THE NEW INDIA ASSURANCE CO. LTD.

(Wholly owned by the Govt. of India)

POLICY SCHEDULE CUM CERTIFICATE OF INSURANCE

Two Wheeler Package Policy
Insured Name:
Customer ID:
Insureds Address:

Prev. Policy no.

Email:
Phone Number :

RAMCHANDRA K. RAWAT
Insured's Details
PO24456923
PLOT NO T--07,H. NO. 1076, SAI
RECEDENCY,,DAULAT WADI,
JWADI,,NAGPUR.,
NAGPUR ,MAHARASHTRA, 440023
16020331130100000326
enquiry@splendidlogistics.in
/ / 9373260111

Geographical Area / Zone:

Name of the Financier:
Type of fuel:
Type of body:
Seating capacity including
Driver:
Automobile Association
membership:
Cover Note No/Cover Note Issue
Date:

Vehicle
34125

Policy number:
Period of cover:

Trailer
0

Registration no.

16020331140100000830
27/11/2014 12:00:01 AM to 26/11/2015
11:59:59 PM
MH-40-AB-2354

Make/Model:
Receipt no.
Fax Number :

HERO MOTOC/SPLENDOR PLUS

10000089141100132178 - 24/11/14
NA / NA

Policy Details
Year of manufacture:
Chassis no./Engine no.:
Cubic capacity ( cc):
Variant:
Colour:

India/B
Petrol
Metal
1
none

Name of registration authority:

2012
34465/32479
0
SPLENDOR PLUS
BLACK
Nagpur - MH 40

Non-Elec Acc
0

IDV (in `)
Electrical Acc
0

Bi-fuel kit
0

Total Value
34125

Schedule of Premium
Own Damage

Liability
Basic TP Cover
Compulsory PA cover for Owner
Driver

Basic OD Cover

NCB(25%)
OD Premium in `

279

TP Premium in `

Net Premium in `:
Service Tax in `:
Total Payable in `:

505
784
97
881

Limitations 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 ` 1,00,000
For individual covers (OD) in`:
34125
Imposed excess in `:
0
Voluntary excess in `:
0
Compulsory excess in `:
100

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.
Signature Not
Verified

Policy No. : 16020331140100000830Document generated by QR_RENEWAL at 24/11/2014 18:29:52 Hours.

Digitally signed
Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
by Srinivasan
For Vaideswaran
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
Date: 2014.11.24
our own
grievance
18:29:54
IST 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.
Page No. 1

THE NEW INDIA ASSURANCE CO. LTD.

(Wholly owned by the Govt. of India)

PA cover for Owner Driver

Name of Nominee
Age of Nominee
NA
NA
PA cover for named persons
Name
none

Address

Phone no
Fax no.
Email

Relationship with the

Insured
NA

CSI Opted(`)
0

Issuing office
WADI/HINGNA (160203),
WADI MICRO OFFICE Sheela Complex, 1st Floor,
Near SBI, Wadi,Nagpur. , , ,
MAHARASHTRA , 440023.

07104220221
NA / NA
nia.160203@newindia.co.in

Name of the Appointee

(if Nominee is a minor)
NA

Nominee
NA

Relationship to the
Nominee
NA

Relationship
NA
New India Contact

Agent / Corp.
Agent / Broker /
Banc Assurance/
Referral Code Name

Mr. Gaurishankar
Sadashiv Borkar (AG00033208)
Gaurishankar Borkar (SI00061972)

Phone no
Fax no.
Email
Development
officer
Name/Code

/ / 9921328593
/
/
Mr. DIRECT BUSINESS MO WADI MO
160203 - (DI00000632)

In witness where of this policy has been signed at Mumbai on this 24/11/2014
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 Package/Liability policy attached/available on the
web site http://newindia.co.in; IMT Endorsement Number(s) printed herewith attached 22.
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.
I/We hereby certify that the policy to which this Certificate
For and on behalf of The New India Assurance Company
relates as well as this Certificate of Insurance are issued in
Limited
accordance with the provisions of Chapter X and XI of M.V.
Act, 1988.NIA S.T.REGN No: AAACN4165CST178.
Date of Issue: 24/11/2014

(Mr. Satyanarayan Mohapatra)

[ Sr. D.M]
Duly Constituted Attorney(s)

Policy No. : 16020331140100000830Document generated by QR_RENEWAL at 24/11/2014 18:29:52 Hours.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
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.
Page No. 2