Schedule – Pedal Cycle Policy 

UIN: IRDAN123P0074V01200203 

Business Location: Gurgaon, Haryana 

Policy Number:  CPP12345678900078431

Customer ID:  82896

Name:  Raghunath Singh Darmwal

Telephone/ Mobile Number:  9927648285

Email ID:  darmwalr@gmail.com

Communication Address:  Fitzo Bicycle & Fitness Store

Kaladungi Road,
Haldwani
Uttarakhand 263139

Business/ Profession:  NA 

Period of Insurance From:  0:00 of   Jun 28, 2019

Period of Insurance To:  Midnight of   Jun 27, 2020

Financier Interest:  NA 

Registered Office: Cholamandalam MS General Insurance Company Ltd, 2nd Floor, "Dare House",  No.2, NSC Bose Road, Chennai ­ 600001, India. 
IRDA Registration No. 123. CIN – U66030TN2001PLC047977 
https://www.cholainsurance.com/ 24X7 Toll free Helpline 1800­200­5544 Email: customercare@cholams.murugappa.com 
 Coverage and Premium Details 

All risks as per Chola MS Pedal cycle Policy excluding STFI* and 
Coverage Details: 
Earthquake.

Premium excluding Terrorism:  ₹441

Terrorism Premium:  NA 

₹79
GST (18%):   
IGST - 18% GSTIN No.: 08AABCC6633K7ZD / PAN: AABCC633K 

Gross Premium:  ₹520

The policy wordings with detailed terms, conditions and 
Special Conditions: 
exclusions are available on our website - cholainsurance.com 

Payment ID:  NA 

Payment Date:  Jun 28, 2019

**STFI means Storm, Typhoon, Flood and Inundation. 

Consolidated Stamp Duty Paid Vide G.O. Rt. No. 470, Commercial Taxes and Registration (J1) Department, 
Tamil Nadu. Dated 06/09/2011 

Note:  
The Certificate of Insurance/ Policy Schedule is an important document issued based on your declaration. We 
request you to verify the details and ensure that everything is in order. In case of any discrepancies, please 
contact us within 15 days from the date of issuance of policy. 

For CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED 

Authorised Signatory  Date: Jun 28, 2019 Place: Gurgaon 

Registered Office: Cholamandalam MS General Insurance Company Ltd, 2nd Floor, "Dare House",  No.2, NSC Bose Road, Chennai ­ 600001, India. 
IRDA Registration No. 123. CIN – U66030TN2001PLC047977 
https://www.cholainsurance.com/ 24X7 Toll free Helpline 1800­200­5544 Email: customercare@cholams.murugappa.com 
 Attached to and forming part of Policy Number 

Geographical Limit:  Within India 

Frame Number &  Sum  Any One  Any One 

Description 
Year of Make  Insured  Accident  Year 
KROSS EXCEED - BLACK
Upto Cycle
NA 12400 NA Cost

Excess: 
For Damage Claims: Rs.50 for each claim 
Theft and Burglary: Nil deductible 

Exclusions: 
As per Chola MS Pedal Cycle Policy Terms, conditions and Exclusion  

Policy Features in Brief 

Specific Inclusions: 
1. Fire: Loss against fire brought about by including but not limited to faulty wiring, explosion of gas,
lightning.
2. Riot and Strike: Loss or damage caused by vandals or other persons acting maliciously or by way of
protest or strikes, labour unrest, riots or civil commotion.
3. Theft: An act of directly or indirectly and illegally permanently depriving the insured or the possession
of the contents by any person by violent or forceful means or otherwise.
4. Burglary: An act involving the unauthorized entry to or exit from your home or attempted threat by
unexpected, forcible, visible and violent means, with the intent to commit an act of Theft.
5. Accidental Loss/Damage: Any externally visible deterioration or destruction of the cycle that results
from an external, unexpected and unforeseeable cause and impedes the proper functioning of the
cycle.

Specific Exclusions: 
1. War and Nuclear perils.
2. Any act of terrorism,
3. Loss or damage due to misplacement, misuse, reckless, abusive, willful or intentional conduct
associated with handling and use of the covered item
4. Loss or damage arising out of any pre-existing conditions.
5. Any contractual liability, legal liability or consequential loss.
6. Loss or damage caused by overloading or strain or mechanical breakdown.
7. Loss or damage to accessories by theft unless the pedal cycle is stolen at the same time.

Important Conditions: 
• This Policy shall be void and all premium paid hereon shall be forfeited to the Company in the event
of misrepresentation, misdescription, or nondisclosure of any material particular.
• If at the time of any loss or damage covered by this Policy there shall be any other Insurance covering 

Registered Office: Cholamandalam MS General Insurance Company Ltd, 2nd Floor, "Dare House", No.2, NSC Bose Road, Chennai - 600001, India.
IRDA Registration No. 123. CIN – U66030TN2001PLC047977 
https://www.cholainsurance.com/ 24X7 Toll free Helpline 1800­200­5544 Email: customercare@cholams.murugappa.com 
 the same risk whether affected by the Insured or not, then the Company shall not be liable for more 
than its rateable proportion thereof. 
● If any claim under this Policy shall be in any respect fraudulent or if any fraudulent means or devices
are used by the Insured or anyone acting on the Insured's behalf to obtain any benefit under the Policy,
all benefits under the Policy shall be forfeited.
● Policy deductible : Rs.50 for each damage claim.
● Depreciation would be applicable to all claims. The claim compensation on theft and damage would be
reduced according to the following table:
○ 0 to 3 months: 15%
○ 3 to 6 months: 20% 
○ 6 to 12 months: 30% 

● There is a waiting period of 3 days after purchase of the insurance, before a claim can be filled.

Basis of Claim settlement: 

● The company will pay to the Insured the value, at the time of happening of such loss of the Cycle(s), so
lost or the amount of such damage.

Claim Intimation 

1. Claim notification to be given to Chola MS immediately on occurrence of the event and not later than
3 days from the day of the incident. If any claim is not intimated to Toffee within 72 hours from the
time of incident (damage/theft) it is liable to get rejected or closed.

2. Completed and duly signed claim form with the following documents to be submitted within 3 days
from the date of the incident.

3. Claim Documentation for Cycle Theft Claims:

a. Copy of FIR / Police Report, wherever necessary

b. Aadhaar card of the insured, if not given at the time of purchase

c. Account details with proof for NEFT transfer

4. Claim Documentation for Cycle Damage Claims:

a. Copy of FIR / Police Report, wherever necessary.

b. Aadhaar card of the insured, if not given at the time of purchase.

c. It will be settled on a cashless basis with an excess or a co-pay of 50 rupees charged by the
dealer.
d. Clear photos of the damage parts of cycle is mandatory.

5. In the event of loss/claim, customer has to visit https://toffeeinsurance.com and click on claims.

6. Customer can also call/email Toffee at 938-9-938-938 / support@toffeeinsurance.com.

7. In theft cases FIR has to be filed within 3 days from the date of incident.

8. In case of theft online FIR should contain necessary details with Cycle frame number, Model
number and Invoice number.

Registered Office: Cholamandalam MS General Insurance Company Ltd, 2nd Floor, "Dare House",  No.2, NSC Bose Road, Chennai ­ 600001, India. 
IRDA Registration No. 123. CIN – U66030TN2001PLC047977 
https://www.cholainsurance.com/ 24X7 Toll free Helpline 1800­200­5544 Email: customercare@cholams.murugappa.com 
Address of Claims Office: 
Cholamandalam MS General Insurance Company Ltd. 
Chola MS Help – Health Claims Department 
Shaw Wallace Building, Old No.154, New No.319 
2nd Floor, Thambu Chetty Street, 
Parrys Corner, Chennai 600001 

Policy Cancellation Procedure: 

1. The Policy may be cancelled by either parties by giving a 15 days written notice.
2. In case of cancellation by the insured, we will retain a part of the premium for the period for which you
were covered under this policy.

Complaints: 
For any Complaints/Grievances, Contact the Toll Free: 1800 2005544, Email: 
customercare@cholams.murugappa.com OR SMS:”CHOLA” to 56677* (Premium SMS charges apply), 
Website: www.cholainsurance.com 

Registered Office: Cholamandalam MS General Insurance Company Ltd, 2nd Floor, "Dare House",  No.2, NSC Bose Road, Chennai ­ 600001, India. 
IRDA Registration No. 123. CIN – U66030TN2001PLC047977 
https://www.cholainsurance.com/ 24X7 Toll free Helpline 1800­200­5544 Email: customercare@cholams.murugappa.com