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Relax. We’ve got you covered.

Dear VENKATESAPERUMAL,

A warm welcome from all of us.

You’ve made a great choice by selecting Edelweiss Two Wheeler Standalone own damage Insurance.
Your Policy No. is 521147629.
We’re going to do our best to provide you amazing service at all times. Count on us to always give you
the full picture, and to be completely fair and honest.
After reading this letter, do take a little time to download and go through the relevant policy information
on our website www.edelweissinsurance.com. It will help you know all the important details of the cover
you now enjoy. We know that insurance documents can make simple things sound difficult, but we really
think you should read them, because this is important!

The above information bears the main features and benefits, of course, and just as importantly, the
features which are not covered under your policy.

You can download the relevant policy information by following the steps given below:
· Visit www.edelweissinsurance.com
· Visit product page
· Select the desired product
· Download the relevant policy information

We’re just a call or an email away if you need to ask us something.


Write to us at support@edelweissinsurance.com or call us at 1800 12000.
Once again, we’re delighted to have you with us.
Warm regards,

Shubhdarshini Ghosh
Executive Director & CEO

Edelweiss General Insurance Company Limited, Corporate Office: 2nd Floor, Tower 3, Wing B, Kohinoor City Mall,Kohinoor City, Kirol Road, Kurla (West),
Mumbai - 400070, Registered Office: 2nd Floor, Tower 3, Wing B, Kohinoor City Mall,Kohinoor City, Kirol Road, Kurla (West), Mumbai - 400070, IRDAI Regn.
No.: 159. CIN: U66000MH2016PLC273758 Reach us on: 1800 12000,Email: support@edelweissinsurance.com, Website: www.edelweissinsurance.com,
Issuing/Corporate Office: +91 22 4272 2200, Grievance Redressal Officer: +91 22 4931 4422, Dedicated Toll-Free Number for Grievance: 1800 120 216216.
Trade logo displayed above belongs to Edelweiss Financial Services Limited and is used by Edelweiss General Insurance Company Limited under license.

15
Edelweiss Two Wheeler Standalone own damage Insurance | UIN: IRDAN159RP0003V01201920
We know you wish to zoom
through your policy, so we’ve
kept the going smooth
Edelweiss Two Wheeler Standalone own damage Insurance - Policy
Schedule
It won’t take long at all to go through your important policy details! Also, it would be great if you saved
a soft copy to your phone. Of course, you can always #TakeUsForGranted to go the distance for you, at full speed!

Intermediary Name: PhonePe Insurance Broking Services P. L.


Intermediary Reference Code: 2210002301 Contact: 2268727374

Policy Details
Policy Servicing Office: CORPORATE OFFICE Policy No. 521147629
Period of Insurance: From 00:00:00 of 09/10/2022 to 23:59:59 of 08/10/2023
Insured's Name: Mr. VENKATESAPERUMAL R Insured's GST No.: NA
Insured's Address:
Insured's ID: 1001193330 Policy Issued On: 07-Oct-2022
Co-insurance Details: N.A Geographical Area: India
Proposal/Cover Note No.: 147189527 Zone: A

It’s not just a pair of wheels!


Here are your vehicle’s important details. Please check if you’ve provided the correct ones?

Vehicle Details
Registration Mark Engine No. Chassis Make Model Variant CC Year of Seating
& Place of Registration No Manufacture Capacity
including driver
TN07CV3326 PASSION SELF DRUM
80109 35706 HERO 97.00 2020 02
CHENNAI SOUTH PRO I3S SPOKE

Insured’s Declared Value (IDV)


For the Vehicle For Side-car Non-electrical Electrical/Electronic Value of CNG Total IDV
Accessories Accessories /LPG Kit
`28,442.00 `0.00 `0.00 `0.00 `0.00 `28,442.00

How have we worked out your premium?


‘Own Damage’, as the term suggests, covers harm or loss to your own vehicle.

A. Own Damage
Base Premium on Vehicle `242.89 Less:
and Accessories 1) No Claim Bonus Discount (25 %) `60.72
Subtotal (deductions) `60.72
Total `242.89

TOTAL OWN DAMAGE PREMIUM `182.17


IGST Amount @ 18% `32.79
FINAL PREMIUM `214.96

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Edelweiss Two Wheeler Standalone own damage Insurance | UIN: IRDAN159RP0003V01201920
No Claim Bonus:60.72 Compulsory Deductible:100.00
Voluntary Deductible:0.00 Additional Compulsory Deductible:0.00
Applicable KM Slab – Up to Km

Note:- “As per Section 34(2) of the CGST Act 2017, GST will not be refunded/adjusted for any cancellation /endorsement/
deletion/refund after 6 months from the end of the previous financial year in which the policy was issued”.

Did you love someone else before we met?


It’s OK, we’ll deal with it. Here are the details of your last insurer.
Previous Insurer: Go Digit General Insurance Limited.
Previous Policy No.: D046524539 Expiry on: 05-Oct-2022

Here are the details of your present Liability insurer.


Liability Insurer Name: HDFC ERGO General Insurance Co. Ltd.
Liability Policy number: 23129100312547 Policy period: From 05.06.2020 To 05.06.2025

Who’s your nominee?


It’s always good to have a Nominee, and you did the right thing by naming one. Given below are the details.
Name and Age of Nominee: VENKATESAPERUMAL R Relationship with insured: Self
Name of Appointee (If Nominee is minor): NA
Relationship of Appointee with Nominee: NA

Red, orange or green?


What kind of loss/damage is covered, and what isn’t? As a thumb rule, here are a few things you should remember.

·Calculation of Depreciation:
If the loss/damage to your vehicle is partial, here's how we calculate the depreciation (unless its covered in your Add-ons).
- For Rubber/Nylon/Plastic parts, Tyres & Tubes, Batteries and Air Bags: 50%
- For Fibre Glass parts: 30%
- For everything made of glass: Nil
Depreciation for all other parts, including wooden ones, is up to a maximum of 50%, depending on how old the car is. If you need
to have your car painted, depreciation of 50% will apply only on the cost of materials. If you get one combined bill for painting,
we'll consider 25% of the total bill amount as material cost, and apply depreciation on it.
·Use of the vehicle:
The Policy covers the use of the vehicle for any purpose except Motor Trade, Hiring or Reward, Carrying Goods (other than samples
or personal luggage), Organized Racing, Pacemaking, Speed Testing, Reliability Trials etc.
· Who can drive?
The driver can be anybody including the insured, provided he/she holds an effective driving license at the time of the accident and is
not disqualified from holding a driving license. However, the driver must satisfy the requirements of Rule 3 of the Central Motor
Vehicles Rules, 1989.

This is most important! Slow down here.


Although we’d love to cover your vehicle without exception, we can’t. Your policy covers loss to your vehicle only if all the terms are
met.And any payment we make because of terms appearing in this Schedule, or to comply with the Motor Vehicles Act, 1988, is
recoverable from you.You should definitely read the clause, ‘Avoidance of certain terms and right of recovery’ in your Policy Wording.
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.
Subject to IMT - 22 Endt. Nos. & Memorandum..... Printed/attached here.
Date of duly signed proposal 07-Oct-2022

35
Edelweiss Two Wheeler Standalone own damage Insurance | UIN: IRDAN159RP0003V01201920
In Witness whereof this Policy has been signed at: CORPORATE OFFICE on this 7th day of Oct 2022
Receipt No.539100164922 Date.. 07-Oct-2022
Consolidated Stamp duty Paid vide Letter of Authorisation No. CSD/353/2022/2343 dated 01-Jun-2022 at General Stamp Office,
Mumbai.
Received premium payment of ` 214.96 vide instrument / reference number VF2210071726595904615155 dated 07-Oct-2022
against receipt number 539100164922
It is certified that your Policy and this Schedule have been issued according to the provisions of Chapter X and Chapter XI of the
Motor Vehicles,Act, 1988.
For Edelweiss General Insurance Company Limited

Address of Issuing Office: EDELWEISS HOUSE, OFF


CST ROAD, KALINA, MUMBAI - 400098
Date of Issue:07/10/2022

Signature Not Verified


Digitally signed by DS EDELWEISS GENERAL INSURANCE COMPANY LIMITED 4
Date: 2022.10.07 17:46:38 IST
Reason: Authentication
Location: Mumbai
Authorized Signatory

Tax is not payable under reverse charge by the recipient


Description of Good or Service : General
GST Registration No.: 27AAECE2328J1ZO HSN/SAC Code : 997134
Insurance Service
Place of Supply State: Karnataka Code: 29
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.

Edelweiss General Insurance Company Limited, Corporate Office: 2nd Floor, Tower 3, Wing B, Kohinoor City Mall,Kohinoor City, Kirol Road, Kurla (West),
Mumbai - 400070, Registered Office: 2nd Floor, Tower 3, Wing B, Kohinoor City Mall,Kohinoor City, Kirol Road, Kurla (West),Mumbai -400070, IRDAI Regn.
No.: 159. CIN: U66000MH2016PLC273758 Reach us on: 1800 12000,Email: support@edelweissinsurance.com, Website: www.edelweissinsurance.com,
Issuing/Corporate Office: +91 22 4272 2200, Grievance Redressal Officer: +91 22 4931 4422, Dedicated Toll-Free Number for Grievance: 1800 120 216216.
Trade logo displayed above belongs to Edelweiss Financial Services Limited and is used by Edelweiss General Insurance Company Limited under license.

45
Edelweiss Two Wheeler Standalone own damage Insurance | UIN: IRDAN159RP0003V01201920
TRANSCRIPT OF THE PROPOSAL

Product Details Valid from (dd-mmm-yyyy) 09/10/2022


Private Motor Long Term 08/10/2023
Product Name 2W
Valid to (dd-mmm-yyyy)
Standalone Own Damage NA
Product Type (Add-on Optional)
Fitness Cerficate Valid upto
Business Type Rollover Previous History
Proposal Details Date of Purchase NA
Gender Male Vehicle was New or Second Hand at Used Car
Proposer Title Mr. the time of purchase
Proposer Name VENKATESAPERUMAL R Vehicle be used exclusively for NA
Proposer DOB *** Private, Social, Domestic, Pleasure &
Proposer Address with Pincode Professional Purpose
Contact Number 8682051798 Carriage Goods other than sample or NA
Email ID govindsledge@gmail.com personal luggage
PAN Number NA Vehicle in Good Condition (Yes/No) NA
GST Number NA If No (Not in Good Condition) - Details NA
Occupation Low to Medium Has any company, in respect of the NA
Policy Period (OD) risk to which this Proposal relates,
Policy Start Date 09/10/2022 ever
Policy Start Time 00:00:00 A) Declined a proposal, refused NA
Policy End Date 08/10/2023 renewal or terminated insurance
Policy End Time 23:59:59 B) Required an increased premium or NA
Policy Period (3 Year TP) imposed special conditions
Policy Start Date Detail if A or B selected as "Yes" NA
Policy Start Time Previous Insurance Details
Go Digit General
Policy End Date Insurer Name
Insurance Limited.
Policy EndTime Policy Number D046524539
Policy Period (CPA) Policy Expiry Date 05-Oct-2022
Policy Start Date Type of Cover Own Damage Contract
Policy Start Time No Claim Bonus Discount (25 %) `60.72
Policy End Date Claim Lodged NA
Policy EndTime Claim Year NA
Vehicle Details Number of Claims NA
Registration Number TN07CV3326 Claim Amount NA
Registration Place CHENNAI SOUTH Nominee Details
07/06/2020 VENKATESAPERUMAL
Registration Date Nominee Name
R
Engine Number 80109 Nominee Age
Chassis Number 35706 Relation with Proposer Self
Vehicle Make HERO Date of Birth
PASSION PRO I3S & SELF NA
Vehicle Model and Variant Name of the Appointee (for Minor)
DRUM SPOKE
Cubic Capacity / GVW / HP 97.00 Relationship to the Nominee NA
Seating Capacity (Including Driver) 02 Insured Declared Value (IDV)
Carrying Capacity 02 Vehicle IDV 28,442.00
Colour Non Electrical Accessories IDV 0.00
Fuel Type PETROL Electrical Accessories IDV 0.00
Body Type Saloon Trailer IDV 0.00
Year of Manufacture 2020 Fuel Value (CNG / LPG) IDV 0.00
Transmission Type NA Fuel discerption for
Vehicle Usage Non Conventional Source
Car Parking Place Proposed Coverage
Financier Details Type of Cover
Financier Type Geographical Area Extn. yes

Page 5 of 7
Edelweiss Two Wheeler Standalone own damage Insurance | UIN: IRDAN159RP0003V01201920
Financier Name Geographical Area India
Financier Address Imported Vehicles without Custom
PUC Details Duty
PUC Number Fibre Glass Tanks NO

Vehicle Used for Driving Tuition NO Infirmity Details


Name of Automobile Association NO Involved / Convicted For Causing Any
Membership No Accident/Loss
Date of expiry of membership Pending Prosecutins Details
Annual Mileage 10000 - 20000 Km Date Of Accident
Voluntary Discount Loss /Cost
Anti-Theft Discount Circumstance Of Accident / Loss
Auto Mobile Association Discount Addon Cover
Vintage Car Consumable Expenses Protect
Used Confined to Own Premises Key and Locks Protect
Discount NCB Protect
Handicapped Discount Mandatory Deduction Protect
Restricted TPPD Personal Belongings Protect
Owner Driver Depreciation Protect
PA Unnamed Passenger SI Engine Protect
PA Unnamed Passenger Number Invoice Value Protect
Emergency Medical Expenses
PA Named Passenger Number
Protect
PA Named Passenger - Name Road Side Assistance
PA Named Passenger - CSI Pillion Protect
PA Named Passenger - Nominee Personal Accident Protect
PA Named Passenger - Relations Tyre Protect
Legal Liability To Employees EMI Protect
Number Pay as You Drive
Payment Details
Legal Liability To Paid Drivers Payment Mode Net Banking
Legal Liability To Other than Paid Instrument Date 07-Oct-2022
VF221007172659590461515
Drivers Instrument / Reference Number 5
Legal Liability To Employee who Premium Amount ` 214.96
are not "Workman" Intermediary Details
PhonePe Insurance Broking
Driver Details Intermediary Name Services P. L.
Driver Name Intermediary Reference Code 2210002301
Driver Relationship with the Intermediary Contact Number 2268727374
Proposer SELF Intermediary Email
Driver Date of Birth Intermediary Sales Person's Name
Driver Occupation Intermediary Sales Person's Contact
Experience - No. of Driving Years 1 Servicing Branch Name
Driver Suffer from Defective vision Servicing Branch Code
or Hearing or any Physical Infirmity

I do not want the physical copy of my policy documents.


I want the physical copy of the policy documents to be sent to my address, as mentioned in the proposal form
* These documents will figure in phyical form unless our system allows upload of information. There should be a corresponding sentence in this box and
it should read as 'Documents related to and submited in pursuance to this proposal shall form part of this proposal.'
*The information, together with all statements, disclosure, representation and declaration, received from you (proposer), as has been reproduced above,
forms the basis of the insurance policy issued to you. Please inform us (insurer) immediately in case of any error or omission contained in such information.
Proposal Transcript Generation Date: 09/10/2022 Time: 00:00:00
As a go-green initiative, Edelweiss General Insurance Co. Ltd. shall be sending the policy documents to your e-mail address, as provided by you in
this proposal form.

Page 6 of 7
Edelweiss Two Wheeler Standalone own damage Insurance | UIN No:IRDAN159RP0003V01201920
Edelweiss General Insurance Company Limited, Corporate Office: 2nd Floor, Tower 3, Wing B,Kohinoor City Mall,Kohinoor City, Kirol Road, Kurla (West),
Mumbai - 400070, Registered Office: 2nd Floor, Tower 3, Wing B, Kohinoor City Mall,Kohinoor City, Kirol Road, Kurla (West), Mumbai -400070, IRDAI Regn.
No.: 159. CIN: U66000MH2016PLC273758 Reach us on: 1800 12000,Email: support@edelweissinsurance.com, Website: www.edelweissinsurance.com,
Issuing/Corporate Office: +91 22 4272 2200, Grievance Redressal Officer: +91 22 4931 4422, Dedicated Toll-Free Number for Grievance: 1800 120 216216.
Trade logo displayed above belongs to Edelweiss Financial Services Limited and is used by Edelweiss General Insurance Company Limited under license.
Insurance is the subject matter of solicitation.
Edelweiss General Insurance Company Limited
Acknowledgment of Premium Receipt
Registered Office Address: 2nd Floor, Tower 3, Wing B, Kohinoor City Mall, Kohinoor City, Kirol Road, Kurla (West), Mumbai 400070

Issuing Office Address: EDELWEISS HOUSE, OFF CST ROAD, KALINA, MUMBAI - 400098

Product Name: Private Motor Long Term 2W Policy No.: 521147629

Receipt Generation
Office Code Office Location Receipt Number
Date/Time

10 Karnataka 539100164922 07-Oct-2022

Name of
Intermediary/Agency Intermediary/Agency
Policyholder’s ID Policyholder/
Code Name
Financier
PhonePe Insurance Mr. VENKATESAPERUMAL
2210002301 1001193330
Broking Services P. L. R

Payment Instrument/
Mode of Cheque Instrument
Received Transaction
Payment Drawn on Date
From Number
VF2210071726
VENKATESAPERUMAL R Net Banking - 07-Oct-2022
595904615155

Branch Address EDELWEISS HOUSE, OFF CST ROAD, KALINA, MUMBAI - 400098

Note:Premium amount is inclusive of GST.

This acknowledgment confirms receipt, by Edelweiss General Insurance Co. Ltd. (Company), of the proposal deposit made in connection with the proposal
for insurance and does not,in any way, constitute confirmation towards accceptance of risk. The acceptance of risk, if and when takes place, shall be
evidenced by the policy schedule issued by the Company. In the event of non-acceptance of the said proposal for insurance, the proposal deposit stated
herein will be refunded bereft of interest.

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