Вы находитесь на странице: 1из 192

efo v³et Fefv[³ee SM³eesjmb e kebÀ. efue.

THE NEW INDIA ASSURANCE CO. LTD.


DeeF&.Deej.[er.S. HebpeerkeÀjCe mebK³ee / IRDA Registration No. : 190
meerDeeF&Sve mebK³ee / CIN No. : U 99999 MH 1919 GOI 000 526

vesle=lJe mes Hejs


Leadership and Beyond

DeefYekeÀlee& cewv³egDeue
Agent’s Manual
SpeWmeer efJeYeeie / AGENCY CELL
ÒeOeeve keÀe³ee&ue³e / Head Office
v³et Fefv[³ee SM³eesjbme efyeefu[bie, 87, cenelcee ieebOeer jes[, HeÀesì&, cegbyeF& - 400 001.
New India Assurance Building, 87, M. G. Road, Fort, Mumbai - 400 001.
otjYee<e / Tel. : 91+22+22708100 / 22708400
JesyemeeF&ì / website : http://newindia.co.in
ìesue ÖeÀer ¬eÀ. / Toll Free No. : 1800-209-1415

(efvepeer efJelejCe nsleg / For Private Circulation Only)

[Updated version upto 01.04.2016]

1
2
CONTENTS

Page No.

Message from our Chairman ............................................................................... 5

Message from our General Manager ................................................................... 7

Agents Club Benefits Schem ............................................................................... 9

Fire Insurance ................................................................................................... 15

Marine Cargo Insurance ................................................................................... 33

Motor Insurance ................................................................................................ 35

Engineering Insurance ...................................................................................... 51

Accident Covers ................................................................................................ 90

Package Covers ................................................................................................ 96

Health Covers .................................................................................................. 112

Rural Insurance Covers ................................................................................... 152

3
THE NEW INDIA ASSURANCE CO. LTD.
At A Glance

Registered Office : New India Assurance Building,


87, Mahatma Gandhi Road, Fort, Mumbai – 400 001.

Website : www.newindia.co.in

CMD : Mr. G. Srinivasan

Employee Strength : 18,783

Organization Structure :

(A) DOMESTIC Regional Office 31


Large Corporate Office 06
Divisional Office 447
Branch Office 578
DAB 27
Micro Offices 1239

(B) FOREIGN Office Type No.

Branches Office 09
Agency Office 07
Associate Co. 03
Subsidiary Co. 08
Representative Office 01

Total 28

Financial Results :

For the year ended 31.03.2016 (Rs. in Crores)

Gross Global Premium 18,371


Net Worth 29,617
Total Assets 62,880

TOLL FREE NUMBER 1800-209-1415


4
MESSAGE FROM OUR CHAIRMAN

Dear Partners,

At the outset I thank all the Agents being the business


partners of this great company.

As you may be aware we have crossed the milestone


of Rs.18,000 crore Global Premium in the Financial
Year 2015-16 and continue to be the market leader
amidst stiff competition. This, we could achieve owing
to our expertise gained over a period of 96 years in
the Indian as well as overseas market. Also our capacity to underwrite major
risks due to the good will enjoyed in the overseas reinsurance market enable us
to achieve this milestone. I am glad to inform you that you the Agency force are
the major contributor of our premium income. It is because of that we have
included all the agents under the preview of APEP in order to recognize and
appreciate good performers.

At this juncture, I would like to share with you that retail line of business is
growing at a faster rate which is going to be the future of our entire industry.
As you are the people, who bring this business to us, I urge upon you to
concentrate more on retail business. There is great potential in tier II, III & IV
cities for personal line of business. These areas are less competitive and a
hardworking agent can easily tap sizable premium from this segment. Micro
insurance is another area which is also to be focussed in coming time. Now we
have also extended portal facility to agents so that it can be used in a big way.

I would also like you to convey the strengths of our company like more than 96
years of presence in the market, number one company in financial rating of 'A
Excellent Stable,' Foreign Operations over 28 countries, high retention capacity
to underwrite major risk and wide network of more than 2200 offices as a
marketing tool to gain the confidence of the customer.

While we value your long term association with us you can equally be proud to
be associated with the New India which is 'Born to lead' the industry forever
and having vision 'Leadership & Beyond'.

I hope this manual enable you to increase your business and service your
customer well.

I look forward to your continued patronage

With regards,

G. Srinivasan
Chairman cum Managing Director

5
6
MESSAGE FROM OUR GENERAL MANAGER
Dear Channel Partners,
I am very happy to place before you the new volume of
agency guidelines which will give you a brief detail of
various types of policies NEW INDIA is having for the
benefit of the insuring masses of our country
Agency channel has contributed significantly in the total
Indian business during 2015-16 and it will continue to
increase its share in coming years. This is because now
RETAIL BUSINESS is going to grow very significantly
due to the increased awareness about insurance and increased per capita income.
It is therefore essential that our agents are updated with the latest information
so as to face the new challenges in the future.
The present booklet has incorporated changes as on April 2016 and it will be our
effort to inform you about the changes in future.
To strengthen our agency force NEW INDIA has initiated many steps and we are
monitoring it further to strengthen you in technical knowledge and provide you
input as you are the face of NEW INDIA before our customers. Apart from the
club scheme, which started in 2008-09 we have created the post of AGENT
MANAGER in each office who will be the single point of contact for all agents in
providing support in all respect so that the agents can provide good service. Two
major initiatives have been launched during this year. They are providing AGENTS
PORTAL and official email facility.
By agents portal you can issue new policies and renew policies where there is no
break sitting at home. The premium can be deposited by you in the designated
bank of your office to conclude the deal. This facility will provide you an opportunity
to serve your clients on 24x7. Presently some policies are available on Portal but
gradually we will be including more policies on Agents Portal.
Another facility of NEW INDIA is the email facility provided to present club
members. By providing email facility agents are having an official identity of
representing NEW INDIA.
We are also in the process of developing a Facebook like profile pages for the
agents. This page will be a mini bio-data of the agent containing the agent’s
photograph, his contact details, product details, commission payable, Club status,
trainings undergone and association with NEW INDIA. This page is a way for
agents to display their capabilities and substantiate their performance while
meeting with prospective clients. The agent can share URL for this page with his
customers. The page will be part of the NEW INDIA website hence, giving
legitimacy to it. We believe this move will empower our agents and assist them
in getting more business.
We look forward to your feedback on this initiative, when you start using this.
With Regards
Rakesh Kumar
General Manager

7
APEP Team at
Head Office

Shri Rakesh Kumar


General Manager

Shri C. Khatri
Chief Manager

Shri C. S. Attal Shri Kiran Yele


Manager Administrative Officer
8
AGENTS CLUB BENEFITS SCHEME W.E.F PERFORMANCE
YEAR 2015-16
In view of a growing demand for changes to be brought in the Agent’s Club Membership
Scheme, our Company’s Board of Directors has approved revision in the scheme to be
effective from Performance Year 2015-16 onwards. The Scheme has been changed
keeping in view that more agents should be able to get the advantage of Club Benefit
Scheme.
S.No. Parameters Revised Scheme
1. ELIGIBILITY CRITERIA a. Minimum Premium of Rs.3 Lacs in previous year.
b. ICR should not be more than 90% for previous year
c. Motor Dealer can not be part of proposed scheme
d. Individual Agent needs to be present in person to
collect the Club Benefits.
e. Individual Agent should attend atleast 75% of
Agent Meetings conducted by Company
f. Only working Individual Agents cer tified by
Operating Office Incharge & Regional Incharge are
eligible.
2. SCORING MECHANISM Maximum points = 35
PREMIUM CRITERIA 1 point each for every 1 lac premium upto 35 lac
ICR CRITERIA Maximum Points = 30
a. For upto 40% ICR, full 30 marks. If ICR exceeds
40%, 1 point for 1% each will be reduced.
b. No points for ICR 70% & above
c. For calculation of ICR, maximum single claim outgo
is capped at Rs.4 lac per claim
GROWTH Maximum Points = 35No points upto 15% accretion
Afterwards for each 1% accretion, 1 point to be given
(i.e. max 35 points for 50% and above accretion)
3. CATEGORY OF We have now following 5 categories :
AGENTS CLUB
CMD CLUB : Above 90 pts... subject to minimum
premium of Rs. 50 lac in Performance Year.
All agents who have procured Rs. 4 crore and above
premium in performance year will also be qualified for
CMD Club irrespective of points earned.
GM CLUB : Above 80 and upto 90... subject to
minimum premium of Rs. 40 lac in Performance Year
RI CLUB : Above 70 and upto 80… subject to
minimum premium of Rs. 30 lac in Performance Year
DM CLUB : Above 60 and upto 70… subject to
minimum premium of Rs. 10 lac in Performance Year
9
BM CLUB : Above 50 and upto 60… subject to
minimum premium of Rs. 3 lac in Performance Year.
Agent will be entitled for any one Club Membership
only
4. BENEFITS CMD AGENT CLUB
TOTAL BENEFIT Upto Rs. ONE lac
Convention Upto Rs. 15000
for HO level+upto Rs.3000 for RO level
Mediclaim Upto Rs. 10000
Domestic Trip with family Upto Rs. 30000
Office related items Upto Rs. 42000
GM AGENT CLUB
TOTAL BENEFIT UPTO Rs. 50000
Convention Upto Rs. 3000
Mediclaim Upto Rs. 7000
Domestic Trip with family Upto Rs. 20000
Office related items Upto Rs. 20000
RI AGENT CLUB
TOTAL BENEFIT UPTO Rs. 30000
Convention Upto Rs. 3000
Mediclaim Upto Rs. 4000
Domestic Trip with family Upto Rs. 10000
Office related items Upto Rs. 13000
DM AGENT CLUB
TOTAL BENEFIT UPTO RS. 20000
Convention Upto Rs. 3000
Mediclaim Upto Rs. 3000
Office related items Upto Rs. 14000
BM AGENT CLUB
TOTAL BENEFIT UPTO RS. 10000
Convention Upto Rs. 3000
Mediclaim Upto Rs. 2000
Office related items Upto Rs. 5000
NB1 : For purchase of 2wheeler/4 wheeler, if agent wishes, he can utilize the budget
of Domestic Trip.
NB2 : Office related items-Laptop/I-Pad/Printer/AC/Refrigerator/Mobile Handset/
Reimbursement of Mobile Postpaid/2 wheeler/etc.
NB3 : HO LEVEL CONVENTION will be National Meet for all CMD Club Member
agents. - (Rs.15000 per person i.e. Hotel & Conference exp upto Rs.7000,
Memento & Misc Rs. 3000 & Rs. 5000 Gift Card towards travel expenses for
attending the Convention).
NB4 : RO LEVEL CONVENTION - RO Level Convention upto Rs. 3000 per person
i.e. upto Rs.1000 for Hotel & Conference exp, Rs. 2000 Gift Card to be given
towards travel expenses for attending RO Level Convention. No extra for
conveyance & Hotel Expenses.
10
TIPS TO AGENTS
❑ Good appearance
❑ Participation of Audience
❑ Good eye contact.
❑ Impress body language.
❑ Knowledge about our product
❑ Knowledge about competitor’s product.
❑ Graphic presentation.
❑ Understand client requirements.
❑ Solution to client needs.
❑ Be clear in sales.
EXPECTATIONS OF CUSTOMERS
● Accuracy
● Communication skills
● Consistency.
● Flexibility.
● Initiative.
● Integrity
● Knowledge
● Problem solving
● Dependability.
NIA’s e-enabling Facilities for Customers
1. Agent Portal
2. Dealer Portal
3. Brokers Portal
4. Development Officers Portal
5. Online Customer Portal Services – On line support @ newindia.co.in
6. Android phone/Smart phone support @”New India Customer app”
7. E-mail facility to Agents
8. E – marine certificate for marine
9. Cr/Dr. card e –payment facility
10. Quick renewal online- Renewal at any office facility with same credit to Dev. Officer/
Agent without break.
11. SMS alerts- 30 days prior to policy renewal
12. Toll free 1800 209 1415 Help desk

11
Special Drive Scheme for Motor Policies
Eligibility Criteria :
A. For Existing Agents
Monthly base motor premium for Accretion for existing Agents
same month of last year
Upto 2 Lakhs 15%
Exceeding 2 Lakhs and upto 5 Lakhs 10%
Above 5 Lakhs 7%
Now, there is no condition for minimum number of policy.
B. For Existing Agents
Since Fresh Agents are not having any base premium in the corresponding
month of previous year, therefore, the criteris of minimum number of policies,
i.e. 10 package & 30 total will be applicable.
Excluded Business
1. Auto tie-up business
2. Any business for which Outsourcing expense (Infrastructure expense) is
payable.
Criteria for Prizes
Class of Vehicle Prize per Policy
Two Wheelers 5% of total premium of each policy
Private Cars 8% of total premium of each policy or Rs. 1,800/- whichever is less
Commercial Vehicles 8% of total premium of each policy or Rs. 1,800/- whichever is less
The other features of the Prize scheme are as follows :
1. The Scheme is effective from 1st January, 2015.
2. The Scheme is open to Agent in all Operating Offices including Micro Offices.
3. Transferred business from one agent to another agent of the Company either
in the same Office or any other Office shall not be considered for the prize
scheme.
4. Division In-charge shall be the Competent Authority to verify and sanction
the prizes to all eligible agents in all the Office under the DO.
5. Prizes are to be released on monthly basis by 5th of succeeding month.
6. The Prizes are to be released only in the form of Gift Voucher / Gift Card /
Memento. No Cash Payment shall be made.
7. TDS will be applicable as per IT laws.
8. The Scheme shall include both new & renewal business.
The Division In-charge will have the authority to decline O. D. Cover for any
undesirable risk in any area considering the higher claim ratio and/or other adverse
factors. Undesirable O. D. business shall not be acceoted even if an agent may
like to include the same for Prize Scheme.
Note : Motor Prize scheme for Agents is subject to change from time to time.
12
Revised Incentive / Prize Scheme for
selling Health Policies
The salient features of the Scheme is as under :

1. The Scheme is applicable for sale of New Policies only.

2. The Scheme will run on monthly basis with effect from 1st September 2014.

3. Premium to be achieved for each month to be eligible for incentive is as under :

PREMIUM (in Rs.) INCENTIVE / PRIZE (in Rs.)

From Rs. 25000 to 49999 1100

From Rs. 50000 to 74999 2400

From Rs. 75000 to 99999 3500

Above Rs. 100000 5100

4. The above incentive/ prizes will be in addition to the commission which agent is
entitled to get under the rules.

5. NEW POLICIES shall mean those policies which were not renewal of New India
(of any Office) in expiring policy. They can be renewal of any insurance company
other than New India Assurance Company Limited. It can also be policies which
insured has taken for the first time.

6. Renewal of policies would mean that expiring policy has been renewed keeping
all the members as per expiring policy. Change of policy from 2007 to 2012 is
permissible. A person can be deleted while renewing the policy only if there is
Death of the member or Member has attained major status or married status
which compels him/her to take a new policy. In all these situations, it would be
construed to be renewal and shall not be treated as new business for the purpose
of incentive scheme.

7. The Divisional Incharge is the Competent Authority to award the prizes for his
Divisional Office and Branches under his/her control.

13
Incentives Scheme for Agents in respect of
Rural & Micro Insurance business
● The incentive scheme is applicable for rural and micro insurance policies only.
● The scheme will run on monthly basis w.e.f. 1st January 2015 and effective upto
31st March 2016.
● The agents shall retain 75% of their rural business to be eligible for this incentive
scheme. In case, the agent is not having any rural premium in rural and micro
insurance, the criteria on number of policies sold shall be applicable.
● The number of individual policies to be sold for each month is 25 and incentive
amount shall be as below (Fresh Business).
● The Agents who are already procuring Rural Business shall be eligible for Prize
Scheme, even if, they procure 25 New Policies.
No. of Policies Minimum Premium(Rs.) Prize(Rs.)
Upto 50 2,50,000 2,500
Above 50 5,00,000 5,000
Above 75 7,50,000 7,500
Above 100 10,00,000 10,000

● In case the agent sells less than 25 new policies in one month, is not entitled for
the benefit.
● The above incentives will be in addition to the commission, which agent is entitled
to get under the rule.
● The divisional in-charge is the competent authority to award the prizes to his
divisional office.
● For Mega rural policies where the premium is more than 25 lakhs, an
incentive of Rs.10,000/- in addition to his regular commission is proposed
in the new incentive scheme. Regional in-charge shall be the authority to
disburse the incentive in presence of head office executives. The incentives
shall be in form of gift cheques as practiced in other departments.
Note : The Rural Insurance Prize scheme for Agents is subject to change from time to
time.

14
FIRE INSURANCE
COVERAGE :
Covers Dwellings, Offices, Hotels, Shops, and Industrial, Manufacturing risks & Utilities,
tank forms/gas holders located outside the Industrial Manufacturing risks. Only
Standard Fire & Special Perils policy with the permitted ADD ON COVERS, if any,
can be issued.
The perils covered under the above policy are :
a) Fire
b) Lightning
c) Explosion/Implosion
d) Aircraft Damage
e) Riot strike and Malicious Damage
f) Storm, cyclone typhoon tempest hurricane tornado flood and inundation
g) Impact Damage
h) Subsidence and landslide including rockslide
i) Bursting and/or overflowing of water tanks apparatus and pipes
j) Missiles testing operation
k) Leakage from automatic sprinkler installation and
l) Bush fire.
TERRORISM :
It is an optional cover with appropriate extra premium.
PREMIUM :
The premium rates are given separately for Dwellings, Offices, Hotels, Shops, Industrial,
Manufacturing risks & Utilities, tank forms/gas holders located outside the Industrial
Manufacturing risks.
Premium for specific Add on Covers are also separately given.
ADD ON COVERS :
1) Architects, Surveyors and Consulting Engineers Fees (in excess of 3 % of
claim amount)
2) Removal of Debris (in excess of 1% of claim amount)
3) Deterioration of Stocks in Cold storage premises
4) Forest Fire, Impact Damage, Spontaneous Combustion
5) Omission to insure additions alterations or extensions
6) Earthquake
7) Spoilage Material Damage Cover
8) Leakage and Contamination Cover
9) Temporary Removal of Stocks Clause
10) Loss of Rent Clause, Additional expenses of Rent for alternative
accommodation.
11) Startup expenses
12) Escalation
13) Damage due to molten material spillage (FT/15/2011 dtd.30/7/2001)
15
DWELLINGS
Long-term policy will be issued for Dwellings based on either of the following 2 methods
Subject to the conditions mentioned below :
l Policy shall be for a minimum period of 3 years.
l Refund shall be allowed for mid term cancellation as per Circular FT/4/05 dtd. 31/
3/2005.
a. If the policy is cancelled within 3 years of inception, the premium to be retained
shall be worked out as per normal rates applicable – that is without allowing
any discount.
b. If the policy is cancelled after 3 years of inception, the discount slab shall be
reworked for the number of years the policy was actually in force. For this
purpose fraction of a year shall be rounded to the next higher year. For example,
if the policy has run for 3 years and 3 months, premium shall be retained for 4
years.
c. Refund, if any, shall be subject to the retention of minimum premium of
Rs.100/- as provided under Rule No.6 of Section I of AIFT.
l Mid term inclusion of perils shall not be allowed.
l Premium for the entire policy period shall be collected in advance.
METHOD A : Premium shall be charged in full without any discount. However
sum insured under the policy shall be deemed to have
increased by 10% of the original sum insured at the end of
every 12 months period.
OR
METHOD B : There shall not be any automatic increase in sum insured as
in Method A. However appropriate discounts shall be allowable
on gross premium as per table below :

Duration of Policy Long Term Policy Premium to be charged


3 Years policy 3 years premium in advance less 15% Discount
4 Years Policy 4 years premium in advance less 20% Discount
5 Years Policy 5 years premium in advance less 25% Discount
6 Years Policy 6 years premium in advance less 30% Discount
7 Years Policy 7 years premium in advance less 35% Discount
8 Years Policy 8 years premium in advance less 40% Discount
9 Years Policy 9 years premium in advance less 45% Discount
10 years and above 10 years premium in advance less 50% Discount

Note : Discount is applicable on basic Fire Premium

16
CLASSIFICATION OF PRODUCTS – FIRE INSURANCE
Risks under Fire Insurance have been categorised on the basis of Sum Insured as
follows :
CATEGORISATION OF PRODUCTS
PRODUCT CLASS RATED INDIVIDUAL RATED
LIMIT OF SUM INSURED LIMIT OF SUM INSURED
Standard Fire and Up to Rs.5 crores Beyond Rs.5 crores
Special Perils Policy. on Material Damage. on Material Damage.
Consequential Where MD sum insured Where MD sum insured
Loss Policy. is up to Rs.5 crores is beyond Rs.5 crores.
Petrochemical Risk — Minimum Rs.50 crores.

RATING PATTERN FOR FIRE PROPOSALS


A. Rate as per AIFT.
B. Less : Rate for deletion of STFI and RSMD.
C. FLEXA Rate (A - B).
D. Less : Technical & Discretionary Discount on FLEXA Rate.
E. Net Rate (C - D).
F. Add : STFI.
Earthquake Cover.
G. Policy Rate (E + F).
H. Net Premium.
I. Premium for Add-on Covers if opted.
J. Premium for Terrorism Cover.
K. Total Premium (H + I + J).
L. Service Tax.
M. Total Premium including Service Tax.
For Discounts, Agents to approach the concerned Operating Office Incharge.
FLOATER POLICY
Floater policy can be issued for stocks at various locations under one SI with 10%
extra premium.
SHORT PERIOD SCALES OF PREMIUM
To be charged as pro-rata premium + 10% applicable on the following :
a) Policies issued or renewed for periods shorter than 12 months and
b) Policies, which are cancelled during currency at the request of the insured.
The Technical Discount, as per the regulations, if any available under the class rated
and individual rated products has to be obtained from the Underwriting Office.
DECLARATION POLICY
To take care of frequent fluctuation in stock values declaration policy can be issued
subject to minimum retention of 50% premium.
17
AIFT FOR ALL THE BELOW CLASSES OF BUSINESS LIKE DWELLINGS,
SHOPS, ETC., IS GIVEN BELOW :
SECTION III
DWELLINGS, OFFICES, HOTELS, SHOPS ETC. LOCATED OUTSIDE THE
COMPOUNDS OF INDUSTRIAL/MANUFACTURING RISKS

RISK RATE DESCRIPTION Building rate Contents rate


CODE CODE Per mille Per mille
1 01 Dwellings, Places of worships, Libraries, 0.50 0.50
Museums, Schools, Colleges, Hospitals
including X-ray and other Diagnostic clinics,
Office premises, Meeting Rooms, Auditoriums,
Planetarium, Mess Houses, Clubs, Marriage
Halls, Showrooms and display centers where
goods are kept for display and no sales are
carried out, Educational and Research
Institutes imparting training in various crafts,
Lodging/Boarding Houses, Cycle Shed and
Dish Antenna, Indoor stadiums.
2 02 Cafes, Restaurants, Hotels, Confectioner
& Sweet meat sellers 1.80 1.80
3 021 Shops dealing in goods otherwise not
provided for including Laundries, Battery
Charging Service Stations, Dry Cleaning,
Amusement parks, Hoarding, Neon signs
and Sports Galleries, Outdoor stadiums. 1.80 2.80
4 022 Shops dealing in hazardous goods as per
the list below and Arms & Ammunition
dealers, Motor Vehicle showroom including
sales and service, Petrol / Diesel Kiosks. 1.80 3.80

Notes -
(1) Reduction in AIFT for deletion of STFI - Rs. 0.15 %o.
(2) Reduction in deletion of RSMD peril - Rs. 0.10 %o.
(3) Presence of Hazardous Goods not exceeding 5 % of total value of the
stock may be ignored.
(4) In multiple occupancy, the risks shall be rated per se.
(6) STFI Rates :
a. On Dwellings - 0.075%o (per mille)
b. Non Industrial
Hotels, Shops as per Section III of erstwhile terif - 0.1125%o (per mille)

18
SECTION IV
INDUSTRIAL /MANUFACTURING RISKS

RISK RATE DESCRIPTION OF RISK Rate (Rs.


CODE CODE per mille)
001 07 Abrasive Manufacturing 2.00
003 05 Aerial Ropeway including trolley stations 1.50
004 07 Agarbatti manufacturing 2.00
005 11 Aircraft Hangers 3.00
006 05 Airport Terminal Buildings (including all facilities like
Cafes, Shops etc)
N.B: Airport Cargo complex shall be rated under Section 1.50
007 18 Aluminums / Magnesium Powder Plants 5.50
009 07 Arecanut and/or Betel nut factories 2.00
010 05 Asbestos Steam Packing and lagging manufacturing 1.50
012 12 Audio/Video Cassette Manufacturing 3.50
015 15 Basket Weavers and Cane Furniture Makers 4.50
016 08 Battery Manufacturing 2.25
017 11 Beedi Factories 3.00
019 14 Bitumens Paper and / or Hessian Cloth
Manufacturing including Tar Felt Manufacturing. 4.00
023 05 Bridges - Concrete/Steel 1.50
024 07 Bridges-Wooden 2.00
025 03 Building In course of construction 1.00
027 11 Camphor Manufacturing 3.00
028 11 Candle Works 3.00
030 05 Capsule Manufacturing 1.50
031 10 Carbon paper / Typewriter Ribbon Manufacturing 2.75
034 15 Carpenters, Wood wool Manufacturing, Furniture
Manufacturing and other wood worker shops (excluding saw mill) 4.50
035 09 Carpet and Drug get Manufacturing (Cotton/jute/wool ) 2.50
036 12 Carpet and Drug get Manufacturing (Others) 3.50
037 11 Cashew nut / Wall nut Factories 3.00
038 07 Cattle feed Mill 2.00
039 24 Celluloid Goods Manufacturing 15.00
042 05 Ceramic Factories and Crockery and Stoneware pipe
Manufacturing/Clay Works. 1.50
044 08 Chemical Manufacturing (others),
Pharmaceuticals, Toiletry products 2.25
19
045 10 Cigar and Cigarette Manufacturing 2.75
046 12 Cigarette Filter Manufacturing
(Using Solvents with Flash Point below 32OC) 3.50
047 10 Cigarette Filter Manufacturing (Others) 2.75
048 11 Cinema Film Production Studios 3.00
049 07 Cinematography Film Editing, Laboratory and Sound
recording rooms where film processing is carried out 2.00
050 05 Cinematography Film Editing, Laboratory and Sound
recording rooms without film processing. 1.50
051 09 Cinema Theatres 2.50
052 22 Circus, Touring Drama Troupes, Touring Cinema Theatres 10.50
053 05 Cloth Processing units situated outside the
compound of Textile mills 1.75
054 18 Coal / Coke / Charcoal ball & briquettes Manufacturing 5.50
055 09 Coal Processing 2.50
056 07 Coffee Curing, Roasting / Grinding 2.00
057 12 Coir Factories 3.50
058 12 Collieries - underground Machinery and pit head gear 3.50
061 Contractors Plant and Machinery
13 At one location only 3.75
15 Anywhere in India (at specified locations) 4.50
062 12 Cork Products Manufacturing 3.50
063 22 Cotton Gin and Press Houses 10.50
064 15 Cotton Seed cleaning / delinting Factory 4.50
067 08 Detergent Manufacturing - others 2.25
069 15 Duplicating/stencil paper Manufacturing 4.50
070 05 Electric Generation Stations - Others 1.50
074 07 Enamel-ware factories 2.00
077 22 Exhibitions, Fetes, Mandaps 10.50
078 18 Explosives / Blasting Factories 5.50
080 12 Filter and wax paper Manufacturing 3.50
081 18 Fireworks Manufacturing 5.50
082 08 Flax / Hemp Mills 2.00
085 15 Foam Rubber Manufacturing 4.50
086 15 French Polish Manufacturing 4.50
091 09 Glass Fiber (Fiber Glass) Manufacturing 2.50
092 10 Glass wool Manufacturing 2.75
094 07 Gold thread factories / Gilding factories 2.00
095 05 Granite Factories using inflammable solvents 1.50

20
096 03 Granite Factories (Others) 1.00
097 09 Graphite electrode Manufacturing 2.50
099 09 Grease / Wax Manufacturing 2.50
100 05 Green Houses/ Algae/ Spiraling and the like 1.50
101 07 Gum/Glue/Gelatin Manufacturing 2.00
102 07 Gypsum board manufacturer 2.00
103 08 Hosiery, lace, Embroidery/Thread factories 2.25
105 05 Ice factories 1.50
106 11 Incandescent Gas mantle Manufacturing 3.00
107 07 Industrial Diamonds Manufacturing 2.00
110 05 Jiggery Manufacturing 1.50
111 15 Jute Mills 4.50
112 12 Katha Manufacturing 3.50
113 07 Khandsari Sugar Manufacturing 2.00
114 09 Lac or Shellac Factories 2.50
115 12 Leather Cloth Factories 3.50
116 07 Leather Goods Manufacturing (incl. boot/shoe) 2.00
117 05 Lime Kiln 1.50
118 09 Lithographic presses 2.50
119 15 Liquefied Gas Bottling Plants 4.50
123 07 Manure Blending works 2.00
124 18 Match Factories 5.50
125 15 Mattress and Pillow making 4.50
126 07 Metallizing works (involving metals only) 2.00
127 11 Metallising Works (others) 3.00
128 09 Metal/Tin printers 2.50
129 07 Mica Products Manufacturing 2.00
130 07 Mineral Oil blending and processing 2.00
131 05 Mosaic Factories 1.50
132 05 Mushroom Growing Premises (Excluding Crops) 1.50
133 24 Nitro Cellulose Manufacturing - Others 15.00
139 12 Oil and Leather Cloth Factories 3.50
145 08 Particle Board Manufacturing 2.25
146 14 Pencil Manufacturing 4.00
149 18 Plywood / Wood veneering Factories/Laminating Factories 5.50

21
151 07 Port Premises including jetties and equipment
thereon and other port facilities 2.00
Note 1:- Storage areas within the port premises shall be charged open
storage rates under section VI and/or under section VII as applicable.
Note 2:- No reduction in rates shall be allowed for
opting out STFI perils.
152 05 Poultry Farms (Excluding birds therein) 1.50
153 22 Presses for coir fibres/waste/Grass/fodder/boosa/Jute 10.50
154 15 Presses for coir yarn / cotton/sienna leaves 4.50
155 12 Presses for carpets, rugs and tobacco 3.50
156 10 Presses for hides and skins 2.75
158 09 Printing Press 2.50
159 05 Pulverizing Plants(Metals and non-hazardous goods) 1.50
160 11 Pulverizing Plants (Others) 3.00
164 05 Rope Works (others) 1.50
165 11 Rubber Factories 3.00
166 12 Rubber Goods Mfg with Spreading 3.50
167 09 Rubber Goods Manufacturing without spreading 2.50
168 03 Salt crushing Factories and Refineries 1.00
169 18 Saw Mills (including Timber Merchants premises where sawing is done). 5.50
172 12 Snuff Manufacturing 3.50
175 11 Spray Painting, Powder coating 3.00
176 05 Stables (excluding animals) 1.50
177 07 Starch Factories 2.00
178 03 Stone quarries 1.00
179 07 Sugar Candy Manufacturing 2.00
181 15 Surgical Cotton Manufacturing 4.50
183 05 Tanneries 1.50
184 07 Tapioca factories 2.00
185 14 Tarpaulin and canvas proofing factories 4.00
186 08 Tea blending / packing factories 2.25
187 09 Tea Factories 2.50
188 05 Telephone Exchanges 1.50
189 Textile Mills
07 Composite Mills (Composite Mills are those where activities
from Blow Room to Cloth processing are involved) 2.00
190 05 Tile & Pottery works 1.50
191 03 Tiny sector industries with values at risk not exceeding Rs. 25 lakhs 1.00
192 05 Tissue Culture Premises (Excluding Crops) 1.50
22
193 12 Tobacco Curing / Refrying Factories 3.50
194 12 Tobacco grinding/ crushing Manufacturing 3.50
195 20 Turpentine and rosin distilleries 6.50
196 08 Tyres and Tubes Manufacturing 2.25
197 11 Tyre Rethreading and Resoling factories 3.00
198 07 Umbrella Assembly factories 2.00
201 05 Weigh Bridges 1.50
203 22 Wheat Threshers 10.50
204 07 Wood seasoning/treatment/impregnation 2.00
205 09 Wool cleaning and pressing factories 2.50
208 07 Zip fasteners Manufacturing 2.00

Notes
Rates for deletion of STFI - 0.25 %o.
Rates for deletion of RSMD - 0.10 %o.
For multiple products manufacturing units, common
utilities to be rated at the highest rate.
Rates for inclusion of STFI - - 0.1875%o (per mille)

23
SECTION – V
UTILITIES LOCATED OUTSIDE INDUSTRIAL /MANUFACTURING RISKS

RISK RATE DESCRIPTION OF RISK RATE (RS.


CODE CODE per mille)
5 08 Analytical / Quality Control Laboratories 2.25
6 05 Boiler House 1.50
7 03 Dams 1.00
8 05 Effluent /Sewage Treatment Plant 1.50
9 05 Electric Sub-Station 1.50
10 05 Electric Transmission / Distribution Lines 1.50
13 05 Pump House (Water) 1.50
14 09 Pump House (Others) 2.50
15 11 Railway tracks 3.00
17 03 Water Treatment Plant 1.00
18 05 Wireless Transmitting Stations 1.50

Notes
Rates for deletion of STFI Rs. 0.25 %o
Rates for deletion of RSMD - Rs. 0.10 %o
Rates for inclusion of STFI - 0.1875%o (per mille)

24
SECTION VI
STORAGE RISKS LOCATED OUTSIDE THE COMPOUNDS OF
INDUSTRIAL/MANUFACTURING RISKS

RISK DESCRIPTION OF RISK MATERIAL STORED IN


CODE
GODOWNS OPEN
AND SILOS
RATE RATE (Rs. RATE RATE (Rs.
CODE per mille) CODE per mille)
23 Storage of Coir Waste, Coir Fibre,
Caddies 23 12.00 22 17.00

24 Cold Storage premises 09 2.50 -- --

(a) Rate for deletion of STFI - Rs. 0.25 %o for godowns and Rs. 1.50 %o for
materials stored in open
(b) Rate for deletion of RSMD - Rs. 0.10 %o for Godowns and for materials
stored in open
(c) Mode of classification of Haz. Goods and list of goods (Cat I, II, III) to
continue except Jute, Cotton and Coal & Coke
(d) Rate for inclusion of STFI :
1. In Godown - 0.1875%o.
2. In Open - 1.125%o.

25
SECTION VII
TANK FARMS/GAS HOLDERS LOCATED OUTSIDE THE COMPOUNDS OF
INDUSTRIAL/MANUFACTURING RISKS

All the items of Section - VII are already included in the Burning Cost Risks Code list.

Notes
Rates for deletion of STFI Rs.0.25%o
Rates for deletion of RSMD Rs.0.10%o
Rates for inclusion of STFI - 0.1875%o

26
Add-on Covers
Sr. Existing Peril New Rate
No. Rate Code
1 1001 Architects, Surveyors and Consulting
Engineers Fees (in excess of 3% of
the claim amount) Policy Rate
2 1002 Removal of Debris (in excess of 1% of
the claim amount) Policy Rate

3 1003 (A) Deterioration of Stocks in Cold


Storage premises due to accidental
power failure consequent to damage
at the premises of Power Station due
to an insured peril 25% of Policy Rate
4 1004 (B) Deterioration of stocks in cold
storage premises due to change in
temperature arising out of loss or
damage to the cold storage machinery
(ies) in the Insureds premises due to
operation of insured peril. Policy Rate
5 1005 Forest Fire Rs.5%o subject to
applicable claims
experience discount /
loading as per
Rules 1 & 2

6 1006 Impact Damage due to Insureds own


Rail / Road Vehicles, Fork lifts, Cranes,
Stackers and the like and articles
dropped there from. 5% of Policy Rate
7 1007 Spontaneous Combustion
1007 Category I goods 0.25%o
1107 Category II goods 0.50%o
1307 Category III goods 0.75%o
1407 Category IV goods 1.00%o
8 1008 Omission to insure additions, alterations
or extensions Policy Rate
9 1009 Earthquake (Fire and Shock)
1109 Zone I 0.5
1209 Zone II 0.25

27
1309 Zone III 0.10
1409 Zone IV 0.05
10 1010 Spoilage Material a) Stocks in specified
blocks 5 times
the policy Rate.
Damage Cover b) Machinery,
Containers &
Equipments in
specified blocks
2.5 times the
Policy Rate.
11 1111 Leakage and Contamination Cover a) Rs.5%o for
where the tanks are within the Leakage Cover
Insureds own premises only and
b) Rs.10%o for
Leakage
& Contamination
Cover.
12 1211 Where the tanks are located a) Rs.6%o for
elsewhere Leakage Cover
only and
b) Rs.12%o for
Leakage
& Contamination
Cover.
13 1012 Temporary Removal of Stocks Clause 10% of Policy Rate
14 1013 Loss of Rent Clause Policy Rate
15 1014 Insurance of Additional Expenses of
Rent for an Alternative Accommodation Policy Rate
16 1015 Start up Expenses Policy Rate

28
Revision in Sum Insured Bands and Terrorism premium rates are as under -
SeriaI Total Sum Insured (TSI) Risk Category Rate Loss Limit
No. per Location/compound per per location /
(MD + LOP/ALOP) Mille compound
(MD+LOP/ALOP)
1 Upto INR 500 crores Residential 0.08
Non Industrial 0.15 TS
Industrial 0.23
2 Over INR 500 crores and On First INR 500 crores as per (1)
upto INR 1,000 crores above PLUS on balance Sum lnsured
as under
Residential 0.08 TS
Non lndustrial 015
Industrial 0.20
3 Over INR 1,000 crores and On First INR 1,000 crores as per (2)
upto INR 1,500 crores above PLUS on balance Sum lnsured
as under
ResidentiaI 0.08 TS
Non lndustrial 0.12
Industrial 0.20
4 Over INR 1,500 crores and On First INR 1,500 crores as per (3)
upto INR 2,500 crores above PLUS on balance Sum Insured
as under
ResidentiaI 0.05 lNR. 1,500 crores
Non lndustriaI 0.12
lndustriaI 0.15
5 Over INR 2,500 crores and On First INR 2,500 crores as per (4)
upto INR 5,000 crores above PLUS on balance Sum lnsured
as under
ResidentiaI 0.05 lNR. 1,500 crores
Non lndustrial 0.10
Industrial 0.10
6 Over INR 5,000 crores and On First INR 5,000 crores as per (5)
upto INR 10,000 crores above PLUS on balance Sum Insured
as under
Residential 0.05 lNR. 1,500 crores
Non Industrial 0.08
IndustriaI 0.08
7 Over INR 10,000 crores On First INR 10,000 crores as per (6)
above PLUS on balance Sum lnsured
as under
Residential 0.05 lNR. 1,500 crores
Non lndustrial 0.06
Industrial 0.06
29
REVISED PREMIUM RATES BASED ON BURNING COST
W.E.F. 28. 01. 2015 - LOB FIRE
Sr. OCCUP OCCUPANCY DESCRIPTION Fire premium
No. ANCY Rate for Operating
CODE Ofice (rate per Mille)
1 1001 Dwelling 0.05
2 1006 Hospitals including X-ray and other Diagnostic clinics 0.08
3 1008 Auditoriums / Planetarium 0.08
4 1023 Shops dealing in goods otherwise not provided for 0.45
5 1024 Shops dealing in hazardous goods 0.40
6 2002 Aerated Water Factories 0.30
7 2008 Aluminium, Zinc, Copper Factories 0.16
8 2011 Atta and Cereal Grinding (excluding Dal Mills) 0.35
9 2013 Automobile Manufacturing 0.07
10 2014 Bakeries 0.35
11 2018 Biscuit Factories 0.36
12 2020 Book Binders, Envelope and Paper Bag Manufacturing 0.36
13 2021 Breweries 0.42
14 2022 Brickworks (including refractories and fire bricks) 0.30
15 2026 Cable Manufacturing 0.85
16 2029 Canning Factories 0.43
17 2032 Cardamom Factories 0.45
18 2033 Cardboard Box Manufacturing 1.00
19 2040 Cement / asbestos / concrete products Manufacturing 0.26
20 2041 Cement Factories 0.20
21 2043 Chemical Manufacturing (Usinag materials with Flash Point
below 32oC), Bulk Druo Manufacturing 0.60
22 2059 Condensed Milk Factories Milk Pasturising Plants and Dairies 0.20
23 2060 Confectionery Manufacturing 0.35
24 2065 Dehydration Factories 0.32
25 2066 Detergent Manufacturing with Sulphonation Plant 0.50
26 2068 Distilleries 0.25
27 2070 Electric Generation Stations Hydro Power Stations 0.30
28 2071 Electric Lamp / T.V. Picture Tube Manufacturing 0.30
29 2072 Electronic Goods Manufacturing/Assembly 0.70
30 2073 Electronic Software Parks 0.15
31 2075 Engineering Workshop - Structural Steel fabricators, Sheet
Metal fabricators, Hot/Cold Rolling, Pipe Extruding, Stamping,
Pressing, Forging Mills, Metal smelting, Foundries,
Galvanising works, Metal Extraction, Ore porocessing
(other than Aluminium, Copoer, Zinc) 0.20
32 2076 Engineering Workshop (Others), Clock/Watch Manufacturing,
Motor Vehicle Garages 0.18
30
33 2079 Fertiliser Manufacturing (other than those
rateable under Petrochemical Tariff) 0.75
34 2083 Flour Mills 0.25
35 2084 Foamed Plastics Manufacturing and/or converting plants 1.25
36 2087 Fruit and vegetable drying/dehydrating factory 0.28
37 2088 Fruit products and Condiment Factories
(including fruit pulp making) 0.37
38 2089 Garment Makers, Topee, Hats and the like makers 0.35
39 2090 Ghee Factories including vegetable Ghee mfg. 0.25
40 2093 Glass Manufacturing 0.39
41 2098 Grain/seeds disintegrating/crushing/
Decorticating factories/ Dal mills. 0.23
42 2104 Ice candy and Ice cream Manufacturing 0.30
43 2108 Industrial Gas Manufacturing 0.45
44 2109 Ink (excluding printing ink) Manufacturing 0.60
45 2120 Malt Extraction Plants 0.40
46 2121 Man-made Fibre Manufacturing (using Cellulose) 0.25
47 2122 Man-made Fibre Manufacturing Plant (Others) 0.24
48 2134 Non-woven fabric Manufacturing 0.85
49 2135 Oil Extraction 0.60
50 2136 Oil Distillation Plants (essential) 0.80
51 2137 Oil Mills Refining (Veg /Animal) 0.60
52 2138 Oil Milis Refining (Vegetable) 0.50
53 2140 Paint factories (Water based) 0.40
54 2141 Paint (others) and Varnish Factories 1.60
55 2142 Paints - Nitrocellulose based 0.50
56 2143 Pan Masala making 0.12
57 2144 Paper and Cardboard Mills (lncludino Lamination) 1.00
58 2147 Petroleum Coke Calcination 0.60
59 2148 Plastic Goods Manufacturing (excluding Foam Plastics) 1.90
60 2150 Polyester Film Manutacturlnc I BOPP Film Manufacturing 0.22
61 2157 Printineg Ink Manufacturing I Roller composition factories 0.80
62 2161 Rice Mills 0.24
63 2162 Rice Polishing Units 0.60
64 2163 Rope works (Plastic), Assembling of Plastic
Goods such as Toys and the like 0.36
65 2170 Sea Food / Meat Processing 1.50
66 2171 Silk Mills I Spun Silk Mills 0.50
67 2173 Soap Manufacturing 0.75
68 2174 Sponge Iron Plants 0.28
69 2180 Sugar factories 0.09
70 2182 Sweetmeat Manufacturing 0.70
71 2189 Textile Mills Spinning mills 0.50
31
72 2199 Velvet Cloth Manufacturing 0.80
73 2200 Vermicelli factories 0.30
74 2202 Weaving Mills 0.50
75 2206 Woollen Mills 0.27
76 2207 Yarn Processing 1.60
77 3007 Pipe lines (carrying water only) 0.03
78 3008 Pipe lines (others) 0.09
79 3012 Roads 0.03
80 4001 Storage of Non-hazardous goods subject to warranty that
hazardous goods of Category I, II, III , Coir waste, Coir fibre
and Caddies are not stored therein. 0.28
81 4002 Storage of Category I hazardous Goods subject to warranty
that goods listed in Category II, III, Coir waste, Coir fibre and
Caddies are not stored therein. 0.50
82 4003 Storage of hazardous Goods listed in Category II subject to
warranty that goods listed in Category III, Coir waste,
Coir fibre and Caddies are not stored therein. 0.80
83 4004 Storace of nazarcous Goods listed in Category III Subject to
warranty that Coir waste, Coir fibre and, Caddies are
not stored therein. 1.00
84 4005 Transporter’s godowns and Godowns
of clearing and forwarding agents. 1.25
85 4007 Cold Storage premises 0.70
86 4008 Gas Holders/Bullets/spheres and storages for liquified gases
except for Nitroqen, Carbon dioxide and inert gases 0.60
87 4009 Gas Holders/Vessels for Nitrogen,
Carbon dioxide and inert gases 0.45
88 4010 Tanks containing liquids flashing at 32oC and below 0.16
89 4011 Tanks (others) 0.06
In pricing the product please take into account the following :
1) The above rates in column no, 2 are the minimum rates applicable.
2) Add NAT/CAT rate (STFI & EQ) at the prevailing rate.
3) The above rates to be charged for all products under LOB Fire except Large Risk.
4) Our renewals to be protected. Where our renewal faces competition from
private players, HO to be contacted for review and revision of rates. U/W
offlces can directly approach fire tech dept, HO.
5) In IAR the Burning Cost would be charged on the FLEXA component of MD and
FLOP only MB rate would continue to be charged as per the earlier rate.
6) Incoming Co-insurance share to follow the Leader’s Rate.
7) The revised rates come into force with effect from 28th January, 2015.
8) The rates referred to above for Dwellings apply for Dwellings other than that of
individual customers
9) For renewals pertaining to private insurers refer the proposal RFQ with three
years claims experience to FIRE TECH, HO for approval and advices.
10) In respect of occupancies other than those listed above you may continue
underwriting the same as per the current underwriting practice.
32
MARINE CARGO INSURANCE
Marine Cargo Insurance covers Loss or Damage to Cargo while being transported By
Rail, Road, Sea and Air.
SCOPE OF COVER :
Cover varies from simple road / rail risks to All risks depending upon the cover taken.
COVER FOR TRANSPORT WITHIN INDIA :
There are THREE types of covers available :
INLAND TRANSIT (RAIL OR ROAD) CLAUSE A, B AND C
CLAUSE A (All Risk) - Provides for All risks of physical loss or damage.
CLAUSE B (Transit Risk) - Provides Basic cover of physical loss or damage of cargo
caused by Fire, Lightning, breakage of bridges and accident/derailment to carrying
vehicle.
CLAUSE C (Basic Risk) - covers physical loss or damage to the cargo by fire and
lightning only.
DURATION :
The duration of cover under Clause A and B is from the time the goods leave the
warehouse till the time they reach final warehouse but not exceeding 7 days after arrival
of the railway wagon or lorry at the destination town.
IMPORTANT EXCLUSIONS :
l Insufficient or unsuitability of packing or preparation.
l Loss or damage to willful misconduct of the insured.
l Wear and tear ordinary/customary loss in weight.
l Loss or damage caused by delay
l Loss or damage caused by inherent property or nature of cargo
l War risks, Riot and Strike and
l Malicious Act (This is excluded only under Clause B & C)
l By paying Extra Premium we can cover the Riot & Strike.
PREMIUM RATES :
Depends upon the factors like nature of cargo, type of packing, Mode of transport,
distance, type of cover required and claims experience etc., The rating will be
determined by the Branch/ DO/ RO/HO depending on the underwriting limits. The
profitability of the portfolio of the client also plays a vital role in determining the rates.
COVER FOR EXPORT/IMPORT :
Cover for exports/imports is subject to a set of Internationally used clauses known as
Institute Cargo Clauses (ICC) Cover under ICC (A) is wider whereas cover under ICC
(B) and (C) are restricted.
(a) Institute Cargo Clauses (C)
Risk covered : Loss or damage to the subject matter by fire, explosion, sinking,
stranding, or grounding of the vessel, overturning or derailment of the land,
33
conveyance, collision of the craft or conveyance. Loss due to discharge of cargo
at a port of distress. Loss by jettisons, general average loss.
(b) Institute Cargo Clauses (B)
Risk covered : As in the case of ‘C above with the addition of loss by earthquake,
volcanic eruption or lightening, loss of the cargo washed overboard water
damage either by entry of sea water, lake water or river water. Total loss of any
package, lost overboard the vessel or dropped during loading or unloading
operations.
(c) Institute Cargo Clauses (A)
This is the widest format of cover. This clause cover the risk in the case of ‘B
above with rainwater damage, piracy, deliberated damage or destruction by
wrongful act of any person, theft, pilferage, non-delivery, contact with mud oils
and acids, damage by other cargo, other extraneous perils all involving a fortuity.
OPEN POLICY
If the insured is having frequent large number of dispatches and/or incoming materials
Dispatches, it becomes inconvenient to go for individual policies for every dispatch. For
such cases Marine Open Policy is very convenient document.
COVERAGE :
Covers for insurance of goods dispatched within the country by Rail/Road/Air Freight
Registered Post or for import or export by air / sea / Regd. Post.
PERIOD :
ONE YEAR
SUM INSURED :
Full premium on the sum insured will be paid in advance and the same will be
determined based upon the estimated dispatches for 12 months. Before the sum
insured is exhausted, same can be enhanced by paying additional premium.
BASIS OF VALUATION :
Invoice cost of goods, freight & Insurance Premium plus generally 10% incidental
charges or CIF + 10%.
At the end of the policy period, premium for unutilized balance of the sum insured
already paid by the insured will be refunded subject to the rules framed by the company.
OPEN COVER :
Open Cover is issued for imports or exports whereby the insurer agrees to issue
individual certificates for individual dispatches/receipts as per predetermined rates
terms and conditions. The Open Cover is not an enforceable document but only an
agreement to insure as distinct from an open policy, which is an enforceable document.
The APD A/c is to be maintained.
ANNUAL TURNOVER POLICY :
By express agreement Covers imports exports domestic transits in a single policy. The
sum insures represent the insureds annual sales turnover and the same is required to
be exhausted by paying appropriate additional premium before getting exhausted by
the declaration based on the sales turnover which should be made every quarter.
34
MOTOR INSURANCE
Motor Insurance is governed by India Motor Tariff 2002 (except rating portion)
COVERAGE :
This Policy covers all type of vehicles viz., Two Wheelers, Three Wheelers, Four
Wheelers and Commercial Vehicles against Third Party Liability, as well as Damage
to Vehicle depending upon the needs of the Customers. Third Party insurance is
compulsory.
PREMIUM :
Depends upon the Zones i.e. Location of RTO of the vehicle concerned, age of the
vehicle, cubic capacity, No. Of passengers, in case of Public Transport Vehicle, Gross
Vehicle Weight, and Insured Declared Value. For all kinds of vehicle IMT 2002 rates
has to be applied. For discounts, if any, Agents to approach the concerned Operating
Office.
GEOGRAPICAL ZONES :
For the purpose of rating, the whole of India has been divided into the following zones
depending upon the location of the office of registration of the vehicle concerned.
(1) Private cars / motorized two wheelers / commercial vehicles ratable under section
IV C.1 & C.4
Zone A : Ahmadabad, Bangalore, Chennai, Hyderabad, Kolkata, Mumbai, New
Delhi & Pune.
Zone B : Rest of India.
(2) Commercial vehicle excluding vehicle ratable under section IV C.1 & C.4
Zone A : Chennai, Delhi/New Delhi, Kolkata, Mumbai.
Zone B : All other State Capitals.
Zone C : Rest of India.
IMT 2002 RATES w.e.f. 01/07/2002 – MOTOR INSURANCE
PREMIUM RATES FOR VARIOUS CATEGORIES OF VEHICLES
I. PRIVATE CAR
Own Damage Premium Rates :
Rate on IDV of the vehicle
ZONE B ZONE A
Age of CUBIC CAPACITY CUBIC CAPACITY
TheVehicle Not Exceeding Exceeding Not Exceeding Exceeding
exceeding 1000 cc but 1500 cc exceeding 1000 cc but 1500 cc
1000 cc not exceeding 1000 cc not exceeding
1500 cc 1500 cc
Not exceeding
5 years 3.039 % 3.191 % 3.343 % 3.127 % 3.283 % 3.440 %
Exceeding
5 years but
not exceeding
10 years 3.191% 3.351% 3.510 % 3.283 % 3.447 % 3.612 %
Exceeding
10 years 3.267 % 3.430 % 3.594 % 3.362 % 3.529 % 3.698 %
35
Liability Premium :
CUBIC CAPACITY OF THE VEHICLE PREMIUM
Not exceeding 1000 cc Rs. 2,055/-
Exceeding 1000cc but not exceeding 1500 cc Rs.2,237/-
Exceeding 1500 cc Rs.6,164/-
For Pvt. Cars Enhanced Cover (Nil Depreciation) can be given upto the age of 7
years. For details : contact Operating Office.
II. TWO WHEELERS
Own Damage Premium Rates:
Rate on IDV of the vehicle
ZONE B ZONE A
Age of CUBIC CAPACITY CUBIC CAPACITY
TheVehicle Not Exceeding Exceeding Not Exceeding Exceeding
exceeding 150 cc but 350 cc exceeding 150 cc but 350 cc
150 cc not exceeding 150 cc not exceeding
350 cc 350 cc
Not exceeding
5 years 1.676 % 1.760 % 1.844% 1.708 % 1.793 % 1.879%
Exceeding
5 years but
not exceeding
10 years 1.760 % 1.848% 1.936% 1.793 % 1.883 % 1.973 %
Exceeding
10 years 1.802 % 1.892 % 1.982 % 1.836 % 1.928 % 2.020 %
Liability Premium :
CUBIC CAPACITY OF THE VEHICLE PREMIUM
Not exceeding 75 cc Rs.569/-
Exceeding 75 cc but not exceeding 150 cc Rs.619/-
Exceeding 150 cc but not exceeding 350 cc Rs.693/-
Exceeding 350 cc Rs.796/-
For Two Wheelers Enhanced Cover (Nil Depreciation) can be given upto the age of
5 years. For details : contact Operating Office.

36
III. COMMERCIAL VEHICLES
GOODS CARRYING :
Class A. 1 – Public carriers (Other than Three Wheelers):FOR GVW Not Exceeding
12000 KG.
Own Damage Premium Rate Rate on IDV of the vehicle
AGE OF THE VEHICLE ZONE - C ZONE - B ZONE - A
Not exceeding 5 years 1.726% 1.743% 1.751%
Exceeding 5 years and not exceeding 7 years 1.770% 1.787% 1.795%
Exceeding 7 years 1.812% 1.830% 1.839%1
Liability Premium :
GROSS VEHICLE WEIGHT (GVW) TP PREMIUM (Rs)
Not exceeding 7500 Kgs. Rs.14,390/-
Exceeding 7500 Kgs. but not exceeding 12000 Kgs. Rs.15,365/-
Exceeding 12000 Kgs. but not exceeding 20000 Kgs. Rs.22,577/-
Exceeding 20000 Kgs. but not exceeding 40000 Kgs. Rs.24,708/-
Exceeding 40000 Kgs. Rs.25,800/-
Class A.2 : Private Carriers (other than Three Wheelers) :
Own Damage Premium Rates :
Rate on IDV of the vehicle
AGE OF THE VEHICLE ZONE - C ZONE - B ZONE - A
Not exceeding 5 years 1.208% 1.220% 1.226%
Exceeding 5 years and not exceeding 7 years 1.239% 1.251% 1.257%
Exceeding 7 years 1.268% 1.281% 1.287%
Liability Premium :
GROSS VEHICLE WEIGHT (GVW) in Kgs. TP PREMIUM (Rs.)
Not exceeding 7500 Rs.7,849/-
Exceeding 7500 but not exceeding 12000 Rs.11,528/-
Exceeding 12000 but not exceeding 20000 Rs.9,390/-
Exceeding 20000 but not exceeding 40000 Rs.12,821/-
Exceeding 40000 Rs.16,655/-

37
Class A. 3: Goods Carrying Motorized Three Wheelers, Motorized Pedal Cycles
and E-carts (Public Carriers) :
Own Damage Premium Rates: Rate on IDV of the vehicle
AGE OF THE VEHICLE ZONE - C ZONE - B ZONE - A
Not exceeding 5 years 1.640% 1.656% 1.664%
Exceeding 5 but not exceeding 7 years 1.681% 1.697% 1.706%
Exceeding 7 years. 1.722% 1.739% 1.747%
Liability Premium:
Premium for Liability Only cover for others Rs. 5,680/- and for E-carts Rs. 3,969/- for
Zones A, B and C.
Class A. 4: Goods Carrying Motorized Three Wheelers, Motorized Pedal Cycles
and E-carts (Private Carriers):
Rate on IDV of the vehicle
AGE OF THE VEHICLE ZONE - C ZONE - B ZONE - A
Not exceeding 5 years 1.148 % 1.159 % 1.165 %
Exceeding 5 but not exceeding 7 years 1.177 % 1.188 % 1.194 %
Exceeding 7 years 1.205 % 1.217 % 1.223 %
Liability Premium :
Premium for Liability Only cover for others Rs. 4,200/- and for E-carts Rs. 3,438/- for
Zones A, B and C.
B. TARIFF FOR TRAILERS
Rate on IDV of the vehicle
No. of Trailers Towed by
under tow at any
one time (by one Agricultural /Forestry Other Vehicles
or more towing Vehicles
vehicles) Own Damage Liability Only Own Damage Liability Only
(per Trailer) (per Trailer) (per Trailer) (per Trailer)
1 Trailer towed 0.87% 1.05%
2 Trailers towed 0.90% For each 1.08% For each
3 Trailers towed 0.93% Trailer 1.12% Trailer
4 Trailers towed 0.96% Rs. 460/- 1.16% Rs. 1125/-
5 Trailers towed 1.00% 1.20%
6 Trailers towed 1.05% (For more one 1.25% (For more one
7 Trailers towed 1.10% than Trailer please 1.32% than Trailer please
8 Trailers towed 1.15% multiplies the 1.38% multiply the
No. of Trailers) No. of Trailers)

38
IV. PASSENGERS VEHICLES :
C. 1.a. Passengers (IV Wheelers) used for hire of reward with Carrying Capacity
not exceeding 6 passengers :
Own Damage Premium Rates : Rate on IDV of the vehicle
ZONE B ZONE A
Age of CUBIC CAPACITY CUBIC CAPACITY
TheVehicle Not Exceeding Exceeding Not Exceeding Exceeding
exceeding 1000 cc but 1500 cc exceeding 1000 cc but 1500 cc
1000 cc not exceeding 1000 cc not exceeding
1500 cc 1500 cc
Not exceeding
5 years 3.191 % 3.351 % 3.510 % 3.284 % 3.448% 3.612 %
Exceeding 5
years but not
exceeding
7 years 3.271 % 3.435 % 3.598 % 3.366 % 3.534 % 3.703 %
Exceeding
7 years 3.351 % 3.520% 3.686 % 3.448 % 3.620 % 3.793 %
Liability Premium :
CUBIC CAPACITY OF THE VEHICLE PREMIUM
Not exceeding 1000 cc Rs. 6,396 + Rs. 1,230 x Total No. of
passengers the vehicle is licensed
to carry.
Exceeding 1000 cc but not Rs.8,408 + Rs.1,035 x Total No. of
exceeding 1500 cc passengers the vehicle is licensed
to carry.
Exceeding 1500 cc Rs.11,144 + Rs.11,283 x Total No. of
passengers the vehicle is licensed
to carry.
C. 1.b. Passengers (III Wheelers / E-Rickshaws) used for Hire & Reward with
Carrying Capacity not exceeding 6 passengers :
Own Damage Premium Rates : Rate on IDV of the vehicle
AGE OF THE VEHICLE ZONE - C ZONE - B ZONE - A
Not exceeding 5 years 1.260% 1.272% 1.278%
Exceeding 5 years but not exceeding 7 years 1.292% 1.304% 1.310%
Exceeding 7 years 1.323% 1.336% 1.342%
Liability Premium :
PREMIUM FOR Rs.1,733/- + Rs.828 for others and Rs.1,125/- + Rs. 538/- for
LIABILITY ONLY COVER : E-Rickshaws x Total No. of Passengers the vehicle is licensed to carry.

39
Class C. 2 : Four (or more) Wheeled Vehicles with Carrying Capacity exceeding 6 Passengers and Three Wheelers /
E-Rickshaws with Carrying Capacity exceeding 17 Passengers for hire or reward :
Own Damage Premium Rates : Rate on IDV of the vehicle
Age of ZONE C ZONE B ZONE A
the vehicle
Maximum Licensed Maximum Licensed Maximum Licensed
Carrying Capacity Carrying Capacity Carrying Capacity

Exceeding 18 passengers

Exceeding 36 passengers

Exceeding 60 passengers

Exceeding 18 passengers

Exceeding 36 passengers

Exceeding 60 passengers

Exceeding 18 passengers

Exceeding 36 passengers

Exceeding 60 passengers
but not exceeding

but not exceeding

but not exceeding

but not exceeding

but not exceeding

but not exceeding


18 passengers

36 passengers

60 passengers

18 passengers

36 passengers

60 passengers

18 passengers

36 passengers

60 passengers
Not exceeding

Not exceeding

Not exceeding
40

Not Rs. 350 Rs. 450 Rs. 550 Rs. 680 Rs. 350 Rs. 450 Rs. 550 Rs. 680 Rs. 350 Rs. 450 Rs. 550 Rs. 680
exceeding + + + + + + + + + + + +
5 years 1.656 % 1.656 % 1.656 % 1.656 % 1.672 % 1.672 % 1.672 % 1.672 % 1.680% 1.680% 1.680 % 1.680 %
Exceeding Rs. 350 Rs. 450 Rs. 550 Rs. 680 Rs. 350 Rs. 450 Rs. 550 Rs. 680 Rs. 350 Rs. 450 Rs. 550 Rs. 680
5 years but not + + + + + + + + + + + +
exceeding 7 years 1.697 % 1.697 % 1.697 % 1.697 % 1.714 % 1.714 % 1.714% 1.714% 1.722 % 1.722 % 1.722 % 1.722 %
Exceeding Rs. 350 Rs. 450 Rs. 550 Rs. 680 Rs. 350 Rs. 450 Rs. 550 Rs. 680 Rs. 350 Rs. 450 Rs. 550 Rs. 680
7 years + + + + + + + + + + + +
1.739 % 1.739 % 1.739 % 1.739 % 1.756 % 1.756 % 1.756% 1.756 % 1.764% 1.764 % 1.764 % 1.764 %

Liability Premium :
Rs. 10,294/- + Rs. 629/- X total number of passengers the vehicle is licensed to carry.
CLASS: C. 3: Motorized Three Wheeled / E-Rickshaws Passenger Carrying Vehicles for
hire or reward with Carrying Capacity exceeding 6 but not exceeding 17 Passengers.
Own Damage Premium Rates : Rate on IDV of the vehicle
AGE OF THE VEHICLE ZONE - C ZONE - B ZONE - A
Not exceeding 5 years 1.759% 1.777% 1.785%
Exceeding 5 years but not exceeding 7 years 1.803% 1.821% 1.830%
Exceeding 7 years 1.847% 1.866% 1.874%
Liability Premium :
Premium for Liability Only Rs.4,155/- + Rs.829/- x Total No. of passengers
cover the vehicle is licensed to carry.
CLASS C.4 : Motorized Two Wheelers used for Carrying Passengers for hire or
reward :
Own Damage Premium Rates : Rate on IDV of the vehicle
ZONE B ZONE A
Age of CUBIC CAPACITY CUBIC CAPACITY
TheVehicle Not Exceeding Exceeding Not Exceeding Exceeding
exceeding 150 cc but 350 cc exceeding 150 cc but 350 cc
150 cc not exceeding 150 cc not exceeding
350 cc 350 cc
Not exceeding
5 years 1.743% 1.830 % 1.917 % 1.794 % 1.884 % 1.973 %
Exceeding 5
years but not
exceeding
10 years 1.787 % 1.876 % 1.965 % 1.839 % 1.931 % 2.023 %
Exceeding
10 years 1.830 % 1.922 % 2.013 % 1.884 % 1.978 % 2.072 %
Liability Premium :
Motorized Two-Wheelers used for Premium Zone - B Premium Zone - A
carrying passengers for hire or reward w. e. f. 01st April 2016 w. e. f. 01st April 2016
Up to 150 cc Rs.702/- + Rs.473/-(P.P.) Rs.702/- + Rs.473/-(P.P.)
Exceeding 150 cc but not exceeding 350 cc Rs.702/- + Rs.473/-(P.P.) Rs.702/- + Rs.473/-(P.P.)
Exceeding 350 cc Rs.1,615/- + Rs.473/-(P.P.) Rs.1,615/- + Rs.473/-(P.P.)

41
Annexure I and II V. Tariff for Miscellaneous & Special Types of Vehicles
(Class : D)
Own Damage Premium Rate : Rate on IDV of the vehicle
AGE OF THE VEHICLE ZONE - C ZONE - B ZONE - A
Not exceeding 5 years 1.190 % 1.202 % 1.208 %
Exceeding 5 years but not exceeding 7 years 1.220 % 1.233 % 1.238 %
Exceeding 7 years 1.250 % 1.262 % 1.268 %
Mobile Units : Endorsement IMT 47 is to be used in respect of the following mobile
units :
(a) Mobile Cranes
(b) Mechanical Navies, Shovels, Grabs, Rippers and Excavators
(c) Dragline Excavators,
(d) Mobile Drilling Rigs
(e) Mobile Plant
Package policies issued to the above units can be extended to cover damage to the
unit by overturning during operational use as a tool of trade at an additional rate of
0.5% of IDV of the vehicle subject to a minimum additional premium of Rs.100/-.
Liability Premium :
TYPES OF VEHICLE LIABILITY ONLY PREMIUM
A. - i) Pedestrian controlled Agricultural Tractors
with Horse Power rating not exceeding
6 HP, Hearses and plane Loader Rs. 897/- (min. value for OD Rs. 10,000/-)
ii) Other Miscellaneous and special
type of vehicles Rs.3,822/- (min. value for OD Rs. 50,000/-)
B. Trailors attached to (i) Rs. 510/- each, (ii) Rs. 1,307/- each.
IRDA vide its Circular IRDA/NL/ORD/MPL/077/03/2012 dtd. 01.04.2012 has shifted
following 7 types of vehicles from Miscellaneous & Special type of vehicles to Goods
Carrying Vehicles, i.e. from Class ‘D to Class 4 A :
1. Tractors other than Agricultural Tractors
2. Dumpors
3. Milk Vans
4. Oil & Transport Vehicles
5. Refrigeration / Pre-cooling Unit
6. Tankers
7. Tippers
Also vide above Circular IRDA has revised the premium for coverage of Paid Drivers,
Conductors and Employees under the WC Act from Rs.25/- per capita to Rs.50/- per
capita.
42
LONG -TERM TWO-WHEELER PACKAGE POLICY
(For 2 or 3 Yrs. Max.) (wef 17.03.15)
❖ IDV calculated for each year as per GR8 for 2 or 3 yrs. policy & Age of Veh. shouldn’t
exceed 6 yrs. as on date of inception of Ins.
❖ No Anti-theft or Automobile Association Membership Discount available.
❖ In case of Claim free expiring Policy, 20% discount on 1st yr. of 3 yrs. policy & 15%
discount on 1st yr. of 2 yrs. policy allowed.
❖ Minimum OD Premium of Rs.600/- for 3 yrs. & Rs.400/- for 2 yrs. policy and entire
premium paid in one instalment.
❖ No Claim Discount (GR 27) as per following :
For 2 Years Policy For 3 Years Policy
If no claim made during 2 yrs. block 20% Disc. If no claim made during 3 yrs. block 30% Disc.
If one claim made during 2 yrs. block 05% Disc. If one claim made during 3 yrs. block 10% Disc.
If > 1 claim made during 2 yrs. block 0% Disc. If > 1 claim made during 3 yrs. block 0% Disc.
LONG-TERM TWO-WHEELER (ENHANCED COVER) POLICY
( ‘0’ Dep.) (Upto 3 Yrs.) (wef 17.03.15)
❖ Age of the vehicle should be < 5 years and to be granted for 2 yrs. or 3 yrs. only.
❖ Sports / Racing Vehicles not to be covered, however, Imported Vehicles can be
covered with HO prior approval.
❖ No Short period rates and No geographical extn. allowed under Two wheeler
Package or Enhanced cover policy.
❖ Two wheeler Package or Enhanced cover policy can be cancelled as per IMT-2002.
LONG-TERM STAND ALONE MOTOR THIRD-PARTY INSURANCE
(Upto 3 Yrs.) (wef 09.09.14)
❖ Premium will be 2 or 3 times of the annual Two-wheeler Third-party Insurance and
entire premium paid in one instalment.
❖ Policy can be cancelled in case of Total Loss, in which premium for full un-utilized
years will be refunded.
❖ All the above policies are having benefits like protection from increase in TP
Premium & Savings in OD Prem.
PRIVATE CAR-Enhanced Cover(ADD ON COVERS)
(Not for Stand Alone Policies)(No discount)(wef 06.04.16)
Max.Age Rates / Terms & conditions (Carry. Cap. Max. 1+9)
(Imported Veh. by HO)
1. Road Tax Cover 5 Yrs. 1.67% of road tax amt. Against Total Loss only
(IDV for Road Tax Amt. will remain same)
2. Return of Invoice 3 Yrs. <1 Yr. 1 to 2 Yrs. 2 to 3 Yrs. Against Total Loss only -
(Inv.value max.<20 Lacs) Diff. of IDV & listed SP on DOA
0.20% of 0.35% of 0.50% of
Inv.Value Inv.Value Inv.Value
43
3. NCB Protection 7 Yrs. IDV Current NCB 0% NCB 20% NCB 25% NCB 35%
Allow next slab of NCB <17 Lacs 0.30% of IDV 0.40% of IDV 0.45% of IDV 0.50% of IDV
(Max. first 2 claims)
>17Lacs 0.40% of IDV 0.50% of IDV 0.55% of IDV 0.60% of IDV
4. Engine Protection 5 Yrs. Agej <1 Yr. 1 - 2 Yrs. 2 - 3 Yrs. 3 - 4 Yrs. 4 - 5 Yrs.
(Consequential loss due
to ingress of water) Without 0.25% 0.25% 0.25% 0.25% 0.25% Dep.on parts
‘0’ Dep. applied
With ‘0’ Dep. 0.20% 0.28% 0.30% 0.35% 0.40%
5. Additional Towing 7 Yrs. 5% of addl.towing charges opted Lump sum addl. Limit of
Rs.10000/- (i.e. max.11500/-)
6. Loss of Contents 7 Yrs. 0.7% of SI for all ages Opt SI of Rs.20000/- with
each item cap of 20% or actual value, whicheve is less
Protection against personal belongings in an accident viz.
Clothes, Jewellery, Key, Mobile, Laptop, CDs but not cash/cheques/cards etc.
Add-on covers at Sr.Nos. 4 to 6 are applicable to any
2 claims at option of the insured during policy period.
I.D.V. (Insured’s Declared Value) (GR 8) :
Period Upto 6M >6M<1Y >1Y<2Y >2Y<3Y >3Y < 4Yrs. >4Y < 5Yrs. More than 5 Years
Depreciation % 5% 15% 20% 30% 40% 50% On Understanding
SHORT PERIOD RATES :
Year Upto 1M Upto 2M Upto 3M Upto 4M Upto 5M Upto 6M Upto 7M Upto 8M > 8 Months
% of Annual 20% 30% 40% 50% 60% 70% 80% 90% Full
Rate Premium
N.C.B. (No Claim Bonus) :
Year 1st 2nd 3rd 4th 5th Sunset Clause : On renewal, If higher NCB, than same %
is allowed. If claim reported afterwards, ‘0%’ on renewal.
NCB% 20% 25% 35% 45% 50%
DISCOUNTS : (On Motor OD Premium)
Auto.Ass. Vintage Cars Anti-Theft Veh.~blind/ Use in own
Membership Handicap premises
Two Wheeler 5% Max.50/- 25% 2.5% Max.500/- 50% 33.33%
Pvt. Cars 5% Max.200/-
TPPD Discount (IMT20) : (If opted for statutatory limit Rs.1 Lac for 2wheelers /
Rs.7.5 Lacs for other veh.) :
(Mid-term change for TPPD limits is not permitted)
Two Wheeler Pvt. Cars Two Wheeler (Comm.Veh.) 3 Wheel./Taxi Goods/Pass.Carr.Veh
Rs.50/- Rs.100/- Rs.50/- Rs.150/- Rs.200/-

44
EXTRAS : Veh. Used for Driving VOLUNTARY DEDUCTIBLES (IMT 22A)
Tuitions (GR44)
Two Wheeler OD Prem.+60% Liab.+60% Two Wheelers Private Cars
Pvt. Cars OD Prem.+60% As per PCT* 500/- 05% max. Rs. 50/- 2500/- 20% max. Rs. 750/-
Goods/Pass. OD Prem.+60% As per CVT^ 750/- 10% max. Rs. 75/- 5000/- 25% max. Rs.1500/-
Carr. Veh.
*As per Private 1000/- 15% max. Rs.125/- 7500/- 30% max. Rs.2000/-
Car Tariff
^ As per Comm. 1500/- 20% max. Rs.200/- 15000/- 35% max. Rs.2500/-
Vehicle Tariff
3000/- 25% max. Rs.250/-
MINIMUM PREMIUM (GR16) Duplicate Transfer Fee (Insured
Certificate Fee must apply < 14 days of Tfr.)
Blind / Handicapped Vehicles All other Vehicles (NCB to be recovered GR27)
Rs. 50/- Rs.100/- Rs.50/- Rs.50/-
DEPRECIATION RATES (In Claims) :
Nylon / Rubber / Plastic Parts & Tyres / Tubes / Batteries / Air Bags 50%
Fibre Glass Components 30%
OTHER PARTS Upto 6 >6M<1Y >1Y<2Y >2Y<3Y >3Y<4Y >4Y<5Y >5Y<10Y >10Y
Months.
(incl. wooden 0% 5% 10% 15% 25% 35% 40% 50%
Parts)
OTHER CHARGES PAYABLE (In Claims) :
Two Wheelers 3 Wheeled Car / Taxis Other Comm. Veh.
TOWING CHARGES 300/- 750/- 1500/- 2500/-
Auth. Repair Charges 150/- 500/- 500/- 500/-
COMPULSORY DEDUCTIBLE (EXCESS) :
Two Wheeler Two Wheeler 2Wheeler PRIVATE CARS
(Hire & Reward) (Enhanced Cover) (Incl. Enhanced cover)
(from 2nd yr., addl.Excess) upto 1500CC > 1500 CC
Rs.100/- Rs.500/- Rs.200/- Rs.1000/- Rs.2000/-
Passenger Carrying Comm. Veh. (1+9 Seater (under Add-on Cover) :
Rs.3000/- in r/o each claim under Add-on
GOODS CARRYING VEHICLES Goods Carr. Veh. (Enhanced Cover)
(from 2nd yr., addl. Excess)
Upto 7500 >7500<16500 >16500 3Wheel./
GVW GVW GVW PedalCycle
Rs.500/- Rs.1000/- Rs.1500/- Rs.500/- Rs.2500/-

45
PASSENGER 4 Wheeled Vehicles 4 Wheeled Vehicles
CARRYING VEHICLES (CV) (upto 6 Pass.)
3Wheel.(<6 Pass.) 3Wheel.(7-17 Pass.) Upto 1500 CC > 1500 CC 7 - 36 Pass. > 36 Pass.
Rs.500/- Rs.1000/- Rs.500/- Rs.1000/- Rs.1000/- Rs.1500/-
Misc. & Special Types of Vehicles 0.5% of IDV, Min. Rs.2000/-
❖ Separate new Proposal Form to be filled for 2 Wheeler/Pvt.Car/
Comm.Veh. & Enhanced Cover Policy.
❖ Proposal form with RC copy, Invoice copy, Prev. Ins.Policy, NCB
confirmation, if any, to be submitted.
❖ For Comm.Veh., besides above, Permit, Fitness & residence proof of
owner reqd.
❖ Proposer / Insured’s Mobile & E-mail ID to be mentioned alongwith
Nominee details in case of PA to Owner-Driver.
❖ Policy can be extended to cover Bangladesh, Bhutan, Nepal, Pakistan,
Sri Lanka, Maldives by charging 500/- for ‘B’ & Rs.100/- for ‘A’ policy
(IMT-1), Air / Sea damages are excluded.
❖ Optional PA cover-2 Wheeler, Pvt.Car & Comm.Veh. @7/-, 5/- & 6/-
respectively per CSI of Rs.10,000/- (Max. Rs.2 Lacs CSI).
❖ The enhanced cover should not be provided for i) Sports; ii) Racer;
iii) Imported Vehicles.
FOR MORE DETAILS, PLEASE SEE ERSTWHILE INDIAN MOTOR TARIFF &
SUBSEQUENT REVISIONS FROM TIME TO TIME.

46
GR 40 Compulsory Deductibles
Claims under Own Damage section of policies covering all classes of vehicles are
subject to a compulsory deductible as per the under noted table :-
TYPE OF VEHICLES COMPULSORY
DEDUCTIBLES
(Rs.)
Commercial Goods carrying Passenger carrying
vehicles (other
than vehicles Not exceeding Not exceeding 500/-
rateable under 7500 Kg. GVW 17 passengers
Class-D, E, F
and G of CVT) Exceeding 7500 Kg. Exceedind 17 1000/-
but not exceeding passengers but not
16500 Kg. GVW exceeding 36
passengers

Exceeding Exceeding 1500/-


16500 Kg. GVW 36 passengers
Vehicles rateable under class D of the Commercial Vehicles 0.5% of IDV of
Tariff (CVT) the vehicle
subject to a
minimum of
Rs. 2000/-
Vehicles rateable under class E, F and G of the Commercial Rs. 50/- for
Vehicles Tariff (CVT) two wheelers
and Rs. 500/-
for other
Taxis and Three Wheelers rated as Commercial Vehicles 500/-
(Not exceeding 1500 cc)
Taxis and Three Wheelers rated as Commercial Vehicles 1000/-
(Exceeding 1500 cc)
Private Cars including three wheelers rated as Private Cars 1000/-
(Not exceeding 1500 cc)
Private Cars including three wheelers rated as Private Cars 2000/-
(Exceeding 1500 cc)
Motorized Two Wheelers 100/-

47
“ZERO DEP –ZERO X’CLUSION” ADD-ON COVER UNDER GOODS CARRYING
COMMERCIAL VEHICLE PACKAGE POLICY

UNDERWRITING GUIDELINES WITH RATES


There has been a growing demand by the Goods Carrying Commercial Vehicle
customers for the extended cover for Zero Depreciation & 100% coverage of Special
Exclusions of IMT 21 of India Motor Tariff 2002. With the view to meet this requirement
we have devised and got approved by IRDA the above mentioned Add-on covers to our
Goods Carrying Commercial Vehicle Package policy.
SCOPE FOR COVER :
This Ad-on cover of “ZERO DEP_ZERO X”CLUSION” provides an extension to the
Goods Carrying Commercial Vehicle Package Policy the cover for depreciation as well
as 100% Special Exclusions of IMT 21 under three Options as below :
A. Coverage of Depreciation on damaged parts in respect of partial losses plus
100% of Special Exclusions of IMT 21 of India Motor Tariff 2002, without
deduction of depreciation.
B. Zero depreciation on damaged parts in respect of partial losses payable under
a normal policy.
C. Coverage of 100% of Special Exclusions of IMT 21 of India Motor Tariff 2002.
Insured shall have the option to take either :
i. Cover ‘A’ or
ii. Cover ‘B’ or
iii. Cover ‘C’
Based on the cover opted, in case of any partial loss claim the depreciation norally
deducted for metallic and non-metallic including rubber/plastic/fiber parts etc. as well
as amount not payable under IMT 21 shall not be deducted from the claim amount
depending on the Add-on cover opted which can be either ‘A’ or ‘B’ or ‘C.’
ELIGIBILITY/APPLICABILITY :
1. The “ZERO DEP_ZERO X’CLUSION” Cover shall be provided only if opted at the
time of taking the Goods Carrying Commercial Vehicle Package policy, and shall
be given as an Add-on cover.
2. The Goods Carrying Vehicles for which coverage is opted should be less than 5
years old.
DECLINED RISKS :
The following type of Goods Carrying Commercial Vehicles shall not be provided the
“ZERO DEP_ZERO X’CLUSION” Add-on cover.
1. Goods Carrying Commercial Vehicles with age beyond 5 years.
2. Imported vehicles
OTHER EXCLUSIONS :
1. Exclusions as in the Goods Carrying Commercial Vehicle package policy other than
48
depreciation, and Special exclusions IMT 21 of the Indian Motor Tariff 2002 without
deduction of depreciation.
2. Improvements and/or extra fittings in the Goods Carrying Vehicle.
3. Claims relating to accidents in extended Geographical are.
4. Coverage for Zero Dep-Zero X’clusion add on is restricted to maximum of
two admissible claims in a policy period.
EXCESS
From the second year age of vehicle, additional excesses of Rs. 2,500/- will be
deducted from the claim amount, in respect of each claim, under Add-on covers.
PREMIUM RATES :
TO BE APPLIED ON THE BASIC OD PREMIUM FOR THE VEHICLE COVERED
WITHOUT ANY DISCOUNT
GVW Cover New & up to 2 years to 3 years to 4 years to
2 years 3 years 4 years 5 years
0-25000 A 33% 40% 45% 52%
B 3% 10% 15% 21%
C 30% 30% 30% 30%
25000-40000 A 34% 45% 48% 48%
B 4% 15% 18% 18%
C 30% 30% 30% 30%
>40000 A 39% 62% 65% 57%
B 9% 32% 35% 27%
C 30% 30% 30% 30%
COVER A-ZERO DEP-ZERO EXCLUSION
COVER B-ZERO DEP COVER ONLY
COVER C-ZERO EXCLUSION COVER ONLY
EXTENSION OF COVER :
In the event of death of the Insured during the policy period, the heirs of the insured shall
continue to be eligible for obtaining the benefit of the “ZERO DEP-ZERO X’CLUSION”
Cover dui\ring the current policy period.
COMMISSION/BROKERAGE: SAME AS IN MOTOR PACKAGE POLICY
ENDORSEMENT WORDING
ENDORSEMENT ATTACHED T AND FORMING PART OF POLICY NO.
Additional Premium Rs.
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 :
49
1. The cover under Section 1 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 under the claim.*
2. The cover under Section 1 of within mentioned policy is hereby extended to the
effect that in the event of any partial loss claim admissible under this policy the
deletions mentioned under Special exclusions of IMT 21 of India Motor\or Tariff
2002 shall stand covered and payable under the claim.*
Subject to the condition that above said coverage shall be applicable only for the
first two partial loss claims admitted and payable under the policy relating to
accidents during the 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 areas outside India.
3. After the first two admissible claims under “ZERO DEP-ZERO X’CLUSION” Cover
during the current Policy Period.
EXCESS
From the second year age of the vehicle, additional excesses of Rs. 2500/- will be
deducted from the claim amount, in respect of each claim under Add-on covers.
All other terms and conditions for within mentioned policy shall remain unaltered.

Duly Constituted Attorney(s)


*Please delete either of the two, as applicable, if only one of the covers (Cover
‘B’ or Cover ‘C’) only is provided.

50
ENGINEERING INSURANCE
MACHINERY BREAKDOWN INSURANCE
INTRODUCTION
Breakdown of machinery can be a drain on the profits and can even cause losses.
Why not seek insurance protection against such breakdowns. Machinery breakdown
insurance offers financial protection in case machinery suffers accidental, electrical
and mechanical breakdown requiring repairs and/or replacement as the case may be.
EQUIPMENTS COVERED
Machinery Breakdown Insurance covers all types of Industrial equipment like Turbines,
Compressors, Generators, Transformers, Rectifiers, Electric Motors, Diesel Engines,
Pumps, Wind Mills etc.
COVERAGE
Under Machinery Breakdown Insurance you are covered against all kinds of Accidental,
Electrical and Mechanical Breakdown due to internal causes, external causes,
operational deficiencies and human errors.
INTERNAL CAUSES
Internal causes could be –damage due to faulty material, defects in casting, faulty
construction, overheating of parts, short circuit, faulty erection, disruption in case of
rotating bodies due to centrifugal forces, failure of operations of safety devices etc...
EXTERNAL CAUSES
External causes include collision or impact from external objects or falling articles ,
failure of lifting machines or cranes, accidental falls during shifting of machinery within
the premises or during overhauling.
OPERATIONAL DEFICIENCIES
Operational Deficiencies include error of judgment, faulty operation, failure of safety
devices, failure of connected machinery, over-speeding, tearing apart on account of
centrifugal forces, short circuit, electrical burn-outs, insulation failures and cracking or
overheating of parts.
HUMAN ELEMENTS
Human Elements include Carelessness, negligence of operators and sabotage or
malicious acts.
PREMIUM RATES
Electric motors Upto 50 HP - Rs 2.00%
Above 50 HP - Rs 1.50%
For other rates please contact your office
ADDITIONAL COVERAGES
a. Damage to foundation of machinery
b. Express freight, holiday rates, overtime charges in the event of claim
51
c. Third Party Liability(including bodily injury and property damage)
d. Additional Custom Duty
RISKS NOT COVERED
l Loss of or damage to belts, ropes, chains, rubber tyres, dyes, moulds, blades,
cutters, knives or exchangeable tools, engraved or impression cylinders or rolls,
objects made of glass, porcelain, ceramics, all operating media e.g lubricating oil,
fuel, catalyst, refrigerator, dowtherm) felts, endless conveyor belts, or wires, sieves,
fabrics, heat resisting and anticorrosive lining and parts of similar nature, packing
material, parts not made of metal (except insulating material) and non-metallic
lining or coating of metal parts.
l Damage due to any cause for which the manufacturer and/or supplier is responsible.
l Overloading operations, experiments and test requiring abnormal conditions.
l Gradually developing flaws, defects, cracks etc.,
l Willful act or gross negligence of the Insured or of his responsible representative.
l Defect existing at the time of taking Insurance known to the Insured but not known
to the Insurers.
l Any type of consequential loss.
THE COVER
Can be taken by the owner of the machinery or a party holding the machinery in trust
or having financial interest in the said machinery, or Operation & Maintenance
contractor.
SUM INSURED
The Sum Insured of each item of machinery must be its Present Day New Replacement
Value of similar machines including all incidental expenses like duties, taxes, excise,
freight, insurance, landing etc.
This is a condensed version. For further details, kindly contact your office.
EXCESS
1% of sum insured for each machine subject to a minimum of Rs. 2500/-
Note : Sum Insured of the machine should be declared as a whole and should not be
apportioned towards parts of machine.

52
MACHINERY INSURANCE POLICY
RATE SCHEDULE
Group I
Electrical Machinery installed in Plants other than Cold Storages and Ice
Plants --
Excess :- 1% of sum insured for each machine subject to a minimum of
Rs. 2,500/- (Rate differs in guide rate)
Risk Sr. Rate Item Rate Remarks
Code No Code (%)
100106 (i) 1. 03 H.T./L.T. Switchgears and
Lightning Arrestors 0.55
100213 2. 07 Oil/Air Circuit Breakers 1.00
103113 3. 07 SF6 Circuit Breakers
Vacuum Circuit Breaker 1.00
100305 4. 03 Cables/Electrical Wiring 0.50
100413 5. 07 Battery Cells 1.00
100506 6. 03 Neutral Grounding Resistor 0.55
100616 7. 09 Series Reactor 1.50
100713 8. 07 HT Isolator Insulator 1.00
9. 08 Voltage Stabilizer 1.25
100816 (ii) 1. 08 Power and Distribution
Transformers. 1.25
100914 2. 08 Current and Potential
Transformers 1.25
101018 3. 10 Testing Transformers 1.75
101116 4. 09 Shunt Reactor 1.50
101213 5. 07 Capacitor Banks 1.00
101316 (iii) 1. 09 Rectifier Transformers 1.50
101419 2. 11 Furnace Transformers 2.00
3. Rectifiers -
101514 a) 07 Mercury 1.00
101613 b) 07 Metal 1.00
101711 c) 07 Silicon 0.80
101813 4. 07 Thyristor Converter/ Thyristor
Control Panel 1.00
(IV) 1. Electric Motors, Motor
Generators (including
AC/DC) & Welding Sets
of capacity -
53
101919 (a) 11 Up to 50HP (37.5 KW) 2.00
102016 (b) Above 50 HP 1.50
2 (a) DG Sets/ Gas Engine 1. Subject to DG Set
Generating Sets Endorsement, and
102117 i) 09 With capacity up to 5 MW 1.60 2. Turbo chargers
cannot be insured
in isolation
102217 ii) 10 With capacity above 5 MW 2.00
102319 iii) 11 Where only engine is to
be covered 2.00
102416 2 (b) 09 Steam Turbo Generator 1.50 1. Rate will apply
Sets with capacity upto irrespective of
500 MW whether the Turbine/
Generator are
covered separately
or together.
2. For higher capacity
beyond 500 MW,
reference shall be
made to Head Office
102520 2 (c) 10 Gas Based Combined Cycle 1.75 1. Rates will apply to
Power Plants/ Gas Turbo Gas Turbine/
Generator Sets Generator
irrespective
of whether they are
covered separately or
together. Other items
to be rated per se.
2. Subject to the
endorsement for
Depreciation
Adjustment for
Components along
the Hot Gas Path
of Turbines.
08 Radio Frequency Drier 1.25 Subject to depreciation
endorsement
07 Electronic & Computer
related equipment facility,
comprising surface mount
technology machine for
placing soldering components
on printed circuit boards, a
screen printer, a re-flow oven,
and in circuit tester etc. 1.00
06 Thermo Vacuum Cleaner 0.75 1. The equipment as
a whole to be insured
2. No MB cover can
be given to refrigerant.
54
Group II
RATES FOR MECHANICAL ITEMS
(MACHINES COMMON TO ALL INDUSTRIES)
Risk Sr. Rate Item Rate Remarks
Code No Code (%)
Air Compressors Refer
‘Compressors’
Air Receivers Refer ‘Receiver
for Compressors’
200104 02 Auto Claves/Agitators 0.45
200203 02 Alignment Machines 0.40
200307 04 Atomiser 0.60
200520 12 Air Conditioner (Room AC) 2.50
200605 03 Automatic Sealing Machine 0.50
200703 02 Automatic Bushing
Condenser Taping Machine 0.40
200803 02 Boring Machines 0.40
200905 02 Broaching 0.50
201003 02 Bar Cutting Machines (other
than Shearing machines) 0.40
201107 02 Bending Machines 0.60
Blending Machines Refer ‘Mixing &
Blending Machines’
201205 02 Blowers 0.50
201305 02 Bag filling and bag
Stitching Machines 0.50
201404 02 Boilers 0.45
201505 03 Beaters 0.50
201610 05 Briquette Machines 0.75
201705 03 Bronzing Machine 0.50
Baling Press Refer ‘Presses’
201810 05 Ball Mill 0.75
201905 02 Bottling and Filling Machines 0.50
202013 07 Burners & Firing System 1.00
202108 03 Chain Pulley Blocks 0.65
06 Chiller Plant (including
Compressor) 1.00
Compressors & Auxiliaries -
202222 04 Up to 25 PSI (8.5 KSC) 0.60
202323 06 Beyond 25 PSI (8.5 KSC)
up to 500 PSI (170 KSC) 0.70
202424 07 Beyond 500 PSI (170 KSC) 0.80
55
202502 01 Receivers for compressors 0.20
202602 01 Cooling Towers 0.20
202703 02 Condensers, Chillers,
Evaporators and Pre-heaters, 0.40
202807 02 Centrifuges 0.60
202903 02 Cutting Machines/ Saws (Other
than Shearing Machines) 0.40
203003 02 Cigarette Making Machine 0.40
Conveyors See Material
Handling Equipment
07 Concast Machine (continuous) 1.00
203109 05 Crushers (other than
Stone Crushers) 0.75
203206 03 Calendaring Machines, 0.55
Composing Machine -
203308 i) 04 Computerised 0.65
203405 ii) 02 Others 0.50
203503 02 Cooling Machines 0.40
203603 02 Crutcher Machines 0.40
203703 02 Crystalizer 0.40
203803 02 Cooling Coils 0.40
203914 08 Corona Treatment 1.25
Carrier Circulator To be rated as
‘PUMPS’
Cycle Manufacturing Industries
204003 02 i) Spoke Lacing Machine 0.40
204103 02 ii) Swaging Machine 0.40
204203 02 iii) Spoke Rolling Machine 0.50
204305 02 Drilling Machines 0.40
Deep Drawing Press To be rated as
Power Press
204405 02 Dairy & food Processing
Machines not otherwise
specifically provided for 0.50
204503 02 Dry Cleaning Equipment 0.40
204620 12 Deep Freezers 2.50
204710 05 Disintegrators 0.75
204807 04 Driers 0.60
204910 04 Diffusers 0.75
205003 02 Debrassing m/c 0.40
205103 01 Distillation Unit 0.45
205219 11 Diesel Engine 2.00 Subject to ‘Loss
Minimisation
Endorsement’
56
205304 01 De-aerator including
Storage Tanks 0.45
205409 03 Embossing/ Engraving
Machines 0.70
205513 07 Extruders of all types 1.00
205603 02 Evaporators/ Heat
Exchangers 0.40
205707 04 Electrostatic Painting Plants 0.60
205708 04 Electrostatic Precipitators 0.60
205709 05 Electrolyser 0.70
205803 02 Edge Runners 0.40
205913 07 Electrode Assembly 1.00
206003 02 Economiser 0.40
206108 02 E O T Crane 0.65
206213 07 Electric Automatic
Incubators used in Hatchery 1.00
206307 04 Ejector System 0.60
206414 08 Expander Machine 1.25
Electromagnetic Vibro- Refer Vibratory
Feeder Feeder
222510 05 Electromagnetic Machine for
Manufacturing Tapes
(excluding motor) 0.70
222613 07 Electromagnetic Machine for
Manufacturing Tapes
(including motor) 1.00
223313 07 Electric Discharge
Machine (EDM) 1.00
Furnaces -
206513 i) 07 Arc Furnaces with Roof
Lifting & Tilting Mechanism 1.00
206616 ii) 09 Induction Furnace 1.50 Subject to
Depreciation
Endorsement
206714 iii) 08 Heat Treatment/ Annealing 1.25 Subject to
Furnaces Electrical & Depreciation
Vacuum Furnace Endorsement
206816 iv) 09 Oil/Gas/Coal fired Furnaces 1.50
206905 02 Fans including ID/FD Fans 0.40
207005 02 Filling Machines 0.40
207103 02 Flour Mills 0.40
207205 02 Food Processing Machines 0.50
207305 02 Filters 0.50
207403 02 Finishing Machine for
Textile/Jute Mills 0.40
57
207516 08 Forging Machine 1.50
207605 02 Fin Fan Coolers 0.50
207709 05 Flakers 0.70
207814 08 Flaker drum 1.25
207914 08 Final concentrator 1.25
Glass and Graphite
Equipments -
208019 1. 11 Pure Glass and Graphite 2.00 Excess 20 % of claims
Equipments/ Apparatus used amount subject to
for industrial purposes (other minimum of Rs10000
than for laboratory
experiments /analysis and for
storage of chemicals and such
other products)
208116 2. 09 Glass lined Vessels 1.50 -Do-
208203 02 Grinding Machines 0.40
208305 02 Gear Cutting Machines 0.50
208405 02 Granulators 0.50
208512 05 Gas Generators 0.90
208613 07 Gear Boxes 1.00
208713 06 Gas Analysers 1.00
208820 10 Gas Turbine 1.75 Endorsement on
‘Hot Gas Path’
208907 04 Ginning Machines
(excluding Motor) 0.60
209505 02 Hobbing Machines 0.50
209613 07 Hydraulic Presses/ Systems 1.00
209716 08 Hammers excluding
tup and anvil 1.50
209003 02 Heat Exchangers 0.40
209103 02 Humidifiers/Dehumidifiers 0.40
06 Humidification Plants 1.00
209204 02 Hydro Pulper 0.45
209303 02 Hardness Testing Machine 0.40
209410 05 Hammer Mills 0.75
07 Hydro Turbines 1.00
209809 05 Jib Cranes in Industrial
premises only 0.70
209905 02 Jacquard Machine 0.50
02 Jewellery Making Equipments 0.45
210013 07 Kneading Machines
(blades not covered) 1.00
210103 02 Kettles 0.40
210207 04 Kilns 0.60
58
Lifts/Lifting Tackles -
211008 i) 02 Chain Pulley Blocks 0.65 Endorsements
for Ropes in lifts,
cranes & Rope Ways.
211105 ii) 02 Lift for Goods /Passengers 0.50 -Do-
211208 iii) 04 Overhead Cranes
including Monorail 0.65 -Do-
210309 iv) 04 Jib Cranes 0.70 -Do-
210416 v) 07 Magnets for Lifts 1.50 -Do-
210503 02 Lathes (except CNC) 0.40
210608 04 Lathes (CNC)/ All CNC
machines 0.65
210703 02 Laundry/Dry Cleaning 0.40
210816 07 Laboratory Equipments/ 1.50 1. Equipments /
Instruments (excluding Instruments made of
pilot plants) glass will be rated
as per item ‘Glass
lined Vessels’
210916 09 Load Cells along with
weighing Bridges 1.50
212516 07 Magnets for Lifts 1.50
Material Handling Equipments -
212603 02 Belt Conveyors 0.40
212703 02 Chain Conveyors 0.40
211303 02 Bucket Elevators 0.40
211407 04 Screw Conveyors 0.60
211503 02 Pneumatic Conveyors 0.40
211613 01 Ropeways/Cable cars 1.00
Wheel Alignment Machine To be rated
under EEI policy
211703 02 Milling Machines 0.40
211805 02 Metal Punching Machines 0.50
211907 04 Machining Center
(Universal machine) 0.60
Moulding Machines
Pertaining to Foundry –
212013 07 Slinger 1.00
212105 03 Others 0.50
212205 03 Mixing and Blending Machines 0.50
212305 03 Magnetic Separators 0.50
212413 07 Machines not otherwise 1.00 Provisional, to be
provided for referred to the
head Office for
final rates.
59
212808 03 Nibbling Machine 0.65
223212 Nitrogen Plant (modular) (with Rated under item
loss or damage to molecular “Gas Generator”
sieve being excluded).
212908 04 Overhead Cranes (EOT)
including Monorail 0.65
213014 08 Ovens of all types 1.25
213105 03 Oil Expellers 0.50
213219 11 Oil Engines 2.00
213303 02 Planers 0.40
213419 11 Photo copiers 2.00 With an excess of
5 % of the claim
amount subject to a
minimum of Rs.1,000/-.
217305 02 Packing Machines 0.50
PRESSES –
216603 02 Hand Presses 0.40
216710 05 Power Presses 0.75
216813 07 Hydraulic Presses 1.00
Roller Presses in Please see
Cement Plant ‘Roller presses’
Pumps –
216903 02 Pumps handling water 0.40
213510 05 Pumps handling other materials 0.75
Drives for Pumps –
217018 09 Turbine 1.75
217118 09 Engine 1.75
217216 09 Motor 1.50
Note : If a single value is given for the entire pump-set the higher rate of the
Drives should be applied overall.
Pressure/Reaction Vessels -
i) Glass/graphite lined As per Item
‘Glass & Graphite’
213604 02 ii) Others 0.45
213704 02 iii) Stirrers/Agitators 0.45
213801 01 iv) Pipes & fittings 0.20
PLASTICS MFG. -
i) Plastics Extruders Refer Item ‘Extruders’
213916 ii) Injection Presses Refer Item “Presses”
09 iii) Injection Moulding Machines 1.50
214014 08 iv) Blow Moulding Machines 1.25
214107 03 v) Other Misc. Machines 0.60
60
Paper & Cardboard Mills -
214205 03 i) Preparatory Machines
like Bamboo Crushers,
Grass/ Choppers, Shredders,
Dusting Machines, Rag
Cutters, Sorters, Depithing
Machines, Willowing Machines,
beaters etc., 0.50
214304 02 ii) Digesters, Filters, Pulper,
Stock preparatory machines,
Pulp making Machines 0.45
214505 03 iii) Paper and Card board
making Machines 0.50
214401 01 Pipes & fittings (Excluding
instrumentation) 0.20
214609 04 Printing Presses 0.70
216309 04 Printing & Assembling
Machine 0.70
214710 05 Pulverisers 0.75
214807 02 Plate Bending Machine 0.60
214903 02 Pre-heaters 0.40
215013 07 Plate Polishing Machines 1.00
215110 Primary Heating Units
(Nylon plants) 0.75
215219 11 Petrol Engines 2.00
215305 03 Plodders 0.50
215410 05 Pendulum Rollers 0.70
215504 02 Pressure Reducers 0.40
215613 07 Photo Phone Cine Projector 1.00
215705 03 Plastimeter in Rubber
Processing Plant 0.50
Paint Factory Machines -
215810 i) 05 Roller Mill 0.75
215905 ii) 03 Other Machines 0.50
216007 iii) 04 Powder Coating Machines 0.60
216105 iv) 03 Packing Machines 0.50
216207 v) 04 Painting Electrode Static Plant 0.60
216413 vi) 07 Lacquer Painting Machine 1.00
vii) 04 Painting (Lacquering) Plant 0.60
216507 viii) 04 Painting (Varnishing) Plant 0.60
Rope Ways Please refer item
‘Material Handling
Equipments’ subject
to Endorsement
for Ropes etc.

61
218113 07 Rolling Mill (hot) 1.00
217414 08 Rolling Mill (cold) 1.25
217505 03 Coilers for Wire Drawing
Machines 0.50
Reaction Vessels Please refer item
‘Pressure Vessels’
217620 12 Refrigerator
(other than Domestic). 1.50
217720 12 Room Air Conditioner 2.50
217803 02 Riveting Equipment 0.40
217909 05 Refrigeration Plant 0.70
218016 09 Roller Presses in Cement 1.50 Depreciation - 20 %
Plants per annum or part
thereof subject to
a maximum of 80 %
222503 02 Shaping Machines 0.40
222603 02 Slotting Machines 0.40
222703 02 Straightening Machines 0.40
222807 04 Shearing Machines 0.60
222907 03 Sterilizing Machines 0.60
223003 02 Saws of all types 0.40
223104 02 Stirrers 0.45
218205 03 Stitching Machines 0.50
218305 03 Sewing Machines 0.50
218405 03 Sealing Machines 0.50
218503 02 Spooling Machines 0.40
218613 07 Steam Engines 1.00
218703 02 Shafting 0.40
218816 09 Steam Turbines 1.50
218903 02 Spoke Lacing Machines 0.40
219006 03 Shredder Machines 0.55
03 Sterliser Vacuum chamber 0.50
Sugar Factory Machinery -
219103 i) 02 Cane Un-loaders 0.40
219205 ii) 03 Milling Plant 0.55
219306 iii) 03 Leveler 0.55
219406 iv) 03 Fibriser 0.55
219506 v) 03 Rack Carrier 0.55
219606 vi) 03 Sugar Grader 0.55
219706 vii) 03 Sugar Hoppers Centrifuges 0.55
219803 viii) 02 Screen/Sieve Machines 0.40

62
Textile Mills -
219903 i) 02 Blow Room & Carding
Machines 0.40
220002 ii) 01 Preparatory Machines like
Combing, Drawing, Lapping
& Spinning Machines etc. 0.30
220109 iii) 05 Baling Press 0.75
220205 iv) 03 Jacquard Machines 0.50
220305 v) 03 Sizing and Singeing Machines 0.50
220405 vi) 03 Folding/ Mercerising Machines 0.50
220503 vii) 02 Other Machines 0.40
Turbines - Please refer item
‘Steam/Gas
Turbines’
220603 02 Thermic Fluid Heaters 0.40
220705 03 Tabletting and Capsuling
Machines 0.50
220801 02 Valves 0.20
220903 02 Vibrators 0.40
221111 06 Vibratory feeder
(Electromagnetic) 0.80
222405 03 Sterliser vacuum chamber 0.50
221203 02 Wood Peeling Machines 0.40
221316 09 Welding Machines 1.50
221405 03 Washing Machines 0.50
221520 12 Water Coolers 2.50
221616 07 Water Turbines 1.50
221703 02 Wrapping Machines 0.40
221813 07 Wire Drawing Machines 1.00
221903 02 Wheel Turning Machines 0.40
222005 03 Weighing Machines
(Other than Electronic) 0.50
222113 07 Weighing Machine (Electronic) 1.00
03 Wind Mills 0.50 Subject to Wind
Mill Endorsement.
222319 Xerox Machines Rate/Excess as
per ‘Photo copiers’

63
Group III
Machinery in Cold Storages and Ice Plants
Risk Sr. Rate Item Rate Remarks
Code No Code (%)
Power Machines -
300120 1. 11 Diesel Engines and Diesel
Generators Sets 2.50
300220 2. 11 Electric Motors(Including
those for Diffusers & Pumps) 2.50
300314 3. 08 Transformers 1.25
300406 4. 03 HT/LT Switchgear &
Switch board 0.55
300505 5. 03 Cables 0.50
Working Machines -
300616 1. 09 Compressors 1.50
300710 2. 05 Diffusers (Excluding Motors) 0.75
300802 3. 02 Cooling Coils 0.30
300902 4. 02 Condensers (Atmospheric type) 0.30
301010 5. Condensers (Shell & Tube type) 0.75
301103 6. 02 Receivers 0.40
301207 7. 04 Water Pumps(Excluding Motor) 0.60
301305 8. 03 Pipelines, Valves & Fittings 0.50
Ancillary Machines -
301413 1. 07 Electric Hoists 1.00
301516 2. 09 Chain Pulley Block 1.50
301616 3. 09 Suction Drought Blowers
(Exhaust Fans) 1.50
301720 4. 11 Ceiling Fans Over Bunker Coils 2.50

GROUP IV
Fertilizer Plants/Petrochemical Plants/Refineries
Risk Sr. Rate Item Rate Remarks
Code No Code (%)
a) Process/Refrigeration
Compressors including
their drives
400119 i) 11 Turbine Driven 2.00
400216 ii) 09 Motor Driven 1.50
b) Utility Compressors
including their drives
400318 i) 10 Turbine Driven 1.75
400416 ii) 09 Motor Driven 1.50
64
400519 c) 11 Waste Heat Recovery boilers 2.00 Please see note
below
New Waste heat exchangers/Recovery Boilers under high pressure/temperature in
Fertilizer Plants.
i) No MB Cover should be granted for first three years of operation. This may be
covered under BPP policy during this period.
ii) After the initial period of three years above equipment may be covered under MB
policy.
iii) The above decision is applicable only to Petro-chemical/ Fertilizer Plant.
400614 d) 08 ID/FD fans with drive 1.25
e) Pumps & their drives
400710 Pumps -
i) 05 Handling water other than
boiler feed water 0.75
ii) a) 09 Boiler feed pump motor driven 1.50
ii) b) 10 Boiler feed pump turbine/
engine driven 1.75
iii) 08 Other pumps 1.25
Drives -
400818 i) 10 Turbine 1.75
400918 ii) 10 Engine 1.75
401016 iii) 09 Motor 1.50
N.B. If a single value is given for the entire pump set, the higher rate of the drive should
be applied overall.
401116 f) 09 Purge Gas Recovery Plant 1.50
401216 g) 09 Stripper in Urea Plant 1.50
401316 h) 09 H.P. Condenser 1.50
401416 i) 09 Reformer 1.50
401516 j) 09 Expansion Turbine 1.50
401616 11 Ammonia converter 2.00
402914 q) 08 Urea Scraper including
gearbox, motor, coupling etc. 1.25

65
ADDITIONAL RATES -
1. EXPRESS FREIGHT (AIR FREIGHT EXCLUDED), HOLIDAY AND OVERTIME
RATES OF WAGES –
The additional premium for covering express freight (air freight excluded), holiday
and overtime rate of wages, will be at the average rate applied on the limit selected.
2. AIR FREIGHT –
The rate and excess as under shall be charged exclusively for items of air freight
only and subject to the limit selected by the Insured for indemnity against air freight
only.
Rate 2 % on the amount of indemnity selected
Excess 5 % of the Air Freight incurred per claim
3. SURROUNDING PROPERTY -
Additional premium for covering surrounding property will be at an Additional
premium of 25 % of the gross average MB rate applied on the limit of liability
selected with excess of 1% of the limit of liability selected.
4. THIRD PARTY LIABILITY –
Third Party Liability could be covered at an additional premium of 25 % of the
gross average rate applied on the limit of liability chosen for third party liability.
The excess applicable will be 1% of the TPL limits selected.
Maximum sum insured under this extension should not exceed 10% of S.I. subject
to maximum of Rs. 10 Crs Per location.
5. ADDITIONAL CUSTOMS DUTY –
The cover for Additional Custom Duty will be subject to the following rates, terms
and conditions -
a) The cover for Additional Custom Duty will be on first Loss Basis,
b) The specific limit for Additional Custom Duty - either in percentage or in amount
- has to be selected by the Insured at the inception of the Policy and can be
reinstated in the event of loss,
c) The rate and excess will be as under –
Rate 1 % to be charged on the Additional Custom Duty amount
selected
Excess 5 % of the admissible Custom Duty increased, in addition
to the Excess amount applicable for the affected item under
the Policy. Subject otherwise to the terms conditions and
exceptions of the policy.
6. ESCALATION PROVISION -
The additional premium payable will be at 50 % of the full rate, to be charged on
the selected percentage increase.

66
7. SEQUENCE OF COMPUTATION OF RATE
1. Basic rate
2. Apply claim experience discount/loading on (1) above
3. Apply higher excess discount on (2) above
4. Apply technical & or commercial discount on rate arrived at 3 above.
8. GROSS RATES -
All rates specified in this Tariff are Gross Rates and Agency Commission (or
discount in lieu of Agency Commission) can be allowed from these rates, as per
the Rules prevailing from time to time.

EXCLUDED UNDER MB POLICY


(DECLINED LIST OF MACHINES)
a) Stone Crushers
b) Rolling Mill-Stands, Pedestal bearing etc.
Raymond Mill
c) PVC lined, Rubber lined and such other lined vessels
d) Radios, Tape Recorders, TV Sets and Electric and Electrical measuring
instruments
e) Cupolas
f) Pumps-with rubber impellers
g) Computers and other Electronic Equipments other than those not specified in
the Guide Tariff (To underwrite under Electronic Equipment Insurance Policy)
h) Portable and Mobile Equipments
i) Urea Scrubber, )
LP Scrubber, )
Ammonia Scrubber, ) in Fertilizer- appearing in group IV
Ammonia Storage Tanks )
j) Asphalt mixing & recycling plants

N. B. : Rates as per erstwhile Tariff.

67
CONTRACTORS PLANT & MACHINERY INSURANCE
GENERAL REGULATIONS
JURISDICTION
This applies to all risks located in India.
CPM Policy can be issued covering equipment on “Anywhere in India basis” with
following stipulations:
a. Full description with identification number etc., of each and every equipment with
valuation should be declared.
b. Transit risks from site to site will be excluded.
c. Earthquake extra for all the Zones.
d. Loading of 10% on the basic CPM shall be charged to cover Floater risk.
MB risks in case of CPM equipments should not be covered either as an extension of
CPM Insurance policy or under a separate MB policy.
SCOPE
The cover shall be as per the standard policy form in respect of CPM insurance.
The insurance of all types of CPM and equipments engaged for work at any
specified location in India shall be subject to these General Regulations.
In respect of machinery/equipments, whether registered with RTO or not but engaged
at the project site, the Insured has an option either to select the motor/non-motor policy
under Motor Tariff or CPM policy in the Engineering Dept.
NUMBER OF LOCATIONS IN A POLICY
The policy schedule will necessarily include a list of all items of CPM and equipments,
indicating separate value against each item. Any additions or deletions in these items
during the policy period of 12 months can be done on short period basis.
Policy schedule may also include more than one location with separate list of CPM and
equipment at each location. Here also any addition or deletion of different locations of
any items of CPM equipments may be done on short period basis.
However, if the insurance is taken for a period shorter than 12 months premium to be
charged will be on the basis of short period scales provided hereafter.
Similarly, the insurance taken for 12 months initially but cancelled mid-term, before
completing of 12 months will entitle refund on short period scales only.
SHIFTING OF CPM - TRANSIT RISKS
Many a times, items of CPM and equipments require to be shifted from one location to
another location. The risk during transit from one location to another location is outside
the purview of the policy.
However, the risk during shifting of items of CPM and equipments in connection with
work at a Project Site from one point of the Project Site to another point in the same
Project Site is deemed covered within the rates prescribed in Table 1 of Part 1-rate
schedule.
CPM under EAR/SCE/CAR
Where the Sum Insured on CPM equipments under the Project requiring EAR/SCE
insurances not exceeding 5% of the Sum Insured for EAR/SCE or Rs 25 lacs whichever
is lower, such equipments must be rated under the CPM tariff.
68
Where the Sum Insured on CPM equipments under the Project requiring CAR
insurances exceeds 5% of Sum Insured for CAR/EAR , that equipment must be rated
under the CPM tariff.
Floater risks
Loading of 10% on the CPM & Equipment rate shall be charged to cover Floater Risks.
Additional rates for Earthquake(fire and shock) perils
Additional rates are applicable as per CAR/EAR tariff.
CPM equipments mounted on floating vessel/ craft
The CPM Equipments mounted on floating vessel/craft and used for the purpose of
contract work shall attract the rates prescribed in Table 1 of the rate schedule.
However, the Excess applicable for claims on such plant, machinery & equipments
mounted on floating vessel/craft shall be the excess prescribed for claims arising out
of AOG perils in Table III of Part 1 rate schedule.
Short Period scale of Premium Rates
Policy Period required Percentage of Annual Prem
Not exceeding one week 10
Not exceeding 1 month 25
Not exceeding 2 months 35
Not exceeding 3 months 50
Not exceeding 4 months 60
Not exceeding 6 months 75
Not exceeding 8 months 85
Exceeding 8 months Full Annual Premium
Service Tax @ 12.24% extra
Third Party Liability
A rate of 0.25 % per annum should be charged and a total limit of indemnity selected
to cover the Third Party Liability upto the following limits :
A) Any one person Rs 10 lacs
B) Any one accident Rs 25 lacs
C) During the policy period Rs 25 lacs
Third Party Liability Insurance for limits in excess of those mentioned above should be
underwritten in the Miscellaneous Department at the discretion of the Insurer.
The Excesses applicable for TPL Property Damage claims will be the highest of the
Excesses applicable to the Machineries insured.
Mid-term increase in Sum Insured
If the Sum Insured is increased during the currency of the policy
i) Short Period scale of rates shall apply to increased amounts.
ii) If the policy is renewed thereafter for 12 months for an amount not less than the
increased sum insured, the difference of premium between short period scale of
rates and pro-rata rate may be refunded.
69
CONTRACTOR’S PLANT AND MACHINERY INSURANCE TARIFF
INTERNAL GUIDE RATE SCHEDULE
Group of Rates (Rs)(Inclusive
Machinery of all ‘Acts of God
Perils’ including
earthquake)
I 0.42 % 1. In case of railway track testing coach
and Merry Go-Round System
II 0.56 % (including Locomotives and
Wagons), loading of 20% on the rate
III 0.70% applicable.
IV 1.4% 2. Plants and or Machineries working
underground/tunnels should be rated
V 0.14 % at a loading of 50 % over these rates.
EXCESSES
A) For Machinery under Group I, II, III and IV -
(Except for cranes above 10 tonnes capacity)
EXCESSES
Value of equipments For claims arising out For claims arisingout
of AOG perils of perils other than AOG
a. Individual value upto 10 % of S.I. Subject to a 2 % of S.I. subject to
Rs.1 lakh. minimum of Rs. 5,000/- minimum of Rs. 1,500/-
b. Individual value over 5 % of S.I. Subject to a 1.5 % of S.I. subject to
Rs. 1 lakh and upto minimum of Rs.10, 000/- minimum of Rs.2,000/-
Rs. 5 lakh.
c. Individual value over 3 % of S.I. subject to a 1.25 % of S.I. subject to
Rs. 5 lakh and upto minimum of Rs. 25, 000/- minimum of Rs. 7,500/-
Rs. 10 lakhs.
d. Individual value over 2 % of S.I. subject to a 1.00 % of S.I. subject to
Rs. 10 lakhs upto minimum of Rs. 30, 000/- minimum of Rs. 12,500/-
Rs. 25 lakhs
e. Individual value over 1 % of S.I. Subject to a 1% of S.I. Subject to a
Rs. 25 lakhs upto minimum of Rs. 50, 000/- minimum of Rs. 50,000/-
Rs. 50 lakhs
f. Individual value over 1 % of S.I. Subject to a 1% of S.I. Subject to a
Rs. 50 lakhs minimum of Rs. 50, 000/- minimum of Rs. 50,000/-

70
B) For Cranes above 10 tonnes capacity under Group III -
Main Section
Value of AOG claim Normal Boom Section
Equipment in Rs.
a) Over 5 lakhs & 1.5 % of S.I. 0.8 % of S.I. 20 % of claim amount
upto 10 lakhs Subject to a Subject to a Subject to a
minimum of minimum of minimum of
Rs. 10, 000/- Rs. 5, 000/- Rs. 25, 000/-
b) Value over 1 % of S.I. 0.5 % of S.I. -do-
Rs. 10 lakhs & Subject to a Subject to a
upto 25 lakhs minimum of minimum of
Rs. 20, 000/- Rs. 10, 000/-
c) Value over 0.7 % of S.I. Rs. 15, 000/- -do-
25 lakhs & Subject to a
upto 50 lakhs minimum of
Rs. 25,000/-
d) Value over 0.5 % of S.I. Rs. 25, 000/- - do -
50 lakhs Subject to a
minimum of
Rs. 25,000/-
Note :- Excess for Boom section of cranes of above 10 tonnes capacity - In case
damages occur to the crane body as well as boom arising out of the same incident,
the respective excess will be applicable. In case one of the two is damaged, the
corresponding excess only will apply.

C) For Machinery under Group V -


Rs.2,500/- Flat. Excess
GROUPS OF MACHINERY –
Classification of Construction Plant, Equipment and Machinery
Risk Code Group I
101 Chain Blocks and Pulley Blocks
102 Compressor, Air tools
103 Conveyor belts, site hoists, jacks, screws
104 Cranes up to 10 Tons capacity (except Turner and Derrick cranes)
105 Concrete pumping plant
106 Cement silos, water containers, Surveying Equipment
107 Electrical/Electronic Equipment used for Non-destructive testing
108 Fork Lift Trucks (up to 10 Tons Capacity)
71
109 Mixing Machines, Mixing Plants
110 Pavers for asphalt or concrete finishing
111 Permanent way plant (track-laying machinery, track shifters,
tempers)
112 Portable protection tents
113 Pumps, Transformers, Electric Motors
114 Road rollers
115 Railway trackage
116 Rendering Plant
117 Scrapers, scales
118 Vibrators (vibrating compacting rollers, vibration and Mechanical
tamping equipment, concrete vibrating equipment)
119 Workshop Machines, woodworking Machines, Reinforcement bar
benders, drying plant.
120 Welding set.
121 Surveying equipments
122 Tractor 144D
123 Mosaic Polishing Machines
124 Thermoplastic line marking machine
Risk Code Group II
201 Aggregate plant
202 Air locks
203 Gas power-generating plant
204 Graders, pan scrappers, rippers
205 Hauling equipment (dumpers, dump cars, dump trucks)
206 Locomotives, field and steam generating engines, track-shifting
machines.
207 Mobile mixing plant
208 Mechanical sweepers
209 Site power-generating plant (gasoline or diesel engines)
210 Stone crushers, screens, separating plant.
211 Tractors/Trailers
72
212 Seismic Data Collection Equipment Note - Transformer Oil Filtration
Unit (Vehicle carrying this unit) to be covered under ‘Mobile Mixing
Plant’ under this Section
213 Railway track testing coach
214 Stringing machine consisting of hydraulic puller & tensioner used
for the purpose of stringing of transmission lines
Risk Code Group III
301 Bulldozers
302 Cranes above 10 tons capacity, Turner cranes and Derrick Cranes
303 Diving equipments
304 Excavators (Caterpillar shovels, drag-shovels, power shovels, self-
propelled excavators, truck-shovels, bucket excavators, Bucket
trenches).
305 Loaders
306 Pile driving and pile extracting equipment.
307 Bridge Inspection Machines.
308 Mobile diving Rig.(ON Shore)
309 Pipe jacking M/c
310 Rail Mounted Gantry Crane (RMG)
311 Ballotis
312 Top lift Truck (TLT)
313 Break down vehicle
314 Hydraulic Twin Boom Jumbo Drilling Machine
315 Electro Hydraulic Digging Arm Loader
316 Alimak Raise Climber
317 Merry Go Round Systems (see note 1 below)
Risk Code Group IV
401 Drilling Machine for Water Supply
402 Tunnel Boring Machines
Risk Code Group V
501 Other miscellaneous item not specified above with individual value
up to Rs. 1,00,000/-
Note : Internal Guide Rates have been taken.
73
CONTRACTORS ALL RISK (CAR)
(1) Introduction :
The basic concept of contractors all risk insurance is to offer comprehensive and
adequate protection against loss or damage in respect of the contract works,
construction plant and equipment and construction machinery, as well as for third
party claims in respect of property damage or bodily injury arising in connection
with the execution of a Civil Engg. Project.
Ordinarily a civil engineering contractor tenders for a job on the basis of design
specifications provided by the principal on the basis of soil conditions, weather
conditions etc. Contractor is required to construct the civil engineering structure
on the basis of drawings and specifications for materials prescribed by the architect
or structural engineers. His responsibility is restricted to construct as per the
specifications and designs of the architect and/or designer.
Any loss or damage to the contract works during the course of the construction
due to any cause will result in heavy financial loss to the contractor. Thus in the
event of a claim, contractor will not be in a position to find resources for reinstating
the damaged property at his cost.
The Insurance Policy can be taken by Principal or the contractor or sub contractor.
(2) Risks Covered (in Built) / Coverage :
Any sudden and unforeseen loss or damage occurring during the period of
insurance to the property insured on the building site will be indemnified. The most
important perils are…
Fire, Riot & Strike & allied perils, Flood, Cyclone, etc. Theft, Burglary, Construction
Faults like defective material, workmanship, collapse, human errors/lack of skill or
negligence of workers sub. To exclusion.
(T.P. Liability Earthquake & Terrorism under extension cover only)
(3) Exclusions (Only important exclusion taken) :
l Loss or damage due to faulty design
l Cost of replacement of rectification of defective material and/or work-man ship,
but this exclusion shall not be deemed to exclude loss or damage resulting
from an accident due to such defective material and or workmanship.
l Mechanical and or electrical breakdown or derangement of constn, plant, equips.
And constn. Machinery.
(4) Jurisdiction :
This applies to all Risks located in India, for which the value of the Civil Works
involved is more than 50% of the total contract value.
74
(5) Sum Insured :
Basis of sum insured as under :
a) Machinery / Equipments Landed cost at site.
b) Cost of construction.
c) Permanent Civil Engineering Works.
d) Half the escalated value, if escalation is opted for.
(6) Sub-Contractor :
The policy can be taken by either principal / contractor / sub contractor.
As regards sub-contracts forming part of a project, it is claimed that irrespective of
whether the project value has been broken into various sections and orders/
contracts are placed with different suppliers/contractors/sub-contractors or the
insureds carry out the work themselves departmentally, the insurances for all such
sub-contractors are subject to these General Regulation.
(7) Computation of Premium :
Premium shall be computed for the total period commencing from 1)
Commencement of Work or 2) Date of arrival of the first consignment at the site of
erection whichever is earlier.
(8) Mid-term increase during policy period :
The premium should be collected on the additional sum insured at applicable CAR
rates, on short period basis from inception period.

75
CONTRACTORS’ ALL RISKS INSURANCE
RATE SCHEDULE
Risk Sr. Rate Risk Premium Rates (%o) Sum insured up to
Code No. Code Rs.1500Cr.,Excess
5 % of claim amount
subject to Min of Rs
Minimum Addl. Rate Normal AOG/Major
Rate up per month Perils/
to first beyond Collapse
3 months 3 months
(1) (2) (3) (4) (5) (6) (7) (8)
1. Residential and commercial buildings, Office buildings, Schools, Universities,
Hotels, Motels, Restaurants, Hospitals, Airport buildings of – all the floors above
the foundation level, i.e. all floors including basement floors, are to be considered for
rating of Storied Buildings
011011 a) 01 Other than RCC and not 1.00 0.02 15,000/- 50,000/-
more than 2 storeys
012032 b) 04 Other than RCC and 1.75 0.025 25,000/- 1,00,000/-
exceeding 2 storeys
and upto 5 storeys
013022 c) 01 RCC framed structure 1.50 0.025 25,000/- 1,00,000/-
not more than 5 storeys
014043 d) 02 RCC Framed structure 2.00 0.03 25,000/- 1,00,000/-
above 5 storeys and
upto 10 storeys
-- e) 03 RCC Framed structure 2.25 0.035 25,000/- 1,00,000/-
above 10 storeys and
upto 15 storeys
016096 f) 05 RCC Framed structure 3.00 0.05 2,50,000/- 10,00,000/-
above 15 storeys and
upto 25 storeys
017106 g) 07 RCC Framed structure 3.25 0.05 2,50,000/- 10,00,000/-
above 25 storeys and
upto 30 storeys
-- h) 08 RCC Framed structure 3.50 0.05 2,50,000/- 10,00,000/-
above 30 storeys and
upto 40 storeys
-- i) 09 RCC Framed structure 3.75 0.05 2,50,000/- 10,00,000/-
above 40 storeys and
upto 50 storeys
-- j) 10 RCC Framed structure 4.00 0.05 2,50,000/- 10,00,000/-
above 50 storeys and
upto 60 storeys

76
2. Theaters, Auditorium and Cinema Halls -
021041 a) 04 Height not exceeding 2.00 0.02 15,000/- 50,000/-
22 m and span not
exceeding 10 m

022043 b) 04 Height not exceeding 2.00 0.03 25,000/- 1,00,000/-


22 m and span
exceeding 10 m

023063 c) 05 Height exceeding 22 m 2.25 0.03 50,000/- 2,00,000/-


and span not
exceeding 10 m

024073 d) 06 Height exceeding 22 m 2.50 0.03 50,000/- 2,00,000/-


and span exceeding 10 m

3. Factory sheds, Warehouses, Cold storages, Hangars –


031061 a) 05 Other than RCC 2.25 0.02 50,000/- 2,00,000/-
construction

032041 b) 03 RCC 2.00 0.02 25,000/- 1,00,000/-

033051 c) 03 Hangars having walls of 2.125 0.02 50,000/- 2,00,000/-


I) RCC or ii) Rolled
steel in 50 mm thick
concrete or 100 mm
thick masonry with
panel walls of RCC,
burnt bricks, stone or
concrete bonded in
cement and/or lime
mortar and having roof
of combination of RCC
and GI/ Aluminium/ AC
Sheets on steel RCC
framework.

4. Chimneys, Silos and Cooling Towers TV Towers -


041072 a) 06 Up to 15 m height and 2.50 0.025 50,000/- 2,00,000/-
exceeding 10 m
diameter. (Other than
hyperbolic or natural
draught type)

042115 b) 09 Exceeding 15 m height 3.50 0.04 50,000/- 2,00,000/-


and exceeding 10 m
diameter. (Other than
hyperbolic or natural
draught type)

043128 c) 11 Hyperbolic or Natural 4.00 0.105 5,00,000/- 10,00,000/-


draught cooling tower
77
5. Roads -
051042 a) 06 In townships only 2.00 0.025 25,000/- 1,00,000/-
052073 b) 06 In Plain Areas 2.50 0.03 25,000/- 1,00,000/-
053095 c) 09 In Hilly/ Ghat areas 3.00 0.04 50,000/- 2,00,000/-
6. Interior decoration works
061097 31 Interior decoration works 3.00 0.10 50,000/- 2,00,000/-
7. Runways, Aprons and Air Taxiways at Airports.
071042 04 Runways, Aprons and 2.00 0.025 25,000/- 1,00,000/-
Air Taxiways at Airports
8. Subways on Land –
091073 a) 33 Width not exceeding 15 m 2.50 0.30 25,000/- 1,00,000/-
092095 b) 35 Width exceeding 15 m 3.00 0.40 50,000/- 2,00,000/-
9. Road bridges, railway bridges, flyovers on land made of –
101096 a) 08 Steel 3.00 0.05 25,000/- 1,00,000/-
102116 b) 10 RCC or Pre-stressed 3.50 0.05 50,000/- 2,00,000/-
concrete
103136 c) 13 Other materials 5.00* 0.10* 1,00,000/- 4,00,000/-
* Provisional rates, reference to be made to HO for final rate quotation.
10. Bridges on rivers/creeks, dams/coffer dams, aqua ducts, via-ducts, barrages,
structure works in water –
111127 -- 21 BRIDGES ON RIVERS 6.00 0.10 22,50,000/- 75,00,000/-
CREEKS, COFFER
DAMS, aqua ducts, Via
ducts, Barrages,
Weir-cum-causeway,
structures in water
11. (I) Reservoirs/Tanks of materials (Other than steel) –
121093 a) 09 Surface and under 3.00 0.03 25,000/- 1,00,000/-
ground
122115 b) 11 Overhead 3.50 0.04 25,000/- 1,00,000/-
(II) Reservoirs/Tanks of steel –
123062 a) 05 Surface and under 2.25 0.025 25,000/- 1,00,000/-
ground
124073 b) 07 Overhead 2.50 0.03 25,000/- 1,00,000/-
12. Tunnels and/ or other civil constructions therein –
132167 i 25 Below water 10.00 0.10 60,00,000- 120,00,000/-
131157 ii 23 Others 7.00 0.10 30,00,000/- 75,00,000/-
133147 Bridges on rivers/creeks, 6.00 0.10 22,50,000/- 75,00,000/-
Dams, Coffer dams etc
78
13. Water supply -
151043 -- 04 Water Supply 2.00 0.03 15,000/- 50,000/-
Installations for housing
colonies including pump
house with pumps,
valves and piping and
water supply lines but
excluding water storage
tanks
Note - Laying of Water Pipelines Water Supply Scheme - to be rated as per EAR tariff
14. Sewage disposal –
161043 a) 04 System for Housing 2.00 0.03 15,000/- 50,000/-
Colonies including
Pump house with pump,
sewage treatment
Plant, holding ponds,
sewer/ drainage lines
and storm water
drains & Channels
15. Underground and overhead water storage tanks for residential/ commercial
buildings and housing colonies
171073 05 Underground and 2.50 0.03 15,000/- 50,000/-
overhead water storage
tanks for residential/
commercial buildings
and housing colonies
16. Ground leveling and area reclamation work
181013 16 01 Ground leveling and 1.00 0.03 15,000/- 50,000/-
area reclamation work
17. Fixing of pre-cast RCC Parts for buildings
191011 17 01 Fixing of pre-cast RCC 1.00 0.02 15,000/- 50,000/-
Parts for buildings,
const- ruction of
compound wall and
weather sheds for
existing building/
apartments, Other
sundry works for
residential/ commercial
buildings like water
proofing plastering
of walls
18. Sundry works for residential/ commercial buildings
201011 18 01 Other sundry works for 1.00 0.02 15,000/- 50,000/-
residential/ commercial
buildings like water
proofing plastering
of walls
79
19. ALL OTHER RISKS NOT COVERED
211137 19 All other risks not 5.00 0.10 1,00,000 4,00,000/-
covered (Provisional
Rate)

20. Under ground cable ducting


221089 20 08 Under ground cable 2.75 0.50 1,00,000/- 4,00,000/-
ducting

21. Natural Draught Cooling Towers


231128 21 13 Natural Draught 4.00 0.105 5,00,000/- 10,00,000/-
Cooling Towers

22. Pile Foundations


241116 22 09 Pile Foundations alone 3.50 0.05 5,00,000/- 10,00,000/-
in respect of buildings
& other structures

23. Canals/ culverts (Not involving works under water)


251087 23 07 Canals/ culverts 2.75 0.10 1,00,000/- 4,00,000/-
(Not involving works
under water)

24. Laying of railway track/ Railway Gauge conversion


260000 24 08 Railway Gauge 3.00 0.03 50,000/- 2,00,000/-
conversion (Meter
gauge to Broad gauge)
Laying of railway track

25. Aquaculture Project


270000 25 Aquaculture Project : Laying of HDPE Pipes/Accessories for Sea Water
Intake Systems for Aquaculture Project - to be rated as “Works in Water”

Note : The rates given above are Tariff rates and may not match with the rates appearing
in our CWISS Software.

80
ELECTRONIC EQUIPMENT INSURANCE
Section I - Equipments
This policy covers sudden and unforeseen material damage to electronic equipments
due to any cause like Fire, Riot, Strike & allied perils, natural calamity like flood,
cyclone, earthquake, explosion, machinery breakdown, short circuit & voltage
fluctuations, theft, burglary, human error, falling object & entry of foreign bodies etc.
Sum Insured
The sum insured must be the present day replacement value of similar new electronic
equipment including therein all incidental expenses like cost of erection, duty, freight,
taxes etc.
Section II - External Data Media
Section I cover only the material damage to the hardware of equipment whereas
punch card paper tapes, magnetic tapes, disks & cost of reconstruction of date on
these external data media may be covered under Section II only if damaged due to
identifiable peril and if back up system is available.
Section III - Increased Cost of Working
If there is accidental damage to the insured computer and insured will use substitute
computer system then increased cost of hiring computer system is insurable. Additional
expenditure incurred as a result of failure of the EDP system necessitating the use of
a substitute external system can also be covered. Sum insured shall be the amount
which the insured would have to pay as additional expenditure for 12 months use of
substitute EDP equipment of similar performance to the EDP equipment insured.
Discounts for Deleting Fire & Allied Perils
In case of equipment covered under EEI Policy as also Fire Policy. If the insured
desires to delete fire and allied perils the following disorients are permitted.
Cover Discounts
1. EEI + SF&SPP + EQ 10% of the applicable EEI Rate
2. EEI + SF&SPP without STFI or
RSMDT or EQ 7.5% of the applicable EEI Rate
3. EEI + SF&SPP without STFI &
RSMDT & EQ 5% of the applicable EEI Rate
Discount for opting Higher Excess
Higher Excess Discount in
Tariff Rates
7½% of the claim amount subject to a minimum of Rs.3000/- 5%
10% of the claim amount subject to a minimum of Rs.5000/- 10%
12½% of the claim amount subject to a minimum of Rs.10, 000/- 20%
15% of the claim amount subject to a minimum of Rs.20, 000/- 30%
Minimum Premium: The minimum premium shall be Rs.250/-
81
ELECTRONIC EQUIPMENTS INSURANCE
RATE SCHEDULE
Section Risk Description Rate
Code
With Without
AMC AMC
I Equipments 010101 Personal Computers 1.00 % 1.00%
010201 EDP System
010301 Process Control Equipment
010401 Communication Equipment
010501 Laboratory Equipment
010601 Office Equipment
010701 CNC Machines/ Robots
(used in manufacturing)
010801 Film and Television (Studio)
Equipment
010901 Miscellaneous Electronic
Equipment
011001 Bio-medical Equipment 1.00% 2.00%
II External
Data Media 020101 Data Media such as Tapes, As per Section I
Disc Packs, Spools, Rate
Cartridges etc.
020201 Expenses for Reconstruction
and re-recording of information
III Increased 030101 Rates in ‘percent’
cost of
working Time Indemnity period in weeks
Excess
(Working
hours) Upto 12 Upto 26 Upto 40 Upto 52
96 hrs 0.70 0.80 0.90 1.00
168 hrs 0.65 0.75 0.85 0.90
336 hrs 0.50 0.60 0.65 0.70
672 hrs 0.30 0.40 0.45 0.50

Note - 1 week = 7 days, 1 day = 24 computer working hours

82
EXCESS
A. FOR PERSONAL COMPUTER : 5% of claim amount subject to minimum of
RS. 2500/-
B. FOR V SAT EQUIPMENT : 1. for AOG perils : 10% of claim amount subject to
minimum of RS. 10000/- 2. for other claims As per EEI tariff.
C. FOR OTHER ITEMS :

a) For equipments with value upto Rs. 1 lakh -


i) Equipments (other than Winchester 5 % of claim amount subject
Drive & or hard disc drive) to a minimum of Rs.1, 000/-
ii) Winchester Drive & or hard disc drive 10 % of claim amount subject
to a minimum of Rs. 2, 500/-
b) For equipments with value more than Rs. 1 lakh -
i) Equipments (other than Winchester 5 % of claim amount subject
Drive & or hard disc drives) to a minimum of Rs.2, 500/-
ii) Winchester Drive & or hard disc drive 25 % of claim amount subject
to a minimum of Rs. 10,000/-

In case of computers, the term equipment shall include the entire computer system
comprising of CPU, Key boards, Monitors, Priniters, Stabilisers, UPS, System Software
etc.

Note : As per erstwhile tariff.

83
DETERIORATION OF STOCKS (POTATOES)
INTERNAL GUIDE RATE SCHEDULE
I. Rates and Deductibles for Machinery Insurance cover for cold storage plant shall
be as per rate schedule for Group III Machinery of MI Guide Tariff.
II. Rates for deterioration of stocks insurance for cold storage plants shall be as
under :
Rate for cover upto 7 months :
(a) In respect of cold storages which have opted for FOES extension -0.56%
(b) In respect of cold storage which have not opted for FOES - 0.42%
Rate for per month cover beyond 7 months and upto maximum of 12 months :
(a) For cold storages, which have opted for FOES extension: 0.08% for every
extra month or part thereof.
(b) For cold storages, which have not opted for FOES extension: 0.06% for every
extra month or part thereof.
Discount in above rates can be granted as per the technical & commercial discounts
scales based on the risk inspections.
Note : These rates are to be charged on the sum insured i.e. the value of the
potatoes obtained by multiplying the maximum storage capacity of the Cold Storage
by the average price of the potatoes at the time of storage. The price shall include
storage charge for the whole season.
This is further subject to the following :
Cold Storages run on Captive Power only i.e. without having public electric supply
arrangement may also be granted DOS cover provided the cold storage has at
least 100% standby arrangement. Losses arising out of breakdown in DG Sets /
any other source of Captive Power shall be considered under FOES extension.
Deductible Franchise (excess) :
The compulsory deductible franchise applicable to each and every claim under
the policy shall be as under :
(a) In respect of claims falling under FOES extension/ Claims arising out of damage
to DG sets/any other source of Captive Power - 20% of the claim amount
subject to a minimum of Rs.20,000/-.
(b) In respect of other claims - 10% of the claim amount subject to a minimum of
Rs.20,000/-.
The above deductible franchises are in addition to franchise for lack of spare parts
as follows :
Compressors Rs. 10,000
Diffusers Rs. 5,000
Diffuser-motors Rs. 5,000
Expansion Valves Rs. 5,000
Note :
A) In case of annual policies, cover should relate to all the chambers of the Cold
84
Storage and no partial insurance for selected chambers is permitted even at the
instance of banks/financial institutions.
For policies issued for a period less than 12 months, all chambers of the cold
storage that are likely to be used during the entire policy period must be declared
at the time of taking the policy for their full value.
CLAIMS EXPERIENCE DISCOUNTS AND LOADINGS -
Average claims ratio in % for Discount Load-ing EXCESS
5 years preceding the expiring (%) (%)
policy period
Up to 05 30 Policy Excess
Above 05 and up to 15 25 Policy Excess
Above 15 and up to 30 20 Policy Excess
Above 30 and up to 40 15 Policy Excess
Above 40 and up to 45 10 Policy Excess
Above 45 and up to 50 5 Policy Excess
Above 50 and up to 60 Nil Nil Policy Excess
Above 60 and up to 80 5 Policy Excess
Above 80 and up to 100 10 Policy Excess
Above 100 and up to 125 15 Policy Excess
Above 125 and up to 150 20 Policy Excess
Beyond 150 and up to 200 35 Policy Excess
Beyond 200 & UPTO 300 35 1.5 TIMES Policy Excess
ABOVE 300 AND UPTO 400 40 2 TIMES Policy Excess
ABOVE 400 AND UPTO 500 45 2.5 TIMES Policy Excess
Above 500 and up to 1000 50 3 TIMES Policy Excess
Above 1000 100 5 times Policy Excess
Loading and Discount will apply for all proposals. In case more than one policy is
issued in one compound all such policies issued in the compound shall attract the
loading/discount.
i) The claim experience is to be considered for both M.I. & DOS.
ii) The claims ratio to be calculated on incurred basis.
C) Rates will be decided taking into account the claims experience during the 5 years
preceding the expiring policy period. To become eligible for a discounted rate,
the policy should have run continuously for a period of 3 years. Loaded rate, if
any, shall however, be decided from the second year itself.
Rates for Extension beyond policy period:
In case extension of policy period is desired during the currency of the policy, the rate
applicable for such extension period shall be the monthly tariff rate loaded by an extra
of 25%, which should be applied on the balance Sum Insured as on the date of expiry
of the initially selected policy period.

85
BOILER AND PRESSURE PLANT INSURANCE
INTERNAL GUIDE RATING SCHEDULE
Premium rates for insurance of steam boiler explosion and collapse including flue gas
explosion are as follows -
The rates are also applicable to the fittings, super heaters, and built-in-economisers -
Group Risk Type of Boiler Basic Rate Stipulated
Code (Rs. Per mille) age for basic
rate (Years)
1(a) 0101 Coal Fired Boilers 0.80 25
1(b) 0102 Pulverized Coal Fired Boilers 0.80 25
1(c) 0103 Oil Fired Boilers 0.80 25
1(d) 0104 Bagass /Husk Fired Boilers 0.80 25
2(a) 0201 Recovery Boilers 0.80 20
2(b) 0202 Waste Heat Boilers 0.80 20
2(c) 0203 Gas Fired Boilers. 0.80 20
3 0301 Unfired Vessels/ Pressure Plants 0.40 20
4 0401 Steam Pipes 0.20 --
NOTES –
1. For recovery boilers, the basic rate is including explosion due to smelt water
reaction.
2. The basic rate is applicable up to the age stipulated
3. The basic rate will have to be increased @ 0.005 per mille per year for each year
in excess of the stipulated age.
Example for (1) age of boiler at the time of insurance is say 30.
Rate = 0.80 + 0.005 x (30-25)
= 0.80 + 0.025
= 0.80+ 0.025 = 0.825 per mille
4. For boilers not required to be certified by the boiler inspectorate the rate to be
loaded by 50 %
EXCESS: - 5% of claim amount subject to a minimum of Rs. 10,000/-
ADDITIONAL RATES -
1. EXPRESS FREIGHT (AIR FREIGHT EXCLUDED), HOLIDAY AND OVERTIME
RATES OF WAGES –
The additional premium for covering express freight (air freight excluded), holiday
and overtime rate of wages, will be at the average rate applied on the limit selected.
2. AIR FREIGHT –
The rate and excess as under shall be charged exclusively for items of air freight
86
only and subject to the limit selected by the Insured for indemnity against air freight
only.
Rate 2 % on the amount of indemnity selected
Excess 5 % of the Air Freight incurred per claim
3. INSURED’S OWN SURROUNDING PROPERTY -
Additional premium for covering surrounding property will be at an Additional
premium of 25 % of the gross average rate applied on the limit of liability selected
with excess of 1% of the limit of liability selected.
4. THIRD PARTY LIABILITY –
Third Party Liability could be covered at an additional premium of 25 % of the
gross average rate applied on the limit of liability chosen for third party liability.
The excess applicable will be 1% of the TPL limits selected.
Maximum sum insured under this extension should not exceed 10% of S.I. subject
to maximum of Rs. 10 Crs per location.
5. ADDITIONAL CUSTOMS DUTY –
The cover for Additional Custom Duty will be subject to the following rates, terms
and conditions -
a) The cover for Additional Custom Duty will be on first Loss Basis,
b) The specific limit for Additional Custom Duty - either in percentage or in amount
- has to be selected by the Insured at the inception of the Policy and can be
reinstated in the event of loss,
c) The rate and excess will be as under –
Rate 1 % to be charged on the Additional Custom Duty amount
selected
Excess 5 % of the admissible Custom Duty increased, in addition
to the Excess amount applicable for the affected item under
the Policy. Subject otherwise to the terms conditions and
exceptions of the policy.
6. ESCALATION PROVISION -
The additional premium payable will be at 50 % of the full rate, to be charged on
the selected percentage increase.
7. GROSS RATES -
All rates specified in this Guide Tariff are Gross Rates and Agency Commission/
Brokerage (or discount in lieu of Agency Commission) can be allowed from these
rates, as per the Rules prevailing from time to time.
8. COMPUTATION OF RATE :
1. BASE RATE (Including age extra)
2. Add Non IBR extra if applicable
3. Apply technical / commercial discounts on rates arrived at 2 above
9. EXCESS :
5% of claim amount subject to a minimum of INR 20,000/-.
87
ERECTION ALL RISKS / STORAGE-cum-ERECTION INSURANCE
The brief details of our Erection Insurance Scheme are as under :-
Subject Matter :-
All kinds of industrial machinery small or big, old or new, high or low speed etc used
for production purposes.
Insured Party :-
The Insured Party can be manufacturer, Supplier, Contractor, Sub-Contractor or owner
of the machinery.
The policy can be taken jointly by owner covering the interests of all other parties i.e.
Main Contractor, Sub-Contractor etc.
Cover :-
The Policy covers accidental damage due to any cause except those which are
specifically excluded in the policy.
Risk Covered :-
Act of God Risk :-
All kinds of Act of God like earthquake subsidence, landslide, rockslide, flood,
inundation, storm etc.
Other Perils :-
Fire, theft, burglary, strike, riot, civil commotion, tearing apart on account of centrifugal
forces, short circuit, sabotage, faults in erection, lack of skill and carelessness, entry
of foreign object, falling object.
Risk not Covered :-
1. War and similar other risks including Nuclear reaction.
2. Damage’s falling under manufacturer’s guarantee.
3. Losses discovered at the time of taking inventory.
4. Cost of rectification or correction of any error during erection unless results into
physical loss.
5. Willful act or gross negligence of the Insured.
6. Consequential loss of any kind and contractual liability.
7. Normal wear and tear gradual deterioration due atmospheric condition resulting
into rust, scratching of painted ad polished surface, breakage of glass etc.
Sum Insured :-
The Sum Insured should be clearly specified in the policy for each and every item of
the machine stating the FOB/CIF value plus incidental expenses like cost of erection,
custom duty, excise duty, octroi, freight, insurance charges etc in the proposal form
submitted.
Period of Cover : -
The period of cover is given according to the requirement of the client varying from
1 month upon 12/24/30/36 months as may be required and it includes usually
1 moths’s test period for each machine.
One can select more than 1 month’s test period upto maximum 3 months by paying
additional premium. For old machinery testing period is not covered.
88
Deductible Franchise :-
From each and every claim insured is required to share the loss upto the amount fixed
as deductible franchise. The purpose of deductible franchise is to avoid small losses
and administrative work. If deductible franchise selected is higher than normal, then
certain discount is allowed in premium.
Basis of claim settlement :-
a) In the event of partial loss :- Repair charges on the replacement charges of the
spare parts or components plus incidental charges for dismantling, subsequent
re-erection plus to and for freight plus insurance charges, duties, taxes less salvage
and Deductible Franchise will be payable.
b) In the event of total loss :- The replacement value of the item immediately before
the accident less salvage and Deductible Franchise will be payable.
Before final settlement of the claim, the Sum Insured is examined and if it is found to
be more than originally declared. The settlement of claim is done subject to condition
of average.
In the event of claim the Insured is allowed to go ahead with the repairs/replacement
of spare parts as may be necessary. The Insured is not necessarily obliged to wait for
the survey to be conducted. Surveyors will examine the damaged parts which may be
preserved separately for inspection at a convenient date and for approval of the
estimate of repairs/replacement.
Extension of Basic Cover :-
Erection Policy can be suitably extended for the various purposes may be required by
paying extra permium as under :-
1. Third Party Liability - for property damage and personal Injury.
2. Cost of removal of debris.
3. Cost of tools and tackles used for erection purposes.
4. Civil Engineering works connected with Erection of plant machines.
5. Escalation Clause
6. Surrounding property belonging to insured.
7. Extended maintenance cover.
8. Catalysts during test period.
9. Maintenance period.
10. Express Freight, Overtime charges.
Marine-cum-Erection
Our standard Storage-cum-Erection Policy can also be extended to cover Marine
Voyage and local transit on ‘All Risk’ basis from warehouse of supplier to warehouse
at site of erection. Our Marine-cum-Erection Policy covers the risk right from the time
Machinery dispatched from sellers warehouse to warehouse at site of erection, then
during storage at site actual erection and during trials and testing operation.

89
ACCIDENT COVERS
PERSONAL ACCIDENT (INDIVIDUAL)
COVERAGE :
Covers Death and Disablement caused by accident during the policy period at any
time. World Wide - 24 hrs cover.
Age: 5 years to 70 years. Continuous renewal after 70 years allowed. (If necessary
with loading)
BENEFITS :
1. Death 100% CSI
2. Loss of 2 limbs or 2 Eyes or 1 limb and 1 eye 100% CSI
3. Loss of 1 limb or 1 eye 50% of CSI.
4. Permanent Total Disability 100% CSI
5. Permanent Partial Disability % As per Table
6. Temporary Total Disablement 1% of CSI subject to Rs. 20000/-
maximum per week - Max 100 Weeks.
RATING :
Based on Risk Group consisting of I, II and III.
The brief classification of Risk Groups is as under :
Risk Group I : Accountants, Doctors, Lawyers, Architects, Consulting Engineers,
Teachers, Bankers, and Persons engaged in administrative functions, Persons
primarily engaged in occupations of similar hazard.
Risk Group II : Builders, contractors and engineers engaged in superintending
functions only, veterinary doctors, paid drivers of motor cars and light motor vehicles
and persons engaged in occupations of similar hazard and not engaged in manual
labour.
Risk Group III : Persons working in underground mines, explosives magazines,
workers involved in electrical installation with high tension supply, jockeys circus
personnel, persons in activities like racing on wheels or horseback, big game
hunting, mountaineering, winter sports, skiing, ice hockey, ballooning, hang gliding,
river rafting, polo & persons engaged in occupations/activities of similar hazard.
Premium Rates (Per Mille) : Risk Group
Benefits I II III
1 to 6 1.50 2.00 3.00
1 to 5 1.00 1.25 1.75
1 to 4 0.70 0.90 1.30
1 Only 0.45 0.60 0.90
FAMILY PACKAGE COVER :
a) Earning Member (Person Insured) and Spouse if earning 100% of CSI for each.
b) Spouse if not earning - 50% of CSI of the earning member or Rs. 25 lakhs whichever
is lower. However, Table A benefits restricted to 50% S.I. of earning member or
5 lakhs whichever is leas.
c) Dependant Children between the Age of 5 and 25 years 25% of CSI of earning
member or Rs. 5 lakhs whichever is lower per child. (Cover excludes Table
A benefits)
Discount of 10% on Gross Premium under the Family Package Cover, can be allowed.
SUM INSURED :
Table A should not exceed 24 months Income and the total sum insured comprising
all the table should not exceed 72 months Income.
90
EXTENSION :
Policy can be extended to include Medical Expenses arising out of accident to the
extent of 40% of valid claim, by charging 20% additional premium.
CUMULATIVE BONUS :
The Sum payable under item 1 to 4 can be increased by 5% for every claim free year
on renewal of policy upto a limit of 50%
1. Cover in request of Terrorism – Inbuilt
2. Education Grant – (Maximum all policies one life)
❖ Death/PTD of the insured person, education grant for dependent children of
age below 25
❖ One dependent child - 10% of CSI subject to maximum Rs.25000/-
❖ More than one dependent child - 10% of CSI subject to maximum Rs.50000/-
3. Expenses for Carriage of Dead Body : less (for transportation of dead body to
residence)
In the event of death of the insured person due to accident outside his/her residence,
the Company shall pay additional amount of 2% of CSI of Rs.25000/- whichever is
IMPORTANT EXCLUSIONS :
Services on Duty with any armed forces
1) Services on Duty with any armed forces
2) Intentional Self Injury / Suicide / Attempted Suicide / Insanity / Venereal disease,
under the influence of intoxicating Drugs
3) Aviation other than as Passenger
4) Committing any breach of law with criminal intention.
5) Medical or surgery expenses (except where such treatment is rendered necessary
within the scope of the policy and medical extension taken).
Table : Permanent Partial Disablement
Parts Lost Percentage of
Capital sum Insured
i) Loss of toes – all 20
Great – both phalanges 05
Great – one phalanx 02
Other than great, if more then one toe lost each 01
ii) Loss of hearing – both ears 75
iii) Loss of hearing – one ear 30
iv) Loss of four fingers and thumb of one hand 40
v) Loss of four fingers 35
vi) Loss of thumb – both phalanges 25
– one phalanx 10
vii) Loss of index finger – three phalanges or
two phalanges or one phalanx 10
viii) Loss of middle finger – three phalanges or
two phalanges or one phalanx 06
ix) Loss of ring finger – three phalanges or
two phalanges or one phalanx 05
x) Loss of little finger – three phalanges or
two phalanges or one phalanx 04
xi) Loss of metacarpals – first or second
(additional) or third, fourth or fifth (additional) 03
xii) Any other permanent partial disablement Percentage as
assessed by the Panel
Doctor of the Company
91
PERSONAL ACCIDENT INSURANCE POLICY WITH
MEDICAL EXPENSES ARISING OUT OF ROAD ACCIDENT
(RASTA APATTI KAVACH)
The policy offers PERSONAL ACCIDENT cover including reimbursement of
Hospitalisation expenses incurred due to road accident.
SECTION - I PERSONAL ACCIDENT
If the Insured/Insured Person shall sustain any bodily injury resulting solely and directly
from Accident caused by outward, violent and visible means then the Company shall
pay/reimburse to the Insured the sum hereinafter set forth that is to say :-
a) If such Injury shall within twelve Calendar months of its occurrence be the sole
and direct cause of the death of an insured/insured person the capital sum insured
in the schedule hereto.
b) If such injury shall within twelve Calendar months of its occurrence be the sole
and direct cause of the total and irrecoverable loss of sight of both eyes or both
hands or both feet or of the actual loss of one eye and such loss of one of two
entire hands or two entire feet, or of the one entire hand and one entire foot, or of
such loss of sight of one eye and such loss of one entire hand or such loss of one
entire foot of an insured person the Capital Sum Insured in the schedule hereto.
c) If such injury shall within twelve Calendar months of its occurrence be the sole
and direct cause of the total and irrecoverable loss of sight of one eye or of the
actual loss of one entire hand or one entire foot of an insured person, fifty percent
(50%)of the Capital Sum Insured stated in the Schedule hereto.
d) If such injury shall as a direct consequence thereof immediately, permanently,
totally and absolutely disable an insured person from engaging in being occupied
with or giving attention to any employment or occupation of any description
whatsoever, the Capital Sum Insured stated in the schedule hereto.
SECTION II - Medical Expenses for bodily injury caused by and arising out of road
accident.
In the event of any claim becoming admissible under this scheme, the company will
pay/reimburse to the Insured person the amount of Capital Sum Insured & expenses
as would fall under different heads mentioned below, and as are reasonable and
necessarily incurred thereof by or on behalf of such Insured Person, but not exceeding
the Sum Insured in aggregate in any one policy period, as defined hereinafter.
A) Room, Boarding Expenses as provided by the hospital/nursing home.
B) Nursing Expenses.
C) Surgeons, Anesthetists, Medical Practitioners, Consultants, Specialists Fees.
D) Anesthesia, Blood, Oxygen, Operation Theater Charges, Surgical Appliances,
Medicines & Drugs, Diagnostic Materials and x-ray, Artificial Limbs & Cost of Organs
and similar expenses.
E) Ambulance Charges for carrying the injured from accident spot to Hospital and at
the time of discharge upto residence.
EXTENSION :
HOSPITALISATION EXPENSES ARISING OUT OF ACCIDENT IN THE COURSE
OF EMPLOYMENT
AGE LIMIT :
This insurance is available/applicable to persons between the age of 5 years and
80 years. This age limit is not applicable to third party and unnamed passengers.
92
SUM INSURED :
Section I : PA Cover - Rs.25000, Rs.50000, Rs.75000 or Rs. 100000 per person
Section II : Medical Expenses for Road Accident upto Rs. 25000, Rs.50000,
Rs.75000, or Rs.100000 as selected
Extension : Medical expenses whilst accident on duty upto Rs.25,000/-,
Rs.50,000/-, Rs.75,000/-, or Rs.1,00,000/- (within the limits of
Section II above) as selected.
PREMIUM :
SUM INSURED BASIC PREMIUM
RS. RS.
SECTION I - 25,000
SECTION II - 25,000 40
SECTION I - 50,000
SECTION II - 50,000 80
SECTION I - 75,000
SECTION II - 75,000 120
SECTION I - 1,00,000
SECTION II - 1,00,000 160
EXTENSION FOR HOSPITALISATION EXPENSES ARISING OUT OF ACCIDENT
IN THE COURSE OF EMPLOYMENT
(For Factories & Industrial Establishments)
(This premium is inclusive of basic cover)
SUM INSURED BASIC PREMIUM
RS. RS.
25,000/- (40+25)
50,000/- (80+50)
75,000/- (120+75)
1,00,000/- (160+100)
N.B. 1. No income tax benefit
2. Service tax as applicable
3. Sum Insured limit of basic cover for hospitalisation expenses remains the
same for extending coverage of industries in the course of employment
The above policy is also available for groups as under :-
The Group Personal Accident policy will be available to any Group/Association/
Institution/ Corporate Body like Fleet owners, Riksha owners Association, Contract
Bus owners Association etc. consisting of more than 50 persons provided it has a
central administration point. Each Insured should cover all eligible members (Insured
Persons) under one group policy only. The proposer/such group can also cover
passengers travelling in their vehicle & also Third parties.
93
Group Discount
The Group Discount is permissible as per the following scale depending upon the
total number of Insured Persons covered under the Group policy at the inception.
Increase/Decrease in the sizes of the group during the currency of the policy is
permissible. The final Group discount (increase/decrease) will be adjusted on the
basis of the size of the group existing on the last day of the policy period provided the
policy is renewed for the next 12 months.
No. of Persons Insured under the Group Policy Group Discount %
First 100 Persons 15
Next 400 Persons 20
Next 500 Persons 25
Next 4000 Persons 30
Next 5000 Persons 35
Next 15000 Persons 40
Next 25000 Persons 50
Over and above 50000 Persons 66.2/3
Bonus / Malus :
a) LOW CLAIM RATIO DISCOUNT (BONUS) :
Low claim Ratio Discount at the following scale will be allowed on the Total premium
at renewal only depending upon the incurred claims ratio for the entire group insured
under the Group Mediclaim Insurance Policy for the preceding 3 completed years
excluding the year immediately preceding the date of renewal. Where the Group
Mediclaim Insurance Policy was not in force for 3 completed years, such shorter
periods of completed years excluding the year immediately preceding the date of
renewal will be taken into account.
Incurred Claims ratio under the group Policy Discount %
Not Exceeding 60% 5
Not exceeding 50% 15
Not exceeding 40% 25
Not exceeding 30% 35
Not exceeding 25% 40
b) HIGH CLAIM RATIO LOADING (MALUS)
The Total Premium payable at renewal of the group policy will be loaded at the
following scale depending upon the incurred claims ratio for the entire group insured
under the Group Mediclaim Insurance Policy for the preceding 3 completed years
excluding the year immediately preceding the date of renewal. Where the Group
Mediclaim Policy has not been in force for the 3 completed years, such shorter
94
periods of completed years excluding the year immediately preceding the date of
renewal will be taken into account.
Incurred Claims Ratio under the Group Policy Loading %
Between 80% and 100% 25
Between 101% and 125% 55
Between 126% and 150% 90
Between 151% and 175% 120
Between 176% and 200% 150
Over 200% Cover to be reviewed
Note : Incurred claim would mean claims paid plus claims outstanding in respect of
the entire group insured under the policy during the relevant period.
Details of Insured Person
The Insured shall be required to furnish a complete list of Insured Persons in the
following format according to Sum Insured. Any additions and deletions during the
currency of the policy should be intimated to the company in the same format. However
such additions and deletions will be incorporated in the policy from the first day of the
following month subject to pro-rata premium adjustment. No change of sum Insured
for any Insured Person will be permitted during the currency of the policy.
Sr. Names of Insured Persons with their Salary Age Sex Name of Sum
No. Roll No. or any such identification for Nominee/ Insured
Employees Members of the Insured Assignee
1.
2.
3.
No refund of premium will be allowed for deletion of Insured Person in the event of
Insured Person having made/recovered a claim under the policy.
All other terms, condition and per person premium is as per the Individual policy
mentioned above.
To achieve the desired market penetration in retail business , to accentuate the growth
of the Personal Accident premium and achieving a sizeable growth in the Insuring public,
it has been envisaged to introduce a customised Individual Personal Accident Cover for
Individuals.
We have introduced Personal Accident Cover for 2 bands of Sum Insured viz: Rs 5 lacs
and Rs 2.50 lacs on a restricted death only cover and PTD on competitive rates. This
cover may be offered on a Pan India basis to individuals falling on Risk Groups I & II only.
Accordingly the premium recommended are Rs 125/- including service tax for Risk
Group I and Risk Group II the Sum Insured of Rs 5/- lacs for the Death Only /PTD Cover.
For the band of Sum Insured of Rs 2.50 lacs the premiums recommended are Rs. 162.50
including service tax for Risk Group I for the Death Only /PTD Cover.
This product is predominantly positioned for our Customer Portals, Bancassurance,
retail agents and micro offices. The two bands have been created to cater to the urban,
semi-urban and rural population.
This cover is meant for individuals only and cannot be given to a family. No further
discount can be allowed on this rate.
The Standard terms and conditions applicable for Death and PTD cover shall apply to
this policy.
(Available in Portal only)
95
PACKAGE COVERS
JEWELLERS BLOCK INSURANCE
This is a special package policy devised to meet the various insurance requirements
of jewelers pursuing their business.
Moral hazard is of considerable importance in this class of business. Proposers
who are known for their integrity, good reputation may be accepted with the permission
of R.O.
A careful scrutiny of the proposal form is also necessary in order to know the claim
history, security factors, since earlier history has bearing on underwriting; a proposal
of jeweler operating for the 1st year is a bad risk.
The proposal form is a detailed one. Since the business relates to valuable items like
gold and jewellery, the security factors of the risk assume considerable importance.
Answers to question 3 of the proposal form should be carefully scruitinsed. The question
relates on particulars of safe, occupancy at night, night watchman, burglar alarm
system, etc. Separate limits (sums insured) are provided for risks on the premises,
outdoor risk when the property is in the custody of gold smiths, brokers, agents, cutters,
partners and employee, including transit risks. There is separate item for furniture
fixtures and fittings at the premises. The proposer has to complete question No.8 very
clearly, giving full values of insurance. The basis of valuation shall be the insured cost
plus 10% thereof.
1. Scope of Cover
The cover accorded by the policy is divided into 4 sections as under :
Section – I
This section covers loss of or damage to property, whilst contained in the premises
where the insureds business is carried on or at other premises where the insureds
property is deposited as specified in the Schedule by Fire, Explosion, Lightning,
Burglary, House-breaking, theft, hold-up, Robbery and Riot and strike damage only.
Terrorism also becomes part of cover at an additional premium of Rs.0.03 per mille.
Limits of indemnity (i.e. Sum insured) are shown separately for :
(A) Property insured on the premises :
(1) Property in display windows
(2) Property in locked safe on the premises
(3) Elsewhere in the premises
(B) Cash and currency notes:
(1) Bank Lockers
(2) Private Lockers (Address of all Lockers required) subject to insured
maintaining separate register to record all deposits, withdrawal in such
lockers.
The property insured is defined as stock in trade consisting of jewellery,
gold and silver ornaments, pearls, precious stones, cash, currency notes,
96
etc. usual to the conduct of the insureds business, belonging to him or held
in trust or on commission for which he is responsible.
The cover is subject to the warranty that all stocks whilst at the premises
specified in the schedule shall be secured in locked burglar proof safe at
night and at all times out of business hours.
Section – II
Loss of or damage to property insured under items (a) and (b) of Section II of the
schedule and carried and conveyed outside the specified premises for the purpose of
insureds business by any cause whatsoever except as herein after provided.
Property insured by the insured excluding cash and currency notes whilst in the custody
of brokers or agents or cutters or cutters or goldsmiths or sorters of diamonds not in
regular employment of the insured, whether directly entrusted by the insured or
otherwise subject to appropriate documentary evidence being available relating to
such entrustment.
Section – III
This section covers insured property (excluding cash and currency notes) whilst in
transit within India by:
(a) Registered Insured Post Parcel not exceeding the limit of Rs.5 Lakhs or 10%
of the sum insured under Section I, whichever is less
(b) Airfreight (20% value should be declared to the Airline and included in the
Airway Bill)
(c) Angadia (Courier Service in North is not covered).
Transit by means other than above are covered, Basis of valuation for property
other than cash or currency notes in respect of Section I, II and III shall be the
insureds cost plus 10% thereof.
Note : 1) S.I. under Sec. II & III each should not exceed 25% of sum insured under
Sec. I.
2) The condition of average would be applicable to Sec. II & III also after
taking value of risk in to consideration under Sec. I, II & III.
3) Warranty to be imposed – warranted that all property including cash &
currency note whilst at the premises specified in the schedule shall be in
locked safe of standard make at all times out of business hours. It is further
warranted that if numerical safe is used for storage, then combination
number of safe shall be known & used by partners/directors & nominated
employees, Mr./Mrs. - & Mr./Mrs. – at all times during the currency of the
policy.
Section – IV
This section covers loss/damage to office furniture, fittings being used in connection
with the insureds business whilst contained in the premises where the insureds
business is carried out caused by fire, Explosion, Lightning, Burglary, Housebreaking,
Theft, Hold-up, Robbery and Riot & Strike damage only.
97
Notes :
(a) All the rates are inclusive of Riot & Strike damage risks.
(b) If required by the insured, cover for Earthquake/FST insurance may be
included in the policy at an additional premium as per Fire guidelines.
(c) Coverage under this policy for Sections I and IV only without any coverage
under Sections II and III, if required by the proposer, may be considered.
(d) If claim ratio is favourable appropriate discount may be given as no claim
discount.
2. Rating
The current prem. structure under market agreement is as under:
Section I
Sum Insured Class I Class II Class III
(a) Up to Rs.1 Crore 0.25% 0.35% 0.50%
(b) Above Rs.1 Cr. Up to Rs. 5 Cr.
(on the excess over Rs. 25 lakhs) 0.20% 0.30% 0.45%
(c) Above Rs. 5 Cr. On the excess
over Rs. 50 lakhs) 0.175% 0.275% 0.425%
(d) On the excess over Rs.10 Cr. 0.15% 0.25% 0.40%
Class I means : Watchman employed for 24 hours at all the listed premises.
Class II means : Common watchman for the building or night watchman.
Class III means : All others.
NB : Special discount of 10% may be allowed only in respect of those premises
where special protective device or special security measures are adopted,
e.g. built in vaults, strong rooms, closed circuit. T.V. systems, armed guard. In
the event of the insured having more than one of the named protective devices
or security measures a maximum discount of 15% may be allowed in respect
of such premises only which are eligible for the discount.
Section II
(a) On the first part of the aggregate of the individual limits under Section II, upto
50% of Section I sum insured – 0.40%
(b) On the next 25% of Sec. I sum insured – 0.50%
(c) On the next 25% of Sec. II sum insured – 0.70%
Section III : 1% on aggregate sum insured under this section.
Section IV : 0.20% on the sum insured under this section.
Extension of Terrorism cover together with Riot & Strike is given under Section I & IV
only at an additional premium as per Terrorism Pool.
Service Tax 12.36% is payable extra.
98
OFFICE PROTECTION SHIELD (GENERAL)
COVERAGE :
Covers Building, Contents and various other properties that are generally found in
offices against various perils. Policy consists of various sections covering different
properties of the insured.
RATING
Sections Coverage Rate Per Mille
I BUILDING As per Fire Policy Building including
landlord fixtures, fittings boundary wall and fences. 0.40
II A OFFICE CONTENTS (Fire 0.65+ Burglary 0.75)
Risk Covered : As per Sec. I including burglary,
robbery and dacoity. 0.75
II B TENANTS LIABILITY Liability as a Tenant for
damage to Office PremisesIncluding Fixtures and
Fittings. Risk Covered : As per Sec II A 0.40
III MONEY INSURANCE Loss of money whilst in transit,
on the premises duringOffice hours and in safe after
office hours, againstany accident and/or misfortune. 2.40
IV FIEXD GLASS AND SANITARY FITTINGS Covers
loss or damage due to accident/breakage including
Damage to frames. 8.50
V FIDELITY GUARANTEE Pecuniary loss caused by
fraud and/or dishonest act of any salaried person
employed by the insured. Additional Rs.10/- per
capita for total number of persons covered. 5.00
VI A ELECTRONIC EQUIPMENT Unforeseen sudden
physical loss or damage due to anyCause other than
those specifically excluded.
Major Exclusions : All pre existing fault or defect,
Wear and tear loss due to climatic conditions defects
or designs or materials for which suppliers are
responsible.
EXCESS : As per Electronic Equipment Policy. 9.00
VI B COST OF REINSTATEMENT OF DATA
Risk Covered : As per Section VI A 9.00
VI C PORTABLE COMPUTERS : Whilst being carried
anywhere in the world.
Risk Covered : As per Sec VI A 18.00

99
VII ADDITIONAL EXPENSES ON RENT For alternate
accommodation if premises occupied isDamaged and
declared unfit for occupation.
Coverage as per Sec II A. 0.40
VIII PERSONAL ACCIDENT Coverage for Self and
employees. Benefits terms and conditions as per As per PA
P A guidelines. guide rates
IX BREAKDOWN OF OFFICE APPLIANCES
Electrical and Mechanical Breakdown 12.00
X BAGGAGE Loss or damages to Baggage belonging
to Self and/orEmployees whilst on journey anywhere
in the world.Covers any accident and/or misfortune. 6.00
XI A PUBLIC LIABILITY Death or bodily injury and/or
damage to property ofthird party. 1.00
XI B WORKMEN COMPENSATION As per W C
guide rates.
1. Section I and 2 A are compulsory for Owners (Building) insured
2. Section 2 A compulsory for Tenants (Building) insured
3. Minimum No. of Sections to be insured by owner is 5 (FIVE)
4. Minimum No. of Sections to be insured by Tenant (building) insured is 4 (FOUR)
SECTION DISCOUNT
A) For additional 2 sections above minimum sections as per 3 and 4 above : 10%
discount on premium.
B) For additional 4 sections 15% discount on premium.
C) For additional 7 sections 20% discount on premium.
TERRORISM COVER :
Optional.
RENEWAL DISCOUNT :
First renewal – 5%
Second renewal – 10%
Third renewal – 15%
Fourth renewal – 20% (maximum)

100
HOUSE HOLDERS INSURANCE
COVERAGE :
Covers the House, Contents and various properties of the householder under one
single policy, against various perils. Policy consists of various sections covering different
properties of the insured.
RATING
Sections Coverage Rate Per Mille
I (A) BUILDING (FIRE) 0.25
I (B) CONTENTS (FIRE)
Risk Covered : Fire, Lightning, Explosion of Gas in
domesticAppliances, Riot and Strike, Malicious
Damage, Flood,Cyclone etc., Impact Damage,
Aircraft Damage, Subsidenceof Landslide Bursting
and overflowing of Water Tanks,Apparatus or
pipes and Earthquake 0.25
II BURGLARY AND HOUSE BREAKING
Risk Covered : Burglary, Housebreaking, Larceny or
Theft (Insurance on Contents for this Section should
be equal tovalue mentioned under
Section I (B) above.) 0.75
III ALL RISKS
Risk Covered : Jewellery and Valuables against
Loss or damage by accident or misfortune
whilst anywhere in India. 6.00
IV PLATE GLASS
Risk Covered : Fixed Plate Glass against
accidental damage 9.00
V BREAKDOWN OF DOMESTIC APPLIANCES
Risk Covered : Damage caused by and/or solely due
to Mechanical or Electrical breakdown of Domestic
electrical or Mechanical appliances apparatus or
gadgets. Sum Insured should be present day
replacement value of similar new equipment. 0.80
VI TV/VCR SET ETC.,
Risk Covered : Covered as per Section I & II ,
accidental External means and Mechanical or
Electrical Break down.Legal Liability upto Rs.25000/-
and Damage to Insured Own property due to
collapse of Antenna upto Rs.3000/- 9.00

101
VII PEDAL CYCLE
Risk Covered : Loss or Damage due to Fire,
Lightning, internal explosion, Riot and Strike,
Terrorism, Malicious Damage, Earthquake, Flood,
Cyclone etc., Burglary, Housebreaking, and/or theft,
external accident and legalliability subject to
limit of Rs.10, 000/- 10.00
VIII BAGGAGE
Risk Covered : Loss or Damage to insured
accompanied baggage by accident or misfortune
whilst the insured is traveling on tour or holiday
anywhere in India. 5.00
IX PERSONAL ACCIDENT
Risk Covered : As per P A (Individual) Policy As per P A
terms and conditions. guide rates.
X A - PUBLIC LIABILITY
Risk Covered : Insured Legal Liability for Bodily
injury orLoss or Damage to Property of third
party limited to amountspecified in the Schedule. 0.35
B - WORKMENS COMPENSATION LIABILITY
Risk Covered : Liability for Domestic servants As per W C
engaged I the Insured Premises. guide rates.
XI PERSONAL COMPUTERS
Risk covered : Terms conditions and exclusions
as per Electronic Equipment Policy. 9.00
TERRORISM COVER IS OPTIONAL
SECTION DISCOUNT :
For covering more than 4 and up to 6 sections (including Tariff rated section) 15%
discount on Non Tariff section premiums only. For more than 6 sections (including
Tariff rated sections) 20% discount on Non-tariff section premiums only.
Minimum Sections to be covered : 3 (THREE) Section I & II are compulsory
MAJOR EXCLUSIONS :
Loss or damage by War/Civil War and the like depreciation, wear and tear,
Consequential loss etc.

102
NEW INDIA GRIHA SUVIDHA POLICY
UNDERWRITING GUIDELINES
This policy is an abridged form of the existing Householders´ Package Policy. It has four
options and each option has five sections. Its main object ive is to target the average
householders ’ contents on first loss basis. The main highlights of the policy is its
simplicity and ease to the customer in providing the details and description of the
contents and also a simple and hassle free process of claims administration. The policy
also has an Optional Sect ion VI where the Residential Premises can be covered on Full
Sum Insured Basis.
This policy is available to any person residing in India, including foreign nationals,
provided the con tents proposed for insurance are situated within the Indian territory.
The settlement of claims shall be in Indian currency only.
SECTIONS UNDER THE POLICY
SECTION – I : CONTENTS (EXCLUDING JEWELLERY& VALUABLES) AGAINST
FIRE & ALLIED PERILS INCLUDING EARTHQUAKE & TERRORISM ON FIRST
LOSS BASIS .
This section covers contents, which are kept and installed in the premises, as mentioned
in the schedule, against fire and allied perils including earthquake. This section is
broadly meant to cover Furniture Fixtures Fittings, Upholstery, Clothes and Apparels
and Domestic appliances. The insured need not furnish a detailed list of the items for
which insurance cover is sought.
This section shall exclude :
a) loss of or damage to articles of consumable nature.
b) loss of or damage to money, securities, stamps, stamp collections, bullion, livestock,
motor vehicles and pedal cycles.
c) loss of damage of deeds, bonds, bill of exchange, promissory notes shares and stock
certificates, business books manuscripts documents of any kind, unset precious
stones and jewelry and valuables, unless specifically declared and covered.
Excess under this section : 1% of S.I. ( Item less than Rs.1000/- not covered)
SECTION – II : CONTENTS (EXCLUDING JEWELLERY) AGAINST BURGLARY &
HOUSEBREAKING
The sum insured in this section is same as section I. Under this section also the insured
need not furnish the details of the items for which insurance is sought. This section is
broadly meant to cover Furniture Fixtures Fittings, Upholstery, Clothes and Apparels
and Domestic appliances.
This section shall exclude :
a) loss or damage by burglary, housebreaking or theft where any of the members of
the your family is involved as principal or accessory.
b) loss of or damage to livestock, motor vehicles and pedal cycles.
c) loss or damage to money, securities for money, stamps, bullion, deeds, bonds, bills
of exchange, promissory notes, stock and share certificates, business books,
manuscripts, documents of any kind, unset precious stones and jewelry and
valuables, unless specifically declared.
Excess under the section : 1% of S.I. ( Item less than Rs.1000/- not covered)
SECTION - III : JEWELLERY AND VALUABLES :
This section is meant to cover Jewellery and valuable items worn or kept in the premises
103
against perils including but not limited to Fire & Allied Perils including earthquake,
Burglary, House -Breaking &Theft and such other sudden accident or misfortune. The
policy shall also cover the perils whilst being worn by the Insured or his/her immediate
family members permanently living with the insured. Based on the items required to be
covered, the commensurate option needs to be chosen by the customer. Description
of the items in simple terms needs to be specified only for items the value of which
exceeds 10% of the Sum Insured under this section. A Maximum of 5 such items can
be opted for under this section.
This section shall exclude :
a) Loss or damage due to cracking, scratching or breakage of lens or glass whether
part of any equipment or otherwise or to china marble, gramophone records and
other articles of brittle or fragile nature .
b) Mysterious disappearance, unexplainable losses, loss due to misplacement and
missing items.
c) Loss or damage caused by moth, mildew, vermin or any process of cleaning, dyeing,
repairing or restoring to which the property is subjected.
d) Loss or damage caused by mechanical derangement or over winding of watches
and clocks.
e) Theft from car except from car of fully enclosed saloon type having all the doors,
windows and other openings securely locked and properly fastened.
f) Loss or damage whilst being conveyed by any carrier under contract of
affreightment.
Excess under the section : 1% of S.I. ( Item less than Rs.1000/- not covered)
SECTION - IV : BREAKDOWN OF DOMESTIC APPLIANCES
The description details of such appliances , restricted to the make & model, needs to
be specified in the single page proposal form itself.. The value of the gadgets proposed
for insurance under this section is also part of the sum insured under section I & II
against Fire and Burglary.
This section shall exclude :
a) Loss or damage caused by or arising out of Your willful gross negligence
b) Loss or damage due to faults existing at the time of commencement of this insurance
and known to You.
c) Loss or damage for which the manufacturer or supplier of the Property is liable under
contract.
d) Cost of transport to the repair shop and back to the Insured’s premises of any
insured Property arising out of any damage.
e) Loss of or damage to any insured Property by perils which are insurable under other
Section of this policy.
f) Loss of or damage to any insured Property occasioned by permanent or temporary
dispossession resulting from confiscation commandeering or requisition by any
lawfully constituted authority of such Property or by permanent or temporary
dispossession of any building, resulting from the unlawful occupation by the insured
of the building.
Excess under the section : 1% of S.I. ( Item less than Rs.1000/- not covered)
SECTION - V : TV /DESKTOP INSURANCE
This section is meant to cover the Television &/or Desktop, in the premises. The cover
104
is against Fire, Earthquake, Burglary & House Breaking, Electrical and Mechanical
Breakdown.
The section shall exclude :
a) Loss of or damage to External antenna or fittings by theft unless the Television
Apparatus &/or Desktop is self is stolen at the same time.
b) Loss of or damage caused by or arising out of or traceable to erection, repairing or
dismantling of the Television Apparatus &/or Desktop
c) Loss of or damage for which the manufacturer or supplier of the Television apparatus
&/or Desktop is responsible either by and / or contract.
d) Liability assumed by the Insured by Agreement unless such liability could have
affected to the insured not withstanding such agreement.
Excess under the section : 1% of S.I.
SECTION - VI : (PREMISES) AGAINST FIRE & ALLIED PERILS INCLUDING
EARTHQUAKE & TERRORISM
This section is optional and covers residential premises where the above described
contents are kept and installed, against fire and allied perils including earthquake &
terrorism. Here full Sum Insured value of the premises has to declared by the proposer.
The Condition of Average and Under Insurance are applicable.
Excess : 5% of the claim amount subject to a minimum of Rs 10000 for AOG perils only.
OPTIONS AVAILABLE
Sum Insured on First Loss Basis ( I to V)
Sections Cover Description Option 1 Option 2 Option 3 Option 4
(on First SI SI SI SI
Loss
basis)
I Fire & Allied Perils (contents) 100000 250000 500000 1000000
II Burglary House Breaking & Theft (contents) 100000 250000 500000 1000000
III Valuables and Jewellery 50000 100000 200000 400000
IV Breakdown of Domestic Appliances 50000 75000 100000 200000
V Television/Desktop Insurance 25000 40000 60000 75000
VI Fire & Allied Perils (Property) (Full Sum (Full Sum (Full Sum (Full Sum
Insured as Insured as Insured as Insured as
per the per the per the per the
value of value of value of value of
the the the the
property) property) property) property)
*TOTAL PREMIUM (5 sections) 1125 2120 3880 7175
Fire & Allied Perils – Section VI 0.30 per 0.30 per 0.30 per 0.30 per
(Property as per value opted for) mille mille mille mille
If the Insured desires to also cover his Residential Property along with the contents he
may do so, under Section VI.
The premium under Section VI will be calculated at the rate given above on Full Sum
Insured and added to the Premium of Sections I to V of the selected option.
*Premium (in Rupees) ......................................................... plus Service Tax Extra.

105
PORTABLE EQUIPMENT
Laptop Computers / Medical Equipments etc.
1. Risk Covered : Fire, Explosion, Lightning, Riot & Strike – terrorist, Burglary / Theft,
Accidental external means, Electrical & Mechanical Breakdown.
2. Basis of valuation is reinstatement value.
3. The value of items covered under this policy individually shall not be less than
Rs. 10,000/-.
4. Following factors to be considered for rating:
a) Power input
b) Mode of Transport
c) Servicing
d) Whether kept at a particular place or transported from one place to another.
e) Persons operating equipment. (If assistants whether qualified)
f) Safety features (in built stabilizers, etc) or back-up units.
g) If re-agents used – how are they stored, whether of inflammable nature.
h) Frequency of transit (whether daily/weekly)
5. If the geographical scope is within a radius of 100 kms from normal residence, the
given rate will be applied. If a wider scope required, the rate may be suitably
loaded.
6. Rate : It may range from 1.75% to 2.50% depending upon the above factors.
Loading as under on basic rate to be applied.
Age of the equipment Loading (%)
Over 2 years up to 5 years 10%
Over 5 years up to 10 years 25%
Over 10 years 30%
7. Excess :
Age of the equipment % of S.I. Minimum Excess
Up to 2 years 1% 500/-
Over 2 years up to 5 years 1.5% 750/-
Over 5 years 2% 1,000/-
For theft, the excess would be 25% of the claim amount.
Minimum Premium : Rs.50/- + 12.36%( S.T.)

106
SHOPKEEPERS INSURANCE
COVERAGE :
Covers Building, Contents and various other properties of a Shopkeeper under a Single
Policy against various perils. Policy consists of various sections covering different
properties of the insured.
RATING
Sections Coverage Rate Per Mille
I (A) FIRE - BUILDING 0.65
I (B) FIRE - CONTENTS (Excluding Money and Valuables)
Risk Covered : Fire and Allied PerilsTotal Sum
Insured under item A & B should not exceed
Rs.10 crores.
Risk Covered : Fire, Lightning, Explosion of Gas in
domestic Appliances, Riot and Strike, Malicious
Damage, Flood, Cyclone etc., Impact Damage,
Aircraft Damage, Subsidence Of Landslide Bursting
and overflowing of Water Tanks, Apparatus or
pipes and Earthquake 0.65
II BURGLARY AND HOUSE BREAKING
Cover against Loss or Damage to Property in the
premises Due to Burglary and House breaking.
Insurance on contents should be for value equivalent
to Section I (B) as above (Up to Rs.10 crores) 0.75
III MONEY INSURANCE Money in transit (Maximum Up
to Rs 25,00,000/-)In Safe (Maximum Up to
Rs 25,00,000/-I) In till/Counter (Maximum Up to
Rs 5,00,000/-)Covers Money in the Cashier till or at
the counter on in safe/steel Cupboard or whilst being
carried to/ from the Bank against theft, burglary
and hold up 1.50
IV PEDAL CYCLE : Damage or Loss to Pedal Cycle
and accessories includingPublic Liability of Rs.10000/- 12.00
V PLATE GLASS Maximum Up to Rs 15,00,000/-In the
business premises or the show windows against
accidental and/or Malicious breakage. 8.50
VI NEON/GLOW SIGN (Including theft of the whole
sign) Maximum Up to Rs 10,00,000/- Against Loss or
damage due to accident, fire and allied perils
Riot and Strike 8.50
VII BAGGAGE INSURANCE Maximum Up to
Rs 1,50,000/-. Against Theft/accident 6.00

107
VIII PERSONAL ACCIDENT
Risk Covered : As per P A (Individual) Policy terms As per P A
and conditions. guide rates.
IX FIDELITY GUARANTEE Per Person Up to
Rs 5,00,000/- Aggregate Up to Rs 25,00,000/-
Coverage against Fraud or Dishonesty by employees 9.00
X A - PUBLIC LIABILITY
Maximum Up to Rs 5,00,000/- 0.35
B - WORKMENS COMPENSATION LIABILITY As per W C
guide rates.*
XI Electronic Equipment/Personal Computer Only
Risk covered : Terms conditions and exclusions
as per Electronic Equipment Policy. 7.50
XII LOSS OF PROFIT COVER Description of Property
as in Section ISum Insured as in Section I BCovers
Loss of Profit due to interruption in Business
consequent upon loss sustained by the property
mentioned in Sec I of the Policy due to Rates as in
perils stated in the policy. Section IB
TERRORISM COVER IS OPTIONAL
* Refer Annexure - A
SECTION DISCOUNT :
For covering more than 4 and up to 6 sections (including Tariff rated section) 15%
discount on Non Tariff section premiums only. For more than 6 sections (including
Tariff rated sections) 20% discount on Non-tariff section premiums only.
Minimum Sections to be covered : 4 (FOUR) Section I & II are compulsory

108
Workmen s Compensation Liability Section XB
of Shopkeepers Insurance
ANNEXURE - A
Risk Rate per Mille
Shop Risk - Class – A
Art, Bric-a-brac and curio and art needle works 3.92
Bakers 3.92
Barometer, Hydrometer, Thermometer and
Mathematical Instruments 3.92
Biscuits 3.92
Book 3.92
Shop Risk – Boot and Shoe, excl. markers and repairs 3.92
Chemists 3.92
China and Glass 3.92
Confectioners 3.92
Cutlery 3.92
Diaries 3.92
Drapers 3.92
Dress Maskers 3.92
Fancy Goods 3.92
Shop Risk – Florist and Seedsmen 3.92
Furriers 3.92
Haberdashers 3.92
Hatters 3.92
Hoosiers 3.92
Leather Goods 3.92
Milliners 3.92
+Wholesale 3.92
Musicalist Instruments (Salesmen only) 3.92
Naturalist not taxidermists 3.92
Newsagents 3.92
Opticians 3.92

109
Photographic Records 3.92
Photographic appliances 3.92
Photographers 3.92
Stationers 3.92
Surgical Instrument and Appliances 3.92
Tailors, Clothiers and Outfitters 3.92
Toys 3.92
Tobacconists 3.92
Wall Papers 3.92
Watch Makers 3.92
Shop Risk – Class B
Fruiterers 6.24
Groceries and provisions – no license and no machinery +
All other employees 6.24
Ironmongers excl. Mechanics 6.24
Italian warehouse men 6.24
Oil and colour 6.24
Sticks and umbrellas, incl. Finishing mouting and Repairing 6.24
Shop Risk – Class C
Chandlers (not ship chandlers) 7.40
Cheese mongers 7.40
Cooked Meat or cooked fish 7.40
Corn Chandlers, Dealers and Merchants retail only – using no
machinery driven by mechanical power and excl. delivery 7.40
Corn Chandlers, Dealers and Merchants retail only – using
machinery but excl. delivery 9.72
Furniture Electrical items excl. delivery by hand,
handcraft and otherwise 7.40
Grocery and provisions – Off license where no bottling buy
machinery is done + All other employees 7.40
Hair Dressers 7.40
Pawnbrokers 7.40
Perambulators 7.40

110
Picture and Picture Frame Dealers excl. Machinery 7.40
Sewing and Washing machines 7.40
Wine, spirit and beer dealers 7.40
Off license where no bottling by machinery is done 7.40
+All other employees 7.40
Shop Risk - Class D
Groceries Provisions
Off license where bottling by machinery is done
+All other employees 9.72
Gunsmiths 9.72
Wine Spirit and Beer dealers – Off license only where bottling
by machinery is done + All other employees 9.72
Shop Risk - Class E
Butchers 14.80
Fishmongers 14.80
Furniture removers(see Classification No.175)
Groceries and Provisions (Full license)
All employees engaged partially or wholly in serving drink 14.80
+All other employees where no bottling by machinery is
done excl. delivery by hand or otherwise 7.40
+All other employees where bottling by machinery is
done excl. delivery by hand or otherwise 8.56
Poulterers 14.80
Publication 14.80
Wine Spirit & Beer dealers-Ful-Licence – All employees 14.80
Short Mfgrs. 19.44

111
HEALTH COVERS
Mediclaim 2012
(Salient Features)
l The policy covers the Hospitalization expenses in respect of all Hospitalization of
Insured persons during the policy period up to a Sum Insured Stated in the policy.
l This policy covers In-patient Hospitalization expenses incurred in India.
l A person can insure Self, Spouse, children and parents in a single policy.
l Sum Insured options available are Rs. 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7 and 8 lakhs.
l Insured who is migrating from Mediclaim 2007 to Mediclaim 2012 can also opt for
Sum Insured of Rs. 1.25, 1.75, 2.25, 2.75, 3.5 and 4.5 lakhs.
l Entry age will be upto 65 years.
l Policy can be renewed lifelong, if there’s no break in the policy.
l “Dependent Children” can be covered from the age of 3 months to the age of
25 years. But in case of “Mentally Challenged Child” and “Unmarried Dependent
Daughter” there is no upper age limit.
l Pre-acceptance Medical checkup will be applicable on age above 45 years.
l Area of coverage has been distributed in 4 zones in this policy.
l "If premium if paid for lower zone and treatment is taken in higher zone, then
company's liability will be
a) Sum Insured
b) 80% of admissible claim amount whichever is less."
l If entering in fresh Mediclaim 2012 policy, at the age of 55 years our liability will be
a) Sum Insured or
b) 80% of admissible claim amount whichever is less."
l For person above the age of 55 years, entering in Mediclaim 2012 for first time, then
the entry sum insured could be maximum upto Rs. 3 lakhs.
l Provision for increasing the Sum Insured without Medical check-up will be given as
a onetime option at the time of migration from Mediclaim 2007 to Mediclaim 2012.
l Cumulative Bonus earned in Mediclaim 2007 policy will be available as Cumulative
Bonus Buffer after migration to Mediclaim 2012. Cumulative Bonus Buffer could be
carried over to the next year only if the renewal is effected before or within 30 days
of the expiry of the policy. The Cumulative Bonus Buffer will be continued to be
carried forward to the next year unless and until it is completely used.
l Provides hospital cash benefit at 0.1% of Sum Insured for per day of hospitalization
for any one illness, only if the Sum Insured is more than or equal to 3 lakhs.
The amount shall not exceed 1% of Sum Insured. (Should be hospitalized for more
than 24 hrs).
l Congenital external diseases covered after 48 months of continuous coverage,
maximum upto 10% of Sum Insured.
l Ambulance charges paid up to 1% of the Sum Insured.
l Health check-up after claim free coverage of 3 years upto 1% of Average SI, subject
to maximum of Rs. 5000/-.
112
l Free look period : Insured will be allowed a period of fifteen days from the date of
receipt of the policy to review the terms and conditions of the policy and to return the
same if not acceptable.
l No loading or Co-pay for adverse claim experience.
l No Loading for Diabetes and Hypertension with effect from 1st August 2013.
l Use of tobacco leading to cancer has been removed from the exclusion.
l 32+Procedures covered under day care treatments. (Hospital cash benefit will not
be paid here.)
l For Cataract, claim paid upto 20% of the Total Sum Insured i.e. Sum Insured +
Cumulative Buffer, for each eye, subject to maximum of Rs. 24000/-.
l Option to service the policy directly by the company (only reimbursement claims).
In such cases the claim will be settled by claims department. No discount will be
given for not using the TPA’s service.
l No claim discount available from 2% to 15%.
l Ayurvedic / Unani / Homeopathic Treatment covered upto 25% Sum Insured.
l Pre and Post Hospitalization expenses will be covered for 30 and 60 days
respectively under the policy.
l Proof of age must be obtained, especially for persons on the borderline of age band
requiring medical examination and / or higher premium and on increasing the Sum
Insured.
l 10% discount on premium is granted for covering family members under
MEDICLAIM 2012.
l Any person above the age of 45 entering the Mediclaim 2012 for the first time would
be charged an entry load, as per table given below. This load will be discontinued
after two continuous claim free years.
SUM ASSURED Upto 45 45-50 51-55 56-60 61-65
Upto 3 Lakhs Nil Nil 1000 1500 2000
3 lakhs to Rs.5 lakhs Nil 1000 2000 NOT ELIGIBLE NOT ELIGIBLE
Over 5 lakh Nil 2000 4000 NOT ELIGIBLE NOT ELIGIBLE

EACH ZONE IS CLASSIFIED AS BELOW : (The Cities mentioned below would


include their Urban Agglomeration)
Zone - I Greater Mumbai (Greater Mumbai MC, Mira-Bhayandar MC, Thane
MC, Navi Mumbai MC, Kalyan- Dombivali MC, Ulhasnagar MC,
Ambarnath MC, Badlapur MC)
Zone - II Delhi and Delhi NCR ,Bangalore, Chennai, Hyderabad and
Secunderabad, Ahmedabad and Kolkatta, Vadodara
Zone - III Rest of India (other than those areas specified in Zone I,II and IV)
Zone - IV The States of Bihar, Orissa, Arunachal Pradesh, Assam, Manipur,
Meghalaya, Mizoram, Nagaland, Tripura, Jharkhand, Sikkim,
Chhattisgarh, Uttarakhand, Jammu and Kashmir
113
NO CLAIM AGE<=60 AGE>60
DISCOUNT
% Discount per year Max. Discount % % Discount per year Max. Discount %
SUM INSURED
<300000 2 10 3 15
SUM INSURED
=>300000 3 15 3 15
AT THE TIME OF MIGRATION FROM MEDICLAIM 2007 TO MEDICLAIM 2012
Age Upto 45 46-55 56-65 Over 65
Present
Sum Insured Without Claim or Hospitalization in the Two Preceding Years
500000 Yes. Upto Yes. Upto Yes. Upto Yes. Upto
Eight Lakhs Eight Lakhs Eight Lakhs Eight Lakhs
without Medical without Medical without Medical
Examination Examination Examination
Less than Yes. Upto Yes. Upto Upto 5 Lakhs Yes. Upto
500000 Eight Lakhs Eight Lakhs without Medical Five Lakhs
but more than without Medical Examination without Medical
or equal to Examination AND Examination
300000 Upto 8 Lakhs with
Medical Examination
Less than Yes. Upto Yes. Upto Upto 3 Lakhs Yes. Upto
300000 Eight Lakhs Five Lakhs without Medical Three Lakhs
without Medical Examination without Medical
Examination AND Examination
Upto 5 Lakhs with
Medical Examination
AT SUBSEQUMENT RENEWALS UNDER MEDICLAIM 2012
Age Upto 45 46-55 56-65 Over 65
Present
Sum Insured Without Claim or Hospitalization in the Two Preceding Years
500000 Yes. Upto Yes. Upto Yes. Upto
Eight Lakhs Eight Lakhs Eight Lakhs No
without Medical with Medical Enhancement
Examination Examination
Less than Yes. Upto Yes. Upto Yes. Upto 5 Lakhs
500000 Eight Lakhs Five Lakhs with Medical No
but more than without Medical Examination Enhancement
or equal to Examination
300000
Less than Yes. Upto Yes. Upto Yes. Upto 3 Lakhs
300000 Eight Lakhs Three Lakhs with Medical No
without Medical Examination Enhancement
Examination
WITH ONE HOSPITALISATION IN TWO PRECEDING YEARS
Upto 45 46-55 56-65 Over 65
Upto Eight Lakhs By Upto One Lakh By Upto One Lakh No
without Medical without Medical with Medical Examination Enhancement
Examination Examination Subject to Maximum of Overall
Sum Insured of Three Lakhs
114
Family Mediclaim 2012
(Salient Features)
l This policy is in force with effect from 8th July 2013 with applicable premium rates
of Mediclaim 2012 for each insured member.
l The individual premium of each member for selected Sum Insured will be added
and then the discount as per below table will be applied on the total premium
payable.
DISCOUNT FOR FAMILY (FLOATER) FLOATER SUM INSURED
MEDICLAIM 2012
% DISCOUNT ON TOTAL PREMIUM
NUMBER OF PERSONS UPTO 300000 300000 AND MORE
(SUM INSURED) (SUM INSURED)
TWO 11 13
BETWEEN 3 AND 4 13 15
MORE THAN 4 16 18
l Health Check-up benefit for the Insured person will not be available in this Policy.
l Cumulative Bonus / Buffer is not available under this policy.
Premium Table applicable to Mediclaim 2012 and Family Mediclaim 2012 :
MEDICLAIM 2012 PREMIUM RATE
ALL RATES ARE EXCLUSIVE OF SERVICE TAX
SUM ZONE 0TO5 6TO25 26TO30 31TO35 36TO40 41TO45 46TO50 51TO55 56TO60 61TO65 66TO70
INSURED
100000 I 1650 1500 1600 1650 1950 2600 3700 4300 4800 5400 6200
125000 I 2000 1900 2000 2050 2350 3100 4500 5200 5800 6500 7200
150000 I 2300 2300 2350 2400 2750 3500 5200 6000 6900 7700 8500
175000 I 2700 2600 2650 2700 3100 4000 6100 7000 8000 9000 10000
200000 I 3000 2900 3000 3050 3400 4400 6800 8000 8800 10200 11400
225000 I 3400 3200 3300 3350 3800 4700 7500 9000 10000 11600 12800
250000 I 3600 3400 3500 3600 4100 5200 8200 9800 10500 12600 14000
275000 I 4000 3700 3800 4000 4450 5700 8900 10400 11600 13700 15000
300000 I 4200 4000 4100 4300 4800 6200 9700 11500 13000 14700 16500
350000 I 4700 4500 4600 4900 5400 7000 11000 12500 14800 16700 18800
400000 I 5200 4900 5000 5300 6000 7700 12200 14500 16500 19000 21000
450000 I 5700 5500 5600 5900 6500 8500 13800 16000 18000 21000 23500
500000 I 6200 6000 6200 6400 7000 9200 15000 17500 20000 23000 26000
600000 I 7000 7000 7200 7500 7700 10500 17000 20000 23000 25000 30000
700000 I 7800 7500 8000 8500 8700 11500 20000 23000 26000 30000 35000
800000 I 8500 8000 8800 9000 9300 12500 22000 25000 30000 33000 40000
115
MEDICLAIM 2012 PREMIUM RATE
ALL RATES ARE EXCLUSIVE OF SERVICE TAX
SUM
INSURED ZONE 0TO5 6TO25 26TO30 31TO35 36TO40 41TO45 46TO50 51TO55 56TO60 61TO65 66TO70
100000 II 1600 1450 1550 1600 1900 2500 3300 4000 4400 4800 5500
125000 II 1950 1850 1950 2000 2300 3000 4000 4700 5300 5800 6600
150000 II 2250 2200 2300 2350 2700 3400 4800 5500 6300 7000 7700
175000 II 2600 2500 2600 2650 3000 3900 5500 6400 7300 8200 9000
200000 II 2900 2850 2900 3000 3300 4300 6300 7400 8300 9300 10400
225000 II 3300 3150 3200 3250 3600 4700 7000 8200 9100 10600 11600
250000 II 3500 3350 3400 3500 4000 5100 7600 8900 10000 11500 12700
275000 II 3900 3650 3700 3800 4400 5600 8200 9700 10800 12500 13700
300000 II 4150 3950 4200 4200 4700 6000 9000 10500 11800 13300 15000
350000 II 4650 4400 4600 4700 5300 6800 10400 12000 13500 15200 17000
400000 II 5000 5000 5000 5200 5800 7500 11500 13300 15000 17300 19000
450000 II 5600 5400 5500 5700 6400 8200 12500 14800 16800 19200 21500
500000 II 6100 5800 6000 6200 6900 8800 14000 16000 18500 21000 23600
600000 II 6800 6400 7000 7400 7600 10000 16500 18500 21000 24000 27000
700000 II 7300 7000 7800 8300 8500 11000 19000 21000 24000 28000 32000
800000 II 7700 7300 8400 8800 9000 12000 21000 23000 27000 30000 35000
MEDICLAIM 2012 PREMIUM RATE
ALL RATES ARE EXCLUSIVE OF SERVICE TAX
SUM ZONE 0TO5 6TO25 26TO30 31TO35 36TO40 41TO45 46TO50 51TO55 56TO60 61TO65 66TO70
INSURED
100000 III 1550 1400 1500 1550 1850 2400 3100 3500 4000 4400 4900
125000 III 1900 1800 1900 1950 2200 2800 3600 4200 4800 5300 5900
150000 III 2300 2150 2250 2300 2550 3200 4500 5000 5600 6300 6900
175000 III 2550 2450 2550 2600 2900 3800 5200 5700 6600 7300 8100
200000 III 2850 2800 2850 2900 3250 4250 5800 6600 7400 8400 9300
225000 III 3250 3100 3150 3200 3500 4500 6500 7400 8200 9500 10500
250000 III 3450 3300 3350 3450 3900 4900 7000 8000 8800 10300 11400
275000 III 3800 3600 3650 3750 4200 5500 7700 8700 9700 11200 12300
300000 III 4000 3900 4000 4100 4600 5700 8300 9400 10500 12000 13500
350000 III 4550 4350 4500 4600 5200 6700 9000 10700 12200 13700 15300
400000 III 4950 4700 4900 5050 5700 7400 10000 11500 13500 15500 17300
450000 III 5500 5200 5400 5550 6200 7900 10500 13000 15000 17300 19300
500000 III 6000 5700 5900 6050 6800 8500 12500 14200 16500 19000 21200
600000 III 6500 6200 6800 7000 7400 9500 15000 17000 19000 22500 25000
700000 III 7000 6800 7500 8000 8200 10500 17000 19000 22000 26000 29000
800000 III 7400 7300 8000 8500 8800 11500 19000 22000 25000 29000 32000
116
MEDICLAIM 2012 PREMIUM RATE
ALL RATES ARE EXCLUSIVE OF SERVICE TAX
SUM ZONE 0TO5 6TO25 26TO30 31TO35 36TO40 41TO45 46TO50 51TO55 56TO60 61TO65 66TO70
INSURED
100000 IV 1315 1250 1250 1250 1480 1850 2500 2810 3260 3650 4110
125000 IV 1695 1615 1615 1615 1860 2280 2990 3530 4010 4510 5060
150000 IV 2015 1920 1920 1920 2210 2715 3770 4240 4840 5450 6060
175000 IV 2305 2195 2195 2195 2530 3100 4340 4880 5660 6360 7090
200000 IV 2595 2470 2470 2470 2845 3490 4910 5660 6420 7310 8210
225000 IV 2850 2715 2715 2715 3130 3830 5440 6270 7110 8260 9180
250000 IV 3105 2955 2955 2955 3405 4175 5960 6880 7810 9070 10120
275000 IV 3360 3200 3200 3200 3685 4520 6480 7490 8500 9840 10920
300000 IV 3615 3445 3445 3445 3970 4865 6990 8090 9200 10540 11820
350000 IV 4065 3870 3870 3870 4460 5470 7950 9210 10480 12030 13440
400000 IV 4510 4295 4295 4295 4950 6070 8910 10340 11780 13530 15030
450000 IV 4960 4725 4725 4725 5470 6735 9860 11460 13070 15040 16790
500000 IV 5410 5150 5150 5150 5935 7275 10820 12580 14350 16520 18460
600000 IV 6000 6000 6500 6800 7000 9000 14000 16000 18000 21000 24000
700000 IV 6500 6500 7200 7800 8000 10000 15000 17000 20000 24000 27000
800000 IV 7000 7000 7700 8300 8500 11000 16000 20000 23000 27000 30000
* For person over 70 years, Premium charged will be additional 2.5% for each
year on the premium applicable on age bang 66 to 70.

117
Mediclaim 2012 and Family Mediclaim 2012
Revised FAQs as on 1st October 2013
1. Who can take the policy?
ð Any person between age of 18 years and 65 years can take the policy, subject to
terms and conditions mentioned in the policy. Children between the age of 3 months
and 25 years can be covered provided parents are covered simultaneously. In case
of mentally challenged child and unmarried dependent daughter there is no upper
age limit.
2. Can Mediclaim 2012 or Family Mediclaim 2012 policy be issued with parents
of age more than 65 years?
ð No. No member can be added after the age of 65 years. However there is no cover
ceasing age, i.e. Policy can be renewed after the age of 65 years.
3. Is fresh proposal required while a person is migrating from Mediclaim 2007
to Mediclaim 2012?
ð Yes. A fresh proposal is required, if the person is migrating from Mediclaim 2007 to
Mediclaim 2012. There should be a declaration by the insured that he has read the
prospectus and has specifically chosen to opt for migration into the Mediclaim 2012
policy.
4. Is fresh proposal required for continuing the renewal in Mediclaim 2007
policy?
ð Yes. A fresh proposal is also required when the person continues to renew in
Mediclaim 2007, along with a declaration of having made the choice.
5. How long can a person renew his policy?
ð There is no cover ceasing age. A person can renew his policy beyond age of
65 years, provided the policy is with us without any break.
6. Can I cover my family?
ð Yes, you can cover your family members in one policy, with separate Sum Insured for
each Insured Person and You will get a Family Discount of 10% on the total premium
payable. The members of the family who could be covered under the Policy are :
l Proposer
l Proposer’s Spouse
l Proposer’s Children
l Proposer’s Parents
ð You may also cover the entire family as defined above, under a Single Sum Insured.
If You cover the other family members under a single Sum Insured, discounts at
the following rates are admissible :
NUMBER OF PERSONS % DISCOUNT ON TOTAL PREMIUM
SI, UPTO 300000 SI, 300000 AND MORE
TWO 11 13
BETWEEN 3 AND 4 13 15
MORE THAN 4 16 18
* Our existing Family Floater Mediclaim Policy is still available to the
customers as a fresh and renewal with revised rates of Mediclaim 2012. The
rating pattern continues to be 100% for the proposer, 50% for spouse and
25% for each of the children on the eldest member’s premium.
118
7. How will we calculate Premium under “Floater Mediclaim 2012”?
ð The Premium of each member for selected Sum Insured will be added and then
the discount as per above table will be applied on the total premium payable.
For example, If a person is 47 years old, his spouse is 42 years old and his child is
15 years old then, zone I premium for Sum Insured of Rs. 4 lakhs will be calculated
as below :
Premium for Proposer : Rs. 12,200
Premium for Spouse : Rs. 7,700
Premium for Child : Rs. 4,900
Total Premium : Rs. 24,800
As per the above given table, the discount for the family of 3 members and Sum
Insured above Rs. 3 lakhs is 15%.
This discount will be given in the total Premium.
So Premium payable will be Rs. 21,080/-
8. If the person migrates from “Mediclaim 2007” to “Mediclaim 2012”, what will
happen to his Cumulative Bonus?
ð His earned Cumulative Bonus will be carried forward as Cumulative Bonus
Buffer in “Mediclaim 2012”. This Buffer will be carried forward until the Buffer
is completely used.
ð E.g. 1: SI = Rs. 2,00,000 and CB Buffer = Rs. 60,000,
If a claim arises of Rs. 2,00,000, then during renewal the CB Buffer will be
Rs. 60,000.
ð E.g. 2: SI = Rs. 2,00,000 and CB Buffer = Rs. 60,000,
If claim arises of Rs. 2,20,000 then during renewal the CB Buffer will be Rs. 40,000.
ð The CB Buffer will never become zero until it is completely used.
9. If a person has Cumulative Bonus in “Mediclaim 2007” and while migrating he
opts for a higher Sum Insured, then how Cumulative Bonus Buffer will be
calculated?
ð His Cumulative Bonus will be converted to monetary limit using the earlier Sum
Insured and that monetary amount will be taken for Cumulative Bonus Buffer. For
example, if a person has 20% CB in his current policy of Rs. 5 lakhs and he opts for
Rs. 8 lakhs SI at migration, then he will be given 5% additional CB as per terms &
conditions of “Mediclaim 2007”. At the time of migration this 25% CB will be
converted to Cumulative Bonus Buffer. So his Buffer will be 25% of Rs. 5 lakh, i.e.
Rs. 1,25,000/-.
10. If there is a claim in the previous policy (Mediclaim 2007 where CB should
become zero), and the person is renewing in Mediclaim 2012 policy, what will
be the CB?
ð If the person is has a claim and then migrating to Mediclaim 2012, then his CB
becomes zero and nothing will be carried forward to Cumulative Buffer. But after
migrating to the Mediclaim 2012 if there is a claim then it will reduce as example
given in point 8.
11. Will the Cumulative Bonus Buffer be used for sub-limits under the policy?
ð No, Cumulative Bonus Buffer will not be used for any sub-limits.
ð Only exception for this will be sub-limit for cataract, which will be not more than 20%
119
of the aggregate of Sum Insured and Cumulative Bonus Buffer for each eye, subject
to maximum of Rs. 24,000/-.
ð E.g. : A person with Rs. 1,00,000 Sum Insured and Rs. 30,000 Cumulative Buffer
is hospitalized for cataract. Then his eligible room rent will be 1% of Sum Insured
i.e. Rs. 1,000 and Total reimbursement limit for Cataract will be 20% of [Sum Insured
+ Cumulative Buffer], i.e. 26,000; But the upper cap for cataract is Rs. 24,000, so
the person will be reimbursed Rs. 24,000 only.
12. What is Hospital cash and how it will be calculated?
ð Hospital cash is a benefit given to the customer irrespective of his expenses. This
benefit will be over and above his/her hospital bill reimbursement, subject to terms
and conditions mentioned in the Policy.
ð In any case the total claim amount will not be more than Sum Insured of the Insured.
Thus, Hospital cash will reduce the Sum Insured.
ð In case of cashless claims, the TPA needs to pay a separate claim to the customers
towards hospital cash directly.
ð If Deductible is applicable on the policy, it will not be applicable on Hospital cash.
ð Hospital cash will be applicable only if the Sum Insured is Rs. 3 lakhs or above.
ð In case of enhancement, Sum Insured must be Rs. 3 lakhs or above. If claim arises
due to pre existing illness, where enhanced Sum Insured is not be reckoned for
claim, the Hospital cash will be paid over and above the Eligible Reimbursement and
will be a part of total Sum Insured.
ð This will be 0.1% of Sum Insured per day maximum for 10 days in any one illness.
The total amount will not exceed 1% of Sum Insured.
ð E.g. 1 : A person is having a Sum Insured of 4 lakhs.
Total admissible claim is 2,80,000, and admitted for 8 days.
Hospital cash = 0.1%*4 lakhs (SI)*8(no of days admitted, max for 10 days)
= 3200
Total payment = 280000 + 3200 = 2,83,200
ð E.g. 2 : A person having a Sum Insured of 4 lakhs.
Total admissible claim is 3,98,000 and admitted for 12 days.
Hospital cash = 0.1% * 4lakhs (SI) * 10 (no of days admitted max of 10 days)
= 4000
Total payment = 398000 + 4000 = 4,02,000
But this amount is exceeding the SI which is not permissible.
Thus total payment = 4,00,000
ð E.g. 3 : A person having a Sum Insured of 1 lakh enhanced it to 3 lakhs and claims
for a heart disease which was admissible for 1 lakh only due to pre-existing condition.
Total Claim amount is 2,30,000
Total Admissible claim is 1,00,000 and admitted for 8 days.
Hospital cash = 0.1% * 3,00,000 (SI) * 8
= 2400
Total payment = 100000 + 2400 = 1,02,400
Though the admissible claim is for Rs. 1,00,000 as per the pre-existing condition,
Hospital cash is calculated on the existing available Sum Insured on the date of
120
Hospitalization, which is Rs. 3,00,000. There by 2400 is payable in the above
example.
13. Does this policy allow an Insured to change the TPA?
ð This policy gives the insured an option to service the policy through TPA or by the
Company. The proposer does not have option to choose his own TPA, but to adhere
to the empanelled TPA allocated to the respective office.
ð Senior citizens have an option to change the TPA at the time of renewals. This option
is valid only if exercised thirty days before renewal of the policy. The underwriting
office will select any other TPA from the enlisted panel of the TPAs, if requested.
14. Can this policy be directly serviced by Underwriting Office?
ð Yes, the Insured can opt for servicing of policy directly through company. For these
customers cashless facility will not be available, claims will be settled in
reimbursement basis by Claims Hub. No discount will be available for opting for direct
service.
15. What loading will be charged for Diabetes and Hypertension?
ð The loading for Diabetes and Hypertension will not be charged either for the new
policy or renewal with effect from 1st Aug 2013.
ð If the person has Diabetes or Hypertension at the time of inception of a fresh policy,
Medical Examination will be insisted and proposal will be accepted only after
satisfying that it is acceptable as per terms and conditions of the policy.
ð If person is suffering from Diabetes type 1 (insulin dependent), which is a declined
risk as per our underwriting guidelines, the proposal will be rejected.
ð These conditions will be considered as pre-existing conditions and no claim will be
paid for any claim arising out of these conditions for first four years.
ð The person who has already paid the loading in previous years and renewing the
policy without any break, he’ll not pay the loading, but the claims will be paid as per
the old table of coverage conditions in the policy.
ð E.g. 1 : A Person has taken a fresh Mediclaim 2012 policy on 1st Aug 2013 and he
is suffering from Diabetes. He will not be charged any loading for Diabetes, but claim
arising out of this will not be payable for four year as it was a pre-existing disease.
ð E.g. 2 : A person who has taken a Mediclaim 2007 on 1st Aug 2012 and also paid
the loading for Diabetes. In renewal on 1st Aug 2013, he’ll not be charged any loading
and related claims will not be paid in the year 2012-13. But 50% of the admissible
claim will be paid for related disease in the year 2014-15, 75% of the admissible
claim will be paid in year 2015-16 and 100% will be paid after 2016, if renewed
without break or within grace period.
ð E.g. 3 : A person who has taken a Mediclaim 2007 in 1st Aug 2011 and have not paid
the loading for Diabetes on 2011 and 2012. In renewal on 1st Aug 2013, he’ll not be
charged any loading and claim arising out of Diabetes will not be paid.
16. When a person will be reimbursed for Health Checkup expenses?
ð A person can take reimbursement for Health checkup after every 3 claim free years.
If the person is migrating from “Mediclaim 2007” and he has not made any claim in
previous 3 years, than he can take reimbursement for Health checkup in the first year
of “Mediclaim 2012” itself.
Without continuous 3 claim free years this benefit could not be given.
121
ð Note : If a person is migrating from some other company and has claim free
experience of 3 or more years yet he will not be eligible for free health check-up. The
customer needs to have continuous claim free experience under Mediclaim 2007
or Mediclaim 2012 or both combined.
17. When will a person be eligible for “No Claim Discount”?
ð A person will be eligible for the “No Claim Discount”, after each claim free years in
“Mediclaim 2012” as per given table. This discount will not be given when a person
is migrating from “Mediclaim 2007” to “Mediclaim 2012”. It will only be given for
subsequent renewals of “Mediclaim 2012”. If there is a claim in the current year, then,
next year there will be no discount.
ð Following table explains the discounts applicable.
AGE<=60 AGE>60
% Discount Max % Discount Max
per year Discount per year Discount
SUM INSURED <300000 2 10 3 15
SUM INSURED >=300000 3 15 3 15

ð Working of No claim Discount :


E.g. 1 : If insured is 57 years old and SI is 2 lakhs, then the discount will be 2% per
year maximum up to 10%.
E.g. 2 : If insured is 57 years old and SI is 4 lakhs then the discount will be 3% per
year max up to 15 %.
E.g. 3 : If customer is more than 60 years old then irrespective of the SI, the
discount will be 3% per year maximum up to 15%.
18. If the policy is renewed after the expiry of the policy but within the grace
period, then will the CB buffer and discount be applicable.
ð Yes. If the policy is renewed within the grace period then the continuity benefits as
well as CB buffer and discount will be applicable. But if the policy is renewed after
30 days of the expiry of the policy, then it will be considered as break in insurance
and all the continuity benefits, CB buffer and discount will be withdrawn.
19. In which cases Entry Load will be applicable?
ð The entry load will be applicable to all the cases except those that are migrating from
Mediclaim 2007 to Mediclaim 2012.
20. How long will the entry load be charged?
ð Entry load will cease to be charged after two Claim Free years of Continuous
coverage. If there is a claim every year, then entry load will continue to be charged.
Once the entry load is ceased to be charged it will not be charged again.
21. Can hospital be changed during the course of treatment?
ð Yes. It is possible to shift to another hospital for reasons of requirement of better
medical procedure. However, this will be evaluated by the TPA on the merits of the
case and as per policy terms and conditions.
22. Will the entire amount of the claimed expenses be paid?
ð Yes. The entire amount of claim is payable, if it is within the Sum Insured and is
122
related with the hospitalization as per policy terms and conditions except the
expenses which are excluded.
ð For persons aged over 55 and entering the Mediclaim 2012 policy for the first time,
the Company will pay
A) Sum Insured or
B) 80% of the admissible claim
Whichever is less, until he has four years of Claim Free Continuous coverage.
ð For person taking the treatment outside the area of coverage, the Company will pay
A) Sum Insured Or
B) 80% of the admissible claim
Whichever is less.
23. If the insured wants to continue with the original policy i.e. Mediclaim 2007,
will he get CB?
ð Yes. If the insured continues with the original policy i.e. Mediclaim 2007, then he will
continue to get CB according to the terms and conditions of the original policy.
However the terms and conditions will be revised as per the new Health Regulations
given by IRDA.
24. If the person continues in Mediclaim 2007 or Family Floater Mediclaim Policy,
would adverse claim loading and Co-pay be applicable?
ð Yes, the adverse claim loadings and co-pay will be applicable as per terms and
conditions of the Mediclaim 2007 and Family Floater Mediclaim policy.
25. If the customer wants to continue with the original policy i.e. Mediclaim 2007,
what will be his premium and what zone will be selected?
ð The insured can continue with his original policy i.e. Mediclaim 2007, but the
premium will be according to the revised premium rates and new zones.
26. If a person continues with the Mediclaim 2007 policy, what will be the co-pay
if treatment is availed in higher zone?
ð If a person is continuing with Mediclaim 2007 policy then the co-pay logic will be as
given in the table below :
Treatment Taken Zone IV Zone III Zone II Zone I
Premium Paid
Zone I 100% paid 100% paid 100% paid 100% paid
Zone II 100% paid 100% paid 100% paid 90% paid
Zone III 100% paid 100% paid 90% paid 80% paid
Zone IV 100% paid 100% paid 90% paid 80% paid

27. What are the Migration benefits given on 1st renewal of Mediclaim 2007 after
1st Aug 2013?
ð Age deductible will not be levied, even if the person’s age is above 55 years at the
time of entering the Mediclaim 2012 policy.
123
ð The Insured will have an onetime option to enhance the Sum Insured as mentioned
in table below :
Age Upto 45 46-55 56-65
500000 Yes. Upto Yes. Upto Yes. Upto
Eight Lakhs Eight Lakhs Eight Lakhs
without Medical without Medical
Examination Examination
Less than Yes. Upto Yes. Upto Upto 5 Lakhs
500000 Eight Lakhs Eight Lakhs without Medical
but more than without Medical Examination
or equal to Examination AND
300000 Upto 8 Lakhs with
Medical Examination
Less than Yes. Upto Yes. Upto Upto 3 Lakhs
300000 Eight Lakhs Five Lakhs without Medical
without Medical Examination
Examination AND
Upto 5 Lakhs with
Medical Examination
28. If the person does not migrate at the next renewal of “Mediclaim 2007”. Will
he be given migration benefit if he wishes to switch to “Mediclaim 2012”
subsequently?
ð No, Migration benefit will be offered only for the first renewal of “Mediclaim 2007”
after introduction of “Mediclaim 2012”. If a person wishes to migrate subsequently,
he’ll not get the migration benefits.
ð For example, if a “Mediclaim 2007” policy is due for renewal on Nov 1, 2013. The
person can migrate to “Mediclaim 2012” on this renewal with migration benefits.
If he wishes to continue, he’ll not get these benefits of subsequent renewal on
Nov. 1, 2014.
ð The enhancement of Sum Insured will be limited as mentioned in table below :
Age Upto 45 46-55 56-65 Over 65
500000 Yes. Upto Yes. Upto Yes. Upto
Eight Lakhs Eight Lakhs Eight Lakhs No
without Medical with Medical Enhancement
Examination Examination
Less than Yes. Upto Yes. Upto Yes. Upto 5 Lakhs
500000 Eight Lakhs Five Lakhs with Medical No
but more than without Medical Examination Enhancement
or equal to Examination
300000
Less than Yes. Upto Yes. Upto Yes. Upto 3 Lakhs
300000 Eight Lakhs Three Lakhs with Medical No
without Medical Examination Enhancement
Examination
124
29. If a person had a claim in the previous years can he enhance the Sum Insured
at the Migration or subsequent renewals?
ð Yes, If the person had only one claim in preceding two years and he is not suffering
from the following ailments:
❑ Diabetes
❑ Hypertension
❑ Any chronic Illness/ailment
❑ Any recurring Illness/ailment
❑ Any Critical Illness, then he can enhance his Sum Insured at the Migration as
well as in subsequent renewal as per limits mentioned in the following table :
Upto 45 46-55 56-65 Over 65
Upto Eight Lakhs By Upto One Lakh By Upto One Lakh with Medical No
without Medical without Medical Examination Subject to Maximum Enhancement
Examination Examination of Overall Sum Insured of Three Lakhs
30. Can an insured migrate from Floater 2007 to Mediclaim 2012? Will he get the
migration benefits?
ð Yes. Any person from Floater 2007 can migrate to Mediclaim 2012. Such cases will
still be considered as migrated cases and the insured will get all benefits during
Migration.
31. Can a person migrate from Senior citizen policy or Janata Mediclaim to
Mediclaim 2012?
ð No. A person cannot migrate from Senior citizen policy or Janata Mediclaim to
Mediclaim 2012. He will be considered as fresh proposer for Mediclaim 2012. The
insured will continue to get the continuity benefits, but will not get any migration
benefits.
32. What will be the premium for the customers above the age of 70 (only in case
of renewals)?
ð For persons over 70 years, the rate chargeable will be at a loading of 2.5% for every
completed year. Such loading will be made on the premium applicable for 66-70
years age band.
33. If any customers is entering at the age of 55 or above (deductible of 20%),
paying premium for Zone I and getting treated in Zone II, will the deductible
be applicable?
ð Yes. The deductible will be applicable. Zone wise co-pay and deductible are two
different things. First the co-pay for zones will be checked. If there is no co-pay, then
deductible will be checked. So under any circumstances the deductible and co-pay
will not cancel each other.
34. Should Diabetes Mellitus type I be accepted for underwriting?
ð No, Diabetes Mellitus type II is a declined risk. It should not be accepted.
ð Diabetes Mellitus type II and Gestational Diabetes should be referred to Regional
Office and may be accepted without any loading after Regional Office approval.
35. Will there be any loyalty discount?
ð No. Loyalty discount will not be applicable under any circumstances.
36. What amount of the pre-acceptance health check-up will be reimbursed?
ð The company will reimburse 50% of the amount and rest will be paid by the
customer.
125
ð The Laboratories/Hospitals for Pre-acceptance Medical examinations are to be
approved by the company including the cost.
ð Note : This amount will be paid only if the proposal is accepted. If any proposal is
rejected then this amount will not be paid. The amount will be paid only for the
mentioned test in the policy documents. If the customer has done some extra test,
the cost of such tests will not be paid.
37. Will there be any staff discount in Mediclaim 2012 policy?
ð Yes. Staff discount will be applicable even in Mediclaim 2012 policies.
38. If a policy is cancelled by a customer or by the company, then what will be the
basis of refund of premium?
ð If any policy is being cancelled by the company then the refund will be on the
pro-rata basis.
And if the policy is being cancelled by the customer then the refund will be on ‘short
period basis’.
ð No Policy can be cancelled except on limited grounds, as mentioned in the policy.
ð Note : This refund is subject to no claim under the policy for the period when the
policy was active.
39. Will the claim be paid within 30 days of the policy, if due to accident?
ð Yes. Any claim arising out of accident will be paid even within first 30 days of the
policy.
40. Which area does greater Mumbai and Delhi NCR includes?
ð The census definition of Greater Mumbai and National Capital Region Planning
Board definition of Delhi NCR has been taken to define the urban agglomeration.
ð Census Urban Agglomeration of Greater Mumbai includes :
l Greater Mumbai l Mira – Bhayandar
l Thane l Navi Mumbai
l Kalyan – Dombivali l Ulhasnagar
l Ambarnath l Badlapur
ð Census Urban Agglomerationof Delhi NCR includes :
l NCT of Delhi l Faridabad
l Gurgaon l Mewat
l Rohtak l Sonepat
l Rewari l Jhajjhar
l Panipat and Palwal l Meerut
l Ghaziabad l Gautam Budha Nagar
l Bulandshahar l Baghpat
l Alwar
41. What happens when an individual comes to floater policy?
ð If persons were covered in the individual policy and they shift to a floater policy, then
they can opt for the same Sum Insured as a floater, which the proposer was enjoying
in the individual policy.
ð Under floater policy Cumulative Bonus earned by them, in individual policy, will be
forfeited.

126
JANATA MEDICLAIM POLICY
COVERAGE :
As per Mediclaim Policy 2007
SUM INSURED :
Only 2 slabs : Rs.50000 and Rs.75000/-
PREMIUM CHART :
Sum 3 Over 5 Over 35 Over 40 Over 45 Over 50 Over 55 Over 60 Over 65
Insured months yrs to yrs to yrs to yrs to yrs to yrs to yrs to yrs to
to 5 yrs 35 yrs 40 yrs 45 yrs 50 yrs 55 yrs 60 yrs 65 yrs 70 yrs
50000 750 700 800 1100 1400 1430 1660 1900 2130
75000 1125 1050 1200 1650 2100 2170 2500 2820 3190

Loading for Pre existing conditions will be applicable as per Mediclaim Policy 2007.
CLAIMS :
Policy stipulates specific Maximum charges inclusive of Room Rent ICU charges,
Surgeon Fees, Cost of Medicines etc., for various types of illness/operations. In case
of the specified illness/operation, Maximum amount of Claim payable will be as per
the specified charges given in the policy itself subject to the Sum Insured. For any
charges not mentioned in the schedule, the payment will be considered as per the
Central Govt. Health Scheme (CGHS) rates prevalent at the time of claims.

127
GROUP MEDICLAIM 2007
COVERAGE :
All terms and conditions as per Mediclaim Policy 2007 except for the following:
1) Cumulative Bonus Cost of health check up and Family Disc: Not applicable.
2) Group proposed for Insurance must comply with the provisions of definitions of
group issued by IRDA.
3) Group Discount : Applicable as per existing rules and the rates are as under:
Number of Prime members Discount %
Up to 500 Nil
501 – 2000 5
2001 - 5000 10
5001 and above 15
4) Age limit, basic premium, benefits and exclusions as per Mediclaim Policy 2007
5) Extension for Maternity Benefits: This is an optional cover, which can be obtained
on Payment of 20% of Total Basic premium for ALL the insured person under the
policy. Maximum Benefit allowable under this clause will be 10% of the Sum Insured
for Normal Delivery subject to Maximum of Rs25000/-. Under Caesarean Section
benefit will be 20% of Sum Insured subject to Maximum Rs.50000/-. Pre and
Postnatal expenses are not covered. The overall liability including Maternity Benefit
will not exceed the basic sum insured. Waiting period of 9 months is applicable for
payment of any claim.
6) Renewals of other insurer will be treated as FRESH proposals.
7) No Policy to be issued for Unnamed Group.
8) Policy for prime members below 500 can be given without Group Discount.
9) Additions/Deletions of named persons during the currency of the policy is allowed
on pro rata basis.
10) Bonus/Malus will apply at the time of Renewal depending upon the claims ratio.
11) Premium Chart: As per Mediclaim Policy 2007.
12) If the incurred claim ratio of the group for three years or for a lesser period (if the
cover has not been in force for three years) excluding the year immediately
preceding the date of renewal exceeds 70% to 200%, the premium for renewal of
policy will be loaded with 25% to 150% as prescribed in policy.
13) Likewise provision for low claim discount is available if claim ratio is below than
60%. This discount will vary from 5% to 40% as per incurred claim ratio.

128
SENIOR CITIZEN MEDICLAIM POLICY
New Policy introduced w.e.f. 01-10-2007, for the benefit of Senior Citizens.
COVERAGE :
As per Mediclaim Policy 2007.
AGE :
Available for person s between the Ages of 60 to 80 years. Insured’s may renew their
policies beyond the age of 80 years provided there is no break in insurance.
Persons opting for a policy for the first time have to undergo prescribed Pre Health
check up from an empanelled doctor. Cost of check up has to be borne by the proposer.
FAMILY :
Comprises of the Insured and the Spouse only.
SUM INSURED :
Rs. 1 lac or Rs.1.5 lac per person.
PREMIUM :
Sum Rates Rates Rates Rates
Insured 60 - 65yrs 66 - 70yrs 71 -75yrs 76 - 80yrs
100000 3850 4250 4700 5150
150000 5720 6310 6980 7650
Loading for renewal between 81 to 85 years: 10% of the age band of 76 – 80 years.
86 to 90 years : 20% of the age band of 76-80 years.
Additional premium for covering Hypertension, Diabetes Mellitus from the Inception
of Policy :- 10% of the relevant basic premium for each condition.
DISCOUNTS :
Discount for opting Voluntary Excess of Rs.10000/- 10%
Discount in case of Spouse is covered 10%
CUMULATIVE BONUS :
l Every Claim free Year 5% subject to Maximum of 30%
l Renewals from other companies will not be eligible for CB and will be treated
as FRESH ?
l In the event of claim, Cumulative Bonus accrued will be reduced at the same rate
at which it is accrued.
COST OF HEALTH CHECKUP :
Once in 4 claim free years up to 1% of average sum insured excluding CB for
preceeding 4 years of New India Policy.

129
CLAIM PROCEEDURES :
Each claim under the policy is subject to an excess of 10%
In the event of a claim, the policy contains the following sub limits:
Room/Boarding 1% Sum Insured Per Day
ICU 2% Sum Insured Per Day
Over All Limit For The Above Should Be 25%
Surgeon/Anesthetist/Medical Practitioner, Over All Limit 25% of
Consultants, Specialist Fees, Nursing Expenses Sum Insured.
Anesthesia, Blood, Oxygen, O T Charges, Over All Limit 50% of
Surgical Appliances, Medicines, Drugs Sum Insured.
Diagnostic, Materials And X Ray, Dialysis,
Chemotherapy, Radiotherapy, Cost of Pacemaker,
Artificial Limb Cost of Stents and Implants
Policy stipulates specific Maximum charges inclusive of Room Rent ICU charges,
Surgeon Fees, Cost of Medicines etc., for various types of illness/operations. In case
of the specified illness/operation, Maximum amount of Claim payable will be as per
the specified charges given in the policy itself subject to the Sum Insured.
The waiting period for specified diseases / ailments / conditions stipulated in the policy
is for a period of 18 months only instead of 24 months as stipulated in the Mediclaim
Policy 2007. But the waiting period for a) age related OSTEOARTHRITIS and
OSTEOPOROSIS and b) JOINT REPLACEMENT due to degenerative condition, is
48 months as stipulated in the Mediclaim Policy 2007.
Agency Commission : As per Mediclaim Policy 2007.
Special Discount in lieu of Agency Commission : Not allowed
Rebate under Sec 80 D of I T Act; : As per prevalent provisions.
PRE EXISTING CONDITIONS :
All diseases/injuries/conditions, which are pre existing when the cover incepts for the
first time will be excluded. This exclusion will be deleted after 18 months of continuous
claim free insurance with our company.
COMPULSORY COVERAGE FOR PRE EXISTING CONDITIONS
The existing condition of Diabetes Mellitus and Hypertension, at the time of inception
of the policy, have to be covered compulsorily by payment of additional premium at
the rate of 10% of basic premium per each pre existing condition. This additional
premium will be payable at every subsequent renewals.

130
OVERSEAS MEDICLAIM POLICY
Policy provides worldwide cover for Indian Residents making bonafide trips
abroad for
A) Business and Holiday Purpose
B) Employment and Studies.
ELIGIBILITY :
A) Any Indian Resident.
B) Foreign Nationals working in India with Indian employers or multinational companies
getting salary in Indian Rupees.
C) Foreign Nationals domiciled in India subject to verification of Visa and Filing of IT
returns and if need be, work permit.
D) Employment Policy for Persons deputed abroad on duty by Indian employers
E) Study Policy for Students going abroad for Study or persons deputed for training
purpose.
AGE :
l 6 months to 70 Years.
l Proposal over 70 Years to be accepted after obtaining Medical reports and
appropriate loading of premium.
LOADING STRUCTURE - In case of age over 70 yrs.
71 & 72 years 25% (if no adverse history)
73 & 74 years 50% (if no adverse history)
Over 75 years 100% (if no adverse history)
Over 79 years 150% (if no adverse history)
Over 84 years 200% (if no adverse history)
MEDICAL REPORTS :
Must for Proposers over the age of 70 years visiting abroad excluding USA and
CANADA and over the age of 60 years – visiting USA and CANADA.
Blood Sugar/Urine Strip Test and ECG print out .and any other as required by Co.
Medical reports are required when the proposer is traveling for more than 60 days.
In case the proposer is not able to submit required Medical reports, it is possible to
issue a policy by restricting the sum insured under medical expenses to US $ 10000
for Plan A and B only.
PERIOD :
l Initial cover up to 180 days under Business and Holiday.
l Extension for a further period of Maximum 180 days subject to declaration
of Good Health and No Claim.
131
PREMIUM :
Depends upon the Age, Country visited by the Proposer and No. of Days of Stay.
PLANS :
There are various types of plans available under the policy depending upon the nature
of travel and country visited, and benefits offered under the various plans are also
different.
BENEFITS UNDER VARIOUS PLANS :
Business and Holiday :
Sections Benefits A1 A2 B1 B2
All in Us Dollars
A Illness / Accident 50000 250000 100000 500000
Deductible 100 100 100 100
B Personal Accident 10000 25000 25000 25000
C Loss of checked in Baggage 1000 1000 1000 1000
D Delay of Checked in Baggage
over 12 hrs (Outbound flights) 100 100 100 100
E Loss of Passport 150 250 150 250
Deductible 30 30 30 30
F Personal Liability 200000 200000 200000 200000
Deductible 200 200 200 200
NOTE :
Plan A1 and A2 : World wide excluding USA AND CANADA
Plan B1 and B2 : World wide including USA AND CANADA
Plan E1 and E2 for Corporate Frequent Travelers :
Sections Benefits E1 E2
All in Us Dollars
A Illness / Accident 100000 500000
Deductible 100 100
B Personal Accident 25000 25000
C Loss of checked in Baggage 1000 1000
D Delay of Checked in Baggage
over 12 hrs (Outbound flights) 100 100
E Loss of PassportDeductible 15030 25030
F Personal Liability 200000 200000
Deductible 200 200
NOTE :
Plan E1 and E2 : World wide including USA and CANADA.
132
PLAN K: ASIAN COUNTRIES EXCLUDING JAPAN :
Sec A Illness/Accident US $ 15000
Deductible US $ 50 (including Dental)
Sec B Personal Accident US $ 7500
EMPLOYMENT AND STUDIES :
PLAN C : World wide excluding USA AND CANADA :
Medical Expenses US $ 150000
Deductible US $ 100
PLAN D : Worldwide including USA AND CANADA
Medical Expenses US $ 150000
Deductible US $ 100
PLAN D1 : World wide including USA AND CANADA
SEC I MEDICAL US $ 500000
Deductible US $ 100
SEC II CONTINGENCY US $ 750 Per Month
SEC III LOSS OF CHECKED IN BAGGAGE US $ 1000 (outbound flight)
SEC IV DELAY OF CHECKED IN BAGGAGE US $ 100 (outbound flight)
PLAN Z : WORLDWIDE TRAVEL FOR CORPORATE CLIENT ON DECLARATION
BASIS :
PREMIUM CHARTS:
Business & Holiday
Up to 180 Days
PLAN A 1 (Excluding USA & CANADA)
Period / Age 6 Months - 40 Yrs 41-60 Yrs 61-70 Yrs
1-7 500 550 850
8-14 575 630 935
15-21 600 670 990
22-28 670 750 1120
29-35 830 905 1345
36-47 950 1040 1560
48-60 1115 1231 1835
61-75 1380 1520 2305
76-90 1650 1800 2735
91-120 2790 3070 4660
121-147 3360 3685 5600
148-180 4671 5125 7800
133
PLAN A-2 (Excluding USA & CANADA)
Period / Age 6 Months-40 Yrs 41-60 Yrs 61-70 Yrs
1-7 565 627 1130
8-14 637 699 1204
15-21 665 745 1277
22-28 745 836 1446
29-35 927 1013 1741
36-47 1063 1166 2024
48-60 1252 1383 2290
61-75 1554 1714 3000
76-90 1862 2033 3564
91-120 3162 3481 6088
121-147 3812 4182 7319
148-180 5305 5824 10205

Plus applicable Service Tax


PLAN B-1 (Including USA & CANADA)
Period / Age 6 Months-40 Yrs 41-60 Yrs 61-70 Yrs
1-7 950 1385 1675
8-14 1045 1479 1794
15-21 1111 1584 1920
22-28 1254 1837 2208
29-35 1508 2168 2652
36-47 1793 2640 3240
48-60 2893 4290 5227
61-75 4158 6204 7608
76-90 5006 7458 9168
91-120 7051 10560 12960
121-147 9362 14058 17304
148-180 12397 18667 22935

134
LAN B-2 (Including USA & CANADA)
Period / Age 6 Months-40 Yrs 41-60 Yrs 61-70 Yrs
1-7 1050 1620 2065
8-14 1170 1742 2190
15-21 1247 1867 2347
22-28 1409 2168 2703
29-35 1697 2561 3251
36-47 2022 3125 3977
48-60 3276 5090 6430
61-75 4720 7373 9371
76-90 5685 8867 11301
91-120 8017 12564 15982
121-147 10651 16733 21346
148-180 14111 22226 28296

PLAN K — Under B & H (Asian Countries — Excluding JAPAN)


Period / Age 6 Months-40 Yrs 41-60 Yrs 61-70 Yrs
1-7 350 400 700
8-14 400 450 750
15-21 450 500 825
22-30 500 575 900

Extension Under Plan


Extension under the plan shall be done provided :
(a) The original policy period has not expired
(b) There is no claim on the original policy
(c) Declaration of good health required.
(d) The total extension including original period should not exceed 360 days.

135
PREMIUM RATE CHART FOR EXTENSION PERIOD OVER 180 DAYS :
PLAN A-1 EXCLUDING USA & CANADA
Period Upto AGE
(Over 180 Days) 6 Months-40 Yrs 41-60 Yrs 61-70 Yrs
30 DAYS 1150 1250 1600
60 DAYS 1850 1975 2575
90 DAYS 2750 2900 3950
120 DAYS 4600 4900 6500
150 DAYS 5600 5925 7850
180 DAYS 7800 8250 10900
PLAN A-2 (Excluding USA & CANADA)
Period Upto AGE
(Over 180 Days) 6 Months-40 Yrs 41-60 Yrs 61-70 Yrs
30 DAYS 1450 1540 2150
60 DAYS 2300 2430 3340
90 DAYS 3575 3750 5275
120 DAYS 6100 6400 9000
150 DAYS 7325 7700 10850
180 DAYS 10200 10700 14550
PLAN –B -1 (Including USA & CANADA)
Period Upto AGE
(Over 180 Days) 6 Months-40 Yrs 41-60 Yrs 61-70 Yrs
30 DAYS 2200 2775 3150
60 DAYS 5225 6625 7575
90 DAYS 9175 11625 13350
120 DAYS 12950 16450 18850
150 DAYS 17300 22000 25200
180 DAYS 22900 29200 33500

PLAN –B -2 (Including USA & CANADA)


Period Upto AGE
(Over 180 Days) 6 Months-40 Yrs 41-60 Yrs 61-70 Yrs
30 DAYS 2700 3450 4000
60 DAYS 6425 8250 9575
90 DAYS 11300 14475 16900
120 DAYS 15000 19500 23000
150 DAYS 21000 27000 31700
180 DAYS 27500 35500 41575
136
PREMIUM CHARTS :
Employment and Studies (Upto One Year)
PLAN SUM AGE BAND AGE BAND AGE BAND
INSURED & PREM & PREM & PREM
C-STUDENT (EXCL US $ 150000 1month-17 yrs 18-40 yrs 41-60 yrs
USA & CANADA) Rs.818/-p.m. Rs.975/- p.m. Rs.1065/-p.m.
D-STUDENT (INCL. US $ 150000 1 month-17 yrs 18-40 yrs 41-60 yrs
USA & CANADA) Rs.1365/- p.m. Rs.1568/-p.m. Rs.2243/-p.m.
D-1 STUDENT (INCL. US $ 500000 1 month-17 yrs 18-40 yrs 41-60 yrs
USA & CANADA) Rs.1706/-p.m Rs.1960/-p.m Rs.2804/-p.m
C-EMPLOYMENT (EXCL. US $ 150000 1 month-17 yrs 18-40 yrs 41-60 yrs
USA & CANADA) US $ 35/- p.m US $ 41/-p.m US $ 47/-p.m
D-EMPLOYMENT (INCLU. US $ 150000 1month-17 yrs 18-40 yrs 41-60 yrs
USA & CANADA) US $ 60/-p.m. US$ 71/-p.m. US$ 98/-p.m.
PLAN C - (EXCL. USA & CANADA) - EXCEEDING 1 YEAR
AGE 1 month-17 yrs 18-40 yrs 41-60 yrs
EMPLOYMENT US $ 45 P.M US $ 50 PM US $ 55 P.M
STUDIES Rs.818/- PM Rs.975/-P.M Rs.1065/-P.M
PLAN D - (INCL. USA & CANADA) - EXCEEDING 1 YEAR
AGE 1 month-17 yrs 18-40 yrs 41-60 yrs
EMPLOYMENT US $ 90 P.M US $ 100 PM US $ 125 P.M
STUDIES Rs.1365/- PM Rs.1568/-P.M Rs.2243/-P.M
NOTE : Applicable Service Tax has to be added along with the appropriate Premium.
MAJOR EXLUSIONS :
All pre-existing disease/Illnesses certain diseases like mumps, chicken pox measles
etc., in case of children below 5 years of age. Traveling against Medical Advise.

137
NEW INDIA ASHA KIRAN POLICY
HEALTH COVERAGE :
q Health insurance protection for family having only girl children.
q 50% discount on Health Insurance premium for the girl children.
Personal Accident Coverage : (only for parents)
In case of unfortunate event of Accidental Death or Permanent Total Disablement of
Single parent : Full Sum Insured will be paid; Both Parents: 200% of Sum Insured will be
paid.
BENEFITS :
£ Floater Sum Insured of ` 2 lakhs, ` 3 lakhs, ` 5 lakhs and ` 8 lakhs available.
£ Members covered : Self, Spouse and dependent daughter/s.
£ Hospital Cash payable at the rate of 0.1% per day maximum up to 1% of Sum Insured
for Any One Illness.
£ Critical Care Benefit of 10% of Sum Insured as additional benefit.
£ Ambulance charges up to 1% of Sum Insured.
£ AYUSH treatment up to 25% of the Sum Insured.
£ Free Look Period up to 15 days.
£ Tax Benefit under 80D of Income Tax Act.
£ Attractive Zone wise premium.
£ Pre-Hospitalisation expenses up to 30 days.
£ Post-Hospitalisation expenses up to 60 days.
£ Cashless hospitalisation in Network hospitals across India.
£ No loading for adverse claim experience.
£ More than 74 Day Care procedures covered.
MAJOR EXCLUSIONS :
¤ Treatment of any Pre-existing Condition / Disease will not be paid, until 48 months
of Continuous Coverage of such Insured Person have elapsed.
¤ Any Illness contracted during the first 30 days of the commencement date of this Policy.
¤ Waiting period of twenty four months for named diseases.
¤ Waiting period of forty eight months for age related disorders
¤ Payment or compensation in respect of Death, Injury or Disablements directly or
indirectly arising out of or contributed to or traceable to any Disability already
existing on the date of commencement of this policy.

138
¤ Dental treatment or Surgery of any kind unless necessitated by Accident and requiring
Hospitalisation.
¤ Maternity Expenses, treatment arising from or traceable to pregnancy, miscarriage,
abortion or complications.
¤ Genetic disorders and stem cell Implantation / Surgery.
¤ Domiciliary Hospitalisation
MAJOR CONDITIONS :
¥ Communication : You must send all communications or documents to the TPA for
health claims and to the policy issuing office for personal accident claims or any other
matter.
¥ Basis of Insurance : The policy is issued of the basis of truth and accuracy of
statements in proposal.
¥ Premium : Unless premium is paid before commence ment of risk, the policy shall
have no effect.
¥ Enhancement of Sum Insured : Enhancement of Sum Insured will be permitted after
two claim free years of continuous coverage with us.
¥ Portability : The policy is subject to Protection of Policyholders’ Interest Regulations,
2002 and Portability Guidelines issued by IRDA.
¥ Grievance Redressal : In the event of Your having any grievance relating to the
insurance, You may contact any of the Grievance Cells at Regional Offices of the
Company or Office of the Insurance Ombudsman.
**Kindly refer the Prospectus or Policy Document for complete details of Coverage,
Exclusions and Conditions.

139
PREMIUM CHART

Sum PRIMARY MEMBER Premiums applicable at different


Insured Zone ages (Rs. per annum excluding S Tax)
(Rs.)
0-20 21-30 30-35 36-40 41-45 46-50 50-55 55-60 60-65
200,000 I 1,860 2,530 3,010 3,690 4,790 5,850 8,170 10,000 16,860
300,000 I 2,780 3,670 4,140 5,050 6,560 8,010 11,640 14,220 24,040
500,000 I 4,270 5,800 6,530 7,990 9,280 11,340 17,060 20,860 35,420
800,000 I 5,680 7,710 8,690 10,630 12,350 15,080 22,690 28,180 47,110

200,000 II 1,690 2,300 2,740 3,350 4,350 5,320 7,430 9,090 15,330
300,000 II 2,530 3,340 3,760 4,590 5,960 7,280 10,580 12,930 21,850
500,000 II 3,880 5,270 5,940 7,260 8,440 10,310 15,510 18,960 32,200
800,000 II 5,160 7,010 7,900 9,660 11,230 13,710 20,630 25,620 42,830

200,000 III 1,520 2,070 2,470 3,020 3,920 4,790 6,690 8,180 13,800
300,000 III 2,280 3,010 3,380 4,130 5,360 6,550 9,520 11,640 19,670
500,000 III 3,490 4,740 5,350 6,530 7,600 9,280 13,960 17,060 28,980
800,000 III 4,640 6,310 7,110 8,700 10,110 12,340 18,570 23,060 38,550

Sum ADDITIONAL MEMBER Premiums applicable at different


Insured Zone ages (Rs. per annum excluding S Tax)
(Rs.)
0-20 21-30 30-35 36-40 41-45 46-50 50-55 55-60 60-65
200,000 I 250 360 510 620 1,100 1,340 2,840 3,470 10,960
300,000 I 370 520 680 840 1,510 1,850 4,030 4,930 15,610
500,000 I 570 830 1,090 1,330 2,130 2,610 5,910 7,230 23,010
800,000 I 760 1,100 1,450 1,770 2,840 3,470 7,850 9,610 30,600

200,000 II 230 330 460 560 1,000 1,220 2,580 3,150 9,960
300,000 II 340 470 620 760 1,370 1,680 3,660 4,480 14,190
500,000 II 520 750 990 1,210 1,940 2,370 5,370 6,570 20,920
800,000 II 690 1,000 1,320 1,610 2,580 3,150 7,140 8,740 27,820

200,000 III 210 300 410 500 900 1,100 2,320 2,840 8,960
300,000 III 310 420 560 680 1,230 1,510 3,290 4,030 12,770
500,000 III 470 680 890 1,090 1,750 2,130 4,830 5,910 18,830
800,000 III 620 900 1,190 1,450 2,320 2,840 6,430 7,870 25,040

Premium will increase by 2% for every year after the age of 65 years for both
primary and additional member.
Example : premium for primary member of age of 70 years with a Sum Insured
Rs. 2 lakhs will be : Rs. 16860 + (5 years X 2%) = Rs. 18546.

140
NEW INDIA FLOATER MEDICLAIM POLICY
FLOATER HEALTH COVERAGE TO THE ENTIRE FAMILY
£ The sum insured floats over entire family consisting of Proposer, Spouse, Parents,
Dependent children.
£ Minimum two members are to be covered in this policy to avail family floater.
Maximum six members can be covered in a single policy.
£ This policy is available to pesons upto the age of 65 years.
£ The proposer can choose Sum insured from Rs. 2 lakhs, 3 lakhs, 5 lakhs and 8
lakhs.
£ No pre-acceptance medical checkup upto the age of 50 years.
BENEFITS :
¤ Hospitalization expenses
¤ Pre-Hospitalization Benefit, not exceeding 30 days.
¤ Post-Hospitalization Benefit, not exceeding 60 days.
¤ Hospitalization Cash at a rate of 0.1% of Sum Insures per day (maximum 10 days)
of Hospitalization.
¤ Critcal care benefit-10% of Sum Insured as additional benefit over and above the
sum insured, provided the same is diagnosed in the currency of the policy.
¤ Ambulance Charges upto 1% of Sum insured.
SPECIAL COVERAGE :
¤ Cataract claims, upto 10% of the Sum insured or Rs. 50000 whichever less for each
eye.
¤ More than 72 Day Care Procedures covered.
¤ Congenital internal Diseases shall be covered after twenty four months of
Continuous coverage.
¤ Congenital External Diseases shall be covered after fourty eight months of
continuous Coverage, upto 10% of Sum Insured.
¤ New born Baby is also covered under the Sum Insured, without paying additional
premium.
¤ AYUSH treatment will be covered, upto 25% of the Sum Insured.
TIME BOUND EXCLUSIONS :
¤ Treatment of any Pre-existing disease shall be covered after 48 months of
Continuous Coverage.
¤ Any illnesses contracted during the first 30 days of the commencement date of this
policy.
¤ Twenty four months waiting for specified diseases listed in the Policy Document.
¤ Forty eight months waiting for Age-related diseases listed in the Policy Document.

141
PERMANENT EXCLUSIONS :
¤ Circumcision, cosmetic and plastic Surgery, Vaccination and durable implants.
¤ Dental treatment.
¤ Treatment relating to Convalescence, all psychiatric and psychosomatic disorders,
use of intoxicating drugs, obesity, infertility, sterility, Venereal disease, intentional
self-injury.
¤ War and allied perils.
¤ Treatment of any Bodily injury or illness sustained whilst participating in criminal
act or hazardous sport or attempted suicide.
¤ Maternity Expenses.
¤ Sexually Transmitted Diseases, including AIDS.
¤ Genetic disorders and Stem cell implantation.
¤ Domiciliary Hospitalization, Acupressure, acupuncture, magnetic therapies and
Naturopathy etc.
¤ Non-Medical expenses listed in the policy document.
PREMIUM :
¤ Premium is calculated based on Age, Sum Insured and Zone where the Insured
persons would like to take treatment.
CLAIMS MANAGEMENT :
¤ Proposer has options to choose TPA or service directly by policy issuing office.
¤ Insured has an option to avail cashless service from the network Hosptals approved
by GIPSA, in case the policy is serviced by TPA.
¤ Notice of claim to be given within 24 hours.
¤ In case of Reimbursement, claim form along with all relevant documents to be
submitted within 7 days from date of discharge.
FREE LOOK PERIOD :
Insured person will be allowed a period of 15 days from the date of receipt of the policy
to review the terms and conditions of the policy and to return the same if not acceptable.
PORTABILITY :
The policy holders of other Insurance companies can choose to opt this plan as per the
prevailing guidelines of IRDA.
**Kindly refer the Prospectus or Policy Document for complete details of Coverage,
Exclusions and Conditions.

142
PREMIUM CHART

Sum PRIMARY MEMBER


Insured Zone Premiums applicable at different ages (Rs. per annum)
(Rs.)
0-20 21-30 30-35 36-40 41-45 46-50 50-55 55-60 60-65
200,000 I 1,860 2,530 3,010 3,690 4,790 5,850 8,170 10,000 16,860
300,000 I 2,780 3,670 4,140 5,050 6,560 8,010 11,640 14,220 24,040
500,000 I 4,270 5,800 6,530 7,990 9,280 11,340 17,060 20,860 35,420
800,000 I 5,680 7,710 8,690 10,630 12,350 15,080 22,690 28,180 47,110

200,000 II 1,690 2,300 2,740 3,350 4,350 5,320 7,430 9,090 15,330
300,000 II 2,530 3,340 3,760 4,590 5,960 7,280 10,580 12,930 21,850
500,000 II 3,880 5,270 5,940 7,260 8,440 10,310 15,510 18,960 32,200
800,000 II 5,160 7,010 7,900 9,660 11,230 13,710 20,630 25,620 42,830

200,000 III 1,520 2,070 2,470 3,020 3,920 4,790 6,690 8,180 13,800
300,000 III 2,280 3,010 3,380 4,130 5,360 6,550 9,520 11,640 19,670
500,000 III 3,490 4,740 5,350 6,530 7,600 9,280 13,960 17,060 28,980
800,000 III 4,640 6,310 7,110 8,700 10,110 12,340 18,570 23,060 38,550

Sum ADDITIONAL MEMBER


Insured Zone Premiums applicable at different ages (Rs. per annum)
(Rs.)
0-20 21-30 30-35 36-40 41-45 46-50 50-55 55-60 60-65
200,000 I 250 360 510 620 1,100 1,340 2,840 3,470 10,960
300,000 I 370 520 680 840 1,510 1,850 4,030 4,930 15,610
500,000 I 570 830 1,090 1,330 2,130 2,610 5,910 7,230 23,010
800,000 I 760 1,100 1,450 1,770 2,840 3,470 7,850 9,610 30,600

200,000 II 230 330 460 560 1,000 1,220 2,580 3,150 9,960
300,000 II 340 470 620 760 1,370 1,680 3,660 4,480 14,190
500,000 II 520 750 990 1,210 1,940 2,370 5,370 6,570 20,920
800,000 II 690 1,000 1,320 1,610 2,580 3,150 7,140 8,740 27,820

200,000 III 210 300 410 500 900 1,100 2,320 2,840 8,960
300,000 III 310 420 560 680 1,230 1,510 3,290 4,030 12,770
500,000 III 470 680 890 1,090 1,750 2,130 4,830 5,910 18,830
800,000 III 620 900 1,190 1,450 2,320 2,840 6,430 7,870 25,040

Once the Insured Person cross the age of 65 years, the applicable premium on
renewal will be loaded by 2% per year. This loading is applicable on premium for
the age band of 60 years to 65 years.

143
NEW INDIA TOP-UP MEDICLAIM POLICY
HEALTH COVERAGE TO THE ENTIRE FAMILY
l The Policy can be taken on Individual basis or floater basis for entire family.
l The family will consist of Self, Spouse, Parents and Dependent Children.
l A single member or a family of upto six members can take the Policy.
l This Policy is available to persons between the age of 18 years and 65 years.
Childern can be covered from 3 months to 25 years.
l No Pre-acceptance Health Check-up for person upto 50 years of age or if the
person has Health Insurance Policy from our company and there is no claim for
previous two years.
l The Proposer can choose any of the options from the following table :
Coverage Type Sum Insured Threshold
A 5,00,000 5,00,000
B 10,00,000 5,00,000
C 15,00,000 5,00,000
D 7,00,000 8,00,000
E 12,00,000 8,00,000
F 17,00,000 8,00,000
G 22,00,000 8,00,000
BENEFITS :
l Room Rent, upto Rs. 5000 per day for Rs. 5,00,000 Threshold and Rs. 8000 per
day for Rs. 8,00,000 Threshold.
l Hospital cash at the rate of Rs. 500 per day for Rs. 5,00,000 Threshold and
Rs. 800 per day for Rs. 8,00,000 Threshold, maximum for 10 days of
Hospitalisation.
l Get Well Benefit of Rs. 5000 for Rs. 5,00,000 Threshold and Rs. 8000 for
Rs. 8,00,000 Threshold. This benefit will be payable only for the first four
admissible claims.
l Ambulance Charges upto Rs. 5000 for Rs. 5,00,000 Threshold and Rs. 8000 for
Rs. 8,00,000 Threshold.
SPECIAL COVERAGE :
l Cataract claims, upto Rs. 50,000/-, for each eye.
l More than 74 Day Care Procedures covered.
l Congenital Internal Diseases shall be covered after twenty four months of
Continuous Coverage.
l AYUSH treatment will be covered, upto the Sum Insured.
TIME BOUND EXCLUSIONS :
l Treatment of any Pre-existing Disease shall be covered after 48 months of
Continuous Coverage.
l Any Illness contracted during the first 30 days of the commencement date of this
Policy.
l Twenty four months waiting for specified diseases listed in the Policy Document.
l Forty Eight Months waiting for Age-related diseases listed in the Policy Document.
PERMANENT EXCLUSIONS :
l Circumcision, Cosmetic and Plastic Surgery, Vaccination and durable implants.
144
l Dental treatment.
l Treatment relating to Convalescence, all psychiatric and psychosomatic disorders,
use of intoxicating drugs, obesity, infertility, sterility, Venereal disease, intentional
self-injury.
l War and allied perils.
l Treatment of any Bodily Injury or Illness sustained whilst participating in criminal
act or hazardous sport or attempted suicide.
l Maternity Expenses.
l Sexually Transmitted Diseases, including AIDS.
l Genetic Disorders and stem cell implantation.
l Domiciliary Hospitalisation, Acupressure, acupuncture, magnetic therapies and
Naturopathy etc.
l Non-Medical expenses listed in the policy document.
PREMIUM :
Permium is calculated based on Age, Sum Insured and Threshold.
CLAIMS MANAGEMENT :
l Insured got an option to avail cashless service from the Network Hospitals.
l Notice of claim to be given within forty eight hours.
l Claim from along with all relevant documents to be submitted within fifteen days
from date of discharge.
FREE LOOK PERIOD :
Insured Person will be allowed a period of 15 days from the date of receipt of the
policy to review the terms and conditions of the policy and to return the same if
not acceptable.
PORTABILITY :
The Top-Up policyholders of other Insurance companies can choose to take this plan
as per the prevailing guidelines of IRDA.
NEW INDIA TOP-UP MEDICLAIM POLICY - PREMIUM CHART
Threshold Sum Premiums applicable at different ages (excluding tax)
(Rs.) Insured
(Rs.) PRIMARY MEMBER ADDITIONAL MEMBER
18-44 45-54 55-60 61-65 0-17 18-44 45-54 55-60 61-65
5,00,000 1,800 2,900 4,020 6,700 700 900 1,450 2,010 3,350
5,00,000 10,00,000 2,800 4,500 6,300 10,500 1,100 1,400 2,250 3,150 5,250
15,00,000 3,500 5,600 8,040 13,400 1,400 1,750 2,800 4,020 6,700
7,00,000 1,600 2,500 3,840 6,400 600 800 1,250 1,920 3,200
8,00,000 12,00,000 2,300 3,700 5,760 9,600 900 1,150 1,850 2,880 4,800
17,00,000 3,000 4,700 7,440 12,400 1,200 1,500 2,350 3,720 6,200
22,00,000 3,600 5,600 8,940 14,900 1,400 1,800 2,800 4,470 7,450
Once the Insured Person crosses the age of 65 years, the applicable premium on
renewal will be loaded by 2.5% per year.
This loading is applicable on premium for the age band of 61-65 years.
*Kindly refer the Prospectus for complete details of Coverage.
145
CANCER MEDICAL EXPENSES POLICY-INDIVIDUAL
(INDIAN CANCER SOCIETY)
I. INTRODUCTION
WHEREAS
(A) The person specified in the Schedule is a member of the Indian Cancer Society
(hereinafter) called “the Insured”.
(B) By an Agreement dated 21st May 1985 made between The New India Assurance
Company Limited (hereinafter referred to as “New India”) and the Indian Cancer
Society, it has been agreed between New India and the Indian Cancer Society
that members of the Indian Cancer Society would be extended the benefits of
the Cancer Medical Expenses Policy, on the terms and conditions set out herein.
(C) The Insured by virtue of being a member of the Indian Cancer Society has by a
proposal for insurance dated as specified in the schedule applied to New India
for the issue of a Cancer Medical Expenses Policy.
(D) The Insured has declared and represented in the proposal form that both the
Insured and the spouse mentioned in clause II.2 herein are in good health and
the necessary health statement to the said effect has been submitted.
(E) On the basis of the said declarations and representations contained in the
proposal form (which are in form part of the contract of insurance) New India has
agreed to issue this policy.
(F) The partners are desirous of recording the terms and conditions of and relating
to the said Cancer Medical Expenses Policy.
This Policy is being issued to record the said terms and conditions mentioned
hereinafter.
II. NATURE OF COVER
1. Subjects to the terms, conditions and provisions contained hereinafter, if the
Insured during the currency of this Policy or the renewal thereof, suffers from
Cancer (as defined) and if this requires diagnostic investigation or treatment by
a duly qualified medical practitioner or surgeon, New India shall pay to the
Insured the medical/surgical/diagnostic expenses as are actually and
necessarily incurred by the Insured but not exceeding Rs. 50,000/- which is the
limit of the Company’s liability in respect of any Insured person.
2. The Insured for the purposes of this policy shall include the Insured himself/
herself and the spouse if supported by and residing with the Insured. It is
however agreed and understood by and between the parties that of any one of
the said person first contracts cancer, the benefits of this policy shall be
extendable to such persons only and shall therefrom forthwith cease to be
applicable to the other person, the intention being that the benefits of this Policy
are so be availed of by one such person only.
III. PREMIUM
1. The premium shall be paid by the Insured to the Indian Cancer Society as a part
of the membership fee, and the annual premium under the policy is Rs. 100/- The
Cancer Society shall make over this premium to the New India through a monthly
statement to be submitted by the Cancer Society to New India. It is, however,
provided that the Insured shall stand automatically covered from the date he
146
becomes a member of the India Cancer Society even if the Cancer Society has
received the premium but not made over to New India.
2. A like amount of Rs. One hundred to payable annually for renewal of the Policy.
The said sum shall be paid over by the Insured alongwith his subscription for to
the India Cancer Society before the expiry of the period of insurance as a
condition to the renewal of the Policy.
3. The premium shall be paid in the manner aforesaid.
4. If, for any reason, the said premium is not paid and the policy lapses thereon, it
shall be open to New India at its sole discretion, to revalidate and reinstate the
Policy on an application made to it by the Insured in that behalf setting out full
reasons why the said premium was not paid in time.
IV. SCOPE OF COVER
1. The policy is valid for a period of one year from the date the Insured person
becomes a member of the Cancer Society and the risk shall commence as from
the date.
2. No claim, however, shall be payable on any account whatsoever, if the Insured
or his spouse contracts cancer within a period of thirty days from the date of
inception of the initial policy but it is clarified that the said period of thirty days
does not apply to renewals.
3. If after the said period of thirty days and thereafter during the currency of the
Policy, or subsequential renewals, any of the persons falling within the
expression of the term Insured, contracts cancer or is suspected of having
contracted cancer and makes initial claim under the Policy, the Policy shall be
deemed to have been invoked in respect of the said person (and shall lapse as
far as the other is concerned) and the liability of New India shall continue to the
extent of the amount Insured. In the event of the death of the person concerned,
the benefits under the Policy shall cease to operate. It shall be open for the other
person to take out a separate Cancer Policy in his/her own right in accordance
with the prescribed procedure.
4. Policy can be extended to cover two dependent children as an extension to the
existing Cancer Medical Expenses Policy subject to attachment of a suitable
endorsement. Premium chargeable would be Rs. 50/- per child. Separate
proposal form to be filled-in for each of the child. Cumulative Bonus allowed for
each child as it is done in case of the original policy. Medical expenses limit of
the company for each child is restricted to Rs. 50,000/-. Claim by anyone Insured’
child would not affect the Company’s liability in respect of the other child. Further,
policy will not cease to be effective for Insured/spouse if any of the Insured child
contract Cancer.
5. CUMULATIVE BONUS : Claim Payable under the policy shall be increased by
5% on Sum Insured is respect of each completed year during which the policy
shall have been in force prior to the claim but amount of such increase shall not
exceed 50% of Sum Insured. This clause shall not in any way alter the annual
character of the Insurance nor the right of the Company to decline to renew or
to cancel this Policy as hereinafter provided. The earned Cumulative Bonus will
not be lost if the policy is renewed within 30 days after its expiry.
V. CLAIMS
1. Notice of Clauses : A notice of claim shall be served upon New India within a
147
period of 30 days of the happening of any event which gives rise to a claim under
the Policy with full particulars.
2. Proof of Claims : The claim shall be substantiated in full with all supporting
documents including certificates, all of which shall be required to be certified by
the Indian Cancer Society as being genuine and proper as a condition procedure
to the entertainment of the claim by New India.
3. The claim and the requisite information, particulars and documents in respect
of and pertaining to a claim shall be submitted within a reasonable period.
4. Payment of Claims : Claims shall be paid by New India in Indian currency to the
Insured or to the other person included within the expression of the terms
Insured, subject to and in accordance with the limit of liability specified in the
Schedule annexed hereto.
5. Claims for reimbursement of Medical expenses may be submitted by the Insured
to New India on quarterly basis and shall be settled accordingly as per terms/
conditions of the Policy.
VI. CONDITIONS, WARRANTIES, EXCLUSIONS
1. New India shall not be liable for making any payment under the Policy by reason
of any Injury or Illness directly or indirectly caused or contributed by nuclear
weapons, or by reason of the contact of the Insured person with radiation or
radioactivity from any source whatsoever from non-diagnostic or therapeutic
source.
2. No claim shall be payable under or in respect of this Policy if any claim or any
aspect thereof or if any of the representation on the basis whereof this Policy is
issued shall be discovered to be in any manner fraudulent or incorrect of if any
fraudulent means or devices are adopted by the Insured persons at any time in
making or preferring any claim under or in respect of this Policy.
3. No claim shall be payable under this policy and the policy shall lapse immediately
upon the Insured ceasing to be a member of the Indian Cancer Society for any
reason whatsoever, notwithstanding any dispute between the Insured and the
Cancer Society.
4. “No claim shall be payable under this policy unless the diagnostic investigation
reveals positive existence or presence of Cancer.”
5. Cancellation : The Company may at any time cancel this Policy through Indian
Cancer Society on the grounds of misrepresentation, fraud, non-disclosure of
material facts or non-cooperation by sending the Insured 30 days notice by
registered letter at the Insured’s last known address and in such event the
Company shall refund to the Insured a pro-rata premium for un-expired Period
of Insurance. The Company shall however, remain liable for any claim, which
arose prior to the date of cancellation. The Insured may at any time cancel this
Policy and in such event the Company shall allow refund of premium at
Company’s short period scale of rate only (table given here below) provided no
claim has occurred up to the date of cancellation.
PERIOD ON RISK RATE OF PREMIUM TO BE CHARGED (RETAINED)
Up to one month 1/4th of the annual rate
Up to three months 1/2 of the annual rate
Up to six months 3/4th of the annual rate
Exceeding six months Full annual rate
148
VII.DISPUTES SETTLEMENT
If any difference shall arise as to the claim or quantum thereof, such difference shall
be referred to the Committee for settling disputes setup by the Indian Cancer Society
and New Indian and the committee’s decision shall be final and binding on all parties.
VIII. FORFEITURE
It is further agreed and declared that if the Company does not admit or disclaim
liability for any reason whatsoever within three months of the notice of claim or if
there is a dispute as to the quantum payable and if the quantum are not referred to
the Committee for settlement under clause VII hereinabove within three months
thereafter then the claim shall for all purposes be deemed to have been abandoned
and the Company shall not be liable under or in respect of the said Policy at all for
any reason whatsoever.
IX DEFINITIONS
1) CANCER :
I. A malignant tumorcharacterized by the uncontrolled growth & spread of
malignant cells with invasion & destruction of normal tissues. This diagnosis
must be supported by histological evidence of malignancy & confirmed by
a pathologist. The term cancer includes leukemia, lymphoma and sarcoma.
II. The following are excluded -
i. Tumors showing the malignant changes of carcinoma in situ & tumors
which are histologically described as premalignant or non invasive,
including but not limited to : Carcinoma in situ of breasts, cervical
dysplasia CIN-1, CIN -2 & CIN-3.
ii. Any skin cancer other than invasive malignant melanoma
iii. All tumors of the prostate unless histologically classified as having a
Gleason scoregreater than 6 or having progressed to at least clinical
TNM classification T2N0M0.........
iv. Papillary micro - carcinoma of the thyroid less than 1 cm in diameter
v. Chronic lymphocyticleukemia less than RAI stage 3
vi. Micro carcinoma of the bladder
vii. All tumors in the presence of HIV infection.
2) CANCELLATION : Cancellation defines the terms on which the policy contract
can be terminated either by the insurer or the Insured by giving sufficient notice
to other which is not lower than a period of fifteen days.
3) CONTRIBUTION : Contribution is essentially the right of an insurer to call upon
other insurers, liable to the same insured, to share the cost of an indemnity claim
on a rateable proportion.
4) CUMULATIVE BONUS: Cumulative Bonus shall mean any increase in the sum
assured granted by the insurer without an associated increase in premium.
5) ILLNESS : Illness means a sickness or a disease or pathological condition
leading to the impairment of normal physiological function which manifests itself
during the Policy Period and requires medical treatment.
6) INJURY : Injury means accidental physical bodily harm excluding Illness or
149
disease solely and directly caused by external, violent and visible and evident
means which is verified and certified by a Medical Practitioner.
7) INSURED PERSON : means You and each of the others who are covered under
this Policy as shown in the Schedule.
8) MEDICAL PRACTITIONER : is a person who holds a valid registration from the
medical council of any state or Medical council of India or Council for Indian
Medicine or for Homeopathy set up by the Government of India or a state
Government and is thereby entitled to practice medicine within its jurisdiction;
and is acting within the scope and jurisdiction of his license.
Note : The Medical Practitioner should not be the insured or close family
members.
9) PRE-EXISTING CONDITION/DISEASE FOR CANCER : Any condition, ailment
or injury or related condition(s) for which you had signs or symptoms, and / or
were diagnosed, and / or received medical advice / treatment within 48 months
prior to the first policy issued by the insurer.
X. FREE LOOK PERIOD :
The free look period shall be applicable at the inception of the policy.
You will be allowed a period of fifteen days from the date of receipt of the policy to
review the terms and conditions of the policy and to return the same if not
acceptable.
If You have not made any claim during the free look period, You shall be entitled to :
1. A refund of the premium paid less any expenses incurred by Us on medical
examination and the stamp duty charges or;
2. where the risk has already commenced and the option of return of the policy is
exercised by You, a deduction towards the proportionate risk premium for period
on cover or;
3. Where only a part of the risk has commenced, such proportionate risk premium
commensurate with the risk covered during such period.
XI. ARBITRATION :
If we admit liability for any claim but any difference or dispute arises as to the amount
payable for any claim the same shall be decided by reference to Arbitration.
The Arbitrator shall be appointed in accordance with the provisions of the Arbitration
and Conciliation Act, 1996.
No reference to Arbitration shall be made unless We have Admitted our liability for
a claim in writing.
If a claim is declined and within 12 calendar months from such disclaimer any suit
or proceeding is not filed then the claim shall for all purposes be deemed to have
been abandoned and shall not thereafter be recoverable hereunder.
XII.PROTECTION OF POLICY HOLDERS’ INTEREST :
This policy is subject to IRDA (Protection of Policyholders’ Interest) Regulation,
2002.
150
XIII. GRIEVANCE REDRESSAL :
In the event of Insured Person having any grievance relating to the insurance, he/
she may contact any of the Grievance Cells at Regional Offices of the Company or
Office of the Insurance Ombudsman under the jurisdiction of which the Policy Issuing
Office falls. The contact detail of the office of the Insurance Ombudsman is provided
in the Annexure II.
XIV. CONTRIBUTION :
If two or more policies are taken by the Insured Person during a period from one or
more insurers to indemnify treatment costs, the Company shall not apply the
contribution clause, but the Insured Person shall have the right to require a
settlement of his/her claim in terms of any of his policies.
1. In all such cases the Company shall be obliged to settle the claim without
insisting on the contribution clause as long as the claim is within the limits of and
according to the terms of the policy.
2. If the amount to be claimed exceeds the sum insured under a single policy after
considering the deductibles or co-pay, the Insured Person shall have the right
to choose insurers by whom the claim to be settled. In such cases, the insurer
may settle the claim with contribution clause.
3. Except in benefit policies, in cases where an Insured Person has policies from
more than one insurer to cover the same risk on indemnity basis, the Insured
Person shall only be indemnified the Hospitalisation costs in accordance with
the terms and conditions of the policy.
Note : The insured Person must disclose such other insurance at the time of making
a claim under this Policy.

151
RURAL INSURANCE COVERS
CATTLE INSURANCE
The scheme is for underwriting cattle insurance business with in India.
1. SCOPE
The word ‘Cattle’ refers to :
a) Milch Cows and Buffaloes
b) Calves / Heifers
c) Stud Bulls
d) Bullocks (Castrated Bulls) and Castrated Male Buffaloes, whether indigenous,
exotic or cross-bred .
Note :
l Exotic animal means an animal, whose both parents are of foreign breed. This
includes animals born in India as well as those born abroad.
l Cross-bred animal means an animal, one of whose parents is of foreign breed.
2. AGE GROUP
Animals of age in years shown below shall be accepted under the Standard Insurance
Scheme.
I a) Milch cows (Indigenous / 2 years (or age at first calving)
Cross-bred / Exotic ) to 10 years.
b) Milch Buffaloes 3 years (or age at first calving)
to 12 years.
c) Stud Bulls (Cow / Buffalo species) 3 years to 8 years or earlier age
at sexual maturity.
d) Bullock (castrated bulls and 3 years to 12 years.
castrated male buffaloes)
II Indigenous, cross-bred and exotic From 4 months up to the date of
female calves / heifers. first calving or minimum age as in
(I) (a) and (b).
Note : At the time of acceptance, the maximum age should not exceed the prescribed
age limit (in case of annual policy).
3. VALUATION AND SUM INSURED
(i) The Market value of cattle varies from breed to breed, from area to area and
from time to time. The examining Veterinarians’ recommendations shall be
considered as the proper guide for acceptance of insurance as well as for
settlement of claims. Wherever possible, high valued animals shall be inspected
by Company’s representative.
(ii) Sum Insured will not exceed 100% of Market Value.
INDEMNITY
(i) Sum Insured or market value prior to illness whichever is less. Care should be
taken to assess the value of dry animals.
(ii) In case of scheme animals, the policy is issued as agreed value policy, hence
claim will be settled for 100% of Sum Insured, subject to terms, conditions and
exclusions.
152
4. PREMIUM RATES (Annual )
FOR MILCH COWS / MILCH BUFFALOES / FEMALE CALVES / HEIFERS / STUD
BULLS / BULLOCKS AND CASTRATED MALE BUFFALOES.
SPECIES COVERS
Death PTD Extra
1 Scheme Animals (Indigenous /
cross–bred ) 2.25% (net) 0.85% (net)
2 Non-Scheme Animals (Indigenous /
cross–bred) 4.00% (gross) 1.00% (gross)
3 Exotic Animals 4.00% as above
plus 2.00 % extra 1.00%
Scheme Animals for the purpose of concessional insurance rating should cover
animals financed/ subsidised under various Central / State Government
Programmes / Schemes besides IRDP such as
(i) Development of Women & Children Schemes in Rural Areas (DWCSRA), (ii)
Schemes for SC/ST operated by the State Governments,
(iii) Special Livestock Development Programme
(iv) Mini-dairy units in U.P and
(v) Support to training and implementation programme for women.
MALUS :
The premium rates indicated are the minimum to be charged. In case of adverse
claims ratio, following Malus system should be adopted .
% Claim Ratio Percentage of Malus
100 to 110 20%
111 to 130 33%
131 to 160 60%
161 to 200 100%
Above 200 Premium rate to be adjusted such that Claim
Ratio would appear as 90% for the rate.
MINIMUM PREMIUM : Rs. 50 per Policy.
SHORT PERIOD RATES :
Period (not exceeding) Proportion of Premium
1 week 1/8 of annual rate
1 month 1/4 of annual rate
2 months 3/8 of annual rate
3 months 1/2 of annual rate
4 months 5/8 of annual rate
5 months 3/4 of annual rate
8 months 7/8 of annual rate
Exceeding 8 months Full annual premium
153
5. DISCOUNT
(A) Group Discount (For Non-Scheme Only).
A group discount is allowed in case of single /partner ownership and/or single
source of premium payment and covered under a single policy (not applicable to
bank business).
NO. OF ANIMALS RATE OF DISCOUNT
5 – 10 2.5%
11 –15 5%
16 – 25 7.5%
26 – 50 10%
51 – 100 12.5%
101 - 500 15%
(If the Group is over 500 and / or very large, the discount not exceeding
20% may be given with HO apprroval)
(B) LONG TERM DISCOUNT (For Non- Scheme Animals )
Long Term Discount on Non – Scheme
3 and 4 years Policies 15%
5 years and above 25%
(i) Full premium has to be paid in advance
(ii) No refund of premium will be allowed even if claim arise in the earlier years.
(iii) Age limit should be as per Para 2 above .
(C) LONG TERM DISCOUNT (For Scheme Animals )
For Scheme animals, the basic premium for 3 years policy would be 4.80%. For
any additional year over 3 years, the premium would be @ 1.60 % per year. (This
rate is applicable only in case of Long Term Policies). If PTD cover has to be
extended the long term rate applicable for a three year period would be 6.60%.
The working would be as follows
Rate for basic Cover for 3 years 4.80%
Rate for PTD cover for 3 years 1.80%
6.60%
(i) Full premium has to be paid in advance .
(ii) Adjustment of premium : In case of premature death of cattle before the expiry
of policy period, the premium for the balance period after adjusting the period
up to the year In which the animal dies, would be allowed as credit to be adjusted
against premium for the new animal acquired by the Insured.
Explanation : If the animal dies in the first year of the Policy, the premium
@ 2.25% should be deducted from the total premium paid by the insured i.e.,
4.80% for the purpose of adjustment. Similarly, if the animal dies during the
second year of the policy, full premium @ 2.25% for two years should be deducted.
Since no premium will be left for adjustment if the animal dies during the third
year of the policy, there is no question of any adjustment of premium.
(iii) Age limit should be as per Para 2 above.

154
6. INSURANCE COVERAGE
Underwriting offices shall use standard policy wordings for Cattle Insurance as per
the existing specimen clause. The policy shall give indemnity only for death due to :-
a) Accident (Inclusive of fire, lightning, flood, inundation, storm, hurricane, earthquake,
cyclone, tornado, tempest and famine ).
b) Diseases contracted or occurring during the period of this policy.
c) Surgical Operations.
d) Riot and Strike.
The Policy can also be extended to cover PTD on payment of extra premium ;
i) Permanent Total Disability which, in the case of Milch Cattle results in permanent
and total incapacity to conceive or yield milk.
ii) PTD which in the case of Stud Bulls results in permanent and total incapacity for
breeding purpose.
iii) PTD in case of Bullocks, Calves / Heifers and Castrated male buffaloes results in
permanent and total incapacity for the purpose of use mentioned in the proposal
form.
TRANSIT COVER
(a) For Scheme animals, No extra premium to be charged for transit of animal from
the place of purchase to the place of stabling. For non-scheme animals, the distance
is not exceeding 80 kms.
(b) In case of transfer of animal during currency of policy, transit cover can be extended
to the new owner without any additional premium in case the transit is within
80 kms.
(c) In case the transit is for more than 80 kms, an additional premium of 1% shall be
charged and such transit shall only be by road or rail and not by foot.
7. EXCLUSIONS
(A) COMMON EXCLUSIONS :
i) Malicious or willful injury or neglect, overloading, unskillful treatment or use of
animal for purpose other than stated in the policy without the consent of the
Company in writing.
ii) Accidents occurring and /or Disease contracted prior to commencement of risk.
iii) Intentional slaughter of the animal except in cases where destruction is
necessary to terminate incurable suffering on humane consideration on the
basis of certificate issued by qualified Veterinarian or in cases where destruction
is resorted to by the order of lawfully constituted authority.
iv) Theft and clandestine sale of the insured animal.
v) War, invasion, act of foreign enemy, hostilities (whether war be declared or not),
civil war, rebellion, revolution, insurrection, mutiny, tumult, military or usurped
power or any consequences thereof or attempt threat.
vi) Any accident, loss, destruction, damage or legal liability directly or indirectly
caused by or contributed to by or arising from nuclear weapons.
vii) Consequential loss of whatsoever nature.
viii) Transport by air and sea.
ix) Any non-scheme claim arising due to diseases contracted within 15 days
from the date of commencement of risk are not covered.
155
(B) SPECIFIC EXCLUSIONS :
i) Pleuropneumonia in respect of Cattle in Lakhimpur and Sibasagar Districts and
newly carved out districts out of these two districts of Assam.
i) All the claims received without ear tag.
8. ADDITIONAL POLICY CONDITIONS
(i) The provision of 15 days waiting period should be included as policy condition
No. 8. The wording may be as under
“The Company is not liable to pay the claim in the event of death of insured
animal due to disease occurring within 15 days from the commencement of
risk .”
(ii) The provision of No Tag No Claim should be included as policy condition No. 9.
The wording may be as under :
“In the event of death of animal/s covered under the policy, claim/s shall not
be entertained unless the ear tag/s are surrendered to the Company. In the
event of loss of ear tag/s, it is the responsibility of the Insured to give
immediate notice to the Company and get the animal retagged.”
9. VETERINARY EXAMINATION
a) The report of a qualified Veterinarian giving the age, identification marks, health
of the cattle must be obtained for each proposal. Such Certificate should be
obtained in the prescribed format duly filled in all respects.
b) Wherever qualified Veterinarians are not available, the underwriting office with HO
approval may accept Certificate of Health issued by Livestock Inspectors who are
diploma holders. Such certificates will be valid for acceptance of proposals only.
c) Fresh Veterinary Examination is not necessary for renewal of Cattle Insurance
Policy if renewal is made on or before the date of expiry of the policy provided the
animal is within insurable age.
d) Insurers may pay the Veterinarian a fee of Rs.15/- and Rs.5/- towards
examination and tagging per large animal of the proposal which has been
accepted by the insurer. No Veterinary examination fees and Tagging
charges are payable for scheme animals.
e) As regards Veterinary examination fees following the death of animals or for post
mortem if required, the same will be payable by the insurer. If qualified Veterinarians
are not available in the area concerned for certifying cause of death, the insurer may
make suitable alternate arrangements at their discretion. The maximum fees payable
may be as under. Ensure that post-mortem is conducted and report obtained before
payment of fees.
Schedule of Fees
a For issue of Death Certificate Rs. 20/- per animal
b For conducting post-mortem examination Rs. 75/- per animal
and preparing report
(i) A panel of Vet. Doctors / Investigators should be made by Regional Offices and their
services can be utilised at the time of acceptance of risk, settlement of claims and
for investigation purpose.
(ii) The performance of Vet. Doctors, investigators should be evaluated through
appraisal form on half yearly basis by the Regional Offices.
156
(iii) The scale of fees payable to Veterinary Doctors for investigation of claims/
Professional advice will be
Professional fees per claim for technical advice Rs. 100/-
Daily Allowance payable per day Rs. 100/-
Professional fees for spot investigation per claim Rs. 150/-
st
Conveyance – Actual 1 class fare by rail if journey
Undertaken by Rail otherwise conveyance as
applicable for two-wheelers or actual bus fare
For full investigation of individual cattle claim Rs. 200/- and Rs. 100/-
for additional claim in the
same locality, if given
together.
10. IDENTIFICATION OF ANIMAL
All insured animals should be suitably identified by one or more of the following
methods :
(a) Ear tag made of suitable material may be used. The cost of ear-tags and tagging
charges will be borne by the Insurer.
(b) Natural Identification marks and color should be clearly noted in the proposal
form and Veterinarian’s Report.
(c) Photographs of animals may be insisted in case of high value animal.
Tagging Charges
(i) Since Veterinarian fees is inclusive of tagging charges, no further tagging charges
are required to be paid.
(ii) Re- tagging charges of Rs10/- per large animal.
11. TRANSFER OF INTEREST
Provided previous notice in writing is given to the Company, a Policy may be transferred
to an approved new owner or to cover a new (another) animal which is subject to
adjustment of premium on a pro-rata basis and requirements such as ear tag and
health certificate. Transfer fee of Rs 15 should be collected.
12. CLAIM PROCEDURE Non-Scheme Animals
In the event of death of an animal, immediate intimation should be sent to the Insurers
and the following requirements should be furnished :
(a) Duly completed claim form.
(b) Death Certificate obtained from qualified Veterinarian on Company’s form. (c)
Postmortem examination report.
(d) Ear Tag applied to the animal should be surrendered. The underwriting Offices
should follow the principle of ‘ No Tag- No claim’. Generally claim should not be
paid if tag is not submitted. However, in cases of genuine hardship, the higher
Competent Authority may consider the claim if the identity of animal is established.
(e) The value of the animal should be established properly keeping in view of age,
etc.
Scheme Animals.
Information of loss/death of animal should be given to the Company or Financing
Bank immediately, within 7 days. Claimant has to furnish the following requirements
within 30 days.
157
(a) Duly completed and signed claim form along with ear tag.
(b) Certification of death from Veterinary Surgeon or a Certificate jointly by any two of
the following :
i) Sarpanch of the village.
ii) President or any other Officer of Co-op. Credit Society
iii) Official of the Milk Collection Centre.
iv) Supervisor/ Inspector/ Officer of any Banking or Credit Institution (other than
the financing Bank).
v) DRDA or its authorised nominee.
vi) Secretary and Vice President of Panchayat.
vii) Village Revenue Officer / Village Accountant.
viii) Headmaster of a primary school.
Subject to their declaration that they have seen the carcass and Ear Tag intact
in the ear mentioning number thereof.
(c) Post-mortem report, if conducted.
Claim Procedure For PTD Claim
(a) A certificate from the qualified Veterinarian to be obtained.
(b) The animal should be inspected by our Veterinary Officer also.
(c) Complete chart of treatment, medicines used, receipts, etc., should be collected.
(The U/W office may engage an independent qualified Veterinarian or another
investigator in special circumstances).
(d) Admissibility of claim to be considered after two months of obtaining Veterinary
Doctor / Company Doctor’s report. The Company’s Veterinarian should
examine the animal and confirm PTD, before settlement of the claim.
(e) The indemnity is limited to 75% of Sum Insured.
13. SALVAGE
No salvage will be deducted from claims.
1.1 CALF / HEIFER REARING INSURANCE SCHEME FOR SCHEME / NON –
SCHEME BENEFICIARIES
1. The Offices may implement this Scheme with caution and separate statistics
may be maintained for review of the Scheme.
2. The Sum insured is only indicative and depending on local market conditions,
it can be altered. Proportionate premium amount may be charged using the
method given below.
3. The minimum period of coverage should not be less than 12 months.
4. In case of Non-Scheme animals, the premium rate would be @ of 4% and
accordingly, the premium amount should be computed. The premium rate for
Scheme animals would be @ 2.25%.
5. The premium amount is computed from 1 day to 32 months. For example : In
respect of Scheme animals, the premium is Rs. 207.00 for 32 months and for
Non-Scheme animals, the premium is Rs. 368.00 for 32 months as per
enclosed Table.
158
6. The formulae adopted for calculation of premium is as under
Scheme Non - Scheme
Animals Animals
Add : The aggregate sum insured
from 1 day to 32 months = Rs 1,10,450.00 1,10,450.00
Average Sum Insured for = Rs 3,451.60 3,451.60
32 months or 3452.00 or 3452.00
Apply premium rate on = Rs 3,452 x 2.25 3,452 x 4.00
Average amount 77.65 138.08
Average for One month = Rs 77.66 / 138.08 /
126.47 1211.50
Premium for 32 months = Rs 6.47 x 32 11.50 x 32
207.00 368.00
If the cover is given from 6 months onwards, the sum insured for earlier
months is excluded from aggregate sum insured while calculating the premium.
7. The Scope of cover and exclusions are as per Standard Cattle Insurance Policy.
8. The Claim procedure will be same as under Cattle Insurance Policy.
As far as Buffalo Calves are concerned, no changes have been made in the
existing scheme.
CALF REARING SCHEME VALUATION CHART FROM 1 TO 32 MONTHS
Age at the Amount Payable in the event Premium Schedule to be
commencement of death during collected (Rs.)
of Insurance corresponding month
Scheme Non-Scheme
Animals Animals
1 day to 1 month 150 207 368
1 to 2 months 200 207 368
2 – 3 months 300 206 367
3 – 4 months 400 206 366
4 – 5 months 600 205 365
5 – 6 months 800 204 363
6 – 7 months 1000 203 360
7 – 8 months 1200 201 357
8 – 9 months 1400 198 353
9 – 10 months 1600 196 348
10 – 11 months 1800 193 343
11– 12 months 2000 189 337
12 – 13 months 2300 186 330
13 – 14 months 2550 181 322

159
14 – 15 months 2800 177 314
15 – 16 months 3050 171 305
16 – 17 months 3300 166 294
17 – 18 months 3600 159 283
18– 19 months 3900 153 271
19 – 20 months 4200 145 258
20 – 21 months 4500 137 244
21 – 22 months 4800 129 229
22 – 23 months 5100 120 213
23 – 24 months 5400 110 196
24 – 25 months 5700 100 178
25 – 26 months 6000 90 159
26 – 27 months 6300 78 139
27 – 28 months 6600 67 118
28 – 29 months 6900 54 96
29 – 30 months 7100 41 73
30 – 31 months 7400 28 50
31 – 32 months 7500 14 25
VALUATION TABLE FOR BUFFALO CALVES
AGE Valuation For
sum insured
4 days to 1 month Rs 125/- PREMIUM @ RS.145 /-
2nd month Rs 175/- PER BUFFALO CALF
3rd month Rs 200/- FOR THE ENTIRE PERIOD
4th month Rs 250/- FROM 4 DAYS TO
5th month Rs 325/- 45 MONTHS
6th month Rs 400/-
7th month to 12th month Rs 850/-
13th month to 24th month Rs 1500/-
25th month to 36th month Rs 2000/-
37th month to 45th month Rs 3000/-
1.2 FOETUS (UNBORN CALF) INSURANCE SCHEME
This cover can be granted as a separate policy in addition to Cattle Insurance Policy.
SCOPE
The Scheme covers the risk of death of embryo / foetus due to accident or disease
contracted through the recipient or directly from external source. The Scheme
is applicable to both the embryo transferred from a selected donor to the
160
synchronized recipient or frozen embryo transferred to the recipient and also
the embryo / foetus developed by artificial insemination technique. The embryo /
foetus in the uterus of the recipient /mother cow can be covered as a separate policy
in addition to cattle insurance policy covering the recipient / mother cow / buffalo.
PERIOD OF COVER
The cover commences from the 60th day of the transfer of live quality embryo /
successful insemination subject to production of confirmed pregnancy certificate from
a qualified Veterinary Surgeon particularly the specialist in the field. The cover
terminates on 220 (+/-5) days for cow from the date of confirmation of pregnancy or
on the date of calving whichever is earlier. For the recipient /mother cow the period of
insurance is annual similar to standard cattle insurance policy.
PERILS COVERED
1. Still births (If calf has not survived)
2. Abortion of all kinds except otherwise it is proved to be a malafide or induced
abortion by the insured. Malafide or induced abortion caused by a third party falls
within the scope of cover.
3. Accidental Risks – damages caused due to external violent and visible means
including transportation by Road / Rail.
4. Induced abortion carried out under Veterinary advice to save the mother in
conditions like downer cow syndrome, prolapse of uterus, torsion of uterus, fracture
of limbs.
SUM INSURED / VALUATION TABLE
The valuation table is arrived on the basis of input cost, which includes cost of semen
/cost of embryo and cost of medicines used for maintenance of pregnancy.
(i) EMBRYO / FOETUS
Age of the Foetus Through E.T. Technology Rs. Through A.I. Rs.
60 days 1000/- 500/-
61 – 90 days 1100/- 600/-
91 – 120 days 1200/- 700/-
121 – 150 days 1300/- 800/-
151 – 180 days 1400/- 900/-
181 – 210 days 1500/- 1000/-
211 – 240 days 1650/- 1100/-
241 – 270 days 1800/- 1200/-
271 – and above 2000/- 1500/-
(ii) RECIPIENT / MOTHER COW
Market value certified by the Veterinary doctor or sum insured whichever is lower.
PREMIUM
(i) Embryo / Foetus : Rs. 75/- (net) irrespective of the stage of pregnancy
under artificial insemination method. Rs. 100/- (net) in case of embryo
transplants method.
161
(ii) Recipient / Mother Cow: The rate is as per the Cattle Insurance Scheme in
force.
EXCLUSIONS
1. Poor quality of embryo
The cover shall operate only if the embryo is supplied by the main Embryo
Bio–technology (Transfer) Laboratory at Sabarmathy Ashram, Gowshala in
Ahmedabad, 4 Regional Centres at Hassarghatta, Nashik, Salon
Nakarikallu and 25 State Centres in various States set up by NDDB or
embryos produced from reputed centres approved by insurers from time to
time, for example: Raymonds Embryo Research Centre, Bilaspur, Madhya
Pradesh .
2. Unskillful handling of embryo
The embr yo transfer carried out by a qualified Veterinarian who has
undergone special training for embryo transfer technique only shall be covered
by this policy. The qualification and training particulars of the person transferring
the embryo to be shown in the proposal.
3. Unskillful and mishandling of foetus at any stage of pregnancy.
4. Malicious act leading to death, still birth or abortion of foetus by the insured.
5. Abortion /Still birth arising out of negligent /careless act of any person attending
on to the health care of pregnant animal.
6. Death or ejection of embryo / foetus due to administration of steroids /or due
to vaccination which are contra indicated.
CERTIFICATION OF PREGNANCY OF ANIMAL
Since the confirmation of pregnancy is a very vital factor, strict adherence of this
condition of obtaining pregnancy certificate as a documentary evidence, is
necessary at the time of proposal. Also all the insemination receipts /embryo
transfer receipt should be strictly produced along with proposal to correctly assess
the age of the embryo / foetus .
All other terms and conditions of the standard cattle insurance policy holds good.
The insured should intimate claim if any within 24 hours to Insurance Company.

162
POULTRY INSURANCE
A. COMPREHENSIVE COVER FOR POULTRY FARMS
1. SCOPE
The Scheme provides rates, terms and conditions to underwrite Poultry Insurance
Business in India. The word ‘Poultry’ refers to (a) layers (b) broilers (c) parent
stock (Hatchery) which are exotic and cross-bred. Indigenous and non-descript
birds will not be insured. Hereafter, only Comprehensive cover and Parent
Stock (Hatchery) cover are available.
Note :
(a) Exotic bird means whose parents are of foreign breed, which includes birds
born in India as well as those born abroad.
(b) A cross-bred bird for the insurance purpose means one of whose parents is
of foreign breed.
(c) Proposals in respect of birds other than the above do not fall within the
preview of this scheme.
2. APPLICABILITY
A. The Scheme is applicable to poultry farms consisting of all types of exotic and
cross-bred poultry birds in India.
B. All birds in a farm should be covered. After issuing policy, if additional birds
are introduced in the farm, immediate notice to be given to insurer otherwise
claim will be repudiated.
C. The scheme is applicable to poultry farms consisting of minimum number of
birds as follows :
(i) Under Bank finance (for all types of birds) Scheme :
100 (Or as per IRDP norms) Non-Scheme 500
(ii) General :
(a) Broilers 100 per batch
(b) Layers 500 per batch
(c) Hatchery 2000 birds per batch
3. AGE GROUP
Broilers (i) 1 day to 8 weeks
(ii) 1 day to 6 weeks
Layers (iii) 1 day to 20 weeks
(iv) 21 weeks to 72 weeks
(v) 1 day to 72 weeks
Hatchery Birds (Parent Stock) 1 day to 72 weeks

163
4. PREMIUM RATES
SCHEME NON-SCHEME ANNUAL
(NET) (GROSS) PREMIUM
A Broilers1 day Rs. 0.25 per bird per
to 8 weeks batch(net) or 1.5% 6.00%
1 day to 6 weeks Rs. 1.00 per bird
p.a. (net) 1.20% 4.80%
B Layers1 day to
20 weeks * 3.20 %
21 weeks to 72 weeks * 3.50%
1 day to 72 weeks * 5.50%
*(1 day to 72 weeks) Rs. 0.80 net
per bird)
C Parent Stock (Hatchery) 5%
Note :
i) The premium will be charged on Peak Value of birds in each of the above
categories
ii) Minimum value for Parent Stock bird should be Rs. 200/- (Negotiable).
iii) For Scheme (for layers and broilers only) following table and short period
rates may be used :
Period in Maximum value Period in Weeks Maximum value
Weeks payable as per payable as per
SCHEME Chart SCHEME Chart
Layers Rs. Broilers Rs. Layers Rs.
1 day old 5.00 5.00 15th week 15.00
1st week 6.00 6.00 16th week 16.00
2nd week 6.50 6.50 17th week 17.00
3rd week 7.00 7.00 18th week 18.00
4th week 7.50 7.50 19th week 19.00
5th week 8.00 8.00 20th week 20.00
6th week 8.50 10.50 21st week 21.00
7th week 9.00 12.00 22nd week 22.00
8th week 10.00 15.00 23rd week 23.00
9th week 10.50 24th to 37th week 25.00
10th week 11.00 38th to 45th week 23.00
11th week 11.50 46th to 52nd week 22.00
12th week 12.50 53rd to 62nd week 20.00
13th week 13.50 63rd to72nd week 18.00
14th week 14.50
164
SHORT PERIOD RATES
Upto 2nd week 1/8th of premium of full period of insurance
Upto 3rd month 1/4th of premium of full period of insurance
Upto 5th month 1/2of premium of full period of insurance
Upto 6th month 5/8th of premium of full period of insurance
Upto 8th month 3/4th of premium of full period of insurance
Upto 10th month 7/8th of premium of full period of insurance
Above 10 months Full premium
iv) Since there is no standard valuation chart and multiplier factor for Parent
Stock Birds (Hatchery), the valuation chart has to be finalised in consultation
with Hatchery.
5. SUM INSURED
(a) Non-IRDP IRDP
For layers maximum S.I. Rs. 75/- Rs. 25/-
For Broilers maximum S.I. Rs. 45/- Rs. 15/-
(b) Valuation Table :
(i) Any revision in Valuation Chart to be effected should be approved by the Head
Office.
(ii) Valuation chart will be worked out on the basis of multiplier factor given in the
formula as shown hereunder:
FORMULA FOR DETERMINING VALUATION CHART FOR BROILERS
Following multiplier should be applied while calculating week wise valuation :
Weeks Multiplying Factor Weeks Multiplying Factor
1 0.160 5 1.962
2 0.336 6 2.882
3 0.709 7 3.815
4 1.270 8 4.750
The multiplier is to be applied to the prevailing feed cost and day old chick cost should
be added to arrive at week wise valuation.
ILLUSTRATION (ASSUMPTION)
A day old chick cost Rs. 12.65
Feed cost Rs. 7.00 per kg.

165
Week wise valuation will be arrived as follows (1 day to 8 weeks)
Week Multiplier x Feed cost + Chick cost = Total (Rs.) Rounded to (Rs.)
1 0.160 x 7.00 12.65 = 13.77 14.00
2 0.336 x 7.00 12.65 = 15.00 15.00
3 0.709 x 7.00 12.65 = 17.613 18.00
4 1.270 x 7.00 12.65 = 21.54 22.00
5 1.962 x 7.00 12.65 = 26.384 26.00
6 2.882 x 7.00 12.65 = 32.824 33.00
7 3.815 x 7.00 12.65 = 39.355 39.00
8 4.750 x 7.00 12.65 = 45.9 45.00
Week wise valuation chart for broilers 1 day to 6 weeks
WEEK VALUATION
1 14.00
2 19.00
3 24.00
4 31.00
5 38.00
6 45.00
Formula for Determining Valuation Chart for Layer Birds
Week Multiplier Week Multiplier Week Multiplier
1 0.07 11 3.398 21 8.566
2 0.234 12 3.913 22 9.293
3 0.447 13 4.435 23 9.544
4 0.870 14 4.978 24-37 10.200
5 1.120 15 5.523 38-45 7.285
6 1.560 16 6.000 46-52 5.693
7 2.030 17 6.500 53-62 5.523
8 2.560 18 6.925 63-72 4.92
9 2.98 19 7.535
10 3.334 20 8.170
The multiplier is to be applied to the prevailing feed cost and day old chick cost should
be added to arrive at week wise valuation.
Illustration
Assumption :
1. A day old chick cost Rs. 14.60
2. Chick mash cost Rs. 6.50 per kg.
3. Grower and Layer mash cost Rs. 6.00 per kg.
166
The valuations will be arrived as follows :
Week Multiplier x Feed Cost + Chick Cost = Total (Rs.) Rounded to (Rs.)
1 0.070 x 6.50 + 14.60 = 15.055 15.00
2 0.234 x 6.50 + 14.60 = 16.121 16.00
3 0.447 x 6.50 + 14.60 = 17.055 17.00
4 0.870 x 6.50 + 14.60 = 20.255 20.00
5 1.120 x 6.50 + 14.60 = 21.88 22.00
6 1.560 x 6.50 + 14.60 = 24.74 25.00
7 2.030 x 6.50 + 14.60 = 27.795 28.00
8 2.560 x 6.50 + 14.60 = 31.24 31.00
9 2.980 x 6.50 + 14.60 = 33.97 34.00
10 3.334 x 6.50 + 14.60 = 36.271 36.00
11 3.398 x 6.50 + 14.60 = 36.687 37.00
12 3.918 x 6.50 + 14.60 = 40.0345 40.00
13 4.435 x 6.50 + 14.60 = 43.4275 43.00
14 4.978 x 6.50 + 14.60 = 46.957 47.00
15 5.523 x 6.50 + 14.60 = 50.4995 50.00
16 6.000 x 6.50 + 14.60 = 53.60 54.00
17 6.500 x 6.50 + 14.60 = 56.85 57.00
18 6.925 x 6.50 + 14.60 = 59.6125 59.00
19 7.535 x 6.00 + 14.60 = 59.81 60.00
20 8.170 x 6.00 + 14.60 = 63.62 64.00
21 8.566 x 6.00 + 14.60 = 65.996 66.00
22 9.293 x 6.00 + 14.60 = 70.358 70.00
23 9.544 x 6.00 + 14.60 = 71.864 72.00
24-37 10.200 x 6.00 + 14.60 = 75.80 75.00
38-45 7.285 x 6.00 + 14.60 = 58.31 58.00
46-52 5.793 x 6.00 + 14.60 = 49.358 49.00
53-62 5.523 x 6.00 + 14.60 = 47.738 48.00
63-72 4.920 x 6.00 + 14.60 = 44.12 44.00
6. INSURANCE COVERAGE
Standard Policy wordings for Poultry Insurance shall be used as per the existing
clause. The Policy shall provide indemnity against death of birds due to accident
(including fire, lightning, flood, cyclone, storm, tempest, earthquake, strike, riot, act of
terrorism) or diseases contracted or occurring during the period of insurance subject
to the following exclusions.
7. EXCLUSIONS
(a) Malicious / willful injury, neglect.
(b) Transit by any mode of transport.
167
(c) Improper management (including over crowding) i.e. when the farm is not run on
scientific poultry management guidelines and standards laid down by Poultry
Corporations/ Animal Husbandry Department in regard to housekeeping,
watering, feeding, vaccination, deworming, debeaking, lighting/ heating, culling
etc.
(d) Loss / death due to natural mortality, non-specified or unknown diseases or
reasons.
(e) Undergrowth, cannibalism, action of predators like preying birds and carnivorous
animal.
(f) Theft and clandestine sale of birds.
(g) Intentional slaughter of the birds except in cases where destruction is necessary
to terminate incurable suffering on humane consideration and to protect remaining
healthy flock to reduce additional losses on the basis of certificate issued by
qualified Vet. Surgeon or in cases where destruction is resorted to by order of
lawfully constituted authority, under intimation to Insurance Company.
(h) Consequential loss however caused.
(i) Permanent and partial disablement of any nature.
(j) Loss of production i.e. the failure due to any reasons whatsoever to lay required
number of eggs or small sized eggs in layers or to attain proper weight at a particular
age in Broilers.
(k) Marek’s disease, Ranikhet disease, Fowl Pox and Infectious Bronchitis. These
diseases are covered by the policy if the birds are successfully inoculated against
these diseases and the necessary veterinary certificate to that effect is supplied
to the company. Coccidiosis and other diseases are covered only if preventive
and curative measures are taken from time to time.
(l) Malnutrition/ shortage of water, death due to starvation because of non supply
of feed to birds or similar reasons of whatsoever nature.
(m)Undergrowth.
(n) Cannibalism
(o) Loss due to huddling and / or piling of birds.
(p) Avian Leucosis Complex (A.L.C.)
(q) War, invasion, act of foreign enemy, hostilities (whether war be declared or not),
civil war, rebellion, revolution, insurrection, mutiny, tumult, military or usurped
power or any consequences thereof or attempt threat.
(r) Any accident, loss, destruction, damage or legal liability directly or indirectly caused
by or contributed or arising from nuclear weapons.
8. VETERINARY EXAMINATION
i) A Veterinary Certificate from a qualified Veterinarian or the Consultant Veterinarian
of the Insured is necessary.
ii) In case of layer farms having more than 5000 birds inspection of the farm should
preferably be done by Company’s Vet. Officer or Panel Doctor.
iii) Veterinary Health / Examination fees should be borne by the Insurer as per the
168
following chart which would be payable to Panel Doctor only.
No. of Birds Amount (Rs.)
100 to 500 25
501 to 1000 30
1001 to 5000 40
5001 onwards 50
iv) No Vet. Fees is payable for proposals under scheme birds.
v) The Insurer reserves the right to check periodically and depute for the purpose
thereof any representative.
9. DISCOUNTS
(a) No Claim Discount
No claim after completion of 1 year 15% discount on premium
No claim after completion of 2 years 20% discount on premium
No claim after completion of 3 years 25% discount on premium
(For above discount in case of layers 1 year means policy period).
(b) Good features discount : This discount not exceeding 5% may be allowed if the
farm is having any five good features listed below :
i) Farms having Resident / own Veterinary Officer or Farms managed by
Veterinary Doctors.
ii) Farms with layer flock size of 10,000 per batch and above. Farms with broiler
flock size of 5,000 per batch and above.
iii) Farms having good dead birds disposal system i.e. farms with incinerator.
iv) Farms with standard layout such as good distance between sheds, fencing,
wind breaker trees etc.
iv) Farms with sophisticated equipment i.e. farms with automatic feeders, waterers,
etc.
v) Farms with mortality of less than 5% in previous batch.
vii) Presence of thermo regulators to control temperature and humidity.
Note : The above good features should be certified by a Company’s representative.
10. IMPORTANT UNDERWRITING CONDITIONS:
(a) All birds in the farm / shed should be insured.
(b) Poultry farm should have Veterinary facility of their own or on Consultancy basis.
(c) Proper balanced standard food, water and light should be supplied to birds.
(d) Debeaking and deworming should be carried out regularly and record to that
effect has to be maintained.
(e) The minimum number of birds prescribed have to be maintained and all the birds
should be covered on flock basis, thus no identification is necessary.
(f) Proposer must keep all the essential records as mentioned below at the
farm.
i) Flock record on day to day basis – Daily stock register.
ii) Mortality record
iii) Culling
iv) Vaccination and Inoculation particulars
169
v) Feed Consumption.
vi) Production
vii) Debeaking
viii) Incidence of diseases (PM records)
ix) Purchase and Sales.
(g) The farms should not resort to replacement of chicks in the affected sheds i.e.
after claim is reported due to diseases / any other reason.
(h) Answers to all the questions in the proposal form and health certificate should be
properly answered without any blank. (Proposal should have a provision confirming
that all the birds in different sheds in the farm are covered.)
(i) Any change of birds should be informed immediately to the concerned office and
new birds being added into the batch should pass through the Vet. Examination.
(j) Transfer of interest / ownership is not allowed.
(k) The cages must be maintained properly and of normal standard.
11. PROCEDURE FOR CLAIM SETTLEMENT
(a) Admissibility of the Claim
Excess clause : Claim under the policy would be admissible only if the
mortality due to insured peril in the flock exceeds beyond the excess limit
given below :
Mortality
Broilers1 day old to 8 weeks (6 weeks) 5% of population in each batch
Layers1 day old to 8 weeks 5% of population in each batch at
the inception of the policy.
9th week to 20th week 3% of total population at the
beginning of 9th week
21st week to 72 weeks 1% of total population at the
beginning of 21st week and
then every month.
(Excess is not to be applied on cumulative basis).
N.B. Application of excess clauses for Broilers is illustrated below
If the farmer has got 100 birds per batch and following is a week wise mortality
chart the excess will be applied as under :
Week Mortality Week wiseValuation (Rs.) Total value of birds lost
1 2 14 28
2 5 15 75
3 1 18 18
4 2 22 44
5 1 26 26
6 4 33 132
7 2 39 78
Total 17 167 401

170
Average value of each bird = Total value of birds lost
No. of birds lost (Mortality)
= 401/17
Now 5% of 100 birds = Rs. 23.595 birds
Hence the excess of Rs 23.59 x 5 = 117.95 will be deducted from total
amount payable. Thus the excess of 5% will be deducted on average valuation
arrived on the basis of mortality chart presented rather than on the basis of
first 5% birds week-wise.
Compensation towards loss of birds will be made only for death of birds
exceeding the mortality percentage given above.
(b) Liability of the Company : The Insured will be indemnified for 80% of the value of
the birds at the time of death as per valuation table or actual value as decided by
the Veterinary Surgeon before admissibility of claim whichever is less. 20%
additional excess for Gumboro disease.
12. CLAIMS PROCEDURE
(i) In the event of death of birds immediate intimation should be given to the Company
and the Insurer should be supplied with the following documents and required
information :
a) Duly filled in claim form.
b) Vet. P.M. Report for sample birds.
c) Daily records of mortality, feeding etc.
d) Purchase invoices for the birds.
e) Any other point to substantiate the loss like photographs, medical bills, etc.
as and when required.
(ii) In case of alarming death/outbreak of epidemic nature immediate notice
within 12 hours should be given to the Company and all birds should be
segregated and produced to the representative of the Company or to any
person authorised by the Company for inspection.
(iii) Daily mortality details should be sent to the Company on weekly basis
failing which report will be treated as nil for that particular week.
(iv) Delay in reporting of the claim should be avoided and if there is delay for
more than three days the claim would be treated as non-standard.
(v) In case of doubtful claims/ farms for which claim ratio is adverse, Technical
Report from an expert may be insisted for settlement of claim.
13. SALVAGE
During the outbreak of epidemic/ natural calamities in the farm, insured should arrange
emergency sale of live birds in the presence of the representative of the insurance
company in order to avert or minimise the loss. In case the insured realises the value
less than the valuation table agreed upon for the corresponding week then the difference
will be paid to the insured in addition to the cost of dead birds as per terms and
conditions of the policy.
14. STANDARD FORMS
i) Proposal Form
ii) Veterinary Certificate for acceptance of risk (Fitness Certificate)
iii) Claim Form.
iv) Veterinary Certificate to be submitted during claim (Death Certificate and Post
Mortem Report).
171
DOG INSURANCE
1. SCOPE OF SCHEME
Dogs are insured against death due to accident and/or diseases contracted during the
period of insurance subject to usual terms, conditions and exclusions of the policy.
2. AGE GROUP
8 weeks to 8 years. Not to be insured when age is less than 8 weeks and more than
10 years.
3. BREED
Dogs of indigenous origin, cross-bred and exotic breeds are covered under the
scheme. For insuring Exotic and Police Security dogs, prior sanction of H.O. is
necessary.
4. VALUATION
Valuation to be done by qualified Veterinary Doctor at the time of proposing the
insurance.
Note: Authority to accept Dog Insurance up to Rs.50.000/- per dog is vested with
Regional Offices only. If value exceeds Rs.50.000/-, prior approval should be obtained
from Head Office.
5. IDENTIFICATION
Insured dogs must be suitably identified by one of the following methods :
a) Tattooing
b) Nose Print
c) Photograph
Normal identification marks and breed, sex, age etc., should be clearly described in
the Veterinary Certificate. Cost of identification is to be borne by Insured only. Detailed
pedigree record, kennel club record may be obtained along with Vet. Certificate.
6. RATING
5% Of Sum Insured
7. EXCLUSIONS
(a) Common Exclusions: As per Cattle Insurance Scheme item 7 (A)
(b) Specific Exclusions:
(i) Death due to diseases such as Distemper, Rabies, Viral Hepatitis ,
Leptospirosis,
Viral enteritis. These diseases are covered only if the dogs have
been successfully vaccinated and a Veterinary Certificate to that effect is
produced.
(ii) Diseases contracted prior to and within 15 days of commencement of risk.
(iii) Transport, show risk, breeding and whelping risk, third party personal injury
unless additional premium is paid
8. CLAIMS
Company to bear 80% of the claim amount and Insured to bear 20% of the claim
amount which would be ascertained on the basis of Market Value as certified by
Veterinary Doctor or Insured Value whichever is less.
9. CLAIMS DOCUMENTS
(i) Duly completed claim form.
(ii) Veterinary Certificate for death on Company’s form.
172
(iii) Post Mortem report on standard P.M. form.
(iv) Photograph or any other document, if necessary.
10. SALVAGE
In the event of death of the insured dog, any amount received or receivable by the
Insured from third parties and the value of the salvage recovered, if any, would be
deducted from the claim amount.
11. EXTENSION OF POLICY
The policy may be extended as per following Sections, and the proposer may choose
to cover risks under any Section by payment of extra premium
Rate of Extra
Premium
Section (1)
Death by accident in transit by air, rail, road and water,
and show risk 0.5%
Section (2)
Death by accidental poisoning 1.0%
Section (3) Breeding Risk
a) Death by whelping
b) Loss of litter in case the whole litter is stillborn or dies
within 14 days of birth : 0.5%2.0%
Section (4)
Lost or stolen dogs (Including burglary or house breaking) 2.0%
Section (5)
Loss of show entry fees (limit Rs. 250/-) when the dog which
is registered with the Kennel Club is unable to attend the show
because of accident or disease covered by the policy. 0.25%
Section (6)
Loss of value (Limit one half of Sum Insured) resultant upon
an accident which does not result in death but which averts
its show career. 0.5%
Section (7)
Liability for personal injuries and damage to property
(Including animals, poultry) of third parties up to Rs. 5000/-. 1.0%
Note : Liability to members of the Insured’s family or employees is excluded.
Veterinary Surgeon’s fees may be included, when incurred in a successful attempt to
save the life of a dog.
Section (8)
WORLD WIDE TRANSIT CLAUSE @ 2%
This covers transit to various parts of the world and back to India and/or from other
countries to India.
a) Risk of death from any cause (except whelping) but with liberty to be kenneled on
checking.
b) Cover to commence 24 hours after arrival at ultimate destination or until previous
arrivals in quarantine.
Note : All certificates of vaccinations should be produced before leaving the country.
All other terms and conditions as per cattle insurance.
173
INLAND FISH INSURANCE
1. APPLICABILITY
The scheme is applicable to fish farms consisting of fry / fishlings /fingerlings / fish
in stock ponds / breeders etc. in the Pond and Fresh Water Projects. This scheme is
not applicable to Brackish-water and Marine Fisheries. All fish in a farm are to be
covered.
2. BREED
All kinds of fish reared in Fish farms/tanks are coverable (e.g. Rohu, Katla, Mrigal
etc.).
3. AGE GROUP
From stage of fish seed, fingerlings / fry to the stage when fish is ready for catch or
harvest.
4. PERIOD OF COVER
(A) Rearing ponds - fry to fingerling : 3 months period in rearing pond.
(B) Fingerling to fish state : 12 months period in stock ponds.
(C) Breeders age 1 year to 5 years : 12 months
(i) If it is offered for insurance at 400 grams stage insurance period should be
17 fortnights.
(ii) If offered at 600 grams stage insurance period should be 13 fortnights.
5. VALUATION
(a) There is no fixed Sum Insured under this policy because value of fish changes
from stage of seed (fishlings / fingerlings / fry) to the stage of catch / harvest
(adult fish / fish is ready for market).
(b) The following should be taken into consideration while determining the valuation
of fish :
(i) Cost of input.
(ii) Cost of seed / fry / fishlings / fingerlings.
(iii) Other incidental expenses.
(iv) Natural mortality of any kind should be excluded in each stage. It has been
observed that in each stage mortality is about 60% to 70% (If fingerlings seed
left in the fish tank then only 30% to 40% adult fishes will be harvested).
c) Profit should not be included while assessing the valuation of fish.
6. RATING
a) 3.4 % gross per annum on peak value of fish for non-subsidised project.
b) For scheme through FFDA and other similar schemes premium is to be
charged@ 2.90 % net.
c) Minimum premium Rs.30.00
Note : Policy can be extended to cover fish rearing ponds / bunds against fire,
lightning, riot, storm, tempest, flood, malicious damage, explosion, earthquake
and Aircraft damage subject to payment of additional premium of 0.5% of the
value of the ponds in non-flood prone areas and 1% in flood prone areas.
174
7. CERTIFICATES AND VALUATION FEE
(a) Value of fish from seed to harvest period may be certified by one of the following
authorities:
i) Fisheries Extension Officer.
ii) Officer who has been authorised to issue such certificate by State Govt.
Fisheries Department or Central Inland Fisheries Research Institute.
(b) Certified Valuation Table should be submitted along with the proposal, which will
form the basis of claim settlement.
(c) Fee for the valuation table and issuance of certificate will not be borne by the
Insurance Company.
8. INSURANCE COVERAGE
This policy covers only Total Loss and in case the percentage of loss of any particular
stage is equal to or exceeds 80% of the total population of fish in pond it is treated as
Total Loss. However collective loss of different incidents will not be treated as Total
Loss for the purpose of Claim.
ANNEXUE- A
VALUATION TABLE FOR FRY TO FINGERLINGS
SURVIVAL RATE STOCKING PERIOD VALUE OF FRY/
FINGERLINGS
2nd day to 30 days - 75% 1st month Rs. 6 /- per 100
31 days to 60 days - 50% 2nd month Rs. 20/- per 100
61 days to 90 days - 30% 3rd month Rs. 60/- per 100
ANNEXURE-B
VALUATION TABLE FOR FINGERLING TO FISH STAGE
Number of Stages of Progressive Weight Value of
Fish culture in stock ponds (Grams per Fish) Per Acre
1st Fortnight 100 2000
2nd -do- 125 2200
3rd -do- 150 2400
4th -do- 200 2600
5th -do- 250 2800
6th -do- 300 3000
7th -do- 350 3200
8th -do- 400 3500
9th -do- 450 3800
10th -do- 500 4100
11th -do- 550 4400
12th -do- 600 4800
175
13th -do- 650 5600
14th -do- 700 6500
15th -do- 750 7200
16th -do- 800 8000
17th -do- 850 8800
18th -do- 900 9600
19th -do- 950 10500
20th -do- 1000 11500
21st -do- 1050 12500
22nd -do- 1100 13500
23rd -do- 1175 14500
24th -do- 1250 16000
Maximum Value per Hectare Rs. 40.000/-
ANNEXURE - C
VALUATION TABLE FOR BREEDERS
Period Value
1. 1 st year stock Rs.30/- per Kg.
2. 2nd year stock Rs.60/- per 2 Kgs
3. 3rd year stock Rs. 90/- per 3 Kgs
4. 4th year stock Rs. 10O/- per 4 Kgs. Above 5 Kgs is not insurable.

9. EXCLUSIONS
(i) Loss due to improper management and bad handling.
(ii) Loss due to neglect and carelessness.
(iii) Loss due to malicious act, willful injury, error or omission. (iv) Partial loss of any
kind.
(v) Losses due to dangerous insects, predators, competitors, etc.
(vi) Losses due to variation in PH factor, physical & chemical status of the water and
soil.
(vii) Asphyxia.
(viii) Losses due to natural mortality, burglary, house-breaking, theft or infidelity of
any person, (ix) Transit by sea, land and air.
(ix) Accident, loss, destruction, damage or legal liability directly or indirectly caused
by or contributed to or arising from nuclear weapons material.
10. PROCEDURE FOR CLAIM SETTLEMENT
a) For any loss, insured has to intimate to the Company in writing within 24 hours
of the occurrence of loss.
176
b) The assessment of loss would be on the basis of the certification by the Dept. of
Fisheries at the time of actual loss or the value of fish stated in the policy whichever
is less.
c) Liability of the Company: Company’s liability would be 80% of assessed value of
the loss. Insured has to bear 20%.
d) Claim Documents:
i) Intimation by letter, telephone, telegram or in erson,
ii) Duly completed claim form.
iii) Certificate from Dept. of Fishery for the reason of loss / death & valuation of
fish at the time of loss. Above information/documents should be submitted to
the Company within 15 days of the loss.
11. UNDERWRITING CONSIDERATIONS
i) The project area of the farm should have strong and sufficient boundary (bunds).
ii) The water movements must be properly regulated by suitable inlets, outlets and
sluices.
iii) The soil and water of the project area must be proper and it should ensure
expected productivity.
iv) Regular and effective liming, feeding and manuring should be provided.
v) The project should have sufficient attention and help of the service of the Extension
Officer from Fisheries Dept.
vi) Regular and ideal conditions of water must be maintained. Regular analysis of
water and quality testing must be done from time to time.
vii) Dead fishes should be removed immediately.
viii) Proper records of stocking of fish, feeding / disease record, preventive steps,
input and expenditure, daily stock position etc., should be maintained properly
with the daily transit.
ix) Transport of fish/fry/fingerlings should be done with all prerequisite safeguards
as per the direction of Fishery Department so as to avoid deaths of fishes or
seed stock in transit.
x) The work schedule should be properly maintained by Dept. of Fishery.
xi) Proper conditioning should be done before transfer of fry / fishlings / fingerlings
to the project area,
xii) In case of epidemics and parasitical infestation immediate steps should be taken
to prevent the losses by using medicines, chemicals etc.
xiii) Shutting or screening the escape route of fish such as gap in the embankment
should be properly guarded by net etc.
xiv) Deweeding, earth-excavation, de silting and earth improvements should be
done from time to time,
xv) Transfer of interest is not allowed.
177
AGRICULTURE PUMPSET INSURANCE
1. SUBJECT COVERED
Centrifugal pump sets (Electrical and Diesel / Oil) and submersible pump sets used
for agricultural purposes only. It includes Pump, Driving Unit and Starter.
2. IDENTIFICATION
Make, Year of Manufacture, Serial Number, HP.
3. RISKS COVERED
a) Mechanical / Electrical Breakdown
b) Fire and lightning
c) Theft and burglary (only if pump set is lodged in a permanent enclosure and there
is forcible and violent entry but not applicable to submersible pump set ).
d) Riot / Strikes, Malicious damage, Terrorism.
e) Flood (on payment of extra premium @ 2% of Sum Insured 1 % of Sum
Insured in Submersible Pumpset).
4. EXCLUSIONS
i) Normal wear & tear, gradual deterioration due to atmospheric conditions or
otherwise.
ii) Willful act of gross negligence by Insured or his representative.
iii) Faults existing at the time of commencement of risk and known to the Insured
or his representative.
iv) Loss or damage for which manufacturer or supplier of pump set is responsible
either by Law or Under Contract.
v) Cost of dismantling, transport to workshop & back and also cost of re-erection.
5. SUM INSURED
100% of Market Value at the time of issuance of cover or present replacement
value for Submersible Pump set as per annexure ‘C’
6. PREMIUM RATE
As per rating Schedule
a) Premium depends on Horsepower and Type of Pump set as per Annexure “A”
b) For submersible pumpset as per Annexure ‘C’
c) Premium to be loaded by 50% in Case of submersible pump set, if it is older than
10 years.
7. MINIMUM PREMIUM
Rs 40/- (For electric pump set) Rs 55/- (For diesel pump set)
Rs 250/- for submersible pump per unit irrespective of number of pump sets under a
policy.
178
8. DISCOUNTS
a) NO CLAIM DISCOUNT: No claim discounts at the following rates are allowed to
encourage better maintenance of pump sets.
Discount on renewal for the following year :
i) If no claim arises for one year — 10 %
ii) If no claim arises for two consecutive years — 15 %
iii) If no claim arises for three consecutive years — 20%
b) LONG TERM DISCOUNT
i) 2 years policy — 15 %
ii) 3 years to 5 years — 25 %
iii) 6 years to 9 years — 30 %
c) GROUP DISCOUNT
No. of Pump sets
2500 to 5000 — 10%
5001 to 25000 — 15%
25001 to 50000 — 20%
Above 50000 — 25%
9. DEDUCTIBLE FRANCHISE
In respect of Machinery Breakdown claim for agricultural pump set the Insured
has to bear certain amount of claim. For submersible pump set excess of 1 % or
Rs. 250/- whichever is higher.
Details mentioned in Annexure-A
10. IMPORTANT UNDERWRITING INSTRUCTIONS
(i) Insurance of inferior make/quality to be avoided.
(ii) The Sum Insured should not be less than the present replacement value and
not the depreciated value,
(iii) An endorsement regarding maximum rewinding charges as per Horsepower
should be attached to the policy,
(iv) The pump set should be serviced regularly and overhauled annually,
(v) No refund of premium is allowed if the pump is idle or used occasionally.
(vi) All claims are subject to depreciation of 10% per year and maximum depreciation
should not be more than 75% of erected value of pump set.
(vii) Company’s liability for total loss claim where pump set cannot be retrieved in
case of submersible pump set is 50% of assessed loss.
(viii) Pre-acceptance inspection should be recommended for submersible pump sets.
179
(ix) Statistics for submersible pump set for premium and claims to be kept separately
from Agricultural Pump set Insurance
(x) Pump sets beyond 25 H.P. capacity should be insured under Engg. Department.
11. CLAIMS PROCEDURE
i) The insured will inform the Insurance Company immediately in writing about the
loss.
ii) The company registers the claim on receipt of intimation, claim form and estimate
of repairs in case of breakdown and police report in case of Burglary, Act of
Terrorism, Riot and Strike respectively.
iii) A competent surveyor may be sent by the Company to conduct survey and also
investigations if need be.
iv) On receipt of bills and report from repairer / surveyor the claim is processed and
our liability assessed after taking into consideration the salvage, deductible
franchise.
12. LIMIT OF LIABILITY
Limit of liability is cost of repair / damage. Maximum liability for rewinding charges is
as per Annexure ‘B’.
13. FORMS / DOCUMENTS
a) Proposal
b) Policy
c) Claim Form
d) Estimates
e) Bills
f) Receipts
PREMIUM FOR AGRICULTURAL CENTRIFUGAL PUMPSET
‘ANNEXURE’ ‘A’
TABLE I - ELECTRICAL MOTOR
H.P. Premium in Rs. Deductible Franchise Rs.
3.0 40 75
5.0 45 75
5.0 65 85
10.0 70 90
15.0 95 115
17.0 95 115
20.0 110 140
25.0 130 140
180
TABLE II – DIESEL/OIL SETS
H.P PREMIUM IN Rs. DEDUCTIBLE FRANCHISE IN Rs.
5.0 55 90
7.5 60 105
10.0 80 115
15.0 100 140
17.5 110 160
20.0 125 175
25.0 140 200
ANNEXURE ‘B’
REWINDING CHARGES
H. P MAXIMUM LIABILITY IN Rs.
3.0 600
5.0 800
7.5 1000
10.0 1300
15.0 1900
17.5 2000
20.0 2100
25.0 2400
ANNEXURE ‘C’
SUBMERSIBLE PUMPSET
H.P. SUM INSURED PREMIUM REWINDING LIABILITY FOR
CHARGES (Rs.) TOTAL LOSS (Rs.)
3&5 15,000 250 1,500 7,500
7.5 18,000 250 2,000 9,000
10 22,000 275 2,500 11,000
12.5 25,000 315 3,000 12,500
15 28,000 350 4,000 14,000
20 30,000 375 4,500 15,000
25 45,000 565 5,000 22,500
The above premium rates are excluding flood risk.

181
JANATA PERSONAL ACCIDENT POLICY
1. SALIENT FEATURES
Any person irrespective of sex, occupation and profession in the age group of 10 to
70 years may be covered under JANATA PERSONAL ACCIDENT POLICY.
2. SCOPE OF COVER
This insurance will pay to the Insured (or in case of death, to the nominee) the
amount shown against the table of benefits, if the Insured shall sustain any bodily
injury resulting solely and directly from accident caused by outward violent and visible
means and such bodily injury within the twelve calendar months of its occurrence be
the sole and direct cause of :
Table of Benefits Sum Insured Payable
(i) Death 100% of S.I.
(ii) Total and irrecoverable loss of sight of both eyes or
losses of use of two hands or feet or loss of sight
of one eye and loss of use of one hand or foot. 100% of S.I
(iii) Total and irrecoverable loss of sight of one eye or
loss of use of one hand or foot. 50% of S.I.
(iv) Permanent total disablement due to accident. 100% of S.I.
3. SUM INSURED
The policy may be issued for minimum sum insured of Rs.25.000/- per person per
annum and the maximum sum insured is to be limited to Rs.1,00,000/- per person
per annum.
4. PREMIUM
The rate of premium is Rs.15 for a sum insured of Rs.25,000/-. The sum insured shall
be increased in multiples of Rs.25,000 and premium is charged accordingly.
5. GROUP DISCOUNT
Group Size Discount (%)
101 To 1,000 5
1,001 To 10,000 7.5
10,001 To 50,000 10
50,001 To 1,00,000 12.5
1,00,001 To 2,00,000 15
2,00,001 To 5,00, 000 20
5,00,001 To 10,00,000 25
above 10 lacs 30
182
Group insurance policy should be issued only in respect of the named Groups. For
the purpose of availing of Group Discount and other benefits the proposed “Group”
should fall clearly under any one of the following categories :
Employer-employee relationship including dependents of the employee.
Pre-identified segments / groups where the premium is to be paid by the State/
Central Governments.
Members of a registered co-operative society.
Members of Registered Service Clubs.
Holders of credit cards of Banks / Diners / Master / Visa.
Holders of Deposit Certificates issued by Banks / NBFC’s.
Shareholders of Banks / Public Limited Companies.
In case of proposals relating to any further category different from the seven
notified categories, they may be decided upon by Technical Dept., Head Office.
No Group Discount can be offered on the ‘anticipated* group size. Group Discount
is to be considered and worked out only on the actual number of members
registered in the ‘Group’ at the time of taking out the policy.
Under no circumstances claims under such policies can be paid to any one other
than the individual insured.
Wherever group policies for higher Sum Insured are needed, the same shall be
covered under Personal accident policy.
6. LONG TERM DISCOUNT
Term of the Policy (Years) Discount (%)
1 Nil
2 5
3 10
4 15
5 20
7. SPECIAL CONDITION
All discounts including other technical discounts / deductions if any granted in addition
to Group Discount, Long Term Discount, Special Feature Discount, No Claim Discount
and/or discounts / deductions of any other nature in aggregate should not exceed
30% under any circumstances.
8. EXCLUSIONS
I. Any existing disability.
II. Death injury or disablement due to intentional self injuries, suicide or attempted
suicide.
III. Disablement or death under influence of liquor or drug.
183
IV. Death or disablement during racing, shooting, big game hunting, mountaineering,
ice hockey and winter sports.
V. Insanity.
VI. Breach of law with criminal intention. VII. War Group of perils.
VIII. Nuclear group of perils.
10. IMPORTANT UNDERWRITING INSTRUCTIONS
I. The Policy in respect of Individual or Group JPA should be issued for a maximum
period of 5 years.
II. No MOU or Agreement should be signed by any officer below the rank of Manager.
III. No MOU or Agreement should be signed without prior approval of HO Tech Dept
and Legal Dept.
IV. In case of long term-policy, the premium is to be collected in one lump sum
amount in advance.
V. No refund of premium will be allowed even if the claim arises in the earlier years
under long term policy.
VI. No renewal of group policy should be encouraged where loss ratio is 70% and
above.
VII. PTD should be covered as per existing JPA policy and only Death cover should
not be given.
11. CLAIMS PROCEDURE
1. Immediate notice to be given to the Policy issuing office.
2. Claim Form to be submitted with medical certificate and bills.
3. For death claim, Nominee should submit :
(a) Death Certificate
(b) Original Policy
(c) Postmortem report
(d) Police report if complaint is lodged.
4. Claims of person presumed to be dead due to drowning, may be settled after two
years on the submission of the following documents :
(a) Police report and final investigation report.
(b) Report of findings by Customs / Port Authorities.
(c) Affidavit duly notarised.
5. Subject to above, claims of persons of fishing vessels, which is missing, or a total
loss will be presumed dead and claim settled accordingly.
12. STAMP DUTY
Re.1 Per Rs.10,000/- Sum Insured.
184
FARMERS PACKAGE INSURANCE
1. OBJECTIVE : With a view to give comprehensive insurance to cover assets of
farmers the Farmers package insurance policy has been introduced. Particulars are
given below.
SECTION / DESCRIPTION OF POLICY PREMIUM RATE
I) Fire And Allied Perils including earthquake
a) Dwelling/ House (other than Kutcha) 0.60 per mille
b) Contents (Excluding Jewellery & Valuables)
belonging to the insured and members of his
family permanently residing with him. 0.60 per mille
c) For ‘Kutcha’ constructions the premium
to be loaded for (a) & (b) by 4.00 per mille
II) Burglary House breaking Including
Larceny Or Theft 2.40 per mille
III) Agricultural Pump set (For HP Up to 25 Only) As per APS scheme
IV) Animal Driven Cart /Tonga/Coaches 1.40% of market
value of cart
andanimal/s together.
V) Livestock / Cattle/ Sheep & Goat/ As perrespective
Camel/ Horse, Etc. Schemes
VI) T.V. Set 10.00 per mille
VII)Pedal Cycle 20.00 per mille
VIII) Baggage Insurance 7.50 per mille
IX) Janata/ Gramin Personal Accident As per JPA/GPA
X) Jan Arogya Bima Policy As per Scheme
Note : Coverage will be up to a maximum of
Rs. 10, 000/- per person
2. UNDERWRITING GUIDELINES
a) This is a package of various covers. The covers included in the package will be
governed by the rate, terms, conditions, of the respective Schemes.
b) All the Underwriting /Claims guidelines conveyed from time to time by the respective
technical departments for the respective covers/sections will be applicable.
c) The Section I that is Dwelling unit / House & Contents is compulsory.
d) Apart from covering dwelling units it is compulsory to cover any one of the approved
RNTB covers.
e) Minimum three covers should form part of the Farmers Package Policy.
185
f) To be eligible for Sectional discount minimum ‘4’ sections to be covered. The
applicable special discount in premium rates will be 15% for covering more than
4 sections and 20% for covering more than 6 sections. For covers under Sections
I, V, IX and X sectional Discount will not be available. However, these sections
will be counted for the purpose of number of sections to be eligible for sectional
discount. For sections opted to be covered, respective/ applicable proposal forms
should be obtained. In case of Cattle and Livestock / Poultry, respective veterinary
health certificates are also to be attached.
g) In case of coverage of scheme animals “Net” premium rate has to be applied.
h) No long term policy to be issued.
i) If any pre-risk inspection survey or post claim inspection / survey or any other
underwriting guidelines are communicated by Fire/Misc./UNTB/RNTB Depts for
the respective covers then those guidelines should be made applicable here too.
j) The claims of covers / sections which were hitherto underwritten in Misc./ UNTB
/ Fire/ Technical Depts.be continued to be processed by respective Depts. or
their opinion be sought before finalizing these claims. This is to have better control
over claims management.

186
HOTRICULTURE / PLANTATAION (INPUTS) INSURANCE
1. SCOPE OF COVER
Under this policy following Horticulture and plantation crops can be covered.
A) HORTICULTURE CROPS
1) Grape 2) Citrus (Orange, Lime, Sweet Lime)
3) Chikoo 4) Pomegranate
5) Banana.
B) PLANTATION CROPS
1) Rubber 2) Eucalyptus
3) Poplar 4) Teakwood
5) Oil Palm Plantations 6) All types of trees
7) Sugarcane 8) Tea.
2. UNDERWRITING AUTHORITY
Underwriting authority to accept proposals is vested with the Head Office only. Regional
Offices should recommend the proposal to Head Office along with the following
Proposal Form Additional Questionnaire in case of a new crop Input cost duly verified
and certified by an Agriculture / Horticulture expert. Indemnity table in case of a new
crop Package of Practices adopted.
Regional Offices should ensure that proper infrastructure for loss assessment
has been developed before recommending proposals to Head Office. Head
Office approval is needed for fresh proposals as well as renewals.
3. INSURED
a) Individual farmer whether owner or tenant engaged in cultivation of above.
b) However, a policy may be issued in the name of an Association or an organised
and registered body of farmers engaged in cultivation of the specified crops
where such Association / Body has been formed and is functioning for the purpose
of procurement of input processing/marketing of the produce and/or any other
are recorded in schedule (to be attached to and forming part of the policy) in a
manner that in the event of loss, claims can be assessed and settled on individual
basis.
4. PERILS COVERED
The policy shall cover and seek to indemnify the insured to the extent of loss of input
due to loss or damage to the insured tree/fruits (whichever is applicable depending
on the crop insured) occasioned by operation of any one or more of the following
perils either in isolation or in concurrence :
a) Fire (Including Forest Fire and Bush Fire)
b) Lightning
c) Storm, Hailstorm, Cyclone, Typhoon, Tempest, Hurricane, Tornado whilst in
direct and immediate operation over the insured area.
d) Flood and inundation (inspection report is necessary to cover these risks)
e) Riot, Strike and Malicious Damage
187
f) Acts of Terrorism.
These are termed as standard perils and are applicable for all type of insured fruit
crops and plantation crops. Additional/optional cover as is applicable to specific crop
can be granted on selective basis after evaluation of the proposal.
5. PERIOD OF INSURANCE
Crop duration or twelve months (one year) whichever is shorter subject to the following:
a) This policy is valid for one season only. The policy period is taken from the date of
payment of premium until crop in that season is harvested. The policy ceases
after the harvest in the season for which the policy is issued. For fruit crops
having season more than one year, appropriate additional premium will be charged.
For Citrus, Policy period will be one year from the date of issue of policy.
b) Period of insurance in respect of sugarcane crop shall be extendable by such
period beyond twelve months (up to a maximum of eighteen months) as may be
necessitated by the variety grown. This will, however, entail additional premium
on pro rata basis for such period as may be in excess of twelve months.
c) In respect of Rubber, Eucalyptus and Poplar and trees where plants are first required
to be raised in nurseries and then fields, the period of insurance shall commence
after expiry of twelve months from transplanting (Nurseries are not covered) and
policy for these crops can be issued on annual basis.
6. SUM INSURED
Sum Insured shall be based on the cost of cultivation or Input Cost i.e. Cost of
Raising / Development of Insured Trees.
The policy will be issued for fixed Sum Insured, which is given separately under
each crop.
It may be noted that depending on the needs of clients, modified Input Cost Clause
can be considered by the Head office if justifiable.
7. PREMIUM RATES
The following rates are minimum rates and are only indicative. Depending upon the
experience for the crop, area and individual proposal Head Office will be quoting the
rates. The premium should not be accepted unless Head Office confirms the rate.
a) Horticulture Crops
Citrus Fruits (orange, lime, sweet lime), chikoo, 5% of Sum Insured
pomegranate, banana, grapes (standard cover),
Grape crop(optional cover : losses due to Addl. Premium @1.50%
unseasonal rains and frost) of Sum Insured
b) Plantations : Rubber, Eucalyptus,
Poplar, Teakwood 1.25% of Sum Insured
c) Sugarcane 1.25% of Sum Insured
d) Oil Palm : Part “A” 1.50% of Sum Insured
Part “B” 2.00% of Sum Insured
8. FRANCHISE
a) No Claim shall be payable under the policy if the amount of claim assessed
does not exceed 10% of Sum Insured per acre or Rs.1,000/- per affected
acre whichever is lower.
188
b) This franchise clause is not applicable for the fire losses under the Sugarcane
Policy.
9. EXCESS
The Insured shall be deemed to be his own insurer for first 20% of the claim assessed
per acre, only 80% of claim assessed shall be paid under the policy.
10. OTHER DEDUCTIONS
Losses due to any or all of the excluded peril and/or improper maintenance will
be quantified and the said sum will be deducted from the loss assessed to arrive at
the net loss payable.
11. LOSS ASSESSMENT METHOD
a) It should be clearly noted that the expenses incurred during the season for which
the policy has been issued are only to be taken into account for the purpose of
the Policy. Expenses made prior to the season in question are not to be
taken into account. Expenses for establishing an orchard from the date of
establishment are outside the scope of the policy.
b) For the purpose of indemnity, the policy is a valued policy and no statement of
accounts of actual expenses incurred is required to be submitted by the Insured.
Expenses from the previous harvest till the date on which the insured peril operates
only should be taken into account as having spent for the purpose of the claim.
Hence the claim cannot in any case be more than this amount.
c) For calculating this amount sliding scales of inputs have to be attached to the
policy as inputs clause. This inputs clause for each fruit crop is separate. The
percentages given in the input clause have to be applied on the Sum Insured
stated in the policy.
d) The amount of claim payable under the policy shall be such sum arrived after
applying the percentage of the loss of yield to the amount of the cost of inputs at
which the insured perils causing the loss of yield operates, subject to the franchise,
excess and deductions.
12. IMPORTANT POLICY CONDITIONS
a) This policy is Issued on “Input Cost” basis only and no other expenses/
costs are indemnifiable.
b) Failure to Intimate the claim forthwith will forfeit all rights and benefits under the
policy.
c) Condition of Average
If the Insured has more than one acre of horticultural cultivation in any one location,
he is expected to insure all of them, failing which, if claim arises, the same will be
settled in the proportion insured acreage bears to total acreage.
13. LONG TERM POLICY
Long term Policy in respect of Eucalyptus & such other plants can be issued subject
to approval of Head Office. It is precondition that entire premium will have to be
collected in advance.
189
COMPREHENSIVE FLORICULTURE INSURANCE
1. SCOPE OF COVER
Policy can be offered comprising the following sections.
A. Damage to Poly House and its structure.
B. Damage to irrigation system.
C. Cover for death of plants.
D. Cover for loss of inputs due to damage to the flowers.
The perils which are common to all the above 4 sections :
(i) Fire ( including forest fire and Bush Fire)
(ii) Lightning
(iii) Storm, Hailstorm, cyclone, Typhoon, Tempest, Hurricane, Tornado, whilst
indirect and immediate operation over the insured area.
(iv) Flood and Inundation
(v) Riot & Strike
(vi) Act of Terrorism
(vii) Earthquake, Volcanic Eruption or other convulsions of Nature other than
those specifically covered by this Insurance
Section ‘A” & “B’ will also cover following additional perils :
(i) Theft
(ii) Landslide
(iii) Accidental damage to Machineries and pipelines.
(iv) Bursting of pipelines
(v) Machinery Breakdown cover
Section C & D will cover additional perils as follows:
(i) Insects
(ii) Mite
(iii) Pest & disease
2. SUM INSURED
SECTION A: POLYHOUSE
Sum Insured will be on Market value basis and will comprise mainly the following
items
(i) Steel Structure
(ii) Fabrication
(iii) Plastic & Grippers
(iv) Plastic fitting Charges
(v) Gutter & Poly house
SECTION B : Irrigation System
Sum Insured will be on Market Value basis with break up of following items :-
(i) Plastro make system
(ii) Agricorn Associates (values & pipes)
(iii) Fitting Charges
(iv) 2 Motors, 1Pump and other Accessories.
(v) Reservoir
(vi) Transformer
190
SECTION C : Cover For Death Of Plants Sum Insured per hectare will be as
follows
(i) Cost of saplings
(ii) Input cost from planting to first flowering i.e; incubation period of four months.
SECTION D:
Sum Insured will be the Input cost on the lines of Standard Horticulture Policy,
which can be determined on the basis of the project in consultation with the
Proposer.
3. PRE-INSPECTION
Each and every Floriculture Farm proposed for insurance will have to be inspected
before acceptance by a reputed structural Engineer having experience in designing
poly houses and wherever Risk improvisation of the following nature, is suggested
by the structural Engineer, such changes should be carried by the Proposer.
a) Strengthening of win ward side of Poly house by attaching additional wind bracers
to each column from all the sides .
b) Bottom cord continuous and strong of 1 ½ “ diameter
c) Span of the column in both the ends of poly house perpendicular to gutters
reduced by putting additional columns .
Fees of Structural Engineer will be borne by the proposer himself.
4. PREMIUM RATE
1. For the farm having poly house with Aluminum Grippers 1.5%
2. For the farm having poly house with Plastic Grippers 1.75%
5. EXCESS
There will be an excess of Rs. 25,000/- on each and every claim.
6. DEPRECIATION
The policy will be issued incorporating depreciation clause as under.
a) Depreciation of 20% per year from the date of fixing will be applicable for poly
film and plastic grippers.
b) Depreciation of 5% per year on all metal structures.
c) Policy will be issued on Market value basis and not on Reinstatement basis .
7. CO-INSURANCE
The policy will have a Co-Insurance clause of 80:20 i.e. 20% loss to be borne by
insured.
8. UNDERWRITING AUTHORITY
Underwriting authority to accept proposals is vested with the Head Office only.
Regional Offices should recommend the proposal to the Head office along with the
following
Proposal Form
Report of the Structural Engineering
Input cost duly verified and certified by an Agriculture / Horticulture expert. Indemnity
table incase of cover for loss of inputs due to damage to the flowers Package of
Practices adopted.
Head Office approval is required for fresh proposals as well as renewals.

191
Jan Suraksha Laghu Bima Policy
The Micro-Insurance Product – Jan Suraksha Laghu Bima Policy has been
designed to meet the requirements of IRDA-Micro Insurance Regulations, 2005. This
policy will meet the requirements of the poor and needy people living in Rural and
Urban areas. The policy covers whole of the country. This Micro-Insurance Product
covers Five Sections viz.
Section I(A) – Health Insurance for Individuals with minimum sum insured of
Rs.5,000/- and in multiples of Rs.5,000/- maximum upto Rs.30,000/- in the age group
of 3yrs to 70 yrs.
The Rate of Premium to be charged is Rs.1.5% of Sum Insured for persons of age
group of 3 months to 35 years and Rs.2% for 36-70 years.
Section I(B) – Health Insurance with Family Floater – The Sum Insured upto
Rs.30,000/- for 5 to 7 members /- in the age group of 3yrs to 70yrs.
The Rate of Premium to be charged is Rs.548/- for family of 5 and Rs.730/- for family
of 7 including dependent parents.
Section II – Hut, Dwelling and Contents – The Minimum Sum Insuredfor Hut
Rs.5,000/- and in multiples of Rs.5,000/- maximum upto Rs.30,000/-.
The Rate of Premium to be charged is Rs.0.06% for Pukka – with RCC Roof only and
Rs.0.40% for Thatched Roof or any Non-RCC Roof.
Section III – Agriculture and other Tools, Implements and other Assets – Minimum
sum insured is Rs.5,000/- in multiple of Rs.5,000/- with a maximum Sum Insured
Rs.30,000/- per family.
The Rate of Premium to be charged is Rs.0.25%.
Section IV – Cattle/Livestock – The Sum Insured is fixed as per Market Value
of the cattle/livestock certified by a qualified veterinarian subject to maximum of
Rs.30,000/- per animal.
The Rate of Premium to be charged is 4% plus 1% extra for covering Permanent Total
Disablement.
Section V – Personal Accident Cover – PA Cover is available for persons
between the ages 5yrs to 70yrs. For Family members the minimum sum insured is
Rs.10,000/- and in multiple of Rs.10,000/- maximum Rs.50,000/- per person.
The Rate of Premium to be charged is Rs.0.06%.
The proposer can select One or More of the sections I to V. However, under
Section I and I (A) or I (B) can be selected.

(For information on other RID products, rates and commission structure, please refer
RID manual)

192

Вам также может понравиться