HDFC ERGO General Insurance Company Limited

2312100095928100000

Certificate of Insurance cum Policy Schedule

Policy No. 2312 1000 9592 8100 000

0

Two Wheeler Package Policy

Insured Name
Correspondence
Address
Mobile

[Link]
7/2B, Thirupur Kumaran Street, Iyyappa naga West,
Kanchipuram
TAMIL NADU 631 501
9791188800
Phone
E Mail

Period of Insurance

From Date & Time

Make
HERO HONDA

RTO
KANCHEEPURAM
Registration 7/2B, Thirupur Kumaran Street, Iyyappa naga West,
Address
Kanchipuram
TAMIL NADU 631 501
kalakuttyeswaran@[Link]
Registration No.
TN-21-AB-5169
To Date & Time

05/10/2016 Midnight

Policy Issuance Date

Model - Variant

Engine No

Chassis No

Mfg Yr

SPLENOR PLUS

O7M 15E 41074

O7M 16F 28378

2007

Vehicle (`)

Insured's Declared
Value (IDV)

06/10/2015 00:01 hrs

17,820

Side Car (`)

Non Electrical Acc. (`)

Electrical Acc. (`)

CNG/LPG Kit (`)

Named Persons & Nominee (IMT-15)

Nominee (Owner Driver)

Seats(Incl.
of side car)
2

05/10/2015
Body Type
OPEN

CC
97

Total IDV (`)

17,820

Appointee
Premium Details (`)

Own Damage Premium (a)

Basic Own Damage:

314

Liability Premium (b)

Basic Third Party Liability:

538

PA Cover for Owner Driver of `100000

Total Basic Premium

Less: No Claim Bonus (50%)

Total - Less

Net Own Damage Premium (a)

The total Premium amount is inclusive of NCB 50%
Geographical Area India

50

314

157
157

157

Sub Total Addition

588

Net Liability Premium (b)

588

Total Package Premium (a+b)

745

Service Tax (Including Swachh Bharat Cess 0.50% as applicable) 14.50%

108

Total Premium

853

Compulsory Deductible (IMT-22) ` 100

Voluntary Deductible (IMT-22A) ` 0

Payment Details: Fund Transfer No. TW1601000867

Dated : 05/10/2015
Drawn on
BizDirect
Previous Policy No. 0113053114p106784179 Valid from 25/11/2014 to 24/11/2015 of UNITED INDIA INSURANCE [Link]. No Claim Bonus 50%
If declaration found incorrect, benefits under the present policy in respect of own damage section will stand forfeited.

List of Endorsements
Endt No Description

Effective Date

End Date

Premium (In ` )

LIMITATIONS AS TO USE: The Policy covers use of the vehicle for any purpose other than: a) Hire or Reward b) Carriage of goods (other than samples or personal luggage) c) Organized racing d) Pace making e)
Speed testing f) Reliability Trials g) Any purpose in connection with Motor Trade. Persons or Class of Persons entitled to drive: Any person including the insured, provided that a person driving holds an effective
driving license at the time of the accident and is not disqualified from holding or obtaining such a license. Provided also that the person holding an effective learner`s license may also drive the vehicle when not used
for the transport of passengers at the time of the accident and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989. Limits of Liability 1. Under Section II-1 (i) of the
policy - Death of or bodily injury - Such amount as is necessary to meet the requirements of the Motor Vehicles Act, 1988. 2. Under Section II - 1(ii) of the policy -Damage to Third Party Property` 100000 3.P.A.
Cover under Section III for Owner - Driver(CSI): ` 100000 Terms, Conditions & Exclusions: As per the Indian Motor Tariff. A personal copy of the same is available free of cost on request & the same is also
available at our website.
I / We hereby certify that the policy to which the certificate relates as well as the certificate of insurance are issued in accordance with the provision of chapter X, XI of M. [Link] 1988. "The stamp duty of
` 0.50
paid by Demand Draft, vide Receipt/Challan no 116615201314 dated 31/10/2013 as prescribed in Government Notification Revenue and Forest Department No Mudrank 2004/4125/CR 690/M-1, dated 31/12/2004."
Service Tax Registration No.: AABCH0738EST004. IMPORTANT NOTICE: The Insured is not indemnified if the vehicle is used or driven otherwise than in accordance with this Schedule. Any payment made by the
Company by reason of wider terms appearing in the Certificate in order to comply with the Motor Vehicle Act, 1988 is recoverable from the Insured. See the clause headed "AVOIDANCE OF CERTAIN TERMS AND
RIGHT OF RECOVERY." Disclaimer: The Policy shall be void from inception if the premium cheque is not realized. In the event of misrepresentation, fraud or non-disclosure of material fact, the Company reserves
the right to cancel the Policy from inception.
Policy Issuing Office : LEELA BUSINESS PARK, 6TH FLR, ANDHERI - KURLA RD, MUMBAI, 400059.
Policy Issuing Office: Mumbai

Phone No. : +91-22-66383600

For HDFC ERGO General Insurance Company Ltd.

Agent Name: POLICYBAZAAR INSURANCE WEB AGGREGATORS

PVT. LTD
Agent Code: 201714906552 Tel No.: 91-11-27561382

Duly Constituted Attorney

Registered & Corporate Office: 1st Floor, 165-166 Backbay Reclamation, H. T . Parekh Marg, Churchgate, Mumbai - 400020. Customer Service Address: 6th Floor, Leela Business Park, Andheri Kurla Road,
Andheri (E), Mumbai - 400 059. Toll Free : 1800-2-700-700 (Accessible from India only) | Fax : 91 22 6638 3699 | care@[Link] | [Link]

HDFC ERGO General Insurance Company Limited

Frequently Asked Questions (FAQs) - Motor Insurance
WHAT ARE THE MAJOR COVERS UNDER THE POLICY?

HOW DO I FILE A CLAIM?

Loss or Damage to the Insured Vehicle caused due to:

a. Fire, explosion, self ignition or lightning.
b Burglary, housebreaking or theft
c All act of God perils like earthquake, flood, cyclone etc
d Accidental external means, terrorism, riot and strike
Liability to Third Parties:
Provides cover for any legal liability arising out of the use of the vehicle for
a Accidental death / injury to any third party
b Any damage to property owned by third party
Personal Accident Cover:
The policy provides for a mandatory Personal Accident cover for owner driver and optional cover for
passengers covering accidental death and permanent total disability

For Accidental Damage to Insured Vehicle (Own Damage Claims):

Call our customer care Toll-free 1800-2-700-700 (Accessible from India only) if the vehicle meets
with an accident and provide your policy number for reference and register the claim

Alternatively, you can visit and register on IPO (available on website/Download IPO app on your
smart phone) by providing personal details, link your policy and register your claim under "Claims"
tab
Please keep the following details handy while intimating a claim
a. Policy No.
b. Registration details/ RC copy
c. Drivers details at the time of accident including driving license number
d. FIR on a case to case basis
e. Repair estimate

WHAT ARE THE MAJOR EXCLUSIONS OF THE POLICY?

WHAT IS THE CLAIM PROCESS?

a. General aging, wear & tear, mechanical or electrical breakdown, failure, depreciation, any
consequential loss
b. Damage by a person driving without a valid license
c. Damage by a person driving under the influence of liquor or drugs
d. Loss/damage attributable to war, mutiny, nuclear risks
e. Damage to tyres and tubes, unless damaged during an accident
f. Usage on hire & reward (applicable for all classes except public commercial vehicles)
g. Loss or damage to bonnet side parts, mudguard, bumpers, lamps, tyres, tubes, headlights, paint
work (applicable for all commercial vehicles; unless opted additionally)
h. Loss or damage resulting from overturning arising out of operation as a tool (applicable for mobile
cranes, drilling rigs, mobile plants, navvies, shovels, grabs, rippers unless opted for additionally)
i. Loss of or damage to accessories by burglary housebreaking or theft unless the vehicle is stolen at
the same time (applicable to all commercial vehicles & two wheelers)

1. If your vehicle can be driven, take it to the nearest dealer / garage.

2. Get a repair estimate, fill up the claim form and attach a copy of the registration certificate and
driving license of the person driving at the time of the accident.
3. If the garage is within our network, you could avail of cashless claim facility. Pay for non accident
related repairs, depreciation and deductible. We would settle the rest.
4. If the garage is outside our network, you would have to get the claim reimbursed subsequently.

TRANSFER OF INSURANCE (INCASE VEHICLE IS SOLD)

a. No objection letter from the previous insured
b. Form 29/30, Sale Deed OR transferred RC copy. In case of smart card, RTO transfer fee paid
receipt.
c. Differential Premium if any (NCB recovery, PA to Owner - Driver etc)
d. NOC from Financier, if applicable.
e. Pre-inspection is must if transfer request date is >14 days from the endorsed RC copy date
f. Break-in loading >45 days ( if applicable)
Additional Documents
a. Incase of death of Insured - a. Death Certificate b. Legal heir certificate
b. Incase of Employer to Employee transfer - a. Letter from Employer

WHAT CHANGES CAN BE DONE IN MY POLICY ENDORSEMENT

For Changes related to registration of vehicle or vehicle details like
a. Correction in registration number/ location / address
b. Correction in vehicle make & model/ cubic capacity/ seating capacity/ engine & chassis
number/manufacture year
To make above changes, you need following documents:
a. Request letter for the change
b. Policy copy
c. Registration Certificate copy /Invoice Copy for change in vehicle details
d. Cheque for additional premium if applicable

CLAIMS DOCUMENTS For ACCIDENTAL DAMAGE TO INSURED VEHICLE

a.
b.
c.
d.
e.
f.
g.
h.
i.

Duly filled and signed claim form & satisfaction voucher

Registration Certificate (RC)
Driving license of the person driving at the time of the accident
Policy copy , original repair estimate, repair invoice
Payment receipt for non-cashless claims
Original repair invoice for cashless claims
AML documents for amount more than 1 lac (PAN card, 2 passport size photo, residence proof)
Form 35 & original NOC from financer incase of total loss where payment is made to insured
A copy of police FIR/panchnama is required for TP injury / death / property damage

Additional documents required for commercial vehicles:

a. Spot survey
b. Load challan
c. Fitness certificate

Route permit

CLAIMS DOCUMENTS: IN CASE OF LOSS DUE TO THEFT

a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.

Duly filled and signed claim form & discharge voucher ( after loss settlement )
Original Registration Certificate (RC)
Original policy copy
Copy of FIR lodged at the nearest police station
All original keys & vehicle invoice copy
No trace report confirming that the stolen vehicle is not traceable
Original NOC from financer incase of hypothecation / HPA
Intimation to RTO for theft of vehicle
Duly signed RTO transfer papers (Form 26, 28,29,30,35)
RC extract with stolen remark from the concerned RTO after the loss
AML documents for amount more than 1 lac (PAN card, 2 passport size photo, residence proof)
Deed of subrogation cum indemnity on judicial stamp paper

WHAT IS NCB?
NO CLAIM BONUS (NCB):
NCB is provided for every claim free year basis the slab as provided by Tariff.

For addition of electrical and non electrical accessories, CNG & LPG Kit:
a. Request letter for the change
b. Policy copy
c. Invoice copy (mandatory where value of accessory exceeds ` 20,000/-)
d. Endorsed Registration Certificate Copy (For CNG/LPG kit)
e. Cheque for additional premium
E mail or Call us for additional premium details & send relevant documents copy to our customer service
office
For Change of financier details (Hypothecation/Lease/Hire-Purchase)
a. Request letter for the change
b. Policy copy
c. Endorsed Registration Certificate copy
d. NOC from financier (not mandatory for deletion if RC is endorsed)

How can I get No Claim Bonus Reserving Letter?

NCB Reserving letter can be provided only on Sale of vehicle evidenced by transferred RC copy OR
Sale Deed and Form 29 & 30. The OD section of the policy needs to be transferred to the new owner or
cancelled.

HOW DO I RENEW MY POLICY?

a. Visit [Link] to renew instantly
online
b. SMS "RENEW <POLICY NO> " to 9999
700700
c. Visit our nearest branch / your agent

d. Send a copy of the renewal notice along with

premium cheque to our branch office
/Corporate office
e. Call our toll free number 1800 2 700 700
(Accessible from India only)

HOW TO CONTACT US?

Call Toll-free
Fax
E-Mail
Write to us at
(Customer service office)
IPO

Link multiple policies

View/Email your policy

Register Motor claims

Track your claim status

* supports smart phone based on Blackberry, iPhone, Windows 8 & Android platform.

:1800 2 700 700 (Accessible from India only)

:022 6638 3669
:care@[Link]
:HDFC ERGO General Insurance Company Limited
6th Floor, Leela Business Park, Andheri Kurla Road, Andheri (East),
Mumbai - 400 059
:Raise a service request on Insurance Portfolio Organiser (IPO)

View/Edit your contact details

Set Renewal Reminders

Create and track your interactions

Locate our network garages/ branches

Download IPO mobile application from IPO website post log in

This document is a summary of the benefits offered. The information mentioned above is illustrative and not exhaustive. Information must be read in conjunction with the policy wordings.
In case of any conflict between this document and the policy wordings, the terms and conditions mentioned in the policy wordings shall prevail.

Ver.Aug14

For any endorsments on your policy you can contact us through any of the below mentioned modes:
E mail us at : care@[Link] OR Call Toll-free: 1800 2 700 700 (Accessible from India only)
OR Fax your request at: 022 6638 3669 OR Raise a service request on Insurance Portfolio
Organizer (IPO) from [Link]

Manage Your Portfolio

@ [Link] /
Smartphones*

d.