Royal Sundaram General Insurance Co.

Limited
(Formerly known as Royal Sundaram Alliance Insurance Company Limited)
Corporate Office :Vishranthi Melaram Towers No. 2 / 319,
Rajiv Gandhi Salai (OMR),Karapakkam,Chennai - 600097.
Registered Office: 21, Patullos Road, Chennai 600 002.
Call : 1860-425-0000,1860-258-0000 ,E-mail:[email protected]
Website: www.royalsundaram.in
IRDA Registration No.102 | CIN-U67200TN2000PLC045611
Quote
Private Car Package Policy
This quote is issued only for quotation purpose and its not a policy document.
Address:
Mr.JFGJGKG

SURAT, GUJARAT
Tel: Mobile: 99xxxxxx11
Name of Proposer Mr.JFGJGKG
Proposer's Date of Birth Occupation
Quote No. QVPC17388059 Inception Date 24/03/2022
Geographical Area India Issued Date 22/03/2022 15:53:15
Registration Authority GJ05-SURAT Last Modified Date: 22/03/2022 15:53:48
Ref Code BA503599 Registration Date: 27/03/2017
Policy Period 1 OA Code: BR502965
PRIVATE CAR VEHICLE DETAILS
Registration Number GJ05JS8585 Type of Body Hatchback
Engine Number K12MN4248658 Cubic Capacity 1,197
Chassis Number MBHEWB22SHC105636 Year of Manufacture 2017
Registration City SURAT Registration State GUJARAT
Make of the Vehicle MARUTI UDYOG LTD. Seating Capacity (including driver) 5
Model Description New Baleno Delta Net Premium (in Rs.) 13,142
INSURED'S DECLARED VALUE (IDV) (in Rs.)
Non Electrical / Value Loss For Life
For the For Total Invoice
Electrical Electronic of CNG Of Time
Vehicle Trailers IDV Price
Accessories Accessories Kit Baggage Road Tax
333,100 0 0 0 0 333,100 10,000 0 0
A - OWN DAMAGE Rs. B - LIABILITY Rs.

Basic premium on Vehicle 4,543.00 Basic premium including premium for TPPD 3,221.00

Less: For restricted TPPD cover for Rs.6000

Non-Electrical Accessories 0.00 0.00
(IMT 20)
Electrical & Electronic accessories @ 4% (IMT 24) 0.00 Trailers (IMT30) 0.00
Bi-fuel kit (CNG) @ 4% (IMT 25) 0.00 Bi-fuel kit (CNG) 0.00
Add: Add:
a) Trailer 0.00 Personal Accident Benefits
b) Geographical Area Extn.Endt.IMT-1 0.00 a) Geographical Area Extn.Endt.IMT-1 0.00
b) Under Section III (Owner Driver), CSI Rs.
315.00
1,500,000
c) 30% for Imported vehicles without custom duty 0.00 c) Named Passengers, CSI Rs.0 each as per
0.00
(IMT 19) list attached (IMT 15)
d) Unnamed Passengers, CSI Rs.100,000 250.00
each (IMT 16)
e) P.A Cover to Paid Driver, CSI Rs.100,000 50.00
d) Fibre Glass Tanks (IMT 17)
0.00 f) Enhanced PA cover , Owner Driver, CSI
e) 60% on OD Premium for Driving Tution 0.00 0.00
Rs.0
f) Additional Towing ChargesCover 0.00 g) Enhanced PA cover, Named Passengers
0.00 CSI Rs.0.00 Each as per list attached 0.00
g) For any Other extra
h) Enhanced PA cover, Unnamed Passengers,
CSI Rs.0.00 0.00
i) Enhanced PA cover, Paid Driver, CSI Rs.
0.00 0.00
Less: Legal Liability
h) Discount for Anti-theft devices (IMT 10) 0.00 To Paid Driver (IMT 28) 0.00
i) 50% Discount for Vehicles specially designed/ modified 0.00 To Employees (IMT 29)
0.00
for blind, handicapped and mentally challenged persons.
j) Automobile Association Discount (IMT 8) 0.00
For any other extra 0.00
k) Any other discount 0.00
% for Voluntary Deductible (IRDAN102A0006V01200910) of 0.00
Rs.0 TOTAL LIABILITY PREMIUM (B) 3,836.00
(IMT 22 A)
l) Vintage Car Discount 0.00 PACKAGE PREMIUM (A + B) 11,137.00
Deduct:20% No Claim Bonus -908.60 Add: Underwriter Loading % 0.00
Final Discount @0% 0.00
0.00 Less: Special Discount @ %
Add: Underwriter Loading 0.00 NET PREMIUM 11,137.00
Add: Additional Cover for Package Policies
1)Depreciation Waiver (IRDAN102A0011V03201213) 3,064.80
2)Windshield Glass (IRDAN102A0004V01200910) 0.00
3)Facilities in Lieu of Spare Car (IRDAN102A0007V01200910) 0.00 ADD:SGST 1,002.33
4)Full Invoice Price Insurance (IRDAN102A0008V01200910) 0.00 ADD:CGST 1,002.33
5)Life Time Road Tax (IRDAN102A0005V01200910) 0.00
6)Loss of Baggage (IRDAN102A0009V01200910) 100.00
7)NCB Protector Cover (IRDAN102A0002V01201314) 0.00
8)Aggravation Cover (IRDAN102A0001V01201314) 400.00
9)Key Replacement Cover (IRDAN102A0001V01201516) 101.60
10)Tyre Cover (IRDAN102A0003V01201718) 0.00
TOTAL OWN DAMAGE PREMIUM (A) 7,301.00 TOTAL PREMIUM PAYABLE 13,141.66
Quote Valid Up To : 05/04/2022
Disclaimer:This quote is valid for 15 days from the date of issuance of the quote. The premium Quoted is based on the details shared and is
subject to change if there is any revision made in the Third-Party premium by the Regulator or if there is any rate revision or fresh guidelines
issued by Royal Sundaram in the interim period. Any change in the risk or vehicle details from what has been declared will make this quote null
and void
GSTIN : 24AABCR7106G1ZP Base Product UIN: IRDAN102RP0004V02201617 PAN Number : AABCR7106G
Enhanced PA Cover Clause UIN: A0020V01201920

IRDA Registration No.102