Need to make a claim?

03300 240 242

Statement of Fact
Please read the following facts carefully, they are a record of the information provided by you, which is effective
from 17th September 2018 at 17:20. If you are satisfied that, to the best of your knowledge and belief, the
information in this document is correct then you do not need to do anything. If any of the facts are incomplete
or incorrect, please contact us on 03300 240 123.

Failure to correct any incorrect facts may:

• Result in any claim you make being rejected or not fully paid.
• Result in your insurance being cancelled or treated as if it never existed.
• Result in different terms being applied to your policy or your premium increasing.

You will be informed of any changes to your premium or terms.

Your cover

Start date 17/09/2018 at 17:20 Protected NCB Protected

Level of cover Comprehensive Cover Do you have use of other Yes – Own Another Car
vehicles (not including this
car)?

No claims bonus (NCB) 6 years Voluntary excess £100.00

Who, on this policy uses Mr Mandar Kulkarni How many vehicles in your 2
your car the most? household do you have
access to?

Would you like to add any other drivers to your policy? Yes

Your car details

Car registration AJ11XKC Year of registration 2011

Car make and model HONDA JAZZ HE IMA Alarm or immobiliser Thatcham Category 2
HYBRID 1339

Fuel type Petrol Tracking device No

Registered owner Policyholder Registered keeper Policyholder

Right hand drive Right Hand Drive (UK Insured value £4,245.00
Standard)

Modification details None

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Owning and using your car

Purchased car 01/07/2016 Car night location On A Driveway

Car usage Social, Domestic And Total annual mileage 3,000

Pleasure Only

Car day location On A Driveway Business mileage 0

About you

First name Mandar Surname Kulkarni

Contact telephone 07891919064 Email contactmandar@gmail.c

om

Address 214 Queen Ediths Way, Cambridge, Cambridge, CB1 8NL

Marital status Married Employment status Employed

Date of birth 04/12/1977 Main occupation IT Consultant

UK residence since 01/06/2008 Type of main occupation Information Technology

business

Preferred contact method Email Part time occupation None

Home owner Yes Type of part time None

occupation business

Your driving history

Type of driving licence UK Full Additional driving No

qualifications

Driving licence held for 6 years Licence restricted No

In the last 5 years, have you had any accidents, claims No

or damage involving any motor vehicles even if no
claim was made and regardless of blame?

Have you had any driving licence endorsements, fixed No

penalties or driving disqualifications In the past 5
years, or have any prosecutions pending?

Do you have any unspent criminal convictions? No

Have you ever had insurance refused or cancelled, or No

had additional terms applied?

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Named driver information Named driver

First name Yogita

Surname Kulkarni

Date of birth 24/07/1980

Relationship to you Spouse

Marital status Married

UK residence since 2008

Employment status Employed

Occupation Software Engineer

Business Information Technology

Part time occupation None

Part time business None

Driving licence type UK Auto

Driving licence held for 2

Additional driving qualifications No

Do they have any medical conditions that affect their No

driving?

In the last 5 years, have they had any accidents, claims No

or damage involving any motor vehicles?

In the last 5 years have they received or have any No

motoring convictions pending (including fixed penalty
endorsements) or been disqualified?

Have any of the additional drivers had any unspent No

criminal convictions?

Have any of the additional drivers ever had insurance No

refused or cancelled, or had additional terms applied?

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It’s really important to understand what you are and aren’t
covered for, so please review your policy booklet. Have a look
and make sure your policy covers you for what matters so
there are no surprises should you be unfortunate enough to
make a claim. If your cover is not fit for purpose then give us a
call on 03300 240 123.

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How we use your information
The personal information, provided by you, is collected by or on behalf of Covea Insurance plc and may be used
by us, our employees, agents and service providers acting under our instruction for the purposes of insurance
administration, underwriting, claims handling and for research, or statistical purposes. We may also share your
information with reinsurers and regulators, as required by law. From time to time we may need to undertake
some of the processing of your data in countries outside of the European Economic Area, and in such cases we
will ensure that there is an agreement in place which gives equivalent assurances as found in the current data
protection laws.

We will collect sensitive information when dealing with your policy, we will however only collect information that
is relevant to your policy, its administration or claims handling. Your personal information will be kept secure at
all times.

We have appointed a Data Protection Officer who is responsible for overseeing how we handle your
information. Please contact us if you have any questions about our privacy policy or the information we hold
about you.
Write to us at:

The Data Protection Officer

Covea Insurance Plc
50 Kings Hill Avenue
Kings Hill
West Malling
Kent
ME19 4JX

Or email: dataprotection@providentinsurance.co.uk

Fraud prevention and detection

In order to prevent or detect fraud we will check your details with various fraud prevention agencies, who may
record a search. Searches may also be made against other insurers’ databases. If fraud is suspected,
information will be shared with those insurers and fraud prevention agencies. Other users of the fraud
prevention agencies may use this information in their own decision making processes. We may also conduct
credit reference checks in certain circumstances. You can find out further details explaining how the information
held by fraud prevention agencies may be used or in which circumstances we conduct credit reference checks
and how these checks might affect your credit rating by contacting us using the details below.

Disclosure of other people’s personal information

You should show this notice to anyone whose personal information you provide to us. You must ensure that any
such information you supply relating to anyone else is accurate and that you have obtained their consent to the
use of their data for the purposes set out above.

Your rights
Under the Data Protection Act 1998 you have the right of access to the personal information held about you by
Covea Insurance plc. You can exercise this right by contacting us. We will make a charge of £10 for dealing with
these requests.

You have the right to request that we correct any inaccuracies in the personal information we hold about you.
Please contact us if your personal information needs updating.

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 Telephone 03300 240 123
www.providentinsurance.co.uk

Provident Insurance is a trading name of Covea Insurance plc. Registered Office: Norman Place, Reading,
RG1 8DA. Registered in England and Wales, Number: 613259. Covea Insurance plc is authorised by the
Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential
Regulation Authority. Financial Services Register number: 202277.
Correspondence address PO Box 847, Dean Clough, Halifax, HX1 9RE. PIM0010705 08/15
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