THE NEW INDIA ASSURANCE CO. LTD.

(Government of India Undertaking)

POLICY SCHEDULE CUM CERTIFICATE OF INSURANCE

Bundled Motor Policy for Two Wheeler - Enhanced Covers

UIN Number - IRDAN190RP0022V02201819

Policy Number :45080031230900050220

POLICY ISSUING OFFICE: BUSINESS CHANNEL/CPSC User: CLAIM CONTACT:
INDORE DIVISIONAL OFFICE - II (450800), NAME: HARDEEP SINGH CHHABRA - Indore Non Suit Claim Hub (459001)
INDORE DO-2 , 313-316, 3RD FLOOR , (2D10673118) ADDRESS: 209-210 SNEH NAGAR MAIN ROAD,
SHEKHAR CENTRAL, PALASIYA SQUARE , Mr. Satyendra Pratap Singh - (NIAAG00091636), INDORE, 452001 , , , MADHYA PRADESH , 452001.
INDORE , PHONE NUMBER: / / 7223872214 PHONE NUMBER: 123456 /
MADHYA PRADESH , 452001. LAND/FAX NUMBER:/ MOBILE NUMBER:
PHONE NUMBER:07314029854 / EMAIL:[email protected] / Email: [email protected]
07314029855
FAX NUMBER:07314029857 / NA
Email:[email protected]

INSURED DETAILS
Insured Name AMAN DEEP TRIPATHI Customer ID POB2973035 (PAN No :NA)
Insured Address S/W/D:SANJAY Contact Number / / XXXXXX8706
40- C ROAD NO-11 MAYUR NAGAR MUSAKHEDI
INDORE,,,
INDORE ,MADHYA PRADESH, 452001
Email [email protected]
GSTIN NA

POLICY DETAILS
Period of cover OD Cover 05/03/2024 06:32:02 PM to 04/03/2025 Receipt Number 45080081230000031400 -
11:59:59 PM 05/03/24
TP Cover 05/03/2024 06:32:02 PM to 04/03/2029
11:59:59 PM
Previous Insurer Not applicable Previous Policy Number NA

VEHICLE DETAILS
Registration Number New Vehicle Chassis no./Engine Number MD637GE56R2A06551/GE
5AR2206065
Make / Model TVS/APACHE RTR 160 Variant: 4V
Year of manufacture 2024 Type of body / Type of Fuel Metal/Petrol
Colour APACHE RTR 160 Cubic capacity(cc) 160cc
/Wattage(kW):
Seating capacity including 2 Name of registration
Driver authority
Geographical Area / Zone India Name of the Financier TVS CREDIT SERVICES
LIMITED
Cover Note No/Cover Note / Automobile Association none
Issue Date: membership
INSURED DECLARED VALUE (in Rs)
Year Duration Vehicle Trailer Non-Elec Acc Electrical Acc Bi-fuel kit Total Value
First Year 05/03/2024 to 04/03/2025 125032 0 0 0 0 125032

Cover Description Cover Opted Cover Description Cover Opted Cover Description Cover Opted
Consumable Items Cover No Engine Protection Cover No Nil Depreciation Cover Yes
Return to Invoice Cover No Road Tax No No Claim Bonus Protection No
Cover
Roadside Assistance Cover No
SCHEDULE OF PREMIUM
Own Damage Liability
Basic OD Premium 880 Basic TP Premium 1473
(+)Premium for nil depreciation cover 150.04 (-)Discount over Base TP Premium for Restricting TPPD 50
Signature Not
Verified
cover to Rs6000
Calculated OD Premium
Digitally signed 1031 Calculated TP Premium 1423
by DHIRAJ
Total OD Premium
KUMAR 1031 Total TP Premium 7116
Date: 2024.03.05
Net 18:32:58
Premium IST in Rs 8,147
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 THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

GST in Rs 1,466
Total Payable in Rs 9,613
Total Payable in Rs(in words): RUPEES NINE THOUSAND SIX HUNDRED THIRTEEN ONLY
GSTIN(Issuing Office) 23AAACN4165C1ZZ
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:Limit of the amount the Company's Liability Under Section II 1(i) in respect of any one accident: as per the Motor Vehicles
Act, 1988. Limit of the amount of the Company's Liability Under Section II 1(ii) in respect of any one claim or series of claims arising out of one
event: Up to Rs. 6000
For individual covers (OD) in RS:125032 Compulsory excess in Rs:100
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.
PA cover for Owner Driver
As per the declaration given,the Insured has opted out of CPA cover under this policy.
PA cover for named persons
Name CSI Opted(Rs.) Nominee Relationship
none 0 NA NA

Premium and GST Details

Rate of Tax Amount in INR
Premium Rs 8,147
SGST 9 733
CGST 9 733
IGST 0 0

In witness where of this policy has been signed at INDORE DIVISIONAL OFFICE - II on this 05/03/2024WARRANTED 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 Package/Liability policy attached/available on the web site http://newindia.co.in; IMT Endorsement
Number(s) printed herewith attached 20,22,25.
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.
The policy is subject to TWEC endorsement attached.
Date of Issue: 05/03/2024

(Mr. PRAKHAR KASTWAR)

[DIVISONAL MANAGER]

Duly Constituted Attorney(s)

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 THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

BUNDLED MOTOR POLICY FOR TWO WHEELERS - ENHANCED COVERS

(Endorsement Wording for Add on cover - Nil Depreciation)
UIN Number - IRDAN190RP0022V02201819/A0031V01201819

THE FOLLOWING ENDORSEMENT IS TO BE ATTACHED TO THE BUNDLED MOTOR POLICY FOR TWO WHEELERS WHEN THE ENHANCED
COVER IS PROVIDED WITH ADD ON COVER NIL DEPRECIATION FOR BRAND NEW VEHICLE

BUNDLED MOTOR POLICY FOR TWO WHEELERS ENHANCED COVER ENDORSEMENT ATTACHED TO AND FORMING PART OF POLICY NO.
45080031230900050220 Additional Premium: Rs. 150.0384

Notwithstanding anything contained to the contrary in the within mentioned policy it is hereby declared and agreed that subject to the
insured having paid the Additional premium as applicable the cover under Section I of the within mentioned policy is hereby extended to
the effect that in the event of any partial loss claim admissible under this policy, no depreciation shall be deducted for the replaced parts
payable under the claim.

Subject to the condition that the above said coverage shall be applicable only for the first two partial loss claims admitted and payable
under the policy relating to accidents during Own Damage policy period.

Further No claim shall be payable :

1.For any extra fittings and/ or any internal improvements in the vehicle other than provided by the manufacturer in the vehicle originally.

2.In relation to any accident occurring in any geographical area outside India.

3.If the vehicle is in excluded category;

a) Sports model Two wheeler
b) Racer model Two wheeler

4.After the first two admissible claims under the Enhanced Cover during the Own Damage Policy Period.

All other terms and conditions of the within mentioned policy shall remain unaltered.

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 : 45080023P0084143

IRDA Registration Number: 190

NIA PAN NUMBER: AAACN4165C

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