Process Deep Link Request

New Business-SpeedPost-EM019527805IN-353614
Master Policy No : 1901806663 Date : 06-Jul-2022

Certificate No: 00059802
Renewal No: 00
Name : ARTI SHARMA .
Address : H NO 105 A/4A MEERA PATTI
DHOOMANGANJ
ALLAHABAD
UTTAR PRADESH
INDIA
211011
Email ID : [email protected]
Contact No : 8545967649
Dear ARTI SHARMA .,
Welcome to Tata AIG General Insurance Company Limited’s family & we thank you for choosing Tata AIG Bharat Griha Raksha Policy for your
Home.
We are enclosing Policy schedule/certificate of insurance of your Home. You are requested to visit our website www.tataaig.com for policy
wording. Your policy has been issued based on the information and declaration provided by you.
Kindly go through the enclosed information/declaration provided by you and in case your policy shows coverage's, for which you are not
entitled or any other error/discrepancy then we request you to get in touch with us within 15 days of receipt of the policy for correction
otherwise all particulars will be deemed to be correct.
You may also reach us at our 24*7 helpline 1800 266 7780 for providing any information or in case you desire to have a printed copy of policy
wording.
We always assure you of our best services.
For Tata AIG General Insurance Company Limited
Authorized Signatory,
Insurance is the subject matter of the solicitation.For more details on risk factors, terms and conditions, please read sales brochure carefully before concluding a sale.
TATA AIG General Insurance Company Limited.

Registered office : Peninsula Business Park, Tower A,15th Floor, G.K Marg,Lower Parel, Mumbai-400013
24*7 Toll free Number : 1800 266 7780 Fax : 022 6693 8170 Email : [email protected] website : www.tataaig.com
IRDA of India Registration No: 108 CIN: U85110MH2000PLC128425 PAN: AABCT3518Q UIN : IRDAN108RP0019V01202021
TATA AIG GENERAL INSURANCE COMPANY LIMITED
BHARAT GRIHA RAKSHA POLICY
CERTIFICATE OF INSURANCE
Policy Issuing Office Address & Code : ALLAHABAD,90927
Intermediary Name : AXIS BANK LTD

Intermediary License Number : CA0069
Intermediary Contact No : 18002092001
POLICY DETAILS :
Master Policy Number : 1901806663 Certificate No : 00059802
Master Policyholder Name : ARTI SHARMA .
Period of Insurance From : 30/06/2022 To : 29/06/2032
POLICYHOLDER DETAILS :
Name : ARTI SHARMA .
Phone No : Mobile : 8545967649, Landline :
Correspondence H NO 105 A/4A MEERA PATTI Email id : [email protected]

Address : DHOOMANGANJ
ALLAHABAD Insured GSTIN No :
UTTAR PRADESH
INDIA
211011
Place of Supply : UTTAR PRADESH

State Code : 09
Additional Insured ,ARTI SHARMA.

Details :
Nomination : Nominee Name : PRATISHTHA SHARMA

Relationship with the Insured : MOTHER
Hypothecation YES
applicable :
If Yes, Name of AXIS BANK LTD LAN number :PHR028607664022

Financier :
RISK LOCATION DETAILS :

a)Risk Location Address : HOUSE NO.128R/K5/111,MOHALLA PONGHAT ARAZI NO. 331 MAUZA,PONGHAT TALUKA
BAMRAULI,,ALLAHABAD,ALLAHABAD,UTTAR PRADESH,211011
b) Multi-storey / standalone house : Standalone
If Multi-Storey, Floor No :
c) Basement included : No
COVERS OPTED
1.Home Building & Home Contents Yes
2.Home Building Only No
3.Home Contents Only No
COVER DETAILS :
BASE COVERS
Sr.No Benefits Sum Insured Details Premium
1 a.Home Building INR. 2,852,364 1.Carpet Area:88.3312 INR. 9,684
2.Cost of Construction per unit:INR. 32291.7
3.Construction Type:Pucca
2 a. Home Contents INR. 1,000,000 As per Annexure INR. 4,401

IN-BUILT COVERS
Sr.No Benefits Sum Insured Details Premium
3 Loss of Rent INR. 2,400,000 No of months:36 INR. 1,150
PREMIUM DETAILS
Net Premium 15,235.00
UGST/SGST @9 % (Rs.) 1,371.00
CGST @9 % (Rs.) 1,371.00
Total 17,977.00
For full Terms and Conditions please refer to our Policy Wordings on our website https://www.tataaig.com
aa
The Coverage(s) mentioned in this Schedule shall only be available for the Policy
GSTIN: 09AABCT3518Q1ZU - UTTAR PRADESH Service Accounting Code: 997139
The stamp duty of Rs .5 paid in cash or demand draft or by pay order,vide Receipt/Challan no:LOA/CSD/318/2022/1601 dated the 08/04/2022
Special Conditions / Clause :

1.Terrorism Cover Wordings
2.Agreed bank clause
For Tata AIG General Insurance Company Ltd.
Authorized Signatory
NOTE :
This Schedule, the attached Add On Covers, Policy and Endorsements mentioned herein above shall be read together and any 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.
Please note that the details mentioned in the attached policy are based on information furnished by you.
Policy Servicing Office

,,,,,,UTTAR PRADESH,

ANNEXURE
Home Contents
Sr.No Items Sum Insured
1 Furniture, Fixtures and Fittings (Home Furnishings) 0
2 Electrical/Electronic 0
3 Others 1,000,000
Total Sum Insured 1,000,000

RECEIPT
Receipt No : 109271032202985 Receipt Date : 02/07/2022

Policy No : 1901806663 00059802
Received with thanks from ARTI SHARMA a sum of Rs. 17977( Rupees Seventeen Thousand Nine Hundred Seventy-Seven And Paise
Zero Only)Direct Debit, Branch Bank Branch Name - AXIS BANK LTD , ALLAHABAD RAC towards
Sr.No. Policy Number Total Premium Utilized from the receipt for policy Balance
1 1901806663 17977 17977 1
Note :
1. This is a computer generated receipt and does not require a signature.
2. Upon issuance of this Receipt, all previously issued temporary receipts, if any, related to this Policy shall be considered null and avoid.
3. Amounts received by cheque shall be subject to realisation.
4. Any amount received in excess of the Premium is being/shall be refunded by the Company.
GSTIN: 09AABCT3518Q1ZU - UTTAR PRADESH Service Accounting Code: 997139
Revenue (consolidated) Stamp Duty duly paid vide challan No.LOA_NO.CSD/270/2022/727 date 10/02/2022 for applicable cases

TRANSCRIPT OF PROPOSAL FORM

Important :
1. This proposal is for covering Home Building and/or Home Contents against Fire and Allied Perils.
2. Read the Prospectus/Key Features Document/Policy Wordings before filling up this proposal form to understand the meaning of the terms used
herein better.
3. The property proposed for insurance is not covered until the proposal is accepted and premium paid.
Policy Issuing Office Address & Code : ALLAHABAD,90927

Intermediary Name & Code : AXIS BANK LTD 0015455021
A. Details about Proposer and Policy Period :
1. Name of Proposer ARTI SHARMA .
2. Address of Proposer : H NO 105 A/4A MEERA PATTI

DHOOMANGANJ
ALLAHABAD
UTTAR PRADESH
INDIA
211011
3. Phone No :
a. Mobile 8545967649,
b. Landline
4. Email id : [email protected]
5. Policy to be issued in favor of (list

out all the parties who have insurable ,ARTI SHARMA.
interest) including the financial
institutions
6. Period of Insurance From 30/06/2022
To 29/06/2032
(No of Years in case of long term policy : 10)
Note: For Long term policy, Period shall not exceed 10 years.
7. Nomination : Nominee Name : PRATISHTHA SHARMA

Relationship with the insured : MOTHER
B .Covers Opted
Is there any policy in place for the same property? : No
8. If Yes, please provide the details :
Cover/s required:
9. (When Home Building and Home Contents are opted for, cover for General Contents of Home for Sum Insured equal to 20% of the
Sum Insured for Home Building Cover subject to a maximum of INR 10 Lakh [Rupees Ten Lakh] is automatically provided).
Cover Please tick

Home Building & Home Contents Yes
Home Building No
Home Contents No

C. Location of Home Building
Location of Home Building - full postal address with HOUSE NO.128R/K5/111,MOHALLA PONGHAT ARAZI NO. 331
10.
Pin Code : MAUZA,PONGHAT TALUKA BAMRAULI,,ALLAHABAD,ALLAHABAD,UTTAR
PRADESH,211011
11. Is it in a multi-storey building or is it a standalone Standalone

house? :
12. In case of multi-storey building, please provide the

floor number of Your house :
13. Is there a basement to Your house? : No
D. Details of Home Building

Please note :
Your Home Building is a building consisting of a residential unit, having an enclosed structure and a roof, basement (if any) and fixtures and
fittings permanently attached to the floor, walls or roof, like fixed sanitary fittings, electrical wiring and other permanent fittings etc.
It also includes ‘additional structures’ if they are on the same site, are used as part of Your Home Building:
a. garage, domestic out-houses used for residence, parking spaces or areas, if any;
b. compound walls, fences, gates, retaining walls, internal roads;
c. verandah or porch and the like;
d. septic tanks, bio-gas plants, fixed water storage units or tanks, solar panels, wind turbines and air conditioning systems, central heating
systems and the like, if not included in Home Contents Cover, any other structure.
14.Sum Insured (SI) for Home Building:

Please note the following:
(The amount required to construct Your Home Building at the policy Commencement Date. This amount is calculated as follows:
a. For residential structure of Your Home including fittings and fixtures:
Carpet area of the structure in square metres X Rate of Cost of Construction at the policy Commencement Date.
The Rate of Cost of Construction is the prevailing rate of cost of construction of Your Home Building at the policy Commencement Date.
a. SI for residential structure of Your Home including fittings and fixtures (in INR) : 2,852,364
b. For additional structures :the amount that is based on the prevailing rate of cost of construction at the Policy Commencement Date.)
b. SI for additional structures (in INR):
15. Carpet area of structure of Home in square metres : 88.3312square metres

16.Rate of Cost of Construction per square metre at the policy Commencement Date : Rs.32291.7
Other Details
17.Age of Home Building
Less than 5 Years No

5-10 Years Yes
10-20 Years No
Above 20 Years No
18.Construction Details
Please note the following :
(Building(s) having walls and/or roofs of wooden planks/thatched leaves and/or grass/hay of any kind/bamboo/plastic cloth/asphalt/
canvas/tarpaulin and the like are treated as Kutcha Construction.
Construction other than Kutcha Construction is a ‘Pucca Construction’)

Construction
Walls
Floor
Roof
(*strike out what is not applicable)
E. Details of Home Contents

Please note the following:
i) Home Contents refer to articles or things in Your Home that are not permanently attached or fixed to the structure of Your Home. Home
Contents may consist of General Contents and/or Valuable Contents.
ii) General Contents are all the contents of household use in Your Home, e.g., furniture, electronic items and goods, antennas, solar panels,
water storage equipment, kitchen equipment, electrical equipment (including those fitted on walls), clothing and apparel and items of
similar nature.
iii) Valuable Contents of Your Home consist of items such as jewellery, silverware, paintings, works of art, antique items, curios and items of
similar nature.
iv) If You have opted for Home Building and Home Contents cover, the General Contents of Your home equal to 20% of the Sum Insured for
Home Building Cover subject to a maximum of INR 10 Lakhs (Rupees Ten Lakh) are automatically covered.
19. If You want to opt out of in-built cover for General Contents as mentioned in (iv) above and want to have higher Sum Insured Or If You have
opted for Home Contents Only cover, please provide item wise Sum Insured for General Contents.
(Sum Insured represents Cost of Replacement)
Item wise Sum Insured for General Contents (in INR):
Items Sum Insured

Furniture, Fixtures and Fittings (Home Furnishings) 0
Electrical/Electronic 0
Others 1,000,000
20.In case of Basement, if there are contents in it, please provide the Sum Insured : 0
F . In-Built Covers (Loss of Rent & Rent for Alternative Accomodation)

21. Cover for (please tick)
Loss of Rent Yes

Rent for Alternative Accomodation
Loss of Rent :
i. Sum Insured: 2,400,000

ii. No.of months: 36
Rent for Alternative Accomodation :
i. Sum Insured: 0
ii. No.of months: 0
G. Optional Covers (available on payment of additional premium)
22. Do You require ‘Personal Accident Cover’ for Yourself and Your spouse? : NO
If Yes,
Name and age of Your Spouse : &
Your Age :

23. Do You require ‘Cover for Valuable Contents on Agreed Value Basis (under Home Contents cover)’ : No
(Valuable Contents of Your Home consist of items such as jewellery, silverware, paintings, works of art, antique items, curios and items of
similar nature.)
(You have to submit a Valuation Certificate. However, the requirement of valuation certificate is waived if the Sum Insured opted for is upto
INR 5 Lakh and Individual item value does not exceed INR 1 Lakh).
If Yes, please attach list of items and Sum Insured : 0
Valuation certificate attached : No
I . Premium Details
Mode of Payment Direct Debit

Payment Details 109271032202985
Amount (in Rs.) 17977
J.Claims Details
Please specify details of any loss to the proposed Property in last 3 Years:
Date of Loss Cause of Loss Claimed Amount Settled Amount/please specify if claim is outstanding
K.Declaration by Insured
I/ We hereby declare that the statements made by me / us in this Proposal Form are true to the best of my / our knowledge and belief and I / We
hereby agree that this declaration shall form the basis of the contract between me/us and TATA AIG General Insurance Company Limited.
If any additions or alterations are carried out in the risk proposed after the submission of this proposal form, then the same should be conveyed to
the insurers immediately.
Date : 30/06/2022
Place : ALLAHABAD Signature of Proposer
INSURANCE ACT 1938 SECTION 41- Prohibition of Rebates

No person shall allow or offer to allow either directly or indirectly, as an inducement to any person to take out or renew or continue an insurance
in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the
premium shown on the policy, nor shall any person taking out or renewing a policy accept any rebate, except such rebate as may be allowed in
accordance with the published prospectus or tables of the insurer.
Any person making default in complying with the provisions of this Section shall be punishable with fine which may extend to ten lakhs rupees.

Attached to and forming part of Policy No. 1901806663 00059802
Standard Special Clause

Agreed Bank Clause
If You have mortgaged, hypothecated or created any security over Your Home or any of its Contents in favour of a Bank, and the Bank has an
interest in the Policy, the name of such Bank will also be shown in the Policy Schedule under the title ‘Agreed Bank Clause’. If You choose to add
the name of such Bank at any time during the Policy Period, this will be shown as an Endorsement.
Under this Clause You agree as follows:
i. We shall pay to the Bank the entire amount that We are liable to pay under this Policy. Such Bank will receive it for its own demand, and as
agent for any other person interested in the amount.
ii. When We pay the amount to the Bank, Our liability under this Policy will be discharged, and will be binding on all of You and all persons named
as the insured.
iii. Any notice or communication We make to the Bank under the provisions of this Policy shall be sufficient notice or communication to You.
iv.Any settlement or compromise that We make with the Bank will be binding on You and all persons named as the insured. However, such
settlement or compromise will not affect the rights of the Bank to recover any amount from You or any other person.
v. If You make any change in the use of Your Home or sell or transfer the Insured Property, such actions will not prejudice the interest of the
Bank under the Policy and this clause, unless the condition has been broken by the Bank or its employees.
vi. If You commit any act or omission that will increase the risk, the insurance cover will not be invalidated. However, the Bank shall notify Us of
any change or ownership, or alterations and increase in risks as soon they become known to the Bank, and shall pay additional premium from
the time of such change.
vii. When We pay the amount to the Bank, We will become legally and automatically subrogated to all rights of the Bank to the extent of such
payment. This will not impair or prejudice the rights of the Bank to recover any amount from You or any other person.
N.B: The Bank shall mean the first named Financial Institution/Bank named in the policy.

Terrorism Damage Cover Endorsement (Material Damage only)
INSURING CLAUSE
Subject otherwise to the terms, exclusions, provisions and conditions contained in the Policy and in consideration of the payment by the
Insured to the Company of additional premium as stated in the Schedule, it is hereby agreed and declared that notwithstanding anything stated in
the ‘Terrorism Risk Exclusion” of this Policy to the contrary, this Policy is extended to cover physical loss or physical damage occurring during the
period of this Policy caused by an act of terrorism, subject to the exclusions, limits and excess described hereinafter.
For the purpose of this cover, an act of terrorism means an act or series of acts, including but not limited to the use of force or violence and/or
the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organisation(s) or
government(s), or unlawful associations, recognized under Unlawful Activities (Prevention) Amendment Act, 2008 or any other related and
applicable national or state legislation formulated to combat unlawful and terrorist activities in the nation for the time being in force, committed for
political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public or any section of the
public in fear for such purposes.
This cover also includes loss, damage, cost or expense directly caused by, resulting from or in connection with any action taken in
suppressing, controlling, preventing or minimizing the consequences of an act of terrorism by the duly empowered government or Military
Authority.
Provided that If the Insured is eligible for indemnity under any government compensation plan or other similar scheme in respect of the damage
described above, this Policy shall be excess of any recovery due from such plan or scheme.
For the purpose of the aforesaid inclusion clause, "Military Authority" shall mean armed forces, para military forces, police or any other
authority constituted by the government for maintaining law and order.
LOSSES EXCLUDED
This cover shall not indemnify loss of or damage to property caused by any or all of the following:-
1. loss by seizure or legal or illegal occupation;
2. loss or damage caused by:
(i) voluntary abandonment or vacation,

(ii) confiscation, commandeering, nationalisation, requisition, detention, embargo, quarantine, or any result of any order of public or
government authority, which deprives the Insured of the use or value of its property;
3. loss or damage arising from acts of contraband or illegal transportation or illegal trade;
4. loss or damage directly or indirectly arising from or in consequence of the seepage and or discharge of pollutants or contaminants, which
pollutants and contaminants shall include but not be limited to any solid, liquid, gaseous or thermal irritant, contaminant or toxic or hazardous
substance or any substance the presence, existence or release of which endangers or threatens to endanger the health, safety or welfare
of persons or the environment;
5. loss or damage arising directly or indirectly from or in consequence of chemical or biological emission, release, discharge, dispersal or
escape or chemical or biological exposure of any kind;
6. loss or damage arising directly or indirectly from or in consequence of asbestos emission, release, discharge, dispersal or escape or
asbestos exposure of any kind;
7. any fine, levy, duty, interest or penalty or cost or compensation/damages and/or other assessment which is incurred by the Insured or which
is imposed by any court, government agency, public or civil authority or any other person;
8. loss or damage by electronic means including but not limited to computer hacking or the introduction of any form of computer virus or
corrupting or unauthorised instructions or code or the use of any electromagnetic weapon. This exclusion shall not operate to exclude losses
(which would otherwise be covered under this Policy) arising from the use of any computer, computer system or computer software
programme or any other electronic system in the launch and/or guidance system and/or firing mechanism of any weapon or missile;
9. loss or damage caused by vandals or other persons acting maliciously or by way of protest or strikes, labour unrest, riots or civil commotion;
10. loss or increased cost occasioned by any public or government or local or civil authority’s enforcement of any ordinance or law regulating the
reconstruction, repair or demolition of any property insured hereunder;
11. any consequential loss or damage, loss of use, delay or loss of markets, loss of income, depreciation, reduction in functionality, or increased
cost of working;
12. loss or damage caused by factors including but not limited to cessation, fluctuation or variation in, or insufficiency of, water, gas or electricity
supplies and telecommunications or any type of service;
13. loss or increased cost as a result of threat or hoax;
14. loss or damage caused by or arising out of burglary, house - breaking, looting, theft, larceny or any such attempt or any omission of any kind
of any person (whether or not such act is committed in the course of a disturbance of public peace) in any action taken in respect of an act
of terrorism;
15. loss or damage caused by mysterious disappearance or unexplained loss;

16. loss or damage directly or indirectly caused by mould, mildew, fungus, spores or other micro-organism of any type, nature or description,
including but not limited to any substance whose presence poses an actual or potential threat to human health;
17. total or partial cessation of work or the retardation or interruption or cessation of any process or operations or omissions of any kind.
LIMIT OF INDEMNITY
The limit of indemnity under this cover shall not exceed the Total Sum Insured given in the Policy Schedule or INR 20,000,000,000 whichever is
lower. In respect of several insurance policies within the same compound/location with one or different insurers, the maximum aggregate loss
payable per compound/location and /or arising out of single event by any one or all insurers shall be INR 20,000,000,000. If the actual aggregate
loss suffered at one compound/location and/or arising out of single event is more than INR 20,000,000,000 the amounts payable under individual
policies shall be reduced in proportion to the sum insured of the policies.
EXCESS
1% of the claim amount for each and every claim subject to Minimum of INR 10,000 and Maximum of INR 500,000
CANCELLATION CLAUSE
Notwithstanding the cancellation provisions relating to the basic insurance policy on which this endorsement is issued, there shall be no refund
of premium allowed for cancellation of the Terrorism risk insurance during the period of insurance except where such cancellation is done along
with the cancellation of the basic insurance. Where a policy is cancelled and rewritten mid-term purely for the purpose of coinciding with the
accounting year of the insured, pro-rate refund of the cancelled policy premium will be allowed.
If the cancellation is for any other purpose, refund of premium will only be allowed after charging short term scale rates.
Note: The definitions, terms and conditions of main Policy save as modified or endorsed herein shall apply.
SANCTION LIMITATION AND EXCLUSION CLAUSE

No (re)insurer shall be deemed to provide cover and no (re)insurer shall be liable to pay any claim or provide any benefit hereunder to the extent
that the provision of such cover, payment of such claim or provision of such benefit would expose that (re)insurer to any sanction, prohibition or
restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union, United Kingdom or
United States of America
Subject to terms, conditions, endorsements attached with the policy.
For Tata AIG general Insurance Company Limited
Authorized Signatory.
Note: This Schedule, the attached Policy wordings and Endorsements mentioned here in 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 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.


Process Deep Link Request

Uploaded by

Copyright:

Available Formats

Process Deep Link Request

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Process Deep Link Request

Uploaded by

Copyright:

Available Formats

New Business-SpeedPost-EM019527805IN-353614

Master Policy No : 1901806663 Date : 06-Jul-2022

Dear ARTI SHARMA .,

We always assure you of our best services.

For Tata AIG General Insurance Company Limited

TATA AIG General Insurance Company Limited.

Policy Issuing Office Address & Code : ALLAHABAD,90927

Intermediary Name : AXIS BANK LTD

Phone No : Mobile : 8545967649, Landline :

Correspondence H NO 105 A/4A MEERA PATTI Email id : [email protected]

Place of Supply : UTTAR PRADESH

Additional Insured ,ARTI SHARMA.

Nomination : Nominee Name : PRATISHTHA SHARMA

If Yes, Name of AXIS BANK LTD LAN number :PHR028607664022

RISK LOCATION DETAILS :

TATA AIG General Insurance Company Limited.

Special Conditions / Clause :

For Tata AIG General Insurance Company Ltd.

Policy Servicing Office

TATA AIG General Insurance Company Limited.

TATA AIG General Insurance Company Limited.

Receipt No : 109271032202985 Receipt Date : 02/07/2022

GSTIN: 09AABCT3518Q1ZU - UTTAR PRADESH Service Accounting Code: 997139

TATA AIG General Insurance Company Limited.

TRANSCRIPT OF PROPOSAL FORM

Policy Issuing Office Address & Code : ALLAHABAD,90927

A. Details about Proposer and Policy Period :

1. Name of Proposer ARTI SHARMA .

2. Address of Proposer : H NO 105 A/4A MEERA PATTI

5. Policy to be issued in favor of (list

7. Nomination : Nominee Name : PRATISHTHA SHARMA

Cover Please tick

TATA AIG General Insurance Company Limited.

C. Location of Home Building

11. Is it in a multi-storey building or is it a standalone Standalone

12. In case of multi-storey building, please provide the

D. Details of Home Building

14.Sum Insured (SI) for Home Building:

b. SI for additional structures (in INR):

15. Carpet area of structure of Home in square metres : 88.3312square metres

Less than 5 Years No

TATA AIG General Insurance Company Limited.

E. Details of Home Contents

Items Sum Insured

F . In-Built Covers (Loss of Rent & Rent for Alternative Accomodation)

Loss of Rent Yes

i. Sum Insured: 2,400,000

G. Optional Covers (available on payment of additional premium)

TATA AIG General Insurance Company Limited.

Valuation certificate attached : No

Mode of Payment Direct Debit

Place : ALLAHABAD Signature of Proposer

INSURANCE ACT 1938 SECTION 41- Prohibition of Rebates

TATA AIG General Insurance Company Limited.

Standard Special Clause

TATA AIG General Insurance Company Limited.

2. loss or damage caused by:

(i) voluntary abandonment or vacation,

TATA AIG General Insurance Company Limited.