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    INSURANCE

    Uploaded by

    hibakhan112000
    INSURANCE

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    © All Rights Reserved
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    INSURANCE

    Uploaded by

    hibakhan112000
    6 views2 pages
    INSURANCE

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    © © All Rights Reserved

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    INSURANCE

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    6 views2 pages

    INSURANCE

    Uploaded by

    hibakhan112000
    INSURANCE

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    COVERNOTE FOR MOTOR VEHICLE INSURANCE

    PRIVATE CAR PACKAGE POLICY

    Insured Name : YASMEEN Covernote No : 9025478961


    Address : 188 MOHALLA FARRASHAN,SHAHBAD,DIST-,RAMPUR- Period of Insurance : March 21 , 2023 17:30 to
    UTTAR PRADESH-244922 Midnight of March 20, 2024
    Telephone No : Mobile No: Covernote Issued On : March 21, 2023
    Email Address : Named Passenger'sNominee: RTO Location : UTTAR PRADESH-RAMPUR
    Nominee Name : - Hypothecated To :
    Relationship : Invoice Number :
    Age : ServicingBranchAddress :

    GSTIN Number (Customer) :


    Servicing Branch Name : Lucknow

    Registration Make Model Type of CC MfgYr Seating Chassis No. Engine


    No. Body Capacity No.

    UP22AV9414 MARUTI BALENO ZETA RIGID 1107 2022 05 11780 11594


    Vehicle IDV Trailer Non Electrical Electrical / CNG / LPG Unit Total IDV
    (`) (`) Accessories (`) Electronic (`) (`)
    Accessories (`)
    750000 0 0 0 750000

    Additional Risk, if any :


    Special conditions :

    Premium Details
    Premium Collection No. 98750007982 Premium Amount 22408.00 Receipt Date 21-03-2023
    GSTIN Reg.No 09AAACI7904G1ZL HSN/SAC code 9971 / GENERAL
    INSURANCE
    SERVICES

    Form 52 (see rule 142(1) of Central Motor Vehicle Rules, 1989)

    The insured, described in Form '52' referred to above, having the proposed for insurance in respect of Motor vehicle(s) described therein and having paid the sum of
    `: 15600 as premium, the risk is hereby held covered under the terms of the company's usual form of Package Policy applicable thereto (subject to any special
    condition mentioned below) unless the cover be terminated by the company by notice in writing in which case the insurance will thereupon cease and a proportionate
    part of the premium otherwise payable for such instance shall be charged for the time the Company had been at risk.
    The Cover Note wordings provided constitute the legal document with regard to the coverage. In order to help you understand the cover note better. For any further
    clarifications, please call our call center. As per your declaration in the proposal form with reference to your vehicle described below and the premium paid by you,
    we are commencing an insurance cover for your vehicle under PRIVATE CAR PACKAGE POLICY from the date and time mentioned above (subject to special
    conditions described below, if applicable). The cover note would be valid for a period of sixty days from the date of its issue under the Sub-Rule (2) of Central Motor
    Vehicles Rules 1989 unless due to some circumstances, we have to cancel the policy. In such a case, we would send you a written notice and cancel the policy by
    proportionately refunding premium to you for the unexpired period ofcover.
    N.B.In the event of an accident, the Insured should inform the company to arrange sport survey. The details of your vehicle area as described above. Special
    conditions if applicable to your policy any are described here. Limitations as to Use: The Policy covers use of the vehicle for any purpose other than: Hire or
    Reward,Carriageofgoods(otherthansamplesofpersonalluggage),Organisedracing,PaceMaking,ReliabilitytrailsorSpeedtesting,anypurposeinConnectionwith
    MotorTrade.Driver'sClause:Anypersonincludingtheinsured:Providedthatapersondrivingholdsaneffectivedrivinglicenseatthetimeoftheaccidentandisnot 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
    personsatisfiestherequirementsofRule3oftheCentralMotorVehiclesRules,1989.ImportantNotice:Theinsuredisnotindemnifiedifthevehicleisusedordriven 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
    MotorVehicleAct,1988isrecoverablefromtheinsured.Seetheclauseheaded"AVOIDANCEOFCERTAINTERMSANDRIGHTOFRECOVERY".ForLegal
    interpretation, English version will hold good. Disclaimer: Please visit www.icicilombard.com for the policy wordings, 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 realization of cheque. We accept premium only
    via legally recognized 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
    providedbyyouandasdetailedintheRiskAssumptionLettersharedwithyoualongwiththepolicy.GrievanceRedressal:Forresolutionofanyqueryorgrievanceyoumay contact
    us on our toll free no. 1800 2666, or visit any of our branch offices. You can also write to us at customersupport@icicilombard.com. For detailed grievance redressal
    mechanism please visit the "Grievance Redressal" section on our website www.icicilombard.com. You may approach the Insurance Ombudsman, subject to vested
    jurisdiction, for the redressalof the grievance. Details of Insurance Ombudsman offices are available at the IRDA website www.irdaindia.org, as well as, our
    websitewww.icicilombard.com.

    I/We hereby certify that this Cover Note is issued in accordance with the provisions of Chapter X and Chapter XI of Motor Vehicle Act, 1988.
    Date of issue : March,06, 2023
    Policy Issuing Office: ICICI Lombard General Insurance Company Limited, ICICI LOMBARD HOUSE, 414, Veer SavarkarMarg, Near Siddhi Vinayak Temple,
    Prabhadevi, Mumbai 400025.

    AgencyCode : ANIL1087 For ICICI Lombard General Insurance Company Ltd

    AgencyName : ANIL
    Agent Contact No:
    Duly Constituted Attorney
    Mailing Address: 401 & 402, 4th Floor, Interface 11, New Linking Road, Malad (West), Mumbai - 400 064, IRDA Reg. No. 115, CIN: U67200MH2000PLC129408

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