Professional Documents
Culture Documents
Date: 14/03/2011
Policy No.: 0151197809 00
Ms. SENNAMERY .N
NO. 12/1, NAVASANNATHI STREET,,
VILLIANUR,,
PONDICHERRY 605110,
PONDICHERRY
Work Phone:
Your Policy number is 0151197809 00 . The insurance coverage that you have opted for is Scooter/Motor Cycle
Insurance . The details of your coverages and the other guidelines regarding your policy can be had from the policy
document and the guide to our products that is enclosed with this. Please do file these documents for future reference.
I am sure that you will benefit from the best that we have to offer.
You and your family are offered security and convenience by us through a host of benefits under the policy that you
have opted for, security in the feeling that your assets are protected and convenience in accessing us as your insurer.
The most striking feature of this accessibility being the 24 - hour help line for all our policyholders. Please do call us
at this number in case you require any clarifications or services.
We shall work on providing you with many more benefits that will stand by our commitment to provide you with
nothing but the best.
We thank you for choosing us for your requirements and promise you a pleasant experience called insurance.
Sincerely yours,
Tata AIG General Insurance Co. Ltd. Policy Holder Services, P. O. Box No. 9407, Chakala MIDC- Post Office. Mumbai 400093.
TOLLFREE HELP LINE: 1 800 119966
(Regd Office : Peninsula Corporate Park, Nicholas Piramal Tower, 9th Floor, Ganpatrao Kadam Marg, Lower Parel, Mumbai 400013)
RECEIPT
a sum of Rs. 918.00 ( Rupees Nine Hundred Eighteen and Paise 00 Only )
Sr. No. Policy No. Total Premium (Rs.) Utilised from Receipt (Rs.)
1 0151197809 918.00 918.00
Excess: 0.00
REVENUE
STAMP
Note:
1. This is a computer generated receipt and does not require a signature.
2. This receipt is issued subject to realisation of the cheque.
3. Upon issuance of this receipt, all previously issued temporary receipts, if any, related to this policy, are
considered null and void.
4. Any excess amount will be adjusted against subsequent policy applications, or will be refunded on demand.
Service Tax Registration No : Insurance/Tata/Mumbai-I/1542/2001-02 .
Tata AIG General Insurance Co. Ltd. Policy Holder Services, P. O. Box No. 9407, Chakala MIDC- Post Office. Mumbai 400093
TOLLFREE HELP LINE: 1 800 119966
(Regd Office : Peninsula Corporate Park, Nicholas Piramal Tower, 9th Floor, Ganpatrao Kadam Marg, Lower Parel, Mumbai 400013)
RP01 Branch: Chennai ORIGINAL Page 2 of
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Tata AIG General Insurance Company Ltd.
Certificate of Insurance and Policy Schedule
Form 51 of the Central Motor Vehicle Rules, 1989
Agent/Broker Producer Name - Lotus Agencies
Agent/Broker License Code - 505306 Agent/Broker Contact No.-0444990356 1
Certificate & Policy No. Policy Type
0151197809 00 Package Policy -Scooter/Motor Cycle Insurance
Effective time and date of commencement of Insurance From 00:01 Hours on 17/03/2011
Premium (incl.S.Tax) Rs. 918.00
Date of Expiry Midnight on 16/03/2012 Insured's Business/Profession SELF-EMPLOYED
Place of Registration PONDICHERRY Geographical Area INDIA
Name and address of the Insured Under Hire Purchase/Hypothecation/Lease with
Name: SENNAMERY .N
Address : NO. 12/1, NAVASANNATHI STREET,,
VILLIANUR,,
PONDICHERRY 605110,
PONDICHERRY
Less : 20.00% for NCB Rs. 121.00 Add: Compulsory PA Cover for Owner-Driver Rs.1,00,000 Rs. 50.00
A. TOTAL OWN DAMAGE PREMIUM (rounded off) Rs. 482.00 B. TOTAL LIABILITY PREMIUM Rs. 350.00
Receipt(s): W001485939
Service Tax Registration No : Insurance/Tata/Mumbai-I/1542/2001-02.
The stamp duty of Rs. 0.50 /-( Rupees zero and Paise 50 Only) paid in cash or demand draft or by pay
order, vide Receipt/Challan no 29716 dated the 25/10/2010 .
Tata AIG General Insurance Co. Ltd. Policy Holder Services, P. O. Box No. 9407, Chakala MIDC- Post Office. Mumbai 400093
TOLLFREE HELP LINE: 1 800 119966
(Regd Office : Peninsula Corporate Park, Nicholas Piramal Tower, 9th Floor, Ganpatrao Kadam Marg, Lower Parel, Mumbai 400013)
DA17 Branch: Chennai ORIGINAL Page 3 4of
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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 Vehicles Act, 1988 is recoverable from the Insured. See the clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHT OF
REC OVER Y" .
This Schedule, the attached Policy and Endorsements mentioned herein above shall read together and word or expression to which a specific meaning has been attached in any part of this
Policy or of the Schedule shall bear the same meaning wherever it may appear.
Any amendments/modifications/ alterations made on this system generated policy document is not valid and Company shall not be liable for any liability whatsoever
arising from such changes. Any changes required to be made in the policy once issued, would be valid and effective, only after written request is made to the Company
and Company accepts the requested amendments/modifications/alterations and records the same through separate endorsement to be issued by the Company.
Tata AIG General Insurance Co. Ltd. Policy Holder Services, P. O. Box No. 9407, Chakala MIDC- Post Office. Mumbai 400093
TOLLFREE HELP LINE: 1 800 119966
(Regd Office : Peninsula Corporate Park, Nicholas Piramal Tower, 9th Floor, Ganpatrao Kadam Marg, Lower Parel, Mumbai 400013)
DA17 Branch: Chennai ORIGINAL Page 4 4of
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