Policy PDF
Policy PDF
Registered and Head Office: Bajaj Allianz House, Airport Road, Yerwada, Pune
A. Proposer details
1. Proposer Name : PURANSHETIWAR SHASHANK
2. Proposer Address : H.No. 6-71-1,Arya Nagar, Near-Venkateshwar Temple,Borgaon(P), Nizamabad-503230
, , Nizamabad, TELANGANA-503230
3. Proposer Mobile Number : 8884120508
4. Proposer Residential Number : NA
5. Proposer e-mail id : [email protected]
6. Proposer Profession : NA
B.Vehicle Details
Registration Month / Year Vehicle Vehicle Vehicle Sub Cubic Capa- Fuel Type Year of Man- Seating Ca-
Number of Regn Make Model Type city/Kilowatt ufacture pacity
TS16EN9636 SEP/2017 HONDA WRV 1.5 VX MT 1498 Diesel 2017 5
DIESEL
Engine Number Chassis Number Vehicle IDV (in Electrical Non-Electrical CNG/LPG Unit Total IDV (in
Rs.) Accessories Accessories (Extra fitted) Rs.)
IDV (in Rs.) IDV (in Rs.) IDV (in Rs.)
N15A15011563 MAKGL274HH4 827551 0 0 0 827551
009458
C. Coverage opted
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),Organised 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 li-
cense at the time of the accident and is not disqualified from holding or obtaining such a license.
For help and more information:
Contact our 24 Hour Call Centre at 1800-102-5858, 1800-209-5858, 1800-22-5858, Toll Free: 30305858( chargeable, add area code before this number in case of mobile call) Email us at Ba-
[email protected] or Visit our Website www.bajajallianz.com
Corporate Identification Number U66010PN2000PLC015329
Latest Schedule - 20-Dec-2019 09:27:59 AM- Silent_Printing (Web) (0)
Provided also that the person holding an effective Learner's license may also drive the vehicle
when not used for the transport of goods/passengers at the time of the accident and that such a
person satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules, 1989.
Limits of Liability Under section II-I(i) of the policy -> Death of or bodily injury : Such amount is necessary to meet
there requirements of the Motor Vehicles Act,1988. Under section II-I(ii) of the policy -> Dam-
age to Third Party Property : Rs. 750000
No Claim Bonus
Existing Damage Details NA
Nominee Details Name :NA - Relationship :NA
Subject to Warranties/ 22,7,16, 22A, & Plan Name: 24x7 Spot Assistance And Consumableexpensescover And Acci-
IMT-Endorsements/ dental Medical Expenses, SI Rs. 100000 & Plan Description: 24x7 spot assistance , consumable
Add on Package expenses , , accidental medical expenses cover with sum insured Rs.100000
Additional Details Coinsurance Details: - . Transaction Id: -
Premium Details Receipt No. 9906-02852572, Date 24-AUG-19 ** If Premium paid through Cheque, the Policy is
void ab-initio in case of dishonour of Cheque.
Excess Details Compulsory Excess: Rs.1000 Additional Excess: Rs.0 Voluntary Excess: Rs.5000
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.
On specific request and subject to terms and conditions, record of information exchange will be made available.
For & On Behalf of
Bajaj Allianz General Insurance Company Ltd.
Stamp
Duty Rs.
0.25
Authorized Signatory
This document is digitally signed, hence counter signature / stamp is not required.
Consolidated Stamp Duty of Rs.0.25/- paid towards Insurance Stamps vide Challan No. MH003753522201920M Defaced No. 0002277216201920 ORDER NO.CSD/93/2019/3587/19
ORDER DATED 24.07.2019DEFACED DATE dated 23-JUL-19 timing 15:54:05 of General Stamp Office,Mumbai,India.
Principal Location : Bajaj Allianz House, Airport Road, Yerwada, Pune - 411006 PH:66026666 | Services Accounting Code : 997134 -
Motor vehicle insurance services. No reverse charge is payable on these services.
Bajaj Allianz General Insurance Company Ltd.
Bajaj Finserv Building, 1st Floor, Behind Weikfield IT-Park, Viman Nagar, Pune - 411014
Contact No:Contact No: 1800-209-0144
RECEIPT
Authorised Signatory
other type of insurance policy with any other insurer or manufacturer's warranty or recall campaign or under any
other such packages at the same time.(9) Replacement cost of battery and/or any associated repair cost. (10) Cost
of supply of parts or replacements elements or consumables. (11)Repair cost of tyre and/or parts or replacement
cost of any part of consumable at a third party workshop/repairer. (12)Any taxes, levy and expenses incurred in
excess of the limit described under the plan opted by You . (13)Loss of valuables and personal belongings kept in
the Insured Vehicle . (14) Any loss or damage to the Insured Vehicle arising out of participation in a motor ra-
cing competition or trial runs. (15)Where it is proved that You have abused the benefits under '24x7 Spot Assist-
ance'. (16)Any loss or damage caused due to pre- existing damages. (17)Any loss or damage arising out of inter-
vention of Government Authorized Agencies, Police Authorities or Law Enforcing Agencies . (18)Any loss or
damage resulting from the use of Insured Vehicle against the recommendations of the owners manual and/or
manufacturer's manual. (19)Any loss resulting from Your deliberate or intentional and/or unlawful or criminal act
(20)Benefits under 'Taxi Benefits' and 'Accommodation Benefits' for occupants in excess of the seating capacity
as per the registration certificate of the Insured Vehicle . (21)Additional cost incurred in towing the Insured
Vehicle to a dealer/workshop as specified by You instead to Our specified nearest authorized workshop. (22)Ser-
vices organized without Our prior consent for the various assistance services. (23)If You or Your personal repres-
entative is already at a garage for delivery of the Insured Vehicle or at the place of recovery in case of theft
(24)Mechanical and/or electrical breakdowns that require replacement of spare parts and/or specialized tools/
equipments that are usually available only in automotive workshops
If You do not agree whether any of these exclusions apply to Your claim, You agree to accept the burden of proving that
they do not apply.
D. Definitions
The words and phrases listed have special meanings We have set below whenever they appear in bold type and initial
capitals. Please note that references to the singular or to the masculine also include references to the plural or to the fe-
male the context permits and if appropriate.
(1) You,Your,Yourself: The person or persons We insure as set out in the Schedule . (2) We, Our, Us: Bajaj Al-
lianz General Insurance Company Limited and/or the Service Provider with whom Bajaj Allianz General Insur-
ance Company Limited has entered into a contract to provide the benefits under this cover to You . (3) Accident,
Accidental: A sudden, unintended and fortuitous external and visible event. (4) Policy/Motor Insurance Policy:
Private Car Package Policy issued by Us to which this cover is extended. (5) Insured Vehicle : The vehicle in-
sured by Us under the Motor Insurance Policy. (6) Policy Period: The period between and including the com-
mencement date and expiry date as shown in the Motor Insurance Policy Schedule . (7) Schedule : The Sched-
ule and any Annexure or Endorsement to it which sets out Your personal details and the type of insurance cover
in force
A. Endorsement Wordings
In consideration of payment of additional premium, it is hereby agreed and declared that if You/Your family members
(named in the Schedule) are Hospitalized on advice of a Doctor because of an Accidental Bodily Injury sustained dur-
ing the Policy Period while travelling in the Insured Vehicle, then We will reimburse You, the reasonable and custom-
ary medical expenses incurred up to a maximum Sum Insured as shown in the Schedule for this Cover aggregate in any
one Policy Period. The medical expenses reimbursable would include: i) the reasonable charges that You/Your family
members (named in the Schedule) necessarily incur on the advice of a Doctor for In-patient Care in a Hospital for ac-
commodation; nursing care; the attention of medically qualified staff; undergoing medically necessary procedures and
medical consumables. ii) Ambulance charges for carrying You/Your family members (named in the Schedule) from the
site of accident to the nearest hospital, subject to a limit of Rs. 1000 per claim.
B. Conditions
(1) Claims made by You against Us under #Accidental Medical Expenses Cover# are subject to the conditions set
forth under the Motor Insurance Policy (2)In case of transfer of ownership of the Insured Vehicle , the cover un-
der #Accidental Medical Expenses Cover# shall expire
C. Exclusions
In addition to the exclusions mentioned under under Motor Insurance Policy, We will not be liable to indemnify You
for the following events:
1. Where the Own Damage Claim made by You against Us under the Motor Insurance Policy is not payable. 2.
Accidental Bodily Injury that You/Your family members (named in the Schedule) meet with: a) Through suicide,
attempted suicide or self inflicted injury or illness b) While under the influence of liquor or drugs c) Arising or
resulting from You/Your family members (named in the Schedule) committing any breach of law with criminal
intent d) Whilst engaging in aviation or ballooning, whilst mounting into, dismounting from or travelling in any
balloon or aircraft other than as a passenger (fare paying or otherwise) in any duly licensed standard type of air-
craft anywhere in the world. e) Whilst participating as the driver, co-driver or passenger of a motor vehicle during
motor racing or trial runs f) As a result of any curative treatments or interventions that You/Your family members
(named in the Schedule) carry out or have carried out on your body g) Arising out of participation in any naval,
military or air force operations whether in the form of military exercises or war games or actual engagement with
the enemy, whether foreign or domestic 3. Consequential losses of any kind, be they by way of loss of profit, loss
of opportunity, loss of gain, business interruption, market loss or otherwise, or any claims arising out of loss of a
pure financial nature such as loss of goodwill or any legal liability of any kind whatsoever 4. Any injury/dis-
PRIVATE CAR PACKAGE POLICY: ADD ON COVERS(Plan Name: 24x7 Spot Assistance And Consumableex-
pensescover And Accidental Medical Expenses, SI Rs. 100000): POLICY WORDINGS
ablement/death directly or indirectly arising out of or contributed to any pre-existing condition 5. Venereal or
sexually transmitted diseases 6. HIV (Human Immunodeficiency Virus) and/or any HIV related illness including
AIDS (Acquired Immune Deficiency Syndrome) and/or mutant derivatives or variations thereof however caused
7. Pregnancy, resulting childbirth, miscarriage, abortion, or complications arising out of any of these 8. War
(whether declared or not), civil war, invasion, act of foreign enemies, rebellion, revolution, insurrection, mutiny,
military or usurped power, seizure, capture, arrest, restraint or detainment, confiscation or nationalisation or re-
quisition of or damage by or under the order of any government or public local authority 9. Nuclear energy, radi-
ation If You do not agree whether any of these exclusions apply to Your claim, You agree to accept the burden of
proving that they do not apply.
D. Claims Process
1) Making a Claim If You/Your family members (named in the Schedule) meet with any Accidental Bodily Injury that
may result in a claim, then as a condition precedent to Our liability: a) You or someone claiming on behalf must inform
Us in writing immediately and in any event within 30 days b) You must immediately consult a Doctor and follow the ad-
vice and treatment that he recommends c) You must take reasonable steps to lessen the consequence of Bodily injury d)
You must have Yourself examined by Our medical advisors if We ask for this e) You or some one claiming on behalf
must promptly give Us documentation and other information We ask for to verify the claim or Our obligation to make
payment for it f) In the event of Your/Your family members (named in the Schedule) death, someone claiming on de-
ceased#s behalf must inform Us in writing immediately and send Us a copy of the post- mortem report within 30 days
Note: Waiver of conditions (a) and (f) may be considered in extreme cases of hardship where it is proved to Our satisfac-
tion that under the circumstances in which You/Your family members (named in the Schedule) were placed, it was not
possible for You or any other person to give notice or file claim within the prescribed time limit. 2) Claim Settlement a)
You agree that We need only make payment when You or someone claiming on behalf has provided a claim to Our satis-
faction b) We will make payment to You or to Your Assignee. If there is no Assignee, We will pay to Your legal heir, ex-
ecutor or validly appointed legal representative as per succession certificate and any payment We make in this way will
be a complete and final discharge of Our liability to make payment
E. Definitions
The words and phrases listed have special meanings We have set below whenever they appear in bold type and initial
capitals. Please note that references to the singular or to the masculine also include references to the plural or to the fe-
male the context permits and if appropriate. 1. Accident, Accidental: A sudden, unintended and fortuitous external and
visible event 2. Assignee: The person named in the proposal or Schedule to whom the benefits under the cover are as-
signed by You/Your family members (named in the Schedule) 3. Bodily Injury: Physical bodily harm or injury but not
any mental sickness, disease or illness 4. Doctor: A person who holds a recognized qualification in allopathic medicine,
is registered by the medical council of any State of India in which he operates and is practicing within the scope of such
license. 5. Hospital: means any institution in India established for the indoor care and treatment of disease and injury,
which: a) Is registered and licensed as a hospital or nursing home with the appropriate local authorities and is under the
supervision of a registered medical practitioner OR b) Complies with minimum criteria of: i) At least 15 inpatient beds
(10 in Class C towns) ii) Fully equipped OT of its own where surgical operations are carried out iii) Fully qualified nurs-
ing staff under employment round the clock iv) Qualified doctors in charge round the clock but shall not include any es-
tablishment which is a place of rest, a place for the aged, a place for drug-addicts or a place for alcoholics, a hotel or sim-
ilar place 6. Hospitalized/Hospitalization: Your/Your family members (named in the Schedule) required stay of as an in-
patient in a Hospital within India for medically necessary treatment following and due to an insured event 7. In-patient
Care: The treatment for which You/Your family members (named in the Schedule) have to stay in a Hospital for more
than 24 hours for a covered event 8. Insured Vehicle: The vehicle insured by Us under the Motor Insurance Policy 9.
Own Damage Claim: The claims raised by You against Us for loss or damage to the Insured Vehicle due to the perils
mentioned under Section 1 of Motor Insurance Policy 10. Policy/Motor Insurance Policy: Private Car Package Policy is-
sued by Us to which this cover is extended 11. Policy Period: The period between and including the commencement date
and expiry date as shown in the Motor Insurance Policy Schedule 12. Schedule: The Schedule and any Annexure or En-
dorsement to it which sets out Your personal details, the type of insurance cover in force and the Sum Insured 13. Sum
Insured: The amount stated in the Schedule, which is the maximum amount We will pay for claims made by You irre-
spective of the number of claims You make in respect of Yourself/Your family members (named in the Schedule) 14.
You, Your, Yourself: The person or persons We insure as set out in the Schedule 15. We, Our, Us: Bajaj Allianz General
Insurance Company Limited
S17:CONSUMABLE EXPENSES
A. Endorsement Wordings
In consideration of payment of additional premium, it is hereby agreed and declared that if the Insured Vehicle is
damaged by a covered peril mentioned under the own damage section of the Motor Insurance Policy and needs to be
repaired, We will cover cost of consumables required to be replaced/ replenished during the repair of the damaged
vehicle. Consumable for the purpose of this cover shall include engine oil, gear box oil, power steering oil, coolant, AC
gas oil, brake oil, AC refrigerant, battery electrolyte, windshield washer fluid, radiator coolant, nut & bolt, screw, oil fil-
ter, fuel filter, bearings, washers, clip, wheel balancing weights , and items of similar nature excluding fuel.
B. Conditions
(a) This cover is applicable if it is shown on Your schedule. (b) Claims made by You against Usunder 'CONSUM-
ABLE EXPENSES' are subject to the terms and conditions set forth under the Motor Insurance Policy. (c)In case
of transfer of ownership of the Insured Vehicle , the cover under 'CONSUMABLE EXPENSES' shall expire.
(d) The benefits under under 'CONSUMABLE EXPENSES' would be available only if the Insured Vehicle is re-
paired at Our authorized workshops.
C. Exclusions
PRIVATE CAR PACKAGE POLICY: ADD ON COVERS(Plan Name: 24x7 Spot Assistance And Consumableex-
pensescover And Accidental Medical Expenses, SI Rs. 100000): POLICY WORDINGS
In addition to the exclusions mentioned under Motor Insurance Policy, We will not be liable to indemnify You for the
following events: (1)Where the Own Damage Claim made by You against Us under the Motor Insurance Policy is
not payable. (2) Consumables pertaining to any part/ sub part/ accessories not approved for replacement by Us under
Motor Insurance Policy. (3)Where a loss is covered under Motor Insurance Policy or any other type of insurance
policy with any other insurer or manufacturer's warranty or recall campaign or under any other such packages at the
same time.
D. Definitions
The words and phrases listed have special meanings We have set below whenever they appear in bold type and initial
capitals. Please note that references to the singular or to the masculine also include references to the plural or to the fe-
male the context permits and if appropriate.
(1)Authorized workshop / garage / service station - A motor vehicle repair workshop / garage / service station author-
ized by us. (2)Insured Vehicle: The vehicle insured by Us under the Motor Insurance Policy and as shown on the Sched-
ule. (3)Policy/ Motor Insurance Policy: Motor Package Policy issued by Us to which this cover is extended.
(4)Schedule: The Schedule and any Annexure or Endorsement to it which sets out Your personal details and the insur-
ance cover in force. (5)We, Our, Us: Bajaj Allianz General Insurance Company Limited. (6)You, Your, Yourself: The
person or persons We insure as set out in the Schedule.