationNo.:108||2.CINNo.:U85110MH2000PLC128425|| GSTIN No.:36AHVPK1027D2ZF ||UIN No.-IRDAN108RP0007V02201819||
108RP0007V02201819/A0043V01201819||IRDAN108RP0007V02201819/A0047V01201819
07-03-2025 To 06-03- 07-03-2026 To 06-03- 07-03-2027 To 06-03- 07-03-2028 To 06-03- 07-03-2029 To 06-03-
OD Policy Period 2026 2027 2028 2029 2030
IDV 71869 NIL NIL NIL NIL
CPA Rs. 15 lakhs. NIL NIL NIL NIL
Sum Insured of Optional PA Cover:-Sum Insured of Optional PA Cover "Unnamed Passenger"-NA and "Unnamed Hirer/Driver"-NA
LIMITATIONS 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 samples or personal luggage) c) Organized Racing d) Pace Making e) Speed Testing f) Reliability Trials g) Any purpose in connection with
Motor Trade.
DRIVER: 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 and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules, 1989.
LIMIT OF LIABILITY: Limit of the amount of the Company's liability under the Section II-I(i) in respect of any one accident as per M.V. Act
1988. Limit of the amount of the Company's liability under Secion II-I(ii) in respect of any one claim or series of claims arising out of one event :
Upto Rs - 100000/
IMPORTANT NOTICE:--The insured is not indemified 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 Vehicle Act, 1988 is
recoverable from the insured. See the clause headed 'AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY'
I/We certify that the policy to which the certificate relates as well the certificate of insurance are issued in accordance with the provisions of
Chapter X & XI of M.V. Act 1988
Broker : Hero Insurance Broking India Pvt. Ltd. Insured is Liable for a voluntary deductible of Rs. Auto
Secure- Two Wheeler Package Policy.
Premium of Rs. 5993.00 Received Vide CASH TA16. Depreciation Allowances No of claim allowed 4,
Cash/Cheque No. Deductible: First Rs. 250 for each and every claim./- for
MUSTAFA each Claim, if policy having ND product.
Dated Nominee Name The policy is subject to a compulsory excess of Rs.
ALI
100/- & deductible under depreciation allowance is
Drawn on Nominee Age 68 applicable as per policy terms & conditions
Scan to Acknowledgement 07-03- Consolidated Stamp Duty Paid
Renew/View Policy Dt Nominee Relation FATHER
2025 Endorsements: IMT - 22,5,TA16
FOR RENEWALS CONTACT: VISHAL On behalf of Tata AIG General Insurance Co. Ltd.
MOTORS Ph.No-9581631239
07-Mar-2025
Date & Signature of proposer #47-3/1,PLOT NO.8,SRI SAI COLONY MAIN ROAD
CHINTAL,HYDERABAD-500037
Dealer's Stamp & Signature Duly Constituted Attorney
# : Received with Thanks Rs 5993.00 from Mr ASGAR ALI as premium against the money receipt no 023195706389/000000/00
Regd. & Head Office : Peninsula Business Park, Tower A,15th Floor, G.K. Marg, Lower Parel, Mumbai – 400013
For further information about motor insurance policy please also visit http://irda.gov.in >> Grievances >> Policyholder Handbooks
