CIN: U66000MH2014PLC260291, Registered Office: 27 BKC, C 27, G Block, Bandra Kurla Complex, Bandra East, Mumbai 400051. Maharashtra, India
CIN: U66000MH2014PLC260291, Registered Office: 27 BKC, C 27, G Block, Bandra Kurla Complex, Bandra East, Mumbai 400051. Maharashtra, India
CIN: U66000MH2014PLC260291, Registered Office: 27 BKC, C 27, G Block, Bandra Kurla Complex, Bandra East, Mumbai 400051. Maharashtra, India
3/1559230600
Date: 08/05/2021
To,
Ms. Annie Arora
VAISHALI ENCLAVE
PITAM PURA
Delhi - 110034
District: SOUTH DELHI
DELHI, India
Contact Details 9312602454
We welcome you to Kotak Mahindra General Insurance Company Limited and thank you for choosing us as your preferred service
provider.
This is with reference to your above mentioned Policy issued under Kotak Car Secure - OD Only.
Enclosed please find the Policy Schedule and Policy Wordings. We wish to inform you that the proposal is underwritten and policy is
issued based on the information submitted to us as well as acceptance of the terms and conditions.
We request you to carefully go through the same once again and in case of any disagreement, discrepancy or clarifications, please call us
on our toll free number 1800 266 4545 or write to us at [email protected] within 15 days from the date of this letter. Alternatively, you can
also write to us at 8th Floor, Zone IV, Kotak Infiniti, Bldg.No. 21, Infinity IT Park, Off WEH, Gen. AK Vaidya Marg, Dindoshi, Malad(E),
Mumbai – 400 097, India.
Please note that the information provided by you will be verified at the time of claim and the captioned Policy shall be treated as void if we
discover any untrue or incorrect statement, misrepresentation, non-description or non-disclosure in any form whatsoever made by you or
by your agent, on your behalf, at any stage.
As a valued customer, we would like to provide regular updates on your policy through email and SMS. We therefore request you to keep
us updated of any change in your contact details.
Thanking you,
Yours sincerely,
Authorised Signatory
Name: Ms. Annie Arora Policy Issuing Office: H - 78, 7Th Floor, 23 Himalaya HouseKg Marg Delhi
Delhi 110001.
Address: VAISHALI ENCLAVE PITAM PURA Delhi - 110034 District:
SOUTH DELHI DELHI(07), India Period of Insurance:
Place of Supply: DELHI From: 10/05/2021 00:00 to: 09/05/2022 Midnight
Supply State Code: 07 Type Of Vehicle : Private Car
Phone: NA
Policy issued on: 08/05/2021 Cover Note No: NA
Mobile: 9312602454
Hypothecated to: AXIS BANK LTD. (1211)
Email: [email protected]
GSTIN:
VEHICLE DETAILS
Registration Manufacturer Model Variant Year of RTO Location Engine Vehicle Chassis/ Cubic Seating
Number Manufacture Number Trailer Chassis No. Capacity Capacity
Insured Declared Value Non - Electrical Electrical & Electronic Trailer CNG / LPG Kit Total Value of the Vehicle
(IDV) of the Vehicle Accessories fitted to the Accessories fitted to the (in ₹) (in ₹) (in ₹)
(in ₹) Vehicle (in ₹) Vehicle (in ₹)
726000 0 0 0 0 7,26,000
Section I Section II
Own Damage Personal Accident
Basic Own Damage 5,958.28 Not Applicable
Add:
Add on Covers Total Premium # 5,177.45
Less:
No Claim Bonus Percent 25% 1,489.57
Voluntary Deductible For Depreciation Cover Discount 500.00
Total Own Damage Premium 9,146.16
Taxable value of Services (A) 9,146.16
CGST @ 9% 823.15
SGST @ 9% 823.15
Total Premium (in ₹ ) 10,792.00
Add on Covers Opted For: Consumable Cover, Depreciation Cover, Engine Protect, Key Replacement, Loss of Personal Belongings, Return to Invoice, Road Side Assistance
# : For the covers opted as shown in Add On Cover Details Table
Geographical Area INDIA Additional Excess ₹ 0 Compulsory Deductibles ₹ 1,000
Voluntary Deductible ₹ 0 Voluntary Deductible for Depreciation Cover ₹ 1,000 Total Deductible ₹ 2,000
The insurance coverage provided under this Policy is only for Own Damage of the Vehicle and does not cover any other liability/third party liability in respect of the insured vehicle.
INTERMEDIARY DETAILS
* In case above mentioned information is found to be incorrect, all benefits under the policy shall stand forfeited and this policy shall be void ab- initio.
Customer needs to ensure that there is a valid TP cover at all times.
Sr. No. Add-On Cover Sum Insured (₹) Premium (₹) Remarks
Return to Invoice
1 NA 363.00
UIN:IRDAN152RP0012V01201920/A0017V01201920
Consumable Cover
2 NA 212.72
UIN:IRDAN152RP0012V01201920/A0015V01201920
Road Side Assistance
3 NA 500.00
UIN:IRDAN152RP0012V01201920/A0018V01201920
Depreciation Cover
4 NA 3,376.63 Voluntary Deductible: 1,000
UIN:IRDAN152RP0012V01201920/A0014V01201920
Engine Protect
5 NA 397.85
UIN:IRDAN152RP0012V01201920/A0016V01201920
Key Replacement
6 25,000 233.75
UIN:IRDAN152RP0012V01201920/A0020V01201920
Loss of Personal Belongings
7 10,000 93.50
UIN:IRDAN152RP0012V01201920/A0019V01201920
DISCLAIMER
For complete details on terms and conditions governing the coverage and NCB please read the Policy Wordings. This document is to be read with the Policy
Wordings(which are also available on the Company website i.e. www.kotakgeneralinsurance.com). Please refer to the claim form for necessary documents to be
submitted for processing the claim.
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 trails or any purpose in connection with Motor Trade.
DRIVER'S CLAUSES
Any person including the insured: Provided that a person driving hold an effective Driving License at the time of accident and is not disqualified from holding or obtaining
such a license. Provided also that the person holding an effective Learners’ License may also drive the Vehicle and that such a person satisfies the requirements of Rule
3 of the Central Motor vehicles Rules 1989.
No claim made or pending during the preceding full year of insurance 20%
No claim made or pending during the preceding 2 consecutive years of insurance 25%
No claim made or pending during the preceding 3 consecutive years of insurance 35%
No claim made or pending during the preceding 4 consecutive years of insurance 45%
No claim made or pending during the preceding 5 consecutive years of insurance 50%
*No Claim Bonus (NCB) is subject to no claim on the previous policy. Benefits under the policy will be forfeited if claim is/was made in previous policy. Please contact
our Customer Care team in case of wrong NCB % mentioned.
Subject to I.M.T. Endt.Nos. & Memorandum GR27, 7 Printed/herein/attached hereto Under Hire Purchase Agreement with NA
TAX DETAILS
DECLARATION
I/We hereby certify that the policy to which the certificate relates as well as the certificate of insurance are issued in accordance with the provision of chapter X, XI of
M.V.Act 1988.
In Witness whereof this Policy has been signed for and behalf of H - 78, 7Th Floor, 23 Himalaya HouseKg Marg Delhi Delhi 110001. at Mumbai this 08 day of May of
2021
The stamp duty of ₹ 0.50 paid in cash or by demand draft or by pay order, vide receipt/challan no. CSD28420211025 dated 1 6 0 3 2 0 2 1
Authorised Signatory
This document is digitally signed, hence counter signature / stamp is not required.
Year of Manufacture Insured Declared Value (IDV) Engine Number Chassis Number
Special conditions :
Limitation as to use (Package Policy): 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 trails or any purpose in connection with Motor Trade.
Driver’s Clauses: Any person including insured: Provided that a person driving hold an effective Driving License at the time of accident and is not disqualified from holding
or obtaining such a license. Provided also that the person holding an effective Learners’ License may also drive the Vehicle and that such a person satisfies the
requirement of Rule 3 of the Central Motor Vehicle Rules, 1989.
Registration Authority and RTO Date of CNG/LPG/Bi Lease / Hire / Hypothecation (Name Color of Seating
Location Registration Fuel and address of concerned parties) Vehicle Capacity
726000 0 0 0 0 7,26,000
PUC - YES
1. Depreciation Cover# 2. Engine Protect #If Depreciation cover is selected: Voluntary Deductible opted under the
“Depreciation Cover”, which would be applied over and above the Compulsory
3. Return to Invoice 4. Consumable Cover Deductible? Yes, Amount: 1000
6. Key Replacement
5. Road Side Assistance
Sum Insured 25000
7. Loss of Personal Belongings
8. Tyre Cover
Sum Insured 10000
9. Daily Car Allowance 10. NCB Protect
2. Previous Policy Type 1+3 3. Previous Policy Number 0160892936 4. Existing bonus 20 %
* In case above mentioned information declared by the Insured is found to be incorrect, all benefits under the policy in respect of Section I shall stand forfeited and this
policy shall be void ab- initio.
Policyholder declares that there shall be a valid Third Party liability cover for the above said vehicle at all times.
DETAILS OF DEPRECIATION
Table 1:Schedule of depreciation for arriving at IDV:
The Insured's declared value (IDV) of the vehicle will be deemed to be the 'Sum insured' and it will be fixed at commencement of each policy period for each insured
vehicle
Age of The Vehicle % of Depreciation for fixing IDV Age of The Vehicle % of Depreciation for fixing IDV
Not exceeding 6 Months 5% Exceeding 2 years but not exceeding 3 years30%
Exceeding 6 months but not exceeding 1 15% Exceeding 3 years but not exceeding 4 years40%
year
Exceeding 1 year but not exceeding 2 years 20% Exceeding 4 years but not exceeding 5 years50%
Note: IDV of obsolete models of vehicles (i.e. Models which the manufacturers have discontinued to manufacture) and vehicles beyond 5 years of age will be
determined on the basis of an understanding between the insurer and the insured.
I confirm that the premium is paid out of my legitimate sources of fund and the Company has the right to call for documents to establish sources of funds. The
Company has the right to cancel the policy in case I am/have been found guilty by any competent authority or court of law of violating any law/regulation.
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TAX INVOICE
HSN / SAC Total Value of Supply Taxable value of Supply CGST CGST Amt SGST SGST Amt
HSN/SAC Description
Code (Rs.) (Rs.) Rate (Rs.) Rate (Rs.)
Motor vehicle insurance 997134 9146.16 9146.16 9% 823.15 9% 823.15
services
Total
Total Invoice Value (In
10,792.00
Figure)
Total Invoice Value (In
Ten Thousand Seven Hundred Ninety Two
Words)
Whether Tax Payable on a Reverse Basis or Not No
Authorized Signatory