Bharti Axa General Insurance Company Limited

1800-103-2292
customer.service@bhartiaxa.com
TN3008TW0058012 SMS<SERVICE>to 5667700
www.bharti-axagi.co.in
Smart Drive Two Wheeler Package Policy
Insured Name MR HAJANAJEMUDEEN H . Agent Name & No BHARTI AXA GENERAL INS.CO.LTD. (31003595)
Agent contact No (Office) 1800-103-2292
Address NO 11 WEST STREET
AMBAGARATHUR KARAIKAL Policy No FTW/I3980088/31/07/004497
PALLIVASAL NAGAPATTINAM
NAGAPATTINAM-609601 Policy Period July 14, 2019 0.00 to Midnight of July 13, 2020
Pondicherry
INDIA 609601 Policy Period (PA) 0.00 to Midnight of
Telephone No Mobile No 9788105465
Email Address Policy Issued On June 24, 2019
Nominee Name NA Appointee Name Covernote No
Appointee Relation RTO Location KARAIKAL
Relationship NA Age NA Hypothecated To TVS CREDIT SERVICES LIMITED
Registration No. Make/Model Type of Body CC/KW Mfg Yr Seating Capacity Chassis No. Engine No
TVS WEGO DRUM
PY02S5096 110 2018 0002 MD626DG44J1F15551 DG4FJ1723250

Additional Trailer Non Electrical Electrical/ Electronic CNG/ LPG Unit Total IDV
Vehicle IDV Side car
Accessories (`) Accessories (`) Accessories (`) (`) (`)
44,119.00 0.00 0.00 0.00 44,119.00

Premium Details
OWN DAMAGE (A) (`) LIABILITY (B) (`)
Premium on Vehicle and non Electrical Accessory 739.43 Basic Third Party Liability 752.0
Elec Accessory 0 Comp PA
CNG/LPG 0 CNG/LPG 0
AntiTheft 0 Restricted TPPD 0
Handicap 0 LL Others 0
NCB 0 Legal Liability to Paid Driver 0
Load/Discount -356.70 Unnamed PA Cover for 2 Persons each 0.00
Own premises 0 PA to paid driver 0
Voluntary Excess 0 LL to employee 0
Fibre Glass Tank 0 Geographical Area 0
IMT 23 0 Total Liability Premium (B) 752.0
Geographical Area 0 Total Package Premium (A+B) 1,135.00

GST (18%) 204.30

Total Premium Payable in Rs. 1,339.30
Total Own Damage Premium (A) 383.00
Geographical Area Applicable IMT Clauses I022 I007 I015
Compulsory Deductible INR 100.00 Voluntary Deductible 0.00
Receipt No. JB410373 Premium Amount 1,339.30

LIMITS OF LIABILITY: a) Under Section II-I(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-I(ii) of the policy:
Damage to Third Party Property Rs.100,000.00; PA Cover for Owner-Driver under Section III: CSI Rs. p.a. 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 of personal luggage), Organized racing, Pace Making, Reliability trails or Speed testing, any purpose in Connection with Motor Trade. Driver’s Clause: Any person including
the insured: Provided also that a person driving holds an effective driving licence at the time of the accident and is not disqualified from holding or obtaining such a licence. Provided also that the person holding an
effective learner’s licence may also drive the vehicle and that such a person satisfies the requirement of rule 3 of the Central Motor Vehicles Rules, 1989. 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 RIGHTS OF RECOVERY”. For legal interpretation, English version will hold good.
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 of pending during the preceding year(s) as follows: The preceding year - 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 will only be allowed
provided the policy is renewed within 90 days of the expiry date of the previous policy.
Disclaimer: Please visit www.bharti-axagi.co.in for the detailed policy wordings, inclusions, exclusions,for complete details on terms and conditions governing the coverage and NCB. This document is to be read with
the policy wordings. The policy is valid subject to realisation of cheque. We accept premium only via legally recognised modes. In case of dishonour of premium cheque, the company shall not be liable under the policy
and the policy shall be void ab-initio. In case of any discrepancy with respect to the policy, please revert within 15 days from the policy start date. This policy is underwritten on the basis of the information provided by you
and as detailed in the Risk Assumption Letter shared with you along with the policy.
Grievance Redressal: For redressal of your grievance, if any, you may approach any one of the offices – 1. Policy issuing office 2. Corporate office. 3. Contact us: 1800-103-2292 (Toll free), 4.Register Grievances at :
www.bharti-axagi.co.in. In case, you are not satisfied with our own grievance redressal mechanism; you may also approach Insurance Ombudsman. Details of Insurance Ombudsman offices are available at IRDA
website: www.irda.gov.in, or on the website of the General Insurance Council: www.gicouncil.in or on the company website www.bharti-axagi.co.in
ISSUED BY – INB5996 on June 24, 2019

I/We hereby certify that the policy to which this Certificate relates as well as this certificate of insurance are BHARTI AXA GENERAL INSURANCE COMPANY LTD.
issued in accordance with the Provisions of Chapter X and XI of Motor Vehicle Act, 1988. In witness of this
policy has been signed at __________________ on June 24, 2019
Authorised Signatory
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 Vehicles Act is recoverable from the insured. See the clause headed “AVOIDANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY”
The Schedule, the attached Policy and Endorsements mentioned herein 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
Stamp duty paid to the account of The District Registrar of Stamps (ACC Head 0030-02-103-0-10), Bangalore Karnataka.

“Warranted that the Assured named herein/owner of the vehicle insured holds a valid Pollution Under Control (PUC) Certificate on the date of commencement of the Policy and renews and maintains valid and effective
PUC Certificate during the duration of the Policy period. If the PUC is not found valid on the date of loss, the company shall repudiate the OD claim made under the Policy”.