FUTURE GENERALI INDIA

Insurance Company Limited

IND-0208352-01-R-1
MOTOR SECURE - PRIVATE CAR INSURANCE - COMPREHENSIVE POLICY
CERTIFICATE OF INSURANCE CUM POLICY SCHEDULE - Form 51 of the Central Motors Vehicles Rules, 1989
Policy Servicing Office : Future Generali India Insurance Company Limited, 2nd and 3rd Flr, Embassy 9-1-3, M.G.Rd, Indore, Madhya Pradesh, 452001,
Tel_No:0731-6670001
Policy and Certificate Number : 2014-V3136240-FPV Period of Insurance i : From 00:00 hrs of 11/07/2014 To midnight of 10/07/2015.
Insured : M P Ply and Veneer Covernote No :8F8378010zzzz Dated:z30/06/2014zzzzzzZone: B
Address : Lg 2 Shell Tower, 45/47 Sneh Nagar Main Road, Intermediary Name/Code : Landmark Insurance Brokers Pvt Ltd / 60024724
Indore, Madhya Pradesh, 452001 Telephone (Off) : 18004194199
Email Id : indore.ops@landmarkinsurance.in
Previous Policy No : V2484882-00

INSURED MOTOR VEHICLE DETAILS AND PREMIUM COMPUTATION

Registration No., Make/Model of Vehicle Year of Engine No. Chassis No. Cubic Seating Type of Body
RTA Location Manufacture Capacity Capacity
MP09CM9459 HYUNDAI VERNA CRDI SX 1.6 BS 2013 307469 128105 1582 5 SALOON
INDORE IV

INSURED'S DECLARED VALUE

For Vehicle-Rs. For Non-Electrical Accessories-Rs. For Trailers-Rs. For Electrical/Electronic Accessories-Rs. For Bi-Fuel Kit (CNG/LPG)-Rs. Total Value-Rs.
901,787 - - - - 901,787
SCHEDULE OF PREMIUM
A-OWN DAMAGE Rs. B-LIABILITY Rs.
Basic Premium on Vehicle 14,193.09 Basic Premium Including Premium for TPPD 4,109.00
Less : No Claim Discount 20% 2,838.62 Add : PA to persons other than Owner/Driver 100.00
Add : Add-on Premium 3,787.51 No. of persons 5 P.A. Limit - Rs. 40000 per person
Add : Legal Liablity to Paid Driver/Cleaner/Employees 50.00
No. of persons 1
Total Own Damage Premium (A) (rounded off) 15,142.00 Total Liability Premium (B) 4,259.00
Total Annual Premium (A+B) 19,401.00 Total Premium for the Policy Period 19,401.00
Service Tax (Including Cess) 2,399.00
Total Premium (rounded off) 21,800.00
Subject to Endorsement Nos. 22 ,16 ,28 ,07 Hypothecation Agreement with:- H D F C Bank Ltd
LIMITATIONS AS TO USE – As per Motor Vehicle Rules, 1989 :- The Policy covers DRIVERS CLAUSE :- Any person including the insured: Provided that a person driving
use of the vehicle for any purpose other than: a) Hire or Reward, b) Carriage of goods holds an effective driving license at the time of the accident and is not disqualified from
(other than samples or personal luggage), c) Organized racing, d) Pace making, e) Speed holding or obtaining such a license; Provided also that the person holding an effective
testing, f) Reliability Trials, g) Any purpose in connection with Motor Trade 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.
Limits of Liability
Under Section II-I (i) : Death of or bodily injury - Under Section II-I (ii) : Damage to Third Party Property-Rs. Under Section III : PA Owner – Compulsory
Such amount as is necessary to meet the requirements 750000/- in respect of any one claim or series of claims arising Driver as per premium computation Deductible Under
of Motor Vehicles Act, 1988 out of one event. table Sec I - Rs. 2,000.00
SPECIAL CONDITIONS – ADDITIONAL EXCESS –
IMPORTANT - 1. All other Terms, Conditions and Exclusions as per attached Policy Wordings. 2. In case of payment by cheque, in the event of dishonor of cheque for any reason
whatsoever, insurance cover provided under this document automatically stands cancelled from the inception irrespective of whether a seperate communication is sent or not.
I/We hereby certify that the Policy to which this Certificate relates as well as this Certificate of Insurance are issued in accordance with the provisions of chapter X and chapter XI of
M.V. Act, 1988.
Receipt No : For FUTURE GENERALI INDIA INSURANCE CO. LTD.
Date of Issue : 30/06/2014
Place of Issuance : Mumbai*
*Address as mentioned below.
This policy is not valid unless it is countersigned by an authorised signatory

For registration of your Motor claims SMS MOTORCLAIM to 9222211100 (Standard SMS charges applicable) (Authorised Signatory)
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”. For legal interpretation English verison will be good.
For full details on coverage, terms, conditions and exclusions, please refer the standard policy wordings attached with this schedule.
The stamp duty of Rs. 0.50 paid by GRAS DEFACE NO.0000078202201415, dated 09/04/2014.Mudrank 2004/4125/CR/690/M-1,dated 31/12/2004.

Corporate & Registered Office: 6th Floor, Tower - 3, Indiabulls Finance Center, Senapati Bapat Marg, Elphinstone Road, Mumbai-400013, Maharashtra
Care Lines:- 1800-220-233, 1860-500-3333, 022-67837800, Email: fgcare@futuregenerali.in, Website: www.futuregenerali.in
IRDA Regn. No 132, CIN - U66030MH2006PLC165287, Service Tax Registration Number: AABCF0191RSD002
 FUTURE GENERALI INDIA
Insurance Company Limited

Annexure
Forming part of policy number:-2014-V3136240-FPV
Motor Add-on Cover
Serial No. Add-on Description Premium Amount - Rs.
0001 Plan 1 3,787.51

Total Premium 3,787.51

-
Forming part of policy number:-2014-V3136240-FPV
Motor Add-on Cover Details
Zero Depreciation Cap
Theft Or Loss Of Keys
Loss Of Personal Belongings - Maximum payable amount Laptop: Rs. 50,000 ;Maximum payable amount Mobile: Rs. 25,000
Road Side Assistance
Please refer the attached detailed policy wordings for the above mentioned coverages.

Corporate & Registered Office: 6th Floor, Tower - 3, Indiabulls Finance Center, Senapati Bapat Marg, Elphinstone Road, Mumbai-400013, Maharashtra
Care Lines:- 1800-220-233, 1860-500-3333, 022-67837800, Email: fgcare@futuregenerali.in, Website: www.futuregenerali.in
IRDA Regn. No 132, CIN - U66030MH2006PLC165287, Service Tax Registration Number: AABCF0191RSD002