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Basic Third Party Liability:
Sub Total – Addition
Less: Less Reduction in TPPD Cover to 6000 (IMT-20)
Net Liability Premium
Service Tax 15% (Including Swachh Bharat Cess 0.50%, Krishi Kalyan Cess 0.50% as applicable)
MR ASRAFUN NAHAR
NADIA WEST BENGAL 741123
PRITAMBARPUR, DOMPUKUR ,CHAPRA
Period of Insurance
From Date & Time
19/07/2016 00:01 hrs
To Date & Time
Policy Issuance Date
Model - Variant
of side car)
YAMAHA RAY Z
Side Car (`)
Non Electrical Acc. (`)
Electrical Acc. (`)
CNG/LPG Kit (`)
Total IDV (`)
Named Persons & Nominee (IMT-15)
Nominee for Owner driver
Premium (In ` )
HDFC ERGO General Insurance Company Limited
Certificate of Insurance cum Policy Schedule
Policy No. 2320 2014 3184 6900 000
Two Wheeler Liability Only Policy Customer Id:10157470629400010
Premium Details (`)
Geographical Area IndiaPayment Details: Fund Transfer Dated : Drawn on
List of Endorsements LIMITATIONS AS TO USE: The Policy covers use of the vehicle for any purpose other than: a) Hire or Reward b) Organized racing c) Speed testing. Persons or Class 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 requirements of Rule 3 of the Central Motor Vehicles Rules, 1989. Limits of Liability 1. Under Section II-1 (i) of the policy
- Death of or bodily injury - Such amount as is necessary to meet the requirements of the Motor Vehicles Act, 1988. 2. Under Section II - 1(ii) of the policy -Damage to Third Party Property- `6000 3. P. A. Cover
under Section III for Owner - Driver(CSI): ` 0 Terms, Conditions & Exclusions: As per the Indian Motor Tariff. A personal copy of the same is available free of cost on request & the same is also available at
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. "The stamp duty of ` 0.50
paid by Demand Draft, vide Receipt/Challan no 4932771201516 dated 29/03/2016 as prescribed in Government Notification Revenue and Forest Department No Mudrank 2004/4125/CR 690/M-1, dated 31/12/2004."
Service Tax Registration No: AABCH0738EST004. 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 Vehicle Act, 1988 is recoverable from the Insured. See the clause headed "AVOIDANCE OF CERTAIN TERMS AND
RIGHT OF RECOVERY." Disclaimer: The Policy shall be void from inception if the premium cheque is not realized. In the event of misrepresentation, fraud or non-disclosure of material fact, the Company reserves
the right to cancel the Policy. Please note that the insured vehicle was pre-inspected and a report was prepared accordingly. The existing damages to the vehicle as mentioned in the report shall not be paid by the
Company. The policy is issued basis the information provided by you, which is available with the company. In case of discrepancy or non recording of relevant information in the policy, the insured is requested to bring
the same to the notice of the company within 15 days.
Policy Issuing Office : METRO TOWERS,10 TH FLR, 1 HO CHI MINH SARANI,KOLKATTA - 700 071 KOLKATA, 700071. Phone No. : +91-22-39883600
Policy Issuing Office: Mumbai For HDFC ERGO General Insurance Company Ltd.
Agent Name :SANJOY ROY
Agent Code :201989116319 Tel No. : 91-9851020099
Duly Constituted Attorney
Registered & Corporate Office: 1st Floor, 165-166 Backbay Reclamation, H. T. Parekh Marg, Churchgate, Mumbai - 400020. Customer Service Address: 6th Floor, Leela Business Park, Andheri Kurla Road,
Andheri (E), Mumbai - 400 059. Toll Free : 1800-2-700-700 (Accessible from India only) | Fax : 91 22 3699 | email@example.com | www.hdfcergo.com
Ver.Aug14HDFC ERGO General Insurance Company Limited
Frequently Asked Question’s (FAQ’s) - Motor Insurance
WHAT ARE THE MAJOR COVERS UNDER THE POLICY?
Loss or Damage to the Insured Vehicle caused due to:
a. Fire, explosion, self ignition or lightning.
b Burglary, housebreaking or theft
c All act of God perils like earthquake, flood, cyclone etc
d Accidental external means, terrorism, riot and strike
Liability to Third Parties:
Provides cover for any legal liability arising out of the use of the vehicle for
a Accidental death / injury to any third party
b Any damage to property owned by third party
The policy provides for a mandatory Personal Accident cover for owner driver and optional cover for
passengers covering accidental death and permanent total disability
WHAT ARE THE MAJOR EXCLUSIONS OF THE POLICY?
a. General aging, wear & tear, mechanical or electrical breakdown, failure, depreciation, any
b. Damage by a person driving without a valid license
c. Damage by a person driving under the influence of liquor or drugs
d. Loss/damage attributable to war, mutiny, nuclear risks
e. Damage to tyres and tubes, unless damaged during an accident
f. Usage on hire & reward (applicable for all classes except public commercial vehicles)
g. Loss or damage to bonnet side parts, mudguard, bumpers, lamps, tyres, tubes, headlights, paint
work (applicable for all commercial vehicles; unless opted additionally)
h. Loss or damage resulting from overturning arising out of operation as a tool (applicable for mobile
cranes, drilling rigs, mobile plants, navvies, shovels, grabs, rippers unless opted for additionally)
i. Loss of or damage to accessories by burglary housebreaking or theft unless the vehicle is stolen at
the same time (applicable to all commercial vehicles & two wheelers)
TRANSFER OF INSURANCE (INCASE VEHICLE IS SOLD)
a. No objection letter from the previous insured
b. Form 29/30, Sale Deed OR transferred RC copy. In case of smart card, RTO transfer fee paid
c. Differential Premium if any (NCB recovery, PAto Owner - Driver etc)
d. NOC from Financier, if applicable.
e. Pre-inspection is must if transfer request date is >14 days from the endorsed RC copy date
f. Break-in loading >45 days ( if applicable)
a. Incase of death of Insured - a. Death Certificate b. Legal heir certificate
b. Incase of Employer to Employee transfer - a. Letter from Employer
WHAT CHANGES CAN BE DONE IN MY POLICY ENDORSEMENT
For Changes related to registration of vehicle or vehicle details like
a. Correction in registration number/ location / address
b. Correction in vehicle make & model/ cubic capacity/ seating capacity/ engine & chassis
To make above changes, you need following documents:
a. Request letter for the change
b. Policy copy
c. Registration Certificate copy /Invoice Copy for change in vehicle details
d. Cheque for additional premium if applicable
For addition of electrical and non electrical accessories, CNG & LPG Kit:
c. Invoice copy (mandatory where value of accessory exceeds ` 20,000/-)
d. Endorsed Registration Certificate Copy (For CNG/LPG kit)
e. Cheque for additional premium
HOW DO I FILE A CLAIM?
ForAccidental Damage to Insured Vehicle (Own Damage Claims):
¡Call our customer care Toll-free 1800-2-700-700 (Accessible from India only) if the vehicle meets
with an accident and provide your policy number for reference and register the claim
¡Alternatively, you can visit and register on IPO (available on website/Download IPO app on your
smart phone) by providing personal details, link your policy and register your claim under "Claims"
Please keep the following details handy while intimating a claim
a. Policy No.
b. Registration details/ RC copy
c. Drivers details at the time of accident including driving license number
d. FIR on a case to case basis
e. Repair estimate
WHAT IS THE CLAIM PROCESS?
1. If your vehicle can be driven, take it to the nearest dealer / garage.
2. Get a repair estimate, fill up the claim form and attach a copy of the registration certificate and
driving license of the person driving at the time of the accident.
3. If the garage is within our network, you could avail of cashless claim facility. Pay for non accident
related repairs, depreciation and deductible. We would settle the rest.
4. If the garage is outside our network, you would have to get the claim reimbursed subsequently.
CLAIMS DOCUMENTS -
For ACCIDENTAL DAMAGE TO INSURED VEHICLE
a. Duly filled and signed claim form & satisfaction voucher
b. Registration Certificate (RC)
c. Driving license of the person driving at the time of the accident
d. Policy copy , original repair estimate, repair invoice
e. Payment receipt for non-cashless claims
f. Original repair invoice for cashless claims
g. AMLdocuments for amount more than 1 lac (PAN card, 2 passport size photo, residence proof)
h. Form 35 & original NOC from financer incase of total loss where payment is made to insured
i. Acopy of police FIR/panchnama is required forTPinjury / death / property damage
Additional documents required for commercial vehicles:
a. Spot survey b. Load challan c. Fitness certificate d. Route permit
CLAIMS DOCUMENTS: IN CASE OF LOSS DUE TO THEFT
a. Duly filled and signed claim form & discharge voucher ( after loss settlement )
b. Original Registration Certificate (RC)
c. Original policy copy
d. Copy of FIR lodged at the nearest police station
e. All original keys & vehicle invoice copy
f. No trace report confirming that the stolen vehicle is not traceable
g. Original NOC from financer incase of hypothecation / HPA
h. Intimation to RTO for theft of vehicle
i. Duly signed RTO transfer papers (Form 26, 28,29,30,35)
j. RC extract with stolen remark from the concerned RTO after the loss
k. AMLdocuments for amount more than 1 lac (PAN card, 2 passport size photo, residence proof)
l. Deed of subrogation cum indemnity on judicial stamp paper
WHAT IS NCB?
NO CLAIM BONUS (NCB):
NCB is provided for every claim free year basis the slab as provided byTariff.
How can I get No Claim Bonus Reserving Letter?
NCB Reserving letter can be provided only on Sale of vehicle evidenced by transferred RC copy OR
Sale Deed and Form 29 & 30. The OD section of the policy needs to be transferred to the new owner or
HOW DO I RENEW MY POLICY?
E mail or Call us for additional premium details & send relevant documents copy to our customer service
For Change of financier details (Hypothecation/Lease/Hire-Purchase)
a. Visit www.hdfcergo.com to renew instantly
b. SMS "RENEW <POLICY NO> " to 9999
c. Visit our nearest branch / your agent
d. Send a copy of the renewal notice along with
premium cheque to our branch office
e. Call our toll free number 1800 2 700 700
(Accessible from India only)
c. Endorsed Registration Certificate copy
d. NOC from financier (not mandatory for deletion if RC is endorsed)
For any endorsments on your policy you can contact us through any of the below mentioned modes:
E mail us at : firstname.lastname@example.org OR Call Toll-free: 1800 2 700 700 (Accessible from India only)
OR Fax your request at: 022 6638 3669 OR Raise a service request on Insurance Portfolio
Organizer (IPO) from www.hdfcergo.com
HOW TO CONTACT US?
Call Toll-free :1800 2 700 700 (Accessible from India only)
Fax :022 6638 3669
Write to us at :HDFC ERGO General Insurance Company Limited
(Customer service office) 6th Floor, Leela Business Park, Andheri Kurla Road, Andheri (East),
Mumbai - 400 059
IPO :Raise a service request on Insurance Portfolio Organiser (IPO)
Manage Your Portfolio
@ hdfcergo.com /
¡Link multiple policies
¡View/Email your policy
¡Register Motor claims
¡Track your claim status
¡View/Edit your contact details
¡Set Renewal Reminders
¡Create and track your interactions
¡Locate our network garages/ branches
* supports smart phone based on Blackberry, iPhone, Windows 8 & Android platform.
Download IPO mobile application from IPO website post log in
This document is a summary of the benefits offered. The information mentioned above is illustrative and not exhaustive. Information must be read in conjunction with the policy wordings.
In case of any conflict between this document and the policy wordings, the terms and conditions mentioned in the policy wordings shall prevail.
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http://cbs.wondershare.com/go.php?pid=1140&m=dbhttp://cbs.wondershare.com/go.php?pid=1140&m=dbPolicy copy , original repair estimate, repair invoice
Call Toll-free :1800 2