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Go Digit General Insurance Ltd.

Schedule/Certificate
Digit Private Car Policy UIN No.: IRDAN158RP0005V01201718

YOUR DETAILS PARTNER DETAILS

Name: ANIRUDHA B V Partner Name: HYUNDAI INDIA INSURANCE BROKING

PRIVATE LIMITED

Registration Number: KA41P6796

N Partner Code : 1124420

Policy Number: D116596152 / 19092023

Partner Mobile Number: 9876543210
G Mobile Number: xxxxxxxxx4

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H Partner Email : [email protected]

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M Email: [email protected]

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YOUR POLICY DETAILS

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Policy Issue Date 19-Sep-2023 Invoice No. IA108266906 Invoice Date 19-Sep-2023

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MA Period of Policy for
From 28-Sep-2023 00:00:00 NCB % (Current Policy) 50%

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Own Damage Cover

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To 27-Sep-2024 23:59:59 Additional Excess (`) --

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--

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From 28-Sep-2023 00:00:00 Voluntary Deductible (`)
Period of Policy for

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4.5 Third Party Liability
To 27-Sep-2024 23:59:59 Compulsory Deductible (`) 2000
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From 28-Sep-2023 00:00:00
Period of Policy for
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10 PA Owner-Driver
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Address 53/239 SANJEEVINI KALEGOWDA GARDEN BHD R R NAGAR POLICE STATION BEML 5TH STAGE RRNAGAR,BANGALORE-
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560098
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YOUR VEHICLE DETAILS

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Model/Vehicle Variant (Sub-

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RTO Location Bengaluru,KARNATAKA Make HYUNDAI Type) FLUIDIC VERNA/1.6 VTVT SX

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Seating Capacity 5 Fuel Type Petrol Year of Regn./ 2012/2012
Manufacturing
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Engine No. G4FCCU577311 Chassis No. MALCU41DLCM089704 Cubic Capacity 1591 CC

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Odometer FASTag NA Financier Details

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A FASTag NUMBER DECLARATION

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The Policy has been issued subject to your affirmative declaration that a valid FASTag has been affixed on the insured vehicle.
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Call us at 1800-258-5956 to update your contact details. This will help us give you a smooth claim process.
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YOUR VEHICLE IDV

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Year Vechicle IDV Non-Electrical Electrical CNG/LPG Trailer Total PA Owner

(`) Accessories IDV (`) Accessories IDV (`) IDV (`) IDV (`) IDV (`) Driver

Year 1 247000 -- -- -- -- 247000.00 1500000

Year 2 -- -- -- -- -- -- --

Year 3 -- -- -- -- -- -- --
D07
Policy No: D116596152
Page No: 1 of 4
112 Go Digit General Insurance Ltd, GST Reg No 29AACCO4128Q1ZW , PAN No:- AACCO4128Q, HSN: 997134/General Insurance Services, GSTIN Address
:Bangalore MD Business Centre,Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block,Bengaluru,Karnataka,PIN-560095. Website :
www.godigit.com.
Corporate office Address : Atlantis, 95, 4thB Cross Road, Koramangala Industrial Layout, 5thBlock, Bengaluru, Karnataka, PIN - 560095, IRDAI Reg No. 158,
CIN - U66010PN2016PLC167410
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Go Digit General Insurance Ltd.
Schedule/Certificate
Digit Private Car Policy UIN No.: IRDAN158RP0005V01201718
OWN DAMAGE PREMIUM [A] (`)
LIABILITY PREMIUM [B] (`)
Total Basic Own Damage Premium (`) 2283.98 Basic Third-Party Liability (`) 7897.00
NCB Discount Amount (`) -1141.99 PA cover for Owner-Driver (`) 475.00
Others (`) -- Legal Liability to Employees (`)
Own Damage Premium (`) 1141.99 Legal Liability to Paid Driver (`) 50.00
Add-Ons Premium (`) 0.00 PA cover for 5 passengers 0 (`) --
CNG/LPG Premium (`)
PA cover for Paid Driver (`)
Total OD Premium (`) 1141.99 Total Act Premium (`) 8422.00
Net Premium (`) 9563.99 1,142 7897
1721.52
50
1141.99
CGST @ 9% = (`860.76) + SGST/UTGST @ 9% = (`860.76) 1141.99

Final Premium (`) 11285.51

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Note: The above total OD premium is inclusive of all applicable loading / discounts viz (automobile association memberships, voluntary excess, anti-theft

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handicap person, driver tuition, fiber glass, CNG/ LPG unit, geographical extension, imported vehicle etc., wherever applicable).

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In case of an accident to your vehicle, please intimate us immediately for SPOT SURVEY. Failure to intimate in time could prejudice your claim.
If the “Own Damage Cover” under your policy is cancelled during the policy period, then your policy shall be governed by the standard terms and conditions

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of “Act only” policy for the Third Party Cover during the remaining period of policy .

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ENDORSEMENT

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Invoice Number Invoice Date Net Premium Igst Cgst Sgst Utgst Cess Gross Premium

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IA108266906 2023-09-19 9563.99 0.00 860.76 860.76 0.00 0.00 11285.51

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OTHER DETAILS

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Previous Insurer Go Digit General Insurance Limited

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Previous Policy No. D075456556 Previous Policy Expiry Date
24 27-Sep-2023
IMT - Endorsements IMT-22,IMT-28
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GSTIN/UIN No. Unregistered State Code 29

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Payment Mode Online Cheque/Transation No pay_Me6R4UwyrE8Ztr

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Bank Name IFSC/MICR No --

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Premium Payment Details Receipt Number RA123246108 Receipt Date 19-Sep-2023

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Nominee Details MANJU SHREE

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SPOUSE
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19-Sep-1984
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Other Details --
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Details of Existing Damages --

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POSP INFORMATION AKA PARTNER DETAILS

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Name T S PRAKASH
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Unique Number NA
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Location NA
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PAN Number AXKPP0894N

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Aadhaar Number xxxxxxxx7592

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Policy No: D116596152

Page No: 2 of 4
Go Digit General Insurance Ltd, GST Reg No 29AACCO4128Q1ZW , PAN No:- AACCO4128Q, HSN: 997134/General Insurance Services, GSTIN Address
:Bangalore MD Business Centre,Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block,Bengaluru,Karnataka,PIN-560095. Website :
www.godigit.com.
Corporate office Address : Atlantis, 95, 4thB Cross Road, Koramangala Industrial Layout, 5thBlock, Bengaluru, Karnataka, PIN - 560095, IRDAI Reg No. 158,
CIN - U66010PN2016PLC167410
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Go Digit General Insurance Ltd.
Schedule/Certificate
Digit Private Car Policy UIN No.: IRDAN158RP0005V01201718
Follow these rules like you follow the rules of the road.
Geographical Area: Any accidental loss, damage and/or liability caused, sustained or incurred within India shall be covered subject to Policy Terms and Conditions, unless specifically agreed and endorsed.. Limitation as
to use The policy covers use of the vehicle for any purpose other than hire or reward, racing, pace making, reliability trial, speed testing and use for any purpose in connection with the Motor Trade. Person or Class of
persons entitled to drive: Any person including the insured 1) Provided that a person driving holds a valid & effective driving license at the time of the accident and is not disqualified from holding or obtaining such a
license. 2) Provided also that the person holding a valid & effective Learner’s License may also drive the vehicle and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989 and
any subsequent amendment as applicable. Limits of Liability: 1) Under Section I of the policy _ IDV as shown in the schedule. 2) 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. 3) Under Section II _ 1 (ii)of the policy: Damage to Third Party Property _ `750000 4) P.A. Cover for Owner Driver under Section III (CSI) - `1500000
NCB Declaration: The premium has been charged and policy has been issued subject to NCB declared by you as an insured. In the event of NCB found wrongly declared at any point of time during policy period, all
benefits and coverages under the Policy in respect of section I of the Policy will stand forfeited. If there is any disagreement, write to us within 7 days from the date of issuance of policy or before the start date of period of
insurance whichever is earlier.PUC Declaration: The Policy has been issued subject to valid Pollution Under Control (PUC) Certificate disclosed by you as an insured on or before the date of commencement of the Policy .
Cheque dishonor / Non-receipt of payment premium paid through Cheque, the policy is void ab-initio in case of dishonor of Cheque or non-receipt of payment. Violation of Motor Vehicle Act: This policy is issued in
accordance with the provision of Chapter X and Chapter XI of MV act, 1988 and any subsequent amendment as applicable. Any violation will forfeit all benefits and coverages under the Policy. 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 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) in the policy. Pre-existing Damages: All types of pre-existing damages or cost of repair of such
damage will be excluded at the time of claim settlement,as per the attached images. Important Notice: The company may cancel the policy by sending 7 days notice in case of fraud, misrepresentation, non disclosure of
material fact or non co-operation of the insured. This policy is subject to the standard policy wordings, warranties and conditions applicable for this product in addition to Indian Motor Tariff. Break in Insurance: In case of
a break-in, the company may conduct pre-inspection of the vehicle and in such a case, Own Damage cover (Section -I) of the policy would not commence unless the pre-inspection of the vehicle has been done and the
acceptance of risk is subject to evaluation of the vehicle inspection report. In case of any adverse findings in the report, the Company, at its discretion, may cancel the Policy as per the Motor Tariff.
Note: The policy is issued in utmost good faith, relying on the information shared by insured at the time of obtaining the policy. The terms and conditions detailed in this policy schedule as well as the policy document sent
by Digit shall prevail in case of any dispute.

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For & On Behalf of Go Digit General Insurance Ltd.

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Wish to go through your detailed policy wordings, click here.

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In case of claim or any other query, please contact our 24-

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hour Call Centre at 1800-258-5956 or email us at Praveen Bhat
[email protected] or visit our website Digit Insurance: Car,

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Senior Vice President - Customer Experience
Bike, Health & Travel Insurance Online . [email protected]
For instant resolution, you can ping us “Hi” on WhatsApp at

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Authorized Signatory
702 606 1234

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Printed, Signed, and Executed at Bengaluru
For Claims Notification and Procedure click here. Consolidated Stamp Duty has been paid as per

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Letter of Authorization No.67-B/04/2017-18 Date:

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30th May 2017 issued by Department of Stamps

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and Registration , Bengaluru- 560009 -

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KARNATAKA.
Hey, our document is now digitally signed

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24 Click here to view the certificate.
For instant resolution, you can ping us “Hi” on
WhatsApp at 702 606 1234
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Go Digit General Insurance Ltd. Address: Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru, Karnataka 560095. IRDAI Reg No. 158 CIN U66010PN2016PLC167410, GST Reg. No.:
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29AACCO4128Q1ZW HSN: 997134/General Insurance Services, GSTIN Address:Bangalore MD Business Centre,Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block,Bengaluru,Karnataka,PIN-
560095
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Policy No: D116596152

Page No: 3 of 4
Go Digit General Insurance Ltd, GST Reg No 29AACCO4128Q1ZW , PAN No:- AACCO4128Q, HSN: 997134/General Insurance Services, GSTIN Address
:Bangalore MD Business Centre,Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block,Bengaluru,Karnataka,PIN-560095. Website :
www.godigit.com.
Corporate office Address : Atlantis, 95, 4thB Cross Road, Koramangala Industrial Layout, 5thBlock, Bengaluru, Karnataka, PIN - 560095, IRDAI Reg No. 158,
CIN - U66010PN2016PLC167410
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Go Digit General Insurance Ltd.
Schedule/Certificate
Digit Private Car Policy UIN No.: IRDAN158RP0005V01201718

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Policy No: D116596152

Page No: 4 of 4
Go Digit General Insurance Ltd, GST Reg No 29AACCO4128Q1ZW , PAN No:- AACCO4128Q, HSN: 997134/General Insurance Services, GSTIN Address
:Bangalore MD Business Centre,Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block,Bengaluru,Karnataka,PIN-560095. Website :
www.godigit.com.
Corporate office Address : Atlantis, 95, 4thB Cross Road, Koramangala Industrial Layout, 5thBlock, Bengaluru, Karnataka, PIN - 560095, IRDAI Reg No. 158,
CIN - U66010PN2016PLC167410