THE NEW INDIA ASSURANCE CO. LTD.

(Government of India Undertaking)

POLICY SCHEDULE CUM CERTIFICATE OF INSURANCE

Standalone Motor Own Damage Policy for Private car - Enhanced Covers

UIN Number - IRDAN190RP0001V01201920

Policy Number :35241031222000000610

POLICY ISSUING OFFICE: BUSINESS CHANNEL/CPSC User: CLAIM CONTACT:
Keylang Micro Office (352410), NAME:Mr. Tanzin Rigdol - (AG00055739), Keylang Micro Office (352410)
Upper Keylang,Distt. Lahaul Spiti , , , PHONE NUMBER: / / 9459300973 OR
HIMACHAL PRADESH , 175132. LAND/FAX NUMBER:/ CUSTOMER CARE NUMBER: 1800-209-1415
PHONE NUMBER:01900202055 EMAIL: /
FAX NUMBER:NA / NA
Email:nia.352410@newindia.co.in

INSURED DETAILS
Insured Name MUKESH . Customer ID POA1118375 (PAN No :NA)
Insured Address PRAKASH CHAND,VILL. - LE-SUMNAM , P. O. - Contact Number / / XXXXXX0394
TANDI,DISTT. LAHOUL & SPITTI,
KEYLONG ,HIMACHAL PRADESH, 175132
Email
GSTIN NA

POLICY DETAILS
Period of cover 21/12/2022 12:00:01 AM to 20/12/2023 11:59:59 PM Receipt Number 35241081220000000622 -
07/11/22
Previous Insurer ICICI LOMBARD GENERAL INSURANCE CO. LTD. Previous Policy Number 3001/O/MI-
10533523/00/000
Related Bundled/Liability M10147019 Bundled/Liability Policy 21/12/2020 to 20/12/2023
Policy No.: period:
Bundled/Liability Insurer: TATA AIG GENERAL INSURANCE CO. LTD.
VEHICLE DETAILS
Registration Number HP-42-2711 Chassis no./Engine Number MA3EUA61S00G96050/F8
DN6442995
Make / Model MARUTI/ALTO Variant: LXI
Year of manufacture 2020 Type of body / Type of Fuel Convertible/
Colour SUPERIOR WHITE Cubic capacity(cc) 796cc
/Wattage(kW):
Seating capacity including 5 Name of registration Keylong
Driver authority
Geographical Area / Zone India Name of the Financier
Cover Note No/Cover Note / Automobile Association none
Issue Date: membership
FASTag ID:
INSURED DECLARED VALUE (IN Rs)
Vehicle Trailer Non-Elec Acc Electrical Acc Bi-fuel kit Total Value
257600 0 0 0 0 257600

Cover Description Cover Opted Cover Description Cover Opted Cover Description Cover Opted
Additional Towing Charges No Engine Protection Cover No Return to Invoice Cover No
No Claim Bonus Protection No Loss of Contents Cover No Road Tax No
Cover
High Value PA Cover No Personal Belongings Cover No Consumable Items Cover No
Nil Depreciation Yes Roadside Assistance Cover No Key Protect Cover No
Tyre and Alloy Cover No
SCHEDULE OF PREMIUM
Own Damage
Signature Not
Verified
Digitally signed
by JAGATJAYEE Policy No. : 35241031222000000610Document generated by 33587 at 2022/11/07 17:03:17.
PANIGRAHI
Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Date: 2022.11.07
17:03:17 IST Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own grievance redressal mechanism; you may also
approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website http://newindia.co.in.
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 THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

Basic OD Premium 3748

(+)Premium for nil depreciation cover 1803.2
Calculated OD Premium 5551
Total OD Premium in Rs 5551
Net Premium in Rs 5551
GST in Rs 1000
Total Payable in Rs 6551
Total Payable in Rs(in words): RUPEES SIX THOUSAND FIVE HUNDRED FIFTY-ONE ONLY
GSTIN(Issuing Office) 02AAACN4165C1Z3
SAC 997134 (Motor vehicle insurance services)
Limitation as to use:The Policy covers use of the vehicle for any purpose other than: a)Hire or Reward b)Carriage of goods (other than
samples or personal luggage) c)Organized racing d)Pace making e)Speed testing f) Reliability Trials g)Any purpose in connection with Motor
Trade
Limits of Liability:Coverage is only for Own Damage of the vehicle and does not cover third party property damage/personal injury/TP death
and any other Legal Liability.
For individual covers (OD) in RS:257600 Compulsory excess in Rs:1000
Imposed excess in Rs:0 Voluntary excess in Rs:0
Persons or classes of persons entitled to drive: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 requirement of Rule 3 of the Central Motor Vehicles
Rules, 1989.
Premium and GST Details
Rate of Tax Amount in INR
Premium Rs 5551.00
SGST 9 500
CGST 9 500
IGST 0 0

In witness where of this policy has been signed at Keylang Micro Office on this 07/11/2022
WARRANTED THAT IN CASE OF DISHONOUR OF THE PREMIUM CHEQUE, THIS DOCUMENT STANDS AUTOMATICALLY CANCELLED ABINITIO
This policy is subject to the Terms, conditions and exceptions applicable to ODWTOTADON/ODWTHADDON policy attached/available on the
web site http://newindia.co.in; IMT Endorsement Number(s) printed herewith attached .
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, 1988 is recoverable from the
insured: see clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY". It is clarified that in case the declaration regarding
the ncb or other previous policy details made by the insured, is found to be incorrect, all the benefits (including claim) under section-1 of this
policy, will stand forfeited.
Anti Money Laundering Clause: In the event of a claim under the policy exceeding Rs 1lakh or a claim for refund of premium exceeding Rs 1
lakh, the insured will comply with the provisions of AML policy of the company. The AML policy is available in all our operating offices as well
as Company website.
I/We hereby certify that the policy to which this Certificate relates For and on behalf of The New India Assurance Company Limited
as well as this Certificate of Insurance are issued in accordance
with the provisions of Chapter X and XI of M.V. Act, 1988.
Date of Issue: 07/11/2022

Duly Constituted Attorney(s)

Standalone Motor Own Damage Policy for Private car - Enhanced Covers
(Endorsement Wording for Add on cover - NIL Depreciation)
UIN Number - IRDAN190RP0001V01201920/A0003V01201920

ATTACHED TO AND FORMING PART OF POLICY NO. 35241031222000000610 Additional Premium: Rs. 1803.2

In consideration of payment of an additional premium by the Insured, it is hereby agreed and declared that notwithstanding anything to the
contrary contained in the Policy, the Company hereby undertakes to indemnify:

Policy No. : 35241031222000000610Document generated by 33587 at 2022/11/07 17:03:17.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own grievance redressal mechanism; you may also
approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website http://newindia.co.in.
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 THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

1.Depreciation on replacement of parts including tyres, tubes, rubber/plastic for Partial Loss Claims.
2.Midterm inclusion of cover is not permitted.
3.Total Loss and Constructive Total Loss will be settled on the basis of IDV.
Subject otherwise to the terms, exceptions, conditions and limitations of this Policy.
For and on behalf of The New India Assurance Company Limited
Date of Issue: 07/11/2022
Duly Constituted Attorney(s)

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.

Tax Invoice No : 35241022P0000659

IRDA Registration Number: 190

NIA PAN NUMBER: AAACN4165C

Policy No. : 35241031222000000610Document generated by 33587 at 2022/11/07 17:03:17.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with our own grievance redressal mechanism; you may also
approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please visit our website http://newindia.co.in.
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