7/30/2019 Vhl Insuranceh

1/3

Important Notice

Policy Details

Generation Date: 20-Nov-2011

Name of Insured: Mr Malakari S Shendage

Address: MALAKARI.SHENDAGE C/O B C PUJARI AMBUJA NILAY OPP NEW COURT COMPLEX, NAVARASPUR

COLONY BIJAPUR MAHARASHTRA BIJAPUR -KARNATAKA

Mobile: 9766696711

Dear Mr Malakari S Shendage,

We thank you for choosing Bajaj Allianz General Insurance Company Ltd for insuring your Private Car - Package Policy .

Your Policy No is OG-12-2004-1801-00002055 .

We thank you for utilizing the online services of Bajaj Allianz General Insurance Co. Ltd to renew your policy online. This has reference to

your policy number BajajAllianz-OG-12-2004-1801-00002055 for your Private Car - Package Policy. Please find enclosed the policy sched-

ule. As a valued customer, we would like to provide regular updates on your policy, launch of new products and promotions so that you can

take advantage of the same. However if you do not wish to receive any such updates, you can register for 'Do Not Call' services on our web-

site www.bajajallianz.com .

Assuring you of our best services always and thanking you once again for insuring with us.

With Best Regards,

Ms Anamika Rashtrawar

Head - Corporate & Direct marketing

Bajaj Finserv,1st Floor , Survey # 208/1-B, Behind Weikfield IT-Park, Viman Nagar, Pune-411014

http://www.bajajallianz.com/http://www.bajajallianz.com/http://www.bajajallianz.com/http://www.bajajallianz.com/

7/30/2019 Vhl Insuranceh

2/3

Bajaj Allianz General Insurance Company Ltd.

City Pride Office No. 4 - 8, IInd floor 162,Railway lines Nr Employment Chowk Solapur 413001

0217-6450164

Receipt

Receipt Number: 2004-00035389 Receipt Date: 20-NOV-2011 Business Channel: BA

Received with Thanks from: Mr Malakari S Shendage

(Customer ID : 36922963 ) a total sum of Rupees Twenty thousand five hundred thirty-six rupees only .

Instrument Type Instrument Date Amount

DIRECT CREDIT PAYMENT 20-NOV-11 20536

Total Amount Received for this Policy 20536

Issuance of this receipt does not amount to acceptance of the risk by Bajaj Allianz General Insurance Company Lim-

ited. The insurance cover for the risk shall be as per the terms and conditions of the Insurance Policy if and when is-

sued.

Please note: This is an electronically generated receipt and does not require signature.

Regd Office : GE Plaza, Airport Road, Yerwada, Pune - 411 006

http://www.bajajallianz.com/

7/30/2019 Vhl Insuranceh

3/3

Certificate Cum Policy Schedule

Policy Details

Policy Issuing Office: City Pride, Office No. 4 - 8, IInd floor, 162,Railway lines, Nr Employment Chowk Solapur-413001 Ph:0217-6450164

Cover Note No.: Policy Issued On: 20-Nov-2011 18:16:22

Policy Number: OG-12-2004-1801-00002055 Product: Private Car - Package Policy

Period of Insurance: From: 25-Nov-2011, 00:00 To: 24-Nov-2012 Midnight

Insured Name: Mr Malakari S Shendage Zone: B

Insured Address: A/P-KARKAL, TAL-SOUTH SOLAPURSOLAPUR, , SOLAPUR-413001

Policy Holder ID: 36922963 Intermediary: 10003028 - KARUR VYSYA BANK LTD

Hypothecation: THE KARUR VYASYA BANK LTD Sub Imd Code: 2117

Vehicle DetailsRegistartion No. Make Model Sub Type Year Of Mfg.

MH13 TOYOTA INNOVA 2.5 GX (Diesel) 2010

Seat Cap. CC CNG/LPG Unit Elec.Acc Non- Elec. Acc.

8 2494 0 0 0

Vehicle IDV Chassis No. Engine No. Total Insured Declared Value

882602 MBJ11JV4007246744 2KD6666074 882602

Schedule Of Premium

A. Own Damage

Total Own Damage Premium: 15343

B. Liability

Basic Third Party Liability 2750

PA Cover for 8 Passengers of Rs.800000 400

PA Cover for Owner-Driver of Rs.200000 100

LL To Person For Operation/Maintenance for 1 Person 25

Bonus/ Malus 0

Total Liability Premium: 3275

C. Special Discount 0

D. Net Premium (A+B) 18618

E. Service Tax 1862

F. Education Cess 56

Final Premium Rs.(D+E+F) 20536

***All Premium Figures are in Rupees

No Claim Bonus: -20%

I/We declare that I have read the policy schedule and the rate of NCB claimed by me/us is correct and that no claim as arisen in the existing policy period

(copy of the policy enclosed). I further undertake that if this declaration is found to be incorrect, all benefits under the policy in respect of section 1 of the

policy will stand forteited. I hereby agree to confirm within 7 days in case of any objection or disagreement with the above.

Geographical Area India Additional Excess Rs. 0

Compulsary Deductible Rs. 1000 Voluntary Excess Nil

Previous Policy Expired On: 24-NOV-11 Previous Policy Number OG-

11-2004-1801-00001547

The above Total OD Premium is inclusive of all applicable Loading/Discounts viz (Automobile Association Membership, Voluntary Excess, Anti-Theft,

Handicap Person, Driver Tuition, Fiber Glass, CNG/LPG Unit, Geographical Extn., Imported Vehicle etc wherever applicable).

Limits Of Liability:

Under section II-I(i) of the policy -> Death of or bodily injury : Such amount as is necessary to meet there requirements of the Motor Vehicles Act, 1988.

Under section II-I(ii) of the policy -> Damage to Third Party Property : Rs. 750000

Limitation As To Use:

The Policy covers use of the vehicle for any purpose other than : Hire or reward, Carriage of goods(other than samples or personal luggage), Organ-

ised racing, Pace making, Speed testing, Reliability trials, Any purpose in connection with Motor Trade.

Driver:

Any person including the insured Provided that a person driving holds an effective driving licence at the time of the accident and is not disqualified from

holding or obtaining such a licence. Provided also that the person holding an effective Learner's licence may also drive the vehicle and that such a per-

son satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989.

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 byreason 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.

Subject to IMT Endorsement Nos: 22,7,24, 28, 16, Policy wordings attached herewith

*** If premium paid through cheque, the policy is void ab-initio in case of dishonor of cheque.

Premium Collection Details: - [Receipt No/Collection No/Amount] 2004-00035389,/1,/ Rs.20536,

This certificate of insurance is issued in accordance with the provision of Chapter X and Chapter XI of M.V.Act, 1988.

*****In case of any claim, please contact our 24 Hour Call centre at 1800-22-5858, 1800-102-5858, 1800-102-5858, 1800-209-5959(Toll Free)/

91-020-30305858(chargeable, add area code before this number in case of mobile call),or email us at 'info@bajajallianz.co.in' *****

Damage Details:-

Kindly contact our nearest / local offices for No Claim Bonus Confirmations.

This document is a pre signed document and will not be valid unless QC Verified and Signed/Counter Signed by an authorized sig-natory of Bajaj Allianz General Insurance Co.Ltd.

For & Behalf of Bajaj Allianz General Insurance Company Ltd. QC Verified and Signed/Counter Signed by

Stamp

DutyRs. 0.25

Authorized Signatory

Printed , Signed and Executed atPune

QC Verified and Signed/CounterSigned by

Consolidated stamp Duty paid vide Receipt No: .73333 dated26-AUG-11

Regd Office : GE Plaza,Airport Road, Yerwada Pune-411006 (India)

Bajaj Finserv,1st Floor , Survey # 208/1-B, Behind Weikfield IT-Park, Viman Nagar, Pune-411014

http://www.bajajallianz.com/