Dear MR.

MOHAMMED YASEEN,
Welcome to the world of Aditya Birla Capital!
We thank you for the trust you have shown by making us your preferred choice for your protecting needs. It͛s our pleasure to have you
as a valued customer. Aditya Birla Capital͛s protecting solutions enable you to protect against risks to you and your vehicle.

In case of any unforeseen event of a claim, just inform the customer care centre of the insurance company and visit the nearest
preferred workshop and they will ensure fast and hassle-free cash-less claim settlements across the country in preferred garages.
Admission and settlement of claim is at the sole discretion of the insurance company.
Enclosed herewith are the following:

‡ A Policy Schedule cum Certificate of Insurance, containing details of your vehicle insurance cover and premium calculation
‡ Summary of policy terms & conditions.

We hope that you were satisfied with all the insurance company options that were presented to you by your dealer and policy was
issued as per your choice of insurer.
Meeting your life͛s money needs
Our purpose at Aditya Birla Capital is to make money matters simpler to understand to help you live the life you imagined. Therefore, all
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rely on to understand and meet all your money needs throughout your life.

While you have availed our Protecting solution through, Aditya Birla Capital also offers to help you in Investing prudently for your future
to enable you to live the life you aspire. Financing your life͛s immediate desires and fueling your ambitions without having to wait and in
Advising the right solutions for your needs throughout your life.
We assure you of the best customer service always.
Looking forward to a long and successful journey ahead!

Yours sincerely,

Aditya Birla Insurance Brokers Limited

 ICICI Lombard General Insurance Co. Ltd.
BUNDLED - TWO WHEELER POLICY (Product Code: 3005)
(FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)
UIN No : IRDAN115RP0019V01202122

Policy No. 3005/A4-18948869/00/000 Policy Type : N Proposal No. & Date PR446401, 19 Feb 2024
Policy Issued On 19 Feb 2024 12:25PM Period of Own Damage Cover 19 Feb 2024 12:26PM to 18 Feb 2025 11:59PM(Midnight) - 1 Year
Insured Name MR. MOHAMMED YASEEN Period of Liability Cover 19 Feb 2024 12:26PM to 18 Feb 2029 11:59PM(Midnight) - 5 Years
BOUGE ATHIRIGE SEDIVALU MINICOY, MINICOY ,
Insured Add. LAKSHADWEEP-682559 Period of PA Cover 19 Feb 2024 12:26PM to 18 Feb 2025 11:59PM(Midnight) - 1 Year
GSTIN No:
Previous Insurer / Previous NA / NA
Invoice Date 15 Feb 2024
Policy No.
PAN: Service Tax Code No: AAACI7904G
Servicing Office of
Third Floor, Kannankeri Estate, Shanmugham Road, Cochin Kerala 682031, COCHIN , KERALA-682031,GSTIN No:32AAACI7904G1ZW(STATECODE:32)
Insurer:
INSURED MOTOR VEHICLE DETAILS INSURED DECLARED VALUE (IDV) (in Rs.)
Make ATHER Vehicle IDV 148462
Model-Variant 450S Non-Elec. Accessories 0
Registration No.-RTO LD01- LAKSHADWEEP Elec. Accessories 0
Mfg Year-Body Type 2024- SCOOTER Total IDV
148462
Engine -Chassis No. ABBRX172374- MYHAACDA6RBB14414
KW-Seating capacity 5.40- 2 Fuel Type : ELECTRIC
Schedule of Premium (Amount in Rs.)
Own Damage Premium (A)
Basic Premium Amount(Rs) Deductibles Amount(Rs)
Vehicle 1,992 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
Sub Total (Basic Premium) 1,992 No Claim Bonus (0%) 0
IMT-33 0 Sub Total (Deductibles) 0
Geographical Area Extension (IMT-1) 0 Net Own Damage Premium (A) 2,661
Add On Coverages (NIL DEP) 669
Liability Premium (B)
Third Party Liability PA Cover and Legal Liability
Basic Third Party Liability (Including TPPD) 3,273 PA Cover For Owner Driver for Rs.1500000 Lakhs (IMT-15) 450
Third Party Liability For Geographical Area Extension 0 PA Cover ( 0 Per Person) for 0 Persons(IMT-16) 0
Sub Total (Third Party Liability) 3,273 PA Cover For Paid Driver Of Rs.1 Lakh(IMT-17) 0
Legal Liability For Paid Driver (IMT - 28) 0
Legal Liability For Employees For 0 Person(IMT-29) 0
Sub Total (PA Cover) 450
Net Liability Premium (B) 3,723
Total Premium (A+B) 6,384
IGST(18%) 1150

Gross Premium Paid 7,534

Addon UIN: Zero Depreciation - IRDAN115RP0007V01201819/A0030V01201819
We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than the aggregate turnover notified under sub-rule (4) of rule 48, we are not required to prepare an invoice in terms
of the provisions of the said sub-rule.
Note: 1.Policy issuance is subject to realization of cheque 2.Consolidated stamp duty paid to state exchequer. 3.The policy is subject to compulsory deductible of Rs.100 (IMT-22).4.Geographical Area-India.5.The insurance company
will display terms & conditions on its website 5.Consolidated Stamp duty Paid vide Letter of Authorization No CSD6920232872 dated on 14-06-2023 at General Stamp Office, Mumbai.** Not Applicable for the State of Jammu &
Kashmir www.icicilombard.com which can be accessed by you online. *Subject to IMT Endt. Nos.& Memorandum:15,22
Tenure 19 Feb 2024 to 18 Feb 2025 - - - -
Total IDV 148,462 0 0 0 0
Nominee Name SUHAIMA MANIKA Age 29 Relation SPOUSE

Limitations as to use: The policy covers use of the vehicle for any purpose other than (1) Hire or Reward (2) Carriage of goods (other than samples or personal luggage) (3) Organized racing
(4) Pace making (5) Speed testing (6) Reliability trials (7) Any purpose in connection with motor trade.
Driver¶s Clause: 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 also that the person holding an effective learner¶s license may also drive the vehicle & that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules,
1989.
Limits of Liability Clause: Under Section II-1(i) of the policy-Death of or bodily injury: Such amount as is necessary to meet the requirements of the Motor Vehicle Act 1988.Under Section II-1 (ii)
of the policy-Damage to third party property is Rs.1 lakhs PA Cover Under Section III for Owner-Driver for Rs.1500000 Lakhs
No Claim Bonus: 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 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.
Hypothecation Details: ----NA----
POSP Name : Aadhar Card Number : License Number :
MISP Code : AB-MRT000083 MISP Name : PALAL MOBILITY PRIVATE LIMITED DP Name : JEWEL ROSE P JACOB DP CODE : AB-DPRT000059 Aadhar Card Number :
********3171
Important Notice: 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 in order to comply with the Motor Vehicle Act, 1988 is recoverable from the insured. See the clause headed ³AVOIDANCE OF CERTAIN TERMS & RIGHT OF
RECOVERY´For legal interpretation, English version will hold good.
Grievance Clause:For resolution of any query or grievance you may contact us on our toll free no. 1800 2666, or visit any of our branch offices. You can also write to us at
[email protected]. For detailed grievance redressal mechanism please visit the Grievance Redressal section on our website www.icicilombard.com.
Registered and Corporate address Office: ICICI Lombard House, 414, Veer Savarkar Marg, Prabhadevi, MUMBAI, MAHARASHTRA - 400025

CIN No.:l67200MH2000PLC129408
HSN : 997134,Description of Service : Motor Insurance,Place of Supply : Third Floor, Kannankeri Estate, Shanmugham Road, Cochin Kerala 682031, COCHIN , KERALA-
682031,GSTIN:32AAACI7904G1ZW(State Code :32),Invoice Number : 180224209305
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 ICICI Lombard General Insurance Co. Ltd.

Authorized Signatory
Broker's Name & Add. :Aditya Birla Insurance Brokers Limited,, IRDA License Number 146, Broker Code :10000001926
Insurer's IRDA Registration Number-::115
For Renewal/Claims Assistance - Please contact Insurance.Co. on 18002666

Natural Calamities: Fire, explosion, self ignition or lightning, earthquake, In the case of painting, the depreciation rate of 50% shall be applied only on the
flood, typhoon, hurricane, storm, material cost of total painting charges.

tempest, inundation, cyclone, hailstorm, frost, landslide, rockslide.

In the case of a consolidated bill for painting charges, the material component shall be
Man-made Calamities: considered as 25% of total painting charges for the purpose of applying the
- Burglary, theft, riot, strike, malicious act, accident by external means, terrorist depreciation.(Applicable for policies with risk inception date on or after 1st February
activity, any damage in transit by road, rail, inland waterway, lift, elevator or air, 2013).
etc. For all other parts depreciation rate is applicable as following:

-Personal Accident cover for individual owners of the vehicle while driving. Age of the vehicle % of Depreciation

- Legal Liability due to accidental damage for any permanent injury/death of a person. Not exceeding 6 months Nil

- Personal Accident cover for individual owners of the vehicle while driving.
Exceeding 6 months but not exceeding 1 year 5%

- Any damage caused to the property

- Towing charges up to Rs.300 Exceeding 1 year but not exceeding 2 years 10%

Optional Extensions Exceeding 2 years but not exceeding 3 years 15%

- Loss of Electrical/Non-Electrical accessories

Exceeding 3 years but not exceeding 4 years 25%
- Legal Liability to paid driver, cleaner or any workman
- Personal Accident cover for the occupants
Exceeding 4 years but not exceeding 5 years 35%

Other Salient Features

Exceeding 5 years but not exceeding 10 years 40%

- No Claim Bonus available on subsequent renewals in lieu of claims free

experience Exceeding 10 years 50%

- Discount for opting higher voluntary excess Add On Cover

- Discount for installation of approved anti-theft devices If opted, the benefits and exclusions applicable as per insurance company's rules &
- Discount for AAI membership regulations.
- Depreciation is applicable - No depreciation charges to the customer if the vehicle is repaired at authorized
for the parts needing replacement in accident garages
Nil depreciation on metal parts
What is not covered in the Policy? Nil depreciations on plastic parts (other insurance companies plastic parts attracts
- Mechanical/Electrical breakdown, manufacturing defect 50% depreciation)
- Consequential loss, depreciation, wear & tear - This cover is available only at time of purchase & cannot be incorporated in the
- Any contractual liability middle of the year
- Intoxicated driving - In the event of complete loss of the insured vehicle (Constructive Total Loss or
- Deliberate accidental loss Total Loss), no payment shall be made under this add-on.
- Damages due to nuclear weapons material or war - For any claim to become payable under this cover, it should be admitted under
- Accidents outside the Geographical Area Section I ±"Loss or damage to the vehicle insured" of motor comprehensive policy
- Policy Excess - Normal wear and tear not included in this cover.
- Premium rate depends on vehicle model, territory & age of vehicle
Schedule of Depreciation
Schedule of depreciation for fixing IDV of the vehicle

This will not include any penalties, charges, fees levied by the financier. For any claim
Age of the vehicle % of Depreciation to be payable under this cover, it should be admitted under

Section I ±³Loss or damage to the vehicle insured³of motor comprehensive policy.

Not exceeding 6 months 5%

Note: If Add-on covers have been opted for in the policy, a maximum of two claims
Exceeding 6 months but not exceeding 1 year 15% will be processed for benefits accruing out of the add-on covers.
Subsequent claims in the policy period will be processed as per the normal insurance
Exceeding 1 year but not exceeding 2 years 20% covers without the add-on benefits.

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%