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CERTIFICATE CUM POLICY SCHEDULE : Private Car Package Policy

Page 1 of 2

United India Insurance Company Limited

Head Office:24, Whites Road,Chennai-600 014

Website:www.uiic.co.in

Private Car Package Policy CERTIFICATE CUM POLICY SCHEDULE

Certificate cum Policy No: 02090031120110050812

 

 

 

 

 

 

 

 

 

Divisional Office - 9,Rohit Chambers, 5th Floor, Janmbhoomi

Policy Issuing Office Code

20900

Policy Issuing Office Address

 

Marg, Fort Mumbai Mumbai Maharashtra-400001 Telephone :

 

 

 

 

 

 

 

 

 

22838778

 

 

 

Broker Code

 

88888275

Broker Name

 

 

 

TATA MOTORS INSURANCE BROKING & ADVISORY

 

 

 

 

SERVICES LTD.

 

 

 

 

 

 

 

 

 

 

 

 

 

Broker Telephone No

91332345676

Intermediary Code

 

 

200147143882

 

 

Period of Insurance

From 11:59

31/01/2013 To

30/01/2014 Midnight

RTO Location

NALAGARH

 

 

Insured Name

 

SH PARAMJIT SINGH

 

 

 

 

Policy Issued On

31/01/2013

 

 

 

 

S/O SH BABU SINGH, WARD NO-1, NALAGARH

 

 

 

 

 

 

Insured Address

 

DISTT,SOLAN,SOLAN,HIMACHAL PRADESH, PIN -

 

 

 

 

 

 

 

 

174101 , Mobile - 9816021590

 

 

 

 

 

 

 

 

 

Insured E-mail Id:

 

 

 

 

 

 

 

 

 

 

 

 

 

Nominee Name

 

MRS JASWANT KAUR

Nominee Age 31

 

Nominee Relationship Wife

 

 

Previous Insurer Name

UIIC

 

 

 

 

 

Previous Policy

02090031110110059086

 

 

 

 

 

 

Number

 

 

Date Of Expiry of Previous

 

 

 

 

 

 

 

 

 

 

27/01/2013

 

 

 

 

 

 

 

 

 

 

 

Policy

 

 

 

 

 

 

 

 

 

 

 

 

 

STATE BANK OF PATIALA

NALAGARH

 

 

 

 

 

 

 

Hypothecated With

 

 

 

 

 

 

 

Registration

Trailer

 

 

Type of

Built

 

Additional

Mfg

Seating

 

Trailer

 

Registration

Make

Model

CC GVW

Chassis Number

Chassis

Engine Number

Number

body

Type

GVW

Year

Capacity

 

Number

 

 

 

 

 

 

 

 

 

 

Number

 

HP-12-D-6660

NA

TATA

INDIGO CS

Sedan

NA

1405 1515

0

 

2011

5

MAT607161BPA08826.

NA

475IDT14AYYP02488.

MOTORS

LX

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle's Ex-

 

Non-

Showroom

Trailer

Electrical

Price IDV

 

Accessories

344875

0

0

A: OD BASIC

ADD : Electrical Acccessories IMT 24 Premium For CNG Kit IMT 25 Premium For LPG Kit

Premium For Trailer Fibre Glass Tank

Reliability Trials And Rallies Break in loading Geographical Extention Imt 1 For Embassy Vehicles IMT 19 ADD : Driving Tution

Less : Discount For Anti Theft Device IMT 10

Handicapped Discount IMT 12

Less : Voluntary Excess (IMT-22A) Less : For Auto Association membership IMT 8

Less : Other Discounts

Less : Limited To Own Premises IMT 13

Deduct NCB(-25.00%)

Gross (A) :

Electrical/Electronic

CNG/LPG

Retrofittings

Total Value

 

Accessories

Unit

 

 

 

 

0

0

0

344,875.00

 

 

11,005.00

 

B: TP BASIC

925.00

 

0.00

 

ADD : Premium For Trailer

0.00

 

0.00

 

ADD : Premium For CNG Unit

0.00

 

0.00

 

ADD : Premium For LPG Unit

0.00

 

0.00

 

PA to Name Persons

0.00

 

0.00

 

PA To Unnamed Passengers

0.00

 

0.00

 

 

 

 

 

 

0.00

 

PA - Owner

100.00

 

0.00

 

WC To Employee

0.00

 

0.00

 

Geographical Extention

0.00

 

0.00

 

For Soldier Accident

0.00

 

0.00

 

Paid Driver

50.00

 

0.00

 

PA Cover For Paid Drivers, Cleaners

0.00

 

 

And Conductors(IMT-17)

 

 

 

 

 

0.00

 

Employees Of Insured

0.00

 

0.00

 

 

 

 

2,064.00

 

 

 

 

0.00

 

 

 

 

2,751.25

 

 

 

 

6,190.00

 

Gross (B) :

1,075.00

Gross OD & TP :

7,265.00

 

 

Stamp Duty :

.50

Net Premium :

7,265.00

Service tax :

898.00

Net Amount payable

8,163.00

Geographical Area : India

Compulsory deductibles : 1,000.00

Imposed Excess

: 0.00

 

 

LIMITS OF LIABILITY :

 

 

 

 

 

(a)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 Vehicles Act, 1988.

(b)Under Section II - 1 (ii) of the policy -> Damage to property other than property belonging to the insured or held in trust or in custody of control of the insured upto the limit specified Rs. 7.5 Lakhs instead of Damage to Third Party Property rs. 750,000.00 ; PA Cover for Owner-Driver under section III: CSI Rs 2,00,000.00 ; Voluntary Deductable Rs. 0.00 LIMITATIONS AS TO USE: The policy covers use of the vehicle for any purpose other than : Hire or reward, Carriage of goods(other than samples or personal luggage), Organized racing, Pace making, Speed testing, Reliability trials,Any purpose in connection with Motor Trade.

DRIVER'S CLAUSES: Any person including the insured : Provided that a person driving holds an effective Driving License at the time of the accident and is not disqualified from holding or obtaining such a license. Provided also that the person holding an effective Learner's License may also drive the vehicle and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989.

Subject to IMT Endorsement Nos. & Memorandum printed herein / attached hereto : 7,22,28 Under Hire Purchase/Hypothecation/Lease Agreement with : STATE BANK OF PATIALA

Premium Collection Details :- [Collection No / Amount / ReceiptDate] 1001326384 / Rs.8,163.00 / 31/01/2013

Received with thanks from SH PARAMJIT SINGH an amount of Rs. 8,163.00 towards Insurance Premium. Consolidated Stamp Duty Paid.

WARNING THAT IN CASE OF DISHONOUR OF THE PREMIUM CHEQUE , THIS DOCUMENT STANDS AUTOMATICALLY CANCELLED 'AB-INITIO'

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CERTIFICATE CUM POLICY SCHEDULE : Private Car Package Policy

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I/We hereby certify that the policy to which the certificate relates as well as the certificate of insurance are issued in accordance with

For United India Insurance Company Limited

the provision of chapter X,XI of M.V.Act 1988

 

 

Service Tax Registration No. :

AAACU5552CST001

 

Insurance Company PAN No. :

 

 

Service Tax Code Number :

 

 

Category :

 

Duly Constituted Attorney(s)

Stampduty Challan No. :

 

 

Dealer Name: J P MOTORS

 

 

. In Witness whereof this Policy has been signed at SOLAN this

31day of January of 2013 , 12:05:51 PM.

 

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 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 AND RIGHT OF RECOVERY". For legal interpretation,English version will hold good

Please call Toll Free No. 1800 209 7979 for all Insurance Related Assistance

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