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    Activa 4g Insurance

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    dharanmu
    This document is a motor insurance policy schedule for a Honda Activa scooter registered in Tamil Nadu. It provides the policy and vehicle details such as the insured's name and address, policy period, registration number, engine and chassis details of the vehicle. It specifies the insured declared value, persons entitled to drive, limitations of use, and covers provided under the policy including liabilities. Details of premium payable and applicable add-ons, discounts and deductibles are also mentioned.

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    © All Rights Reserved
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    Activa 4g Insurance

    Uploaded by

    dharanmu
    37 views1 page
    This document is a motor insurance policy schedule for a Honda Activa scooter registered in Tamil Nadu. It provides the policy and vehicle details such as the insured's name and address, policy period, registration number, engine and chassis details of the vehicle. It specifies the insured declared value, persons entitled to drive, limitations of use, and covers provided under the policy including liabilities. Details of premium payable and applicable add-ons, discounts and deductibles are also mentioned.

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    Activa 4g insurance (1)

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    This document is a motor insurance policy schedule for a Honda Activa scooter registered in Tamil Nadu. It provides the policy and vehicle details such as the insured's name and address, policy period, registration number, engine and chassis details of the vehicle. It specifies the insured declared value, persons entitled to drive, limitations of use, and covers provided under the policy including liabilities. Details of premium payable and applicable add-ons, discounts and deductibles are also mentioned.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    37 views1 page

    Activa 4g Insurance

    Uploaded by

    dharanmu
    This document is a motor insurance policy schedule for a Honda Activa scooter registered in Tamil Nadu. It provides the policy and vehicle details such as the insured's name and address, policy period, registration number, engine and chassis details of the vehicle. It specifies the insured declared value, persons entitled to drive, limitations of use, and covers provided under the policy including liabilities. Details of premium payable and applicable add-ons, discounts and deductibles are also mentioned.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    MOTOR INSURANCE - Two Wheeler Limited Liability Only SCHEDULE

    Policy Number :22300031200160482069 Previous Policy Number :


    Geographical Area :India Insurance Start Date & Time :21/09/2020 0:00 (hours)
    Insured Name :Sriram K Insurance Expiry Date & Time :20/09/2021 midnight
    Insured Address : Policy Issuing Office Address :

    Divisional Office-30 (Gurugram) Unit no: 34,35,6A,6B,Ground Floor,Vipul Trade Centre, Sector-48,
    2/244 Agragaram street, kali, kali post Mayiladuthurai tk
    Sohna Road
    City :NAGAPATTINAM District :NAGAPATTINAM
    City :GURUGRAM District :Gurugram
    State :TAMIL NADU Pincode :609811
    State :HARYANA Pincode :122001
    Mobile No :9962840409
    Office Contact Details :0124-4051884 Email Id :[email protected]
    Email :[email protected]
    GSTIN :06AAACU5552C1ZN

    Business Channel Code: NA Business Channel Sub Code: BRC0000907


    Helpline No: 18002585970 Broker Name : Policybazaar Insurance Web Aggregator Pvt. Ltd.
    IRDA License Code - Number: IRDAI/WBA21/15 - 06
    VEHICLE DETAILS
    Year of Manufacture Vehicle
    Registration Number TN82D2036 Engine Number JF50ET5331149 2017
    Weight(kg.)
    TN82 Mayiladuthurai /
    RTA Name Chassis Number ME4JF507FHT330932 Cubic Capacity / GVW 110
    Sirkazhi
    Registration Date 14/06/2017 Vehicle Make & Model HONDA - ACTIVA - 4G (110 CC) Type of Body Two Wheeler
    AA Membership Name Seating Capacity 2 Geographical Extension NoExtn

    INSURED DECLARED VALUE (IN RUPEES)


    Electrical /Electronic Non-Electrical Co-Insurance
    Vehicle Trailer FiberGlass CNG Kit LPG Kit TOTAL
    Accessories Accessories Details
    0 0 0 0.00 0.00 0.00 0.00 0 0.00

    OTHER DETAILS
    Financier Branch Name & Address Policy Subject to IMT Endorsements/Applicable covers

    PERSONS OR CLASS OF PERSONS ENTITLED TO DRIVE: As narrated in the certificate of insurance attached herewith.
    LIMITATIONS AS TO USE : As narrated in the certificate of insurance attached herewith.
    LIMITS OF LIABILITY : As narrated in the certificate of insurance attached herewith.

    OTHER DETAILS
    EXCLUSIONS: (1) Any accidental loss or damage and/or liability caused sustained or incurred outside the geographical area. (2) Any claim arising out of any contractual liability. (3) Any accidental loss or
    damage to any property whatsoever or any loss or expense whatsoever resulting or arising there from or any consequential loss. (4) Any liability of whatsoever nature directly or indirectly caused by or contributed
    to or by arising out of ionizing radiations or contamination by radioactivity from any nuclear fuel. For the purpose of this exception, combustion shall include any self sustaining process of nuclear fission. (5) Any
    accidental loss or damage or liability directly or indirectly caused by or contributed to, by or arising from nuclear weapons material. (6) Any accidental loss, damage or liability directly or indirectly or proximately or
    remotely occasioned by contributed to by or traceable to or arising out of or in connection with war, invasion, the act of foreign enemies, hostilities or war like operations(whether before or after declaration of
    war), civil war, mutiny, rebellion, military or usurped power or by any direct or indirect consequence of any of the said occurrences or any consequences thereof and in default of such proof, the company shall not
    be liable to make any payment in respect of such a claim.
    PA COVER CSI (In Rupees) DEDUCTIBLES (Under Section I) (In Rupees)
    Owner- Driver (Under section IV) N/A Compulsory 0.00 Imposed 0.00 Voluntary 0.00

    SCHEDULE OF PREMIUM (IN RUPEES)


    A-OWN DAMAGE PREMIUM B-LIABILITY PREMIUM TOTAL PACKAGE PREMIUM
    Basic Own Damage 0 Basic TP Liability 702 Package Premium 702
    Anti Theft Device Discount PA Owner Driver 0 GST @18.00% 126
    Nil depreciation withoutExcess 0 PA for Unnamed persons
    Sub Total(Additions) 0 Sub Total (Additions)
    NCB Discount @ 0 % 0 Sub Total (Deductions) 0
    Total 0 Total 702

    TOTAL PAYABLE PREMIUM 828


    Receipt Date 20/09/2020
    Receipt Amount 828
    Payment Mode Online
    Paying Party Sriram K

    CHEQUE DETAIL
    Cheque Number Cheque Date Bank Name Branch Name Branch Code Cheque Signatory MICR No
    PG23582025 20/09/2020 INDB Sriram K

    TERMS & CONDITIONS: As per the Indian Motor Tariff, personal copy of the same is available free of cost on request. Further the Indian Motor Tariff is also available and displayed at allUnited India Insurance
    Company Offices and on website http://uiic.co.in/sites/default/files/uploads/downloadcenter/IndianMotorTariff.pdf.
    For terms and conditions for add on covers go to : http://uiic.co.in/sites/default/files/uploads/downloadcenter/motor_additional_covers.pdf
    DISCLAIMER: The policy stands cancelled or void in the event of Cheque Dishonored. The company may cancel the policy by sending 7 days notice in case of fraud, misrepresentation, nondisclosure of material
    fact or non co-operation of the insured.
    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 ofwider 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 ANDRIGHT OF RECOVERY". For Legal interpretation,
    English version will hold good. In case of accident, the insured must inform United India Insurance Co. Immediately to arrange spot survey.Date & Signature of Proposal: 20/09/2020 00:00:00.0
    In Witness whereof this Policy has been signed at GURGAON this day of , Date
    For United India Insurance Company Limited

    CONSOLIDATED STAMP DUTY PAID VIDE


    GRN NO. 49278342 DTD 25/06/19 AND In case of any claim, You can contact nearest local office of United India
    CIN. NO. 43939953 DTD 24/06/19 ISSUED BY Insurance Company ltd or Contact PB on 18002585881
    TREASURY OFFICER, GURGAON
    Duly Constituted Attorneys
    IP Address: 2409:4072:382:f89a:7d2f:e1f7:b1cf:2f3f,
    Print Date: 20/9/2020 17:41:13
    23.44.10.12, 104.124.54.23, 10.40.1.63

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