Insurance
Insurance
Insurance
by:Kishore
Mukul
Date:2013.08.
04
Premium Schedule
Own Damage Liability
Basic OD 5,198.00 Basic Liability 941.00
Basic Own Damage Premium 5,198.00 Basic Liability Premium 941.00
Deduct 45% for NCB - PA Benifits
2,339.2
4
TOTAL OWN DAMAGE PREMIUM 2,859.07 Compulsory PA cover to Owner Driver of CSI 200000(IMT-15) 100.00
Total PA Premium 100.00
Legal Liability
Total Liability Premium 1,041.00
Subject to I.M.T. Endt.Nos. & Memorandum printed/herein/attached hereto. IMT22,15 Service Tax Reg.No. AABCR6747BST001
Category-General Insurance Business Service 00440005
The policy has been issued based on the information provided by you and the policy is not valid if any of the information provided is incorrect. Subject otherwise the terms, conditions and
exclusions of the Reliance Private Car Package Policy. In Witness whereof this Policy has been signed at Mumbai on 04/08/2013 in lieu of Cover Note No. 040813701642 dated
04/08/2013
In the unfortunate event of a claim, Please call along with your Policy No.on 1800 103 1999 (toll free) or 022 41112600 (Standard STD Rates Apply) and register your
claim immediately within 7 days from the date of loss. For Customer service, Please call along with your Policy No. on 1800 300 28282(toll free) or 39898282 (local
charges apply)|www.reliancegeneral.co.in
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 of wider terms appealing in the Certificate in order to comply with the Motor Vehicle Act, 1988 is For Reliance General Insurance Co. Ltd.
recoverable from the Insured.See the clause headed 'AVOIDANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY'. For legal
interpretation,English version will hold good.NOTE: Kindly acknowledge receipt of this policy. In case you find any variations against your
proposal or anydiscrepancy in the policy,kindly contact us immediately
Policy servicing office : Reliance General Insurance Co Ltd 570- Rectifier House, Naigaum Cross Road.Wadala(W).,Mumbai, MAHARASHTRA,India - 400031
Registered Office:
Reliance Centre, 19, Walchand Hirachand Marg,Ballard Estate ,Mumbai -
400 001
Some Important Insurance Terms for your understanding of the Motor Insurance Cover
Major Exclusions:
Every Insurance policy has certain areas which are excluded. Major exclusion under this policy are: Consequential loss, depreciation, normal wear and tear,
mechanical or electrical breakdown failures or breakages. Vehicles insured under Private Car category is not covered if used for commercial purposes or if
driven by an unauthorized driver.
Note: The above exclusions are indicative. For complete details, please refer to the policy wordings on our website www.reliancegeneral.co.in.
Insurance being a contract of Utmost Good Faith requires the customer to disclose all information correctly. If you feel any information is not captured
correctly or is incomplete, we request you to approach us.
Registered Office:
Reliance Centre, 19, Walchand Hirachand Marg,Ballard Estate ,Mumbai -
400 001
Dear Mr. Arunav Talukdar
We thank you for placing your trust with Reliance General Insurance
Proposed by you
This Policy has been issued on the basis of the information provided by you during the transaction. The information has been
captured by the system as ONLINE PROPOSAL FORM for future reference. Given here below is an extract of the same for your records
and reference.
* Against this discount you have accepted an additional voluntary deductible of Rs 0 against each claim
(VIl) PA to Owner Driver - Nominee Details
Nominee Name : MONMI BHARALI TALUKDAR Nominee Relationship with Owner Driver : SPOUSE
Nominee Age : 30 Nominee Address : 4/19, Ground Floor Old Double Storey
Lajpat Nagar-IV DELHI North West Delhi
110024
(VlIl) Payment Details
Payment Mode : Online Bank Name :
Premium Amount : Rs 4382 Amount in Words : Rupees Four Thousand Three Hundred Eighty Two
Registered Office:
Reliance Centre, 19, Walchand Hirachand Marg,Ballard Estate ,Mumbai -
400 001
Declaration
I agree that the insurance benefit available to me shall become voidable in the event of any untrue or incorrect statement,
misrepresentation,
non-description or non-disclosure in any particulars in the application form / personal statement, declaration and connected documents
or any material information has been withheld by me or anyone acting on my behalf to obtain insurance benefit. I hereby declare that I
am not aware of any neglect and omission or error or existence of any circumstances likely to give rise to a claim thereof. I hereby
declare, incase of false declaration the Insurance Company shall have the right to cancel the policy. The insurance company shall have
the right to change the premium and conditions agreed to subject to such terms and conditions as has been communicated to me. I
hereby agree that my enrollment for insurance would be at the sole discretion of the insurance company. I declare and warrant that the
information I have given in this online form will be considered as the proposal form in relation to myself (or other person or categories
of persons to be insured) and any documentation of information accompanying it or arising out of the answers I have given is complete
and accurate in all respects. I understand and agree that this online form and other information and documentation I have given or will
give, relating to myself or any other person to be insured, will be the basis of any insurance that you may issue, and I also understand
the consequences of any default. I further understand that the coverage offered is subject to realization of premium payment.
Online Transaction Facility - Terms and Conditions:
I have read and understood the terms and conditions governing the Online Transaction Facility of Reliance General Insurance Company
Ltd. I have also read and understood the salient, features, terms and conditions of the policy as stated in the brochure.
Insured Name : Mr. Arunav Talukdar Date : 04/08/2013
•
The information that you give to Reliance General Insurance on this online form will be treated as the proposal form and
details in any supplemental information form or documentation supplied by you or on your behalf will influence our decision
to offer insurance and the terms upon which to offer it. Further, any policy we issue will be based on what you have told us.
It is therefore important that your answers are complete and accurate in all respect.
•
The questions in this online form are indicative rather than exhaustive. You must provide us with all information relevant to the
risk to be insured, even if it is not the subject of a question in this online form. If you are in any doubt as to what information
should be given, please email us at [email protected]. Any failure to provide us with full and accurate material
information may mean that your policy can be declared as void.
•
No insurance cover will be in force until we have approved it and the premium has been paid.
Statutory Warning - PROHIBITION OF REBATES (Under Section 41 of Insurance Act 1938)
•
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 or
continuing a policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectuses 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 five hundred rupees.
Yours truly
Authorized Signatory
For Reliance General Insurance Co ltd
Registered Office:
Reliance Centre, 19, Walchand Hirachand Marg,Ballard Estate ,Mumbai -
400 001