Tata AIG Motor Policy Schedule - 3184 - 6201037511-01
Tata AIG Motor Policy Schedule - 3184 - 6201037511-01
Addr e ss : VI LL -N AR I R GI R POST-AM ODE L TH AN A R AM GAR H WA, - 8 45433, M ake /M ode l : TATA M OTOR S / PUN CH
BI H AR ,
Var i an t : CR E ATI VE M T
I N DI A
F u e l Type : PE TR OL
Pe r i od of I n su r an ce OD cove r pe r i od : 19 Jan '24(15:40 H r s) to 18 Jan
'25(M i dn i gh t) E n gi n e N u mbe r /Batte r y N u mbe r : R E VTR N 10AXXM 00352 /
Pol i cy I ssu an ce Date : 19 Jan '24 Ch assi s n u mbe r : M AT634013N PAF 2072
Zon e : B
N on E l e ctr i cal
E l e ctr i cal Acce ssor i e s
Ve h i cl e I DV (₹ ) Acce ssor i e s - Ve h i cl e Bi -F u e l /CN G/LPG K i t (₹ ) Tr ai l e r /Si de car I DV (₹ ) Total I DV (₹ )
(₹ )
I DV (₹ )
770,200 0 0 0 0 770,200
Aut o Se cure - St andalo ne Own Dam age
Privat e Car Po licy
Schedule o f Premium
Own Dam age Pre m ium on Ve hicle & Acce ssorie s Se cti on I Add On Cove r s
(Add) De pr e ci ati on R e i mbu r se me n t (TA 01) ₹ 4,236.10
Basi c Own Damage
₹ 9,8 30.8 3 (Add) Loss of pe r son al be l on gi n gs (TA 09) ₹ 18 0.00
Pr e mi u m on Ve h i cl e an d n on e l e ctr i cal acce ssor i e s
Su m I n su r e d: 10000
Ge ogr aph i cal Ar e a E xte n si on (I M T 01) ₹ 400.00
(Add) E me r ge n cy tr an spor t an d h ote l e xpe n se s (TA 10) ₹ 18 0.00
Di scou n ts u n de r Own Damage Se cti on An y On e Acci de n t :5000
Le ss : (25%) for N CB ₹ 2,557.71 An y On e Ye ar :10000
Total Own Damage Pr e mi u m (A) ₹ 7,673.12 (Add) K e y R e pl ace me n t (TA 15) ₹ 425.00
Su m I n su r e d: 25000pe r occu r r e n ce l i mi t 50% of SI
N e t Pr e mi u m (A+C) ₹ 16,006.00
Agent Name : GUDIYA KUMARI Agent License code : POSPKEJPK1071L Agent Contact Number : 7033308515 (or
Landline)
POSP De tai l s : N ame -N A Code -N A PAN N o -K E JPK 1071L Aadh ar car d -N A Con tact N o -N A
D rive rs Claus e : Pe r son s or cl asse s of pe r son s e n ti tl e d to dr i ve : An y pe r son i n cl u di n g th e i n su r e d. Pr ovi de d th at a pe r son dr i vi n g h ol ds an e ffe cti ve
dr i vi n g l i ce n se at th e ti me of th e acci de n t an d i s n ot di squ al i fi e d fr om h ol di n g or obtai n i n g su ch a l i ce n se . Pr ovi de d al so th at th e pe r son h ol di n g an
e ffe cti ve Le ar n e r 's Li ce n se may al so dr i ve th e ve h i cl e an d th at su ch a pe r son sati sfi e s th e r e qu i r e me n ts of R u l e 3 of th e Ce n tr al M otor Ve h i cl e s R u l e s,
198 9.
Limitatio ns as to us e : Th e Pol i cy cove r s u se of th e ve h i cl e for an y pu r pose oth e r th an : a) H i r e or R e war d oth e r th an for th e pu r pose of dr i vi n g tu i ti on s b)
Car r i age of goods (oth e r th an sampl e s or pe r son al l u ggage ) c) Or gan i z e d r aci n g d) Pace M aki n g e ) Spe e d te sti n g f) R e l i abi l i ty Tr i al s g) An y pu r pose i n
con n e cti on wi th M otor Tr ade
Warrante d that th e i n su r e d n ame d h e r e i n /own e r of th e ve h i cl e h ol ds a val i d Pol l u ti on Un de r Con tr ol (PUC) Ce r ti fi cate , as appl i cabl e , on th e date of
comme n ce me n t of th e Pol i cy an d u n de r take s to r e n e w an d mai n tai n a val i d an d e ffe cti ve PUC an d/or fi tn e ss Ce r ti fi tate , as appl i cabl e , du r i n g th e
su bsi ste n ce of th e Pol i cy.
N o mine e de tails :
N ame o f the N o mine e : N A N omi n e e Age : N A R e l ati on sh i p of th e N omi n e e wi th th e I n su r e d : N A
N u mbe r of cl ai ms cove r e d u n de r De pr e ci ati on R e i mbu r se me n t Cove r : 2 Basi s of cl ai m se ttl e me n t u n de r Tyr e Se cu r e Cove r : N A
Th i s Pol i cy doe s n ot cove r pr e -e xi sti n g damage s as pe r I n spe cti on Ph otogr aph s an d R e por t. I n spe cti on Le ad n o: 5237659
De du cti bl e u n de r Se cti on - I : ₹ 1000(Compu l sor y De du cti bl e ₹ 1,000, Vol u n tar y De du cti bl e : ₹ 0, I mpose d E xce ss : 0.00) F r an ch i se e : N A
D e ductible unde r Engine S e cure : 5% of cl ai m amou n t i n case of r e pai r an d 10% of cl ai m amou n t i n case of r e pl ace me n t Add- o n Co ve r : R e pai r of
Gl ass, R u bbe r & Pl asti c Par ts,De pr e ci ati on R e i mbu r se me n t,Loss of pe r son al be l on gi n gs,E me r ge n cy tr an spor t an d h ote l e xpe n se s,K e y
R e pl ace me n t,E n gi n e Se cu r e ,Con su mabl e e xpe n se s,R oad Si de Assi stan ce
N o Claim Bo nus : Th e i n su r e d i s e n ti tl e d for a N o Cl ai m Bon u s (N CB) on th e own damage se cti on of th e pol i cy, i f n o cl ai m i s made or pe n di n g du r i n g th e
pr e ce di n g ye ar (s), as fol l ows: Th e pr e ce di n g ye ar 20%, pr e ce di n g two con se cu ti ve ye ar s 25%, pr e ce di n g th r e e con se cu ti ve ye ar s 35%, pr e ce di n g fou r
con se cu ti ve ye ar s 45%, pr e ce di n g fi ve con se cu ti ve ye ar s 50% of N CB on OD Pr e mi u m. N CB wi l l on l y be al l owe d pr ovi de d th e pol i cy i s r e n e we d wi th i n 90
days of th e e xpi r y date of th e pr e vi ou s pol i cy.
Su bj e ct to: (A) I M T E n dor se me n t N o. : 01,32,22 GSTI N :10AABCT3518 Q1ZB-BI H AR Se r vi ce Accou n ti n g Code : 997134
TATA AI G Au to Se cu r e e n dor se me n t N o. (TA): 08 , 01, 09, 10, 15, 16, 18 , 19
P o licy S e rvicing Of f ice : BE TTI AH , 2N D F LOOR , K PS COM PLE X,, N E AR PAN I TAN K I CH OWK ,, BE TTI AH 8 42002 Te l . N o :
Receipt
R e ce i pt N o.: PD3000058 37121 R e ce i pt Date : 19/01/2024 Pol i cy N o.: 6201037511 01 00
Uti l i z e d fr om th e r e ce i pt
Sr . N o. Pol i cy N u mbe r M ode of Payme n t Total Pr e mi u m (₹ ) Bal an ce (₹ )
for pol i cy (₹ )
1. Pol i cy N u mbe r : 6 2 0 10 37 5 11
2. Date of e xpi r y: 16 /0 1/2 0 2 4
3. Type of cove r : S tandalo ne OD
4. N ame & addr e ss i f th e I n su r e r : T AT A AIG G EN ER AL IN S UR AN CE CO. LT D . , N A
5. Cl ai m i n Pr e vi ou s Pol i cy Pe r i od: N O
6. N CB i n pr e vi ou s pol i cy: 2 0 %
7. N CB Cl ai me d: 2 5 %
8 . Pe r i od of i n su r an ce
OD cove r pe r i od: N A(0 0 :0 0 H rs ) to N A(Midnight)
TP cove r pe r i od: 17 Jan ' 2 2 (0 0 :0 0 H rs ) to 16 Jan ' 2 5 (Midnight)
1. N ame of N omi n e e : N A
2. Age of N omi n e e : N A
3. R e l ati on sh i p: N A
4. N ame of Appoi n te e (i f N omi n e e i s mi n or ): N A
1. AR AI M e mbe r sh i p N u mbe r : N A
2. I s Vol u n tar y De du cti bl e opte d: N o
3. Amou n t of De du cti bl e opte d: N A
4. Ve h i cl e i s fi tte d wi th An ti Th e ft De vi ce appr ove d by AR AI : N o
5. Add-on Cove r s opte d: R e pair o f G las s , R ubbe r & P las tic P arts , D e pre ciatio n R e imburs e me nt, Lo s s o f pe rs o nal be lo ngings , Eme rge ncy trans po rt and
ho te l e xpe ns e s , Ke y R e place me nt, Engine S e cure , Co ns umable e xpe ns e s , R o ad S ide As s is tance
6. PUC Ce r ti fi cate N u mbe r an d PUC E xpi r y Date : N A- N A
De claration for No Claim Bonus (If NCB Confirm ation is not subm itte d but NCB claim e d)
I /We de cl ar e th at th e r ate of N CB cl ai me d by me /u s i s cor r e ct an d th at N O CLAI M h as ar i se n i n th e e xpi r i n g Pol i cy Pe r i od (Copy of Pol i cy e n cl ose d). I /We
fu r th e r u n de r take th at i f th i s de cl ar ati on i s fou n d i n cor r e ct al l be n e fi ts u n de r th e Pol i cy i n r e spe ct of Own Damage Se cti on I of th e Pol i cy wi l l stan d
for fe i te d.
I h e r e by gi ve my con se n t to r e ce i ve on e page i n su r an ce pol i cy.
AML Guide line s :
I /We h e r e by con fi r m th at al l pr e mi u ms pai d / payabl e i n fu tu r e wi l l be fr om bon afi de sou r ce s an d n ot pai d ou t of pr oce e ds of cr i me an d th at su ch
pr e mi u ms ar e n ot di spr opor ti on ate to my/ou r i n come . I / we u n de r stan d th at th e Compan y h as th e r i gh t to cal l for docu me n ts to e stabl i sh sou r ce s of
fu n ds an d to can ce l th e i n su r an ce pol i cy i n case I / we ar e fou n d gu i l ty by an y compe te n t cou r t of l aw u n de r an y of th e statu te s, di r e ctl y or i n di r e ctl y
gove r n i n g th e pr e ve n ti on of mon e y l au n de r i n g l aw i n I n di a.
I /We ar e n ot Pol i ti cal l y E xpose d Pe r son s * n or ar e th e i r cl ose r e l ati ve s / fami l y me mbe r s / associ ate s. I / we sh al l ke e p th e compan y i n for me d i f we
su bse qu e n tl y be come a Pol i ti cal l y E xpose d Pe r son / cl ose r e l ati ve / fami l y me mbe r / associ ate of Pol i ti cal l y E xpose d Pe r son s.
“Pol i ti cal l y E xpose d Pe r son s” sh al l h ave th e me an i n g assi gn e d to i t u n de r Pr e ve n ti on of M on e y-Lau n de r i n g (M ai n te n an ce of R e cor ds) Ame n dme n t R u l e s,
2023 as ame n de d fr om ti me to ti me .
Disclaimer : S AOD policy is only applicable, if you have an active third-party insurance policy of the vehicle, in place. The Coverage under this policy is only for Own Damage and no other liability in connection with the vehicle. Insurance is the subject matter of solicitation. For
more details on benefits, ex clusions, limitations, terms & conditions, please refer sales brochure/ policy wordings on www.tataaig.com carefully, before concluding a sale. Purchase of Tata AIG General Insurance Company Limited products are purely on voluntary basis. #Add
On covers can only be purchased with the base product and on payment of an additional premium.
Prohibition of R ebates - S ection 41 of Insurance Act, 1938 as amended by Insurance Laws I Amendment) Act, 2015. 1. 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, ex cept such rebate as may be
allowed in accordance with the published prospectuses or tables of the insurer. 2. Any person making default in complying with the provisions of this section shall be liable for a penalty which may ex tend to ten lakh rupees.
Grievance R edressal Procedure : As per Regulation 17 of IRDA of India (Protection of Policyholders Interests) Regulation, 2017.
S ection 6 4 VB of the Insurance Act 19 38 : Commencement of risk cover under the policy is subject to receipt of premium by Tata AIG General Insurance Company Limited.
Auto S ecure - S tandalone Own Damage Private Car Policy - UIN : IRDAN108 RP0001V01201920 • Repair of Glass, Rubber & Plastic Parts - UIN : IRDAN108 RP0001V01201920/A0007V01201920 (TA 08 ) . Depreciation Reimbursement - UIN : IRDAN108 RP0001V01201920/A0003V01201920 (TA 01)
. Loss of personal belongings - UIN : IRDAN108 RP0001V01201920/A0008 V01201920 (TA 09) . Emergency transport and hotel ex penses - UIN : IRDAN108 RP0001V01201920/A0009V01201920 (TA 10) . Key Replacement - UIN : IRDAN108 RP0001V01201920/A0010V01201920 (TA 15) . Engine S ecure
- UIN : IRDAN108 RP0001V01201920/A0012V01201920 (TA 16) . Consumable ex penses - UIN : IRDAN108 RP0001V01201920/A0014V01201920 (TA 18 ) . Road S ide Assistance - UIN : IRDAN108 RP0001V01201920/A0015V01201920 (TA 19)
Tata AIG General Insurance Company Limited
Registered Office : Peninsula Business Park, Tower A, 15th Floor, G.K. Marg, Lower Parel, Mumbai - 400013.Maharashtra, India • 24X7 Toll Free No : 18 00 266 778 0 • Email : customersupport@tataaig.com • website : www.tataaig.com • IRDA of India Registration No: 108 • CIN:
U8 5110MH2000PLC128 425
TAGIC/PS /MRPC/Jan 22/06 Ver1 /All 2536